From paramedic to academic: why I left the NHS frontline
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Version 0 of 1. I’ve always had a nagging feeling that there must be a better way to do things and that we could do more for patients. It started almost immediately as I began my career as a student paramedic. I tried to suppress it; it wasn’t really the done thing. Everyone talked about what was wrong with the way things were but no one talked about how we could make them better. At first it was easy; my mind was awash with all the new experiences of daily ambulance life, busy learning how to fit in, to be a paramedic – doing the things paramedics did. And I loved it, flying through the streets of London with blue lights flashing, responding to calls and patients. However, as I rolled through my days, that nagging feeling began to return, and now it seemed harder to ignore. It was hard to explain to those around me and at times it felt like we were speaking different languages. People talked about how we could “never be wrong for taking someone to hospital” and “what did we know?”. Even my colleagues, who agreed that at times it didn’t feel right, would feel powerless – crippled by a fear and belief that making a mistake would cost them their job. Managers felt just as powerless as the rest of us and were under pressure to keep response times down. The pressure they were under was tangible and communications between frontline staff and managers seemed to hit a brick wall. I grew frustrated and tired; at times it felt claustrophobic, surely if we keep doing what we’d always done then nothing would ever change? The real breakthrough came when I was invited to take part in a collaborative project on frailty. We explored ways in which we could work differently to improve the patient care for the people we had so often responded to by ambulance, setting up a falls response service with community nurses. We shared our skills and experiences to meet the needs of the patients that we would have previously taken to hospital and helped them in their own homes instead. The lead for the project was a Darzi fellow, a GP who had taken a year out of her training to develop herself and her leadership skills. The fellowship is an initiative that benefits both participants and their employing organisations. Over the past seven years, Darzi fellows have led major service improvements, implemented numerous safety and quality initiatives, and made substantial financial savings for trusts. I applied for clinically relevant posts advertised on the NHS jobs website and was invited to interview with a number of trusts across London. I am spending the year working on a project helping people manage their chronic joint pain. Unlike my job as a paramedic the pressure here is different, less immediate, and less obvious but still very much there. It lurks in the background – no one here will die or lose a limb as a result of a mistake I make, but what I do here could play a part in what is the practice of the future. It’s hard to see if what I do will make a difference and often I won’t know for months or even years to come. I find myself stuck between two worlds and constantly explaining what it is I do. I feel I am no longer considered a clinician by my former colleagues and yet I don’t consider myself to be a manager. My former colleagues joke about my office hours and weekends off but equally I am overwhelmed by the words of support and encouragement I have received from them – they enthusiastically ask about my work and are proud of what I, “the paramedic”, have achieved. Despite bridging these two worlds, I feel that I have the best of each – my insight into the clinical frontline as a paramedic and the constant challenge of being a Darzi fellow involved in quality improvement work. The meeting of these two worlds puts me in the privileged position of being able to implement real change for colleagues and the patients we look after. This is an edited version of a piece that orginally appeared on the writer’s personal blog. If you would like to write a blogpost for Views from the NHS frontline, read our guidelines and get in touch by emailing sarah.johnson@theguardian.com. Join the Healthcare Professionals Network to read more pieces like this. And follow us on Twitter (@GdnHealthcare) to keep up with the latest healthcare news and views. |