Emergency medical technicians (EMTs) can operate as a single responder to an incident or support a paramedic on a double-crewed ambulance. They have many of the same skills as paramedics, such as being able to assess, triage and provide lifesaving treatment.
In this account, an EMT describes their current experience of being on the frontline. They talk about patient care, getting stuck in ambulance queues and how they have adapted to new ways of working, beyond their training.
Lastly, they offer insight into where the solutions might lie and how improvements could be made.
It was 21:15. We were due to finish shift at 22:00 and station was a 45 minute drive away. A night crew were offering to take over from us as they had just offloaded their patient to the emergency department (ED).
We didn't want to hand her over to another crew. She had waited 44 hours for an ambulance and we were currently her 3rd crew in a 16 hour wait outside ED. We thanked them kindly for their offer but said we would stick it out. This lady and her daughter had been through enough, there was no need for more disruption.
Besides, we had been told we were definitely the next in. We were. It just took a little time. Everyone was doing their best, but if there's no beds, there's no beds.
This was my situation on Monday evening. I ended up finishing my shift at 23:30, an hour and a half late. In reality, that's not too bad. The evening before I had finished 3 hours late, making my shift 15 hours long. Add that to a 40-minute commute each way to station and you can see why I don't have time to fit much else in on work days.
My poor dog is beginning to think he lives with my neighbour. He actually goes to their gate first when I do manage to take him out for a walk.
I'm an emergency medical technician (EMT). I work in a fairly rural part ofthe UK. Working here is different to working in a city. We have long travel times to hospital and some properties we go to have very difficult access. On a 'normal' shift, things can be challenging. Currently the term challenging doesn't really cut it.
When I finally left the hospital on my shift on Sunday, I had just handed my patient over to her 4th ambulance crew of the day. All day I had been listening to shouts coming across the radio for crew availability for red calls (the most serious) but we were all stuck. Stuck in what has become known as the ED ambulance car park.
We have become a series of triage rooms where doctors and nurses come out to us to assess patients, to take their blood, to give us forms to take the patients to x-ray or CT to then bring them back onto the ambulance. We have become good at making patients cups of tea, seeking out sandwiches and biscuits, trying to come up with ingenious ways of making patients comfortable on hard, narrow stretchers.
We are doing long-term care, not emergency medicine. I'm not trained for this.
Trying to use bed pans when patients need to go to the toilet but are unable to mobilise, checking for pressure sores, regularly taking observations and monitoring any deterioration and ensuring this is passed on to the staff inside. We need to keep patients, and sometimes family members, calm, entertained, comfortable. It's draining. And all the while there are other people in need of an ambulance and we can't go to them.
It's the same inside the hospital. Nurses are at the end of their tether. They're on their feet all day, not getting breaks, trying to manage too many patients, trying to find beds on wards to move patients out of the ED. Then the nurses in wards are trying to find safe ways to discharge patients that no longer need hospital care but are not able to go home and be independent. It's no wonder staff look drained and exhausted.
It's no wonder we are all snapping at each other. The system is broken.
I am relatively new to the service and hope to start my three years of paramedic training next year. I love my job but it's impossible not to get frustrated and demoralised right now. We are not doing what we are trained to do and are unable to provide the service that we are supposed to provide. It's oftentimes heart-breaking.
So what is the solution?
I am asked this question by so many people - patients, patients' relatives, my friends and family. I don't know. There isn't an easy answer.
The ambulance service is short staffed - people are leaving the job because they just can't take this situation anymore and we are struggling to recruit people, especially in rural areas. Hospitals are short staffed for the same reason. Nurses are leaving in droves and recruitment is low.
Of course, making the job more attractive by increasing wages would help, and making training more affordable - university degrees aren't cheap and trying to work alongside a full-time nursing or paramedic degree is tough!
Perhaps providing grants for people to gain their C1 driving licence - this is a requirement for anyone wanting to join the ambulance service and is a massive outlay for people which I'm sure puts a lot of people off applying in the first place.
Then there's the issues within the hospital. There are no beds. Why is this?
Well, up to 50% of patients on wards do not actually need to be in hospital from a clinical point of view. Unfortunately though, they are also not able to go home without some sort of care package in place. This is where the problem lies. Social care. There isn't any.
Again, this is down to massive staff shortages. How do we make social care an attractive job prospect for people? It's long unsociable hours (like nursing and ambulance shifts), it's difficult, it's poorly paid, it involves dealing with patients' personal care, something many are put off by.
I'm not sure what the answer is here either, but something needs to happen to make this an attractive career option.
 Emergency medical technician, healthcareers.nhs.uk, (accessed 20/12/2022) https://www.healthcareers.nhs.uk/explore-roles/ambulance-service-team/roles-ambulance-service/emergency-medical-technician
Are you a patient or staff with a story from the frontline to tell? Do you have insights to share to that will help raise awareness of wider patient safety issues? You can get in touch with us at content@PSLhub.org. If you'd like to comment below this blog, you'll need to sign up here first (for free!).
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