In last month's issue, I delved into the culture within a GP practice, and the ways in which it differs to the culture in the ambulance service. This month I want to talk about relating to the patient in this new environment, and how it seems to affect both the general dynamic and patient satisfaction.
The main thing I have noticed is that in the GP practice, I sort of lose my ‘halo’, for want of a better word. Paramedics have an overwhelmingly favourable public image, simply due to the situations they have to manage and their roles in community safety and emergency healthcare. This gives you a huge amount of grace when trying to deal with situations within limiting factors such as scope, legislation and physical capability. There is almost always a ‘we know you are doing your best’ energy—even if aspects of systemic factors surrounding patient care may cause frustration or disappointment to patients. A huge example of this is waiting times, both when making our way to patients and when safely handing them over in the hospital environment. Although patients (understandably) dislike this element, it rarely feels directed at the paramedic personally.
In the GP Practice there are, of course, also limiting factors: appointment availability, timeframes, resources, appropriate courses of action, to name a few. However, I have found there to be much less grace or understanding that you are doing your best to help them within your scope of practice.
This is honestly a very hard transition to make and I am writing this column in part to try and take the mystery and fear out of the process of transitioning to other paramedic roles. It is understandable that the positive and exciting elements of change need to be balanced out with some of harder adjustments. I do miss that collaborative energy almost every patient had on the frontline, and it is certainly a pleasant surprise when I still receive it. However, overall, there is much more of an antagonistic energy in many cases, which perplexes me, as I honestly only want to do the best thing for every patient.
Another element that can make settling in and progressing more difficult is the phenomenon of imposter syndrome. I have learned and experienced a lot over the past few years; however, I am still so worried that I am here in general practice at all. I do ask for feedback from peers that are performing a similar triage role but are further along in their journey, to check that I'm doing okay, that I'm interpreting the guidelines correctly, and that my decisions are safe. They say that I am having a normal amount of clinical discussions, questioning, etc—however, it is still easy to doubt yourself. In some ways, I think it can be positive. Working on autopilot, working from your memory of guidelines and not having regular clinical discussions, can feel like a comfortable way to work. However, checking things, needing to learn more on this or that subject, and reflecting on and discussing can actually help you grow as a clinician. Although my own uncertainty stems from self-doubt and anxiety, I intend to treat these feelings as a positive trigger to improve as a clinician.
To end on a positive note, I am keenly awaiting the delayed results from my advanced assessment course essay, which are due tomorrow—fingers crossed! The practice is also looking into getting us enrolled on the course for comprehensive training for first contact practitioners—I am so excited about this! I adore learning, especially when it will increase my knowledge and skill for this role! I am now trying to focus more on these elements and use them to maintain my enthusiasm and excitement for this new role.