Having come from editing nursing journals for several years, one of the things that struck me when I started on the Journal of Paramedic Practice is just how much I took for granted the developments in nursing that are only now taking place in paramedicine. But when I remind myself how new the paramedic profession is, I am astounded by how incredibly far it has come so rapidly over the last few decades. As Taffler (2018) noted in a recent blog written for the College of Paramedics, ‘Remember, we've achieved in just over 30 years what it's taken nursing about 160 years.’
Looking at the expedited evolution of the paramedic profession and the growth taking place in prehospital care generally, it's difficult to believe that the paramedic profession is only about 30 years in the making in the form we recognise today, as well as the protected title of paramedic having only come into play in 2001 (Taffler, 2018). One of the aspects in which the profession has developed most is in terms of the scope of practice, and the breadth of clinical skills that are required to be carried out in increasingly complex and varied patient groups.
Sometimes there is a tendency to downplay certain clinical skills as ‘basic’—however, no clinical skill, from the fundamentals of respiratory rate, blood pressure, temperature or pulse measurement (p. 488) to the more complex skills of maintaining a patient's airway, placing a pelvic binder (p. 463) or applying a tourniquet (p. 477) should be undervalued in this way. As Watson (2006) importantly pointed out several years back, accurate observation and recording of ‘basic’ information allows priority-setting based on assessment, placing the patient's care first. This issue of the JPP will focus on research of some of these important clinical skills.
Paramedics are being called upon to carry out increasing skill sets in a range of environments as the story of paramedics being limited to ambulances is one for the history books. Emergency care providers are practising in GP surgeries, prisons and hospices—and accurate clinical skills acquisition has never been more vital.
In fact, why stop with the clinical? Non-clinical skills are just as important in the paramedic sphere: from communication, to empathy and compassion, to consulting, ethics and risk management. In the roles carried out by student to advanced paramedics, these skills are paramount as you're dealing with lives; you're dealing with people; and you're dealing with contributing building blocks of your own to a profession that will continue to grow rapidly over coming years. In her last student column before she transitions to becoming a newly qualified paramedic, Abbygail Elsey reflects that the work you do day-to-day may not seem like much to you, but to the people for whom you make a cup of tea in their home during what could very likely be the worst time of their lives, it is everything.
At the heart of placing the patient, their care and their safety above all, two main points come to mind: one is ensuring that paramedic training and education cover the many clinical and non-clinical skills that are so important to your work; the second, highlighted on p. 462, is creating a culture of patient safety, where there is candour in care, and no-blame workplaces in which everyone feels safe to share experiences and errors with the objective of shared learning and improved care.