A Brutally Honest Day in the Life as an NQP
Here is a brutally honest review of my first day on the road as an NQP (not third manning). I definitely was not expecting it to start off how it did, but the day still went well. Enjoy!
6am - Left for work, very nervous. Since I found out I was on this shift I had been nervous in case I was working with someone entirely unqualified that I could not bat ideas off. I tried to calm my nerves with some music on my 45 minute drive to station.
6.45am - Arrived at my station. I really like this satellite station as I was student out of here for 5 weeks at the start of my final year during my degree. When I turned up I saw my crewmate through the window and immediately felt relieved as she is a paramedic (providing me with a bit of a safety net) and I knew her after working with her as a student. As I sat down we started chatting, waiting for the truck to come in. Once I told her I was attend only as I was waiting for a blue-light course, the atmosphere changed. She told me that she did not feel comfortable working with an NQP who could not drive as 'what happens when it hits the fan and the NQP is in the back and the more senior paramedic has to drive'. I completely understand her point of view as I am pretty nervous due to missing out my final placement block and only having skill heavy jobs in the first half of my degree. She calls the LOM who says that she can swap crewmates so she is not put in an awkward position.
7.15am - I drive back towards our main hub to go and pair up with another crew. Nerves set back in again as I know I am not working with a paramedic but a technician. The nerves are slightly different this time as I know my new crewmate is very experienced, and are more focused towards feeling judged and how well we will get along.
7.45am - I arrive at the main station and find my crewmate who says she has already done the vehicle checks. I go and get the morphine out of the cupboard for the first time, which is slightly terrifying and put my kit on the vehicle. Soon enough we get our first job which is out of area, but thankfully get diverted to a job a bit closer in area.
9am - Our first job is first job is for vomiting. The patient had recently had lots of stress due to the passing of her mother, house renovation and other stresses. After some history taking it was clear she had previously had extensive abdominal investigations and had worried herself by googling her symptoms. As the patient was stable with no abnormal observations, we contacted the GP who was happy to manage the patient themselves, prescribing some lansoprazole and following up in a couple of days, potentially sending for further tests if deemed necessary. The patient, crew and GP were happy with this, so we gave worsening advice and left, finishing our paperwork in the vehicle. I had to call a band 6 clinician to discharge on scene due to being an NQP, so I called the manager as it was straightforward. Then we greened on scene and drove to our next job.
11am - Next job was initially a referral into our medical day unit (MDU) which should have happened yesterday but the family did not want the patient to go in yesterday and waited until today. The family were quite aggressive in their manner towards us, demanding what we do and how, so we had to diffuse the situation. The referral to MDU was only valid yesterday, and when we followed up with the GP and MDU we found out the patient was no longer on the list and had to go to A&E. We tried to get the patient into MDU but the unit would no longer take them. This was a difficult conversation to have with the family, and they were not happy. After a reassuring conversation highlighting that all precautions possible were being taken in hospital, we were able to take the patient in. When reflecting with my crewmate, we think that the initial aggression we were faced with may be due to the family feeling guilty that they had not taken the patient to hospital the day before when they were told to. Either way, the patient will be getting the same treatment and it will not affect their health so it did not matter. I also met a lovely cat on this job and had a cuddle which was really nice.
1pm - Our next job was for a chronic rectal bleed. The patient was quite well and undergoing investigations for it. He had called the day unit where he had recently had some tests due to a minor change in symptoms, who did not want to give advice as he was no longer in their care, and the patient was told to call 999. The patient was well and did not want to go into hospital and was merely looking for some advice, so we spoke to his GP after a long wait on the phone. Initially the GP asked us to take the patient to hospital, which I was happy to do, but it became clear that he was not familiar with the patient. I asked him a question regarding the patients history, when he then asked me to wait so he could pull up the patient's notes (!). After reading the patient's notes, the GP changed his mind and was happy to reduce the patient's blood thinners for a couple of days to reduce the bleeding and follow up with him in three days. This suited the patient's preferences much better and we left after speaking to clinical advice to discharge my patient on scene and giving worsening advice.
2.30pm - After leaving the patient's house, we were in the back of the vehicle having a chat and cleaning the equipment when a general broadcast went out for a cardiac arrest, and we were the nearest paramedic crew. I pulled the face of dread (as I have never actually used paramedic skills in an arrest before) as we offered up for this job. We got ready to head to the job when we were told that another para had greened up closer so we were not needed, this relieved a bit of the stress! I was more than happy to go on the job but still relieved when the responsibility was taken out of my hands.
3.15pm - We headed for meal break and I was starving! The first station we got sent to was overcrowded (due to covid social distancing reducing the number of safe seats in the crew room) so we had to get sent to another station which was approximately 15 minutes away. This meant that we fell into our late meal payment window which was nice and meant a money bonus! By the time we went on meal break I was very ready for food!
4.15pm - We got disturbed in our disturbable period of our meal break, so only got 30 mins of break rather than 45) and got batted across approximately 10 jobs in the space of 10 minutes as there was an influx of category 2 calls with not enough vehicles to cover them. We finally ended up on a patient from a residential home, where the staff were concerned the patient had deteriorated rapidly over the afternoon. When we arrived, the patient was scoring 10 on the NEWS2 (for heart rate, respiratory rate, temperature (40 degrees!) and confusion). The patient looked very unwell and after speaking to his daughter we blue-lighted the patient 40 minutes to red resus. I put my first cannula in as an unobserved NQP and ran fluids for this patient, pre-alerting him and continually monitoring whilst trying to get some paperwork done in the back. Lots of fingers and thumbs trying to do all these bits and feeling under pressure. The drive to hospital was quite intense, although 40 mins goes really quickly when you are busy, and it ended up being quite a stressful way to finish the shift.
7.30pm - We arrived back at station, only 30 minutes late. We restocked the cannulation bag, restocked the drug back and emptied the clinical waste. I returned to the vehicle to retrieve the morphine which I had forgotten about and then was finally able to go home! Even though we had only done four jobs, I felt completely knackered. I really enjoyed my first day as a real paramedic, even during all the stress. I got in my car and headed home with a busy mind from the events throughout the day.
8pm - I got home to my boyfriend who was just plating up chilli and nachos, my absolute favourite. I de-kitted and had dinner. I quickly fell asleep after dinner, and felt glad of a day off the next day.
I hope you enjoyed this post! Feel free to comment or message me on instagram if you have any questions! Stay safe! #TeamGreen