Recent months have brought with them the 1-year anniversaries of several tragedies that hit the UK last year—from the Westminster attack to the Manchester Arena bombing (p. 300), and the London Bridge terror attack, to the Grenfell Tower Fire.
Unfortunately, events like these are becoming more commonplace than any of us might like to admit, and responding to them has got to affect you. In fact, beyond these major incidents, is the cumulative effect of the less dramatic (but impactful) incidents that make up your day's work, as Sasha Johnston points out on p. 309. I can imagine though that it might be difficult to focus on those effects, when you need to keep putting one foot in front of the other, both in terms of your professional and personal life. It's understandable why you might feel you've got to ‘just get on with it’, especially as it's ‘part of the job’—but this would be doing yourself and the paramedic profession a grave injustice.
Before you're a paramedic, you're a human being—and this is likely one of your biggest professional strengths. However, in order to continue feeling human, many of us need the opportunity for reflection, support networks and healthy outlets through which we can share or resolve our experiences. Forcing yourself to ‘get on with it’ is how people can eventually run into burnout, compassion fatigue, post-traumatic stress, depression, anxiety, and even suicide.
But the onus to seek support is not on you alone—it's on your managers, your organisations, and the overarching cultures that exist within ambulance services, paramedicine, and the NHS, to provide this support as well. ‘Debrief’ has got to be more than a tickbox exercise; it has got to mean asking if you're okay out of caring whether or not you're actually okay. Then following this up by providing the necessary resources to ensure you can resolve difficult experiences, and come to work feeling confident and ready to care for your patients, as well as willing and equipped to return home, and care for yourself. What is needed is a culture where it is accepted and embraced to feel human emotions when you see difficult things; where it is encouraged to report when care isn't being delivered up to standard; and where the leaders within your organisations truly have your back.
Here at the JPP, we recently aligned our content with the Four Pillars of Paramedic Practice—Clinical Practice, Research, Education, and Leadership and Management. Interestingly, we receive many more submissions in the first two of these categories than the latter two, and the Leadership and Management pillar in particular.
Is this reflective of the culture that exists within paramedic practice? As we celebrate 70 years of the NHS this month, the focus has been on professionalising the paramedic; on carrying out research to engage in evidence-based practice; and on higher education to increase skill bases and expand professional scopes. In fact, Douglas Chamberlain takes a look back on the last 70 years on the next page—but what will the next 70 years hold? I would suggest a shift with an increased focus towards leadership; staff mentorship; training; education; support; and clear guidance, including on dealing with difficult situations (p. 292; 310)—a true leader-led paramedicine.