There are many things in life people are afraid of. For some its snakes and spiders, for others it’s the dark, and for some of us, myself included, its stepping onto the back of an ambulance for the first time as a Registered Paramedic. The looming responsibility can seem like an ominous storm cloud overhead, but it is important to remember in times of fear what drives us, what gives us courage, and what carries us forward towards our goals?

Everyone has a reason for joining the ambulance service. For some its positive personal experiences with an ambulance crew, for others it is a burning desire to help others and save lives. Mahatma Ghandi once said “Be the change you want to see in the world”. What bigger change can you make in life than to attempt to save that of another? To offer a hand to those in need, whether that is life-saving clinical procedures or simply offering a shoulder for somebody to cry on when they need it the most. Like Hippocrates once said, “Cure sometimes, treat often, comfort always”.

By entering onto the temporary register, you are entering unchartered territory; of that there is no doubt. You are answering a call to arms to support the NHS and serve the communities we hold dear in these strange times of national emergency. You should all be incredibly proud of the clinicians you have become. It is through hard work, determination and maybe I’m speaking just for myself here, but a lot of tears before bedtime… that we have reached this point.

Looking forward it is important to note that what you have learned throughout your course is not all forgotten. When you need it most, it will be there, just take a deep breath and remember your ABC’s. You are not alone. There is support available ALWAYS through peers within your cohort, the service you join and the university. Every day is a school day, never forget that. As you enter employment with a service, whether that’s for the first time or simply a change in role for the ECA’s and Techs among us; this is the point at which the real learning starts.

I wish you all the best of luck going forward into your careers. Not that you’ll need it though.

You’ve all got this!

You are NEVER alone…

“The expectation that we can be immersed in suffering and loss daily and not be touched by it is as unrealistic as expecting to be able to walk through water without getting wet” – Naomi Rachael Remen.

There is a common misperception within the ambulance service that you have to be ‘tough’ and cannot let the things we deal with affect us, but this just isn’t the case. We are exposed to scenes that most people will thankfully not encounter throughout their entire life. It is not only okay, but it is also perfectly normal for these things to affect us. Do not feel that you need to bottle these thoughts and feelings up. It is important to talk about how you feel and to reach out for support if you feel you are struggling. Take advantage of post incident care that is offered and encourage team debriefs.

For those of you that have ever been on an aeroplane you will have likely heard flight attendants instruct passengers to place their own oxygen mask on first before helping others. This is the same with mental health and is incredibly important as a health care professional. You cannot expect to be someone else’s anchor when you are drowning yourself. Self-care is really important.

It is common for healthcare practitioners to move between roles, and some anxiety is expected however the most significant transition is often when student Paramedics graduate and start working independently. There is often a feeling of losing the protection of their student status. This is especially poignant when moving into a high stress, high stakes environment.

(Correll 2019)

The five subgroups of Imposter syndrome

The perfectionist

We all know someone who is like this. A ‘go getter’ that struggles to deal with anything less than full marks. Someone who sets unachievably high goals who then proceeds to crumble with failure and constantly worry if they are/or will ever be good enough. The word Fail directly translates to “First Attempt in Learning”. Learn to take this onboard. Albert Einstein once said, “A person who never made a mistake, never tried anything new” and more accurate words have not been spoken. Reflection is an important element of learning and development. Contemplation on past experiences allows us to take previous errors and learn from them. By asking “what can I change so that I may do better next time” we are forever enhancing the services we offer. A win for us and a win for the service users we attend. Learn to accept feedback maturely and take what you can from it. Every mistake is an opportunity to learn. Just don’t be afraid to ask for help in doing so.

The Expert

This person measures their abilities solely on how much they know. They often believe that they lack the competence to succeed due to simply never knowing enough. This drive to improve knowledge and skill sets can be extremely beneficial. Continuous professional development is an important element of maintaining standards. Where this becomes detrimental is when it is accompanied with crippling self-doubt. Double checking decisions is a good thing – If there’s any doubt, then there is no doubt. However, when double checking hinders progress through indecision it becomes an issue. There is no shame in asking for help, whether that is from colleagues on scene, clinical hub, supervisors or other health care professionals. As Temporary registered paramedics and newly qualified paramedics (NQP’s) it is expected that you may need support.

The Soloist

The soloist is someone who goes it alone. They face tasks independently and will attempt to “fake it till they make it”. Arguably a dangerous approach clinically, as not accepting or acknowledging the need for help and advice can be directly detrimental to patient care. Soloists may feel that they are showing themselves as an “imposter” by asking for advice, but this is not the case. By asking for help you are simply admitting that you want to deliver the best possible care to the service users in your care and that you are willing to ask someone with more experience in order to deliver that. Patient care should always be at the forefront of your mind. Imagining the level of care you would expect for yourself or your loved ones, and aspiring to that will help you develop into a clinician you should be proud of.

The Natural Genius

This form of imposter syndrome causes a feeling of shame when something doesn’t come “naturally”. The harder they have to work to understand something or become proficient at a new skill, the more uncomfortable they will feel. Have you ever felt as though your peers take up a new skill more easily than you have? Was cannulation a skill that others seemed to master while you struggled? Instead of shying away from skills you “just aren’t any good at”, why not spend extra time practicing? Ask peers for hints and tips that may help. Take opportunities to attend CPD sessions that could further your knowledge. “Talent is cheaper than table salt. What separates the talented individual from the successful one, is a lot of hard work” – Steven King

Superman/Superwoman

People in this group truly don’t believe they belong. They feel like frauds and will push themselves to extreme lengths to cover this up. Often working well over their hours seeking external validation. This drive for affirmation can lead to extreme fatigue and eventual burn out – an issue faced by a high number of frontline paramedics. This is not only damaging to your mental health, but fatigue increases the likelihood of human errors; putting service users at risk.

Young, V. (2011). The Secret Thoughts Of Successful Women (1st ed.). New York, New York: Crown Publishing Group.

Paramedics guide to dealing with loss.

“We can’t help everyone, but everyone can help someone” – Ronald Reagan. Learning to deal with the patients we can’t save has been one of the steepest learning curves of my career so far. I think most people start a career in health care with the aim of saving lives. The ambulance service perhaps more so than other professions, as it’s true that prehospitally it really can be won and lost in the first few minutes. Having said that though, it is so important to understand that not everyone can be saved. How you deal with that is how you learn to cope with the losses.

Often dealing with relatives after an incident can be the most mentally demanding part of dealing with the process of death and dying. Having worked in service for a number of years many of the deaths I have attended are no more than a faint memory, but a number have stayed with me. The handful that have stayed with me affected me most of all because of the conversations had with the families left behind.

It is important to remain professional on scene, but we are only human. And after the incident if you need a cup of tea and a chat to decompress. That’s okay. Acknowledging your feelings and understanding that although death can become normalised through recurrent exposure within the profession, it is okay to feel grief for those in our care.