Ismael's placement experience
Ismael shares his placement experiences so far and how they are preparing him for his future career.
Ambulance placements
Placements are a core part of the course, and without a doubt the most enjoyable.
We’re required to have over 1,000 hours of placement time under our belts by the time we complete the course. Practising on frontline ambulances all over Devon, Cornwall, and Somerset forms the bulk of our placement time, where we’re assigned a paramedic mentor whom our shifts are with.
Alternatively, the university facilitates a variety of non-ambulance placements. Some are mandatory year by year such as emergency departments for 1st years and paediatrics for 2nd years. In contrast, there are additional placements where we get a choice such as surgical theatres and cardiology wards.
Alternatively, the university facilitates a variety of non-ambulance placements. Some are mandatory year by year such as emergency departments for 1st years and paediatrics for 2nd years. In contrast, there are additional placements where we get a choice such as surgical theatres and cardiology wards.
Support
It’s pretty normal to feel uncomfortable or overwhelmed especially when starting placement, so it’s quite reassuring to know that the uni is always behind us in offering support and guidance from day 1. It’s in the nature of the job to see traumatic injuries and patients in pain, and naturally, these experiences can affect students in different ways. Having a solid team of paramedic educators, personal tutors/lecturers, and well-being ambassadors at our disposal really makes that difference after experiencing something unpleasant.
One of the best things about placement is developing a strong bond with your educator. The best educators are those who give you just enough space to feel independent, make mistakes, and learn from them; but just enough reassurance to know you have got a watchful eye behind your back that will keep you and your patients safe.
My first day of university was in September 2022. Exactly three and a half months later, I was already sitting in a frontline ambulance, nervously checking equipment with my paramedic educator. Starting out as a first year on the road was pretty daunting; we had covered all sorts of assessment techniques at university, as well as basic life support and received inductions from the local ambulance service, nonetheless, everyone’s first day is and will be daunting. The feeling of excitement, however, can’t be helped, especially when the ambulance computer announced “999 MODE ACTIVATED!” as we set off to our first patient on blue lights.
In one ambulance placement block, I went to a cardiac arrest, countless elderly fallers, a stabbing, a patient who wanted their TV to be turned down, a patient threatening to jump off a building, and many others with mild and serious ailments. Two years on, my typical placement shift consists of checking the ambulance with the emergency care assistant and booking onto the shift, being handed a radio and waiting for the first job. Although most of the patients we attend tend to complain of mild symptoms resulting in slower-moving jobs such as abdominal pain or elderly social jobs, about 10% of calls are labelled Category 1 or ‘life-threatening’. Such was the case in one of the last jobs of my 2nd year: a cardiac arrest. We had covered advanced life support a few months prior, so I was confident in my cardiac physiology and life support algorithms. Being on placement is the chance to put our knowledge to practice, and it was brilliant to work alongside HEMS (Helicopter Emergency Medical Services) consisting of a doctor and critical care paramedic throughout that job.
I had the opportunity to independently manage an airway, analyse cardiac rhythms and use the defibrillator, as well administering life-saving medications such as adrenaline. I learnt an immense amount about resuscitation during that job and felt like I made a real difference whilst working as part of that team; none of which would have been possible had it not been for the realistic simulations that are offered at university. Jobs like those are few and far between, but they’re the ones that we look forward to the most, the opportunity to help people at their most desperate times of need: that’s what makes being a Paramedic the most rewarding and best career.
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Surgical theatres
There are 2 mandatory non ambulance placements every year, as well as a third where we get a choice. At the beginning of my second year, I elected to spend a week in surgical theatres. This placement is designed to allow student paramedics to work with anaesthetists on airway management, prepare patients for surgery, and provide insight into non-emergency care. This by far was the most enjoyable time throughout my course so far and I am incredibly glad and privileged to attend a university that can offer such placements.
I observed surgeries ranging from abdominal, orthopaedic, ophthalmic and colorectal operations. I was given the opportunity to manage the airways of sedated patients, use multiple airway adjuncts such as OPs, BVMs and iGels, as well as practising cannulation and drawing up anaesthetic drugs like Propofol and Rocuronium.
Although at the time, I had 1.5 years of paramedic knowledge under my belt (which felt like a lot at the time), theatres were a whole new level. Working with anaesthetic doctors, operating department practitioners, and surgeons opened my eyes to how interchangeable the skills I’ve learnt at university are. As opposed to the stereotypical high-stress environment of ambulance work, working in theatres provided a calm and thankfully clean environment to learn and practise in as well as liaising with many different healthcare professionals. Granted, once the surgeries had started, I wasn’t handed a scalpel and told to remove a gall bladder or anything like that, but I had the chance to strengthen my communication skills with patients who were nervous and make them feel comfortable before their surgery. In addition, anaesthetic doctors explained how the drugs worked and went through their anaesthetic machines detailing every part of human anatomy they have to care for, as well as advising me on airway complications I may encounter when I start practising as a paramedic. The team at the hospital were very inviting and made me feel comfortable in a new environment, and I was offered the chance to spend half a day in the ICU (Intensive Care Unit) where I learnt a huge amount from critical care doctors and ICU nurses. It’s a placement that I strongly recommend to anyone on the course or thinking about joining the cohort at Plymouth.
Maternity
My maternity placement consisted of spending a week in Derriford hospital’s central delivery suite, where I worked alongside midwives and obstetric doctors. I was assigned to a midwife who was my preceptor, and I was made to feel welcome and supported throughout the entire week. Maternity jobs are quite rare to see whilst on ambulance placements, so this placement itself was very important to consolidate the maternal healthcare we learn in theory and simulations at university.
On day 1, I had the opportunity to assist the midwife in delivering 2 babies and learnt about immediate care for the new born and mothers as well as analgesic medications given and the birthing process as a whole. My second shift was the first time I delivered a baby with support and assistance from my preceptor, and it was probably the highlight of my course so far. From the beginning I was involved in undertaking observations, monitoring foetal activity via interpreting CTG’s, supporting the father through reassurance and communication and finally completing assessments of the baby straight after. It was a real full circle moment when the baby was here, and I felt like I had made a real difference. Again, a great placement and I left my final shift feeling much more confident with maternal patients and how to manage them.
placements are crucial to the course, and I feel they have prepared me well for when I’m by myself on the road. It’s the best chance to put the theory into practise; and all the different corners of the healthcare world that I have been exposed to through hospital, ambulance and surgical placements will hopefully come together to allow me to deliver the best healthcare to my patients.