Day in a Life of a Student Paramedic - Placement Edition

Hi, just as a little intro I am a second year Paramedic Science degree student, currently on my first placement of Year Two. The featured day is a brisk Saturday in November on a placement shift with a crew that I have not worked with before. Most of my shifts are either earlies (starting between 6 and 7am for 12 hours) or lates (starting between 6 and 7pm for 12 hours). This was a weird shift time of 1100 to 2300, which is annoying as it straddles two meal times as you only get one meal break. Surprisingly enough, I actually quite liked this time, however I do prefer really early shifts as you still have a bit of the evening when you get home.




This account is completely true! The variety of patients fluctuates day to day, and this was one of the more interesting ones, but this may also be as it was a Saturday. The times are as close to accurate as possible. We had fewer patients than a usual shift, but travelling times and patient contact time was greater than normal. We did not spend any time at station during our shift.

0730
My alarm goes off! I have had a bit of a lay in this morning as my shift finishes a bit later than normal and I have early plans for Sunday so I tried to stockpile some sleep. I get up, I showered the previous evening so I just wash my face and chill in my pjs for a while, sorting bits out.

0800
Breakfast time! Probably my favourite meal of the day. As a treat my whole family had bacon rolls for breakfast. We sat discussing the day ahead whilst munching away. Definitely feeling a bit jealous as my parents were taking my boyfriend out shopping, instead I had to go on placement and miss out!

0900
So I've been sorting some of my stuff out during the morning. I have made a pile of stuff to pack in my bag which I put by the front door. This usually is just my lunch and my waterbottle as I keep my placement bag packed with the stuff I use every day in it. I also have made a cup of coffee in my travel mug which I will drink on my way to station. I put my uniform on, and put my kit into my uniform: pens, stethoscope, left over gloves, fob watch etc. I brush my hair, tie it back and brush my teeth. I put a tiny bit of make up on, just a small amount of foundation and mascara, so I look natural but slightly fresher than my no-makeup face.

0930
Boots on. Bag packed. Keys in hand. Lets go! I set my navigation on my phone as I have not driven to this station before, luckily my best friend works there so she told me how to get in and where to park. I am leaving early incase I get lost, but also I know my friend is on shift at 10am so if I have a smooth run I will get to say hi! I also like to get to shift super early so I do not feel like I am rushing and it sets a good first impression.

1020
I managed to find the station successfully (always a win) and I found a single parking space out of the way as I am a third man. At this station there is limited parking, so crew mates usually join up together and one blocks the other in. As I am an extra working a funny shift time, I parked in a random spot. Spotted my bestie! Had a chat whilst she checked her vehicle and then she showed me round the station briefly whilst her crew mate signed out the morphine. They then got called to a job so I chilled in the mess room listening to the other Paramedics chat.

1030
Eager to meet my one-off mentor (as my friend says he is great with students), I stick my head in the office and ask them to introduce me to them. I also ask how I can get my flu jab, as my uni have teamed up my placement provider and will give me one for free. I have to wait for 3 weeks as I had just had my BCG vaccination, but I now know who to contact, and they will meet me on station when it suits us both. I meet my mentor - he is called Josh - and we chat briefly, then we start our vehicle checks a bit early.

1045
Obviously this vehicle has been gutted, so I have a stock list as long as my body. Not all stock is accessible for every crew so we ask the manager to let us get some bits out. Happy that our vehicle is stocked, we make sure our kit is on and chill. I meet our other crew mate. Both are so happy and funny (which is a breath of fresh air compared to my first week). I think we are going to have a good shift.

1100
We sign onto duty. I talk to my mentor about how my course is going. I explain that over the past week, the guy I have been working with has not even let me touch a patient, except from basic observations. Josh says that he is not like that! Apparently we will cannulate today (I have not cannulated yet and the very thought terrifies me).

1115
Off to our first job! It is to a chest pain patient. Josh asks me if I want to attend, so apprehensively I say yes. Within seconds, we are stood down and sent to a poorly baby. I do not know that much about paediatrics but it is good practice.

1130
We turn up to quite an upset baby, not eating or drinking and obviously uncomfortable. Go to check his temperature and our tympanic thermometer does not work. Typical. So we use his mums thermometer. We are not too worried, but we offer to run him up to A&E so he can be seen. At home he was screaming. We used the new paediatric harness on the trolley bed and after some upset, he seemed quite happy. During the journey I played with him and by the time we were at hospital he was much happier. Handed him over saying 'he looked far worse than this at home!'.

1245
We greened up and got sent to a job straight away. Came through as unwell patient, and control thought he may have been a repeat caller. Control were wrong. We went into his bedroom and it smelt like a really unwell patient. He had recently had bloods taken and been told there was lots of abnormalities, and to expect a diagnosis of cancer (CA). When we walked in, he did not response at all, and was so pale that he scared us! He was alive, and just in a really bad way. He had pain everywhere, bleeding from lots of places internally and was whiter than some dead people I had seen. He still kept a smile on his face and kept a joke going. I did a GI examination where things clearly were not great as he was in lots of pain and there were abnormalities.
Josh chucked me the cannulation bag. This is probably the most scared I have ever been in my life, not only is this man really sick, but I have to put a cannula in him (and it is likely he is peripherally shut down). I got things ready, found a vein and checked with Josh. He was happy, so I cleaned and stuck the needle in. I got flashback! The cannula was successful! Through all this stress and anxiety I almost could have cried for so many reasons. I flushed the cannula (not without spraying myself with saline as the pre-filled flushes are a bit stiff). Was I wiping sweat or flush from my forehead? No one will ever know. I helped to administer some morphine, then some ondansetron when he was sick. We got him downstairs (after he said goodbye to his dog, which started to break my heart) and into the ambulance. He then said goodbye to his son and wife (which broke my heart more), who would meet him at hospital. I then hooked him up to some IV Paracetamol and we took him in to A&E.
We finished our paperwork, handed over and booked him in. By the time we were sorted his blood results had come back. His haemoglobin count was very low at 40, so they got ready for some blood transfusions. We said goodbye and wished him the best.

