Welcome back to my column discussing working as a community paramedic for a GP practice—and in this new role, it really does feel like being a community paramedic. I have been working with this new GP practice now for 2 months, and so have had enough time to get a handle on the day-to-day flow of expectations and workload. One part that I am very much enjoying is the opportunity to get out to people's houses. A valuable element I have mentioned previously is the feeling of being able to equalise healthcare access to vulnerable patients. From a work experience perspective, being able to manage your own time and prioritise patients as well as getting to know the local area on foot a little better is great! I am chuffed to be able to regularly chat through cases daily, now I am having a weekly tutorial session with a senior doctor who is analysing my decision-making and clinical understanding, as well as deep diving into any topics that are particularly relevant or of interest. This is the type of environment in which it is possible to learn and grow, which is ideal for me as I eventually want to be an advanced clinician.
Having said that, there are some fresh challenges I am encountering in this role! As a lone clinician going out to patient's houses, there is an element of personal risk. Of course, in the same way, LAS first responders are attending as lone clinicians and could be potentially entering an unsafe environment. However, there are more procedures in place to protect these clinicians, including a recorded time of arrival at the scene and a onepush emergency button for police attendance. For myself, visiting patients with records indicating previous verbal abuse or even weapon ownership, safety is a strong consideration.
I ensure I always have my own phone (separate to the work phone) in my pocket to allow for easy access to a call for help. I mark on the calendar which patient I am currently visiting, and I memorise the address so I can quickly share it if needed. However, I have not felt at threat within this role as yet. And the really nice thing about going out to patients' houses as a paramedic is that some of my ‘halo’ has returned. I am almost always welcome without the hostility and frustration previously experienced by in-clinic patients in my previous role. This ability to discuss through care collaboratively with patients and their families is such a motivating factor for me.
Another challenge I have felt in some situations, however, is the communication of healthcare advice and management to housebound patients after liaising with the doctor. This management may involve referrals to appropriate services, medications and lifestyle advice. Conveying the information is no problem—but I have had a case in which the patient stated she had not been told why she was to take a certain medication after I had explained this to her—turned out she meant that a doctor had not directly told her, and so she was unsure if she could trust what I said!
This is one of the reasons why it is so important for frontline paramedics to be aware about and open towards other career options such as working in general practice. The more paramedics are encountered doing clinics and in other community roles, the more aware and accepting the general public will be about us as true clinicians who have undergone a supportive base of education with requirements for reflective continuous professional development (CPD).