Scott's Spiel

Two weeks this very day I will have finished the first paper of year two. I have jumped my revision into what I’d describe as 4th gear. Yesterday I managed to kill my personal record for revising in the SL – a whole 14 hours. Unfortunately this is probably a bit of an overestimate as I do need to eat, excrete and not forgetting procrastinate. I remain worryingly confident that all will be well. Even today, as I glanced over my least favourite of the blocks (gastro), I feel that come two weeks I will still be smiling – perhaps a little nervously.

At the moment I’ve been spending far too long looking at electives for the coming years – this assuming I will pass. Ideally, I’d love to spend my third year (junior) elective with the HEMS team in London and my senior one somewhere abroad. Unfortunately the competitiveness might be too much for me and I’m not generally too lucky. Still, it’s worth an email, I just want to wait till my exam results are in. I can’t really work out plans for my senior one until I know whether I will be intercalating or not. This is a big decision, probably bigger than it should be, and I’m still on the fence. I don’t even know whether I’d be allowed or not.

Three weeks today an I will have finished my first training session as a phlebotomist. Yes, I finally got some news. Apparently there was much of a mess up with recruitment and a few people have been having problems. The date is provisional, which is a bit of a problem come trying to work out a start date for the Safari Park. Hopefully the two should help avoid a financial hell-hole next year, combined with a much reduced rent.

With just over 20 days left to go till the exam week things are beginning to get a bit stressful. In comparison, however, I’m a lot less stressed than the great majority of others. I’m not sure whether that is a good thing or not, a little bit of stress would surely help me get some work done.

We’re largely expecting the exam this year to be a lot easier (or at least fairer) than the one last year. This is a bit of a kick for those resitting and I feel sorry for them. I’m also expecting this exam to be one of the easiest that will be coming up in the next few years, or maybe that’s just me hoping.

In comparison the OSCE is beginning to scare me. Clinical exams are fair enough, I can practice them to hell before the days of the exam. However they’ve promised us 5 “spot” checks which will be unstaffed stations with some sort of item to identify. The item, we gather, could be some sort of x-ray (fair enough, make it simple please), barium swallow (we’ve seen a few of them, not in the mood for interpreting one though), ECG? I hope not, and then the threat of some histology slides – bugger!

Throw in the communication skills stations, one of which will be an ethical case, and then I really start feeling nervous. Worse, they’re spreading the torture over 2 days, the first in a peripheral hospital and the second in the med school. I’m not really expecting many people to fail it so that offers a bit of reassurance. Thankfully we also get the results relatively soon after (especially compared to school exams!).

In true avoiding revision style I’m spending this afternoon doing a moving and handling (part 2) course. Sounds like fun…ish. In fact, I might be giving up the next 2 Saturdays to go to the cup final and part 3. Perfect timing!

Still haven’t heard anything from either job. Apparently the safari park aren’t the best with online applications so I’ve got a form back home to fill out. Seriously need a job….

I’m a regular reader of The Paramedic’s Diary and couldn’t help but notice the new poll question – Should the voluntary services support the ambulance service on frontline duties?

This likely comes from a recent diary post of his and I felt compelled to write just a bit about it.

Firstly, I’m commenting on this as it would be under usual circumstances – in the event of a major incident (London bombings, etc) then things are obviously different. I’m also basing this mainly on experience in St Andrew’s. I’ll be the first to admit St John’s are quite different on a number of aspects although I’ve tried to come at it from a combined VAS point of view.

The problem with this is how the definition of “support” is taken. If it means relying on a VAS crew attending any type of 999 call then I’d have to say no. Whilst training for some of the St John’s advanced courses (say Emergency Transport Attendant) is undoubtedly tough it is still nowhere near the level required for technicians and paramedics. A VAS crew turning up at a large RTC would, I feel, be quite overwhelmed and wouldn’t have the experience to help them.

Taking another situation, lets say a complication in late pregnancy, would possibly be worse still. Not only is there the medical condition to deal with but there is also a highly emotional situation that a number of professionals would probably not like to be in.

Further, what if there were complications in relation to the actions of the VAS crew? Insurance exists, yes, but to what level? What about regulation? A registered paramedic could face being struck off in a serious situation, but what would happen to a voluntary member? Would communication be effective enough to impose levels of discipline?

These may seem a bit far-fetched, but are foreseeable problems.

On the other hand if we take the situation where a patient is assessed by a technician/paramedic and that professional requests and is confident allowing the care to pass to the voluntary crew then that really is a different matter. Transporting a stable patient doesn’t carry quite the same risk as attending an unknown.

But in the event of a cardiac arrest when even basic lifesaving skills can help, this doesn’t really apply. I might even go as far to pick a VAS crew over a number of GPs I’ve met, basic lifesaving having long since left them.

I guess my point then is that VAS crews might have a use, particularly in busy or definite emergencies. The problems will start when they become preferential to qualified professions which, in today’s cost-effective health service, seems all too likely.

I often comment on St Andrew’s rather slow expansion capacity but if we ever get to the point of covering 999 calls I’d want to be damn sure we covered all the bases.

I’d be interested to hear other views on this and I’ll happily admit I’m not totally knowledgeable about the current policies.

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