1515
Got a job over 15 miles away for a fall outside a supermarket. As it was Saturday shopping time, it took us ages to get there, and as the ambulance service was so busy, there was a wait on the call too. By the time we were there, the chap was very cold. He had quite an obvious neck of femur fracture. I tried to cannulate, but I struggled to anchor his vein. I was happy for Josh to cannulate so I did not cause the guy anymore pain. He had some morphine which he took fine, without feeling sick. We strapped his legs together for support and scooped him, along with the duvets the supermarkets had provided to keep him warm. We took him to a different hospital as we were now in a different area. The supermarket brought us out a very large box of doughnuts which was so nice of them!
It was a long journey to hospital (gotta love the countryside), and we were fine the whole way there, until about 7 minutes before we got to hospital where I had to dash to grab some vomit bowls. 'nuff said.

1745
We trolley clear, clean up and eat doughnuts. We save some for later.

1800
We get our break. Josh asked if we would like to have our break in the control room. I've always wanted to go in there so we did! I sat with dispatch who showed me all of his screens, we listened to him speak to crews and he explained what different colours and codes mean. We watched different categories of calls come in and him dispatching crews to them. It was a really awesome experience! We also spoke to some of the call takers, and I want to go back with them and sit with one for longer to see what they have to put up with from callers. Some were really flustered due to how they were spoken to. It is important to understand that they cannot help if the caller refuses to answer the questions!

1845
Our break finishes and we get sent back to area. We are on our way to an elderly fall when we get diverted to a baby with a rash and a cough. The baby seemed to have a minor allergic reaction and croup, potentially which appeared at the same time but unrelated. There was some intercostal recession, and audible stridor whilst the baby was calm. His Modified Taussig Croup Score was 4 (stridor - 2, recession - 2) so we travelled to resus quickly. Paediatrics compensate really well until they do not, and I have heard some horrible stories where they have been reasonable at home, and have decompensated very quickly and have been critical or even dead by the time they were in hospital. Not worth the risk. On a more cheerful note, our little patient was fine.

2000
As we are at the hospital where we took our poorly patient from earlier, we spoke to the nurses in A&E to check up on how he was doing. Control gave us some time for a welfare check as they were not rammed with potential patients. A&E had given him a couple of blood transfusions and transferred him to the oncology ward. We went to visit him. He looked a better colour than earlier, but was still really poorly. We found out that his prognosis was not great. They thanked us and we asked them to update us if they wanted to by dropping a note into our ambulance station. When we left, it felt like a punch in the stomach, painful yet heart numbing. A very odd feeling. We all felt this other families pain as if it were our own. This job definitely makes you hug your loved ones tighter.

2030
Off to my third RTC in three shifts. Unknown number of patients, unknown injuries, unknown damage to car, unknown if breathing, unknown if ejected from car etc. We arrived to see a guy being wrestled to the ground by six police officers, which quickly increased to eight. He was swearing, spitting and shouting. This was all happening in the middle of a big roundabout just off a duel carriageway, where a car had driven through a barrier and into a tree on the roundabout island. We noticed movement from the car where a girl appeared. The police officers had not seen her as she had just appeared from nowhere. She did not quite understand that she could not talk to the boy or give him a cigarette as he was being arrested. He failed his drugs test on multiple counts. Talking to the girl in the ambulance, her boyfriend of over six years was the one driving and crashed. Her stories were a little wild and she was hard to keep up with. We felt exhausted after talking to her. She told the police officer with us a number of different stories. Thankfully she was not aggressive and was quite friendly, although likely that she was under the influence of something too. Both patients were fine although they had not been wearing their seatbelts. She was definitely quite interesting to talk to, but the bit that really got me was how she called her 'bit on the side' (her exact words - not mine) to pick her up from the ambulance. Neither boyfriend or 'bit on the side' knew about the other. We discharged her on scene to be picked up by family.

Thanks for your parking Josh
2230
My crewmate give me the ePCR to read through before finalising. Without me even touching it, it crashed! We spent half an hour calling different managers in different areas to find out if we had to redo it. Thankfully we found out that it was on the system and that we were saved from having to redo it. We headed back to station with the blessing from control. The stress of losing the ePCR and our last patient was a good excuse to have enough doughnut.

2330
Back to station. We clean up, get rid of our sharps and clinical waste. I thank my crew for an amazing
shift. It was definitely the best day I've had on placement so far. Hopefully I will get more shifts with Josh in the future. I climbed into my car over the passenger seat as Josh parked the ambulance beautifully.

0030
I get home! I take off my uniform and chill out for a while. After shifts, my brain is always still going so quickly! I told my boyfriend all about my day as he had waited up for me (bless him). Good night!

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