Everyday EMTs work with people in medical emergencies and ensure their safe delivery to the hospital.
Sinead Ní Shuilleabhain has always had the passion for helping people and an interest in pre-hospital emergency care. She wanted to be an EMT after leaving school in 2008 but there wasn’t a formal course at the time.
Then in 2017, she finally bit the bullet and attended an emergency medical technician course with the Irish Ambulance Training Institute and graduated with a qualification in Emergency Medical Technology (NQ- EMT).
“It was an intensive course. It used to be a year long but now it’s only four weeks. I did it full time, a week on, a week off. We started off learning cardiac first response at an advanced level. So, if someone was to go into cardiac arrest, I am able to administer drugs and use advanced life-saving techniques in an effort to save them.
“From that, we moved onto spinal care, the full body anatomy, respiratory arrest. All the major issues you’d encounter out on the road or in trauma incident. For example, if someone’s in a car accident this training informs you on how to help someone based on their signs and symptoms. After that, we had to do forty weeks of clinical placement on an ambulance that was followed by two state exams.”
Every EMT student has to pass the Objective Structured Clinical Examination (OSCE). The OSCE is used to assess health care professionals in a clinical setting. However, unlike other clinical exams, the OCSE expose the trainees’ communication skills and the ability to handle unpredictable patient behaviour which is vital for emergency work.
“The exams are tough. The first one is a multiple choice questionnaire and the second one is an observed structured clinical exam. In this, you’re just given a scenario where you have to go down a mental checklist from A to Z and make sure you hit all the boxes. It’s hard, you’ve only eight minutes to do it.”
The stress that comes with this training is no doubt high with exams and the constant pressure to perform but her advice for people getting ready to sit the OSCE is practice makes perfect.
“Practice. Keep practising. Ask your family member to help out. Take their blood pressure, take basic vitals. Keep practising procedure and doing it over and over in your head until you know it start to finish and then do it some more. The OSCE is so important and if you miss something you have to be able to identify it and then come back to it at the end. You need to know that you’ve looked after your patient from start to finish and that their care is 100% complete,” she said.
Being an EMT can be physically and emotionally draining and they often deal with situations that increase their stress levels and have an impact on their emotional state. Caroline Elton’s book “Also Human” dives into research on what it is like to be a junior doctor but focuses on emotion in medicine. The book has caused a lot of debate around whether emotions should be removed from medicine.
Sinead said: “No, I don’t think emotion should be removed from what I do. I think that if you say you’re not going to be emotional and you’re not going to take on your patient’s emotions then you’re not in the right job. You need to be able to balance both aspects of emotional care and professional. Someone might have gotten the worst news of their life in a hospital room and then you have to sit with them for the next two hours. In this situation you’ll find that you’re more than an EMT but also a spiritual guide. Some people might not have a family, we can’t lie to our patients. Understanding patients emotions and what they need during this time is crucial.
“I’ve dealt with a lot of patients that are going for end of life care and then when I’m working up in the control room you might find out that, that person has actually passed away.
“You’re one of the final people that they meet on their journey to [the] hospice and that can mean the world to someone and to that person’s family.
“You have to take on the emotional side of it but remember that you have people and family at home that can support you. Sometimes, it takes a lot out of you and I know it sounds cheesy and that everyone says it but knowing that you’ve looked after someone to the best of your ability is the most rewarding feeling,” she continued.
Ms Ní Shuilleabhain’s week consists of two rotating jobs between an on the road EMT and as a Duty Controller in the control room scheduling and managing the chaos.
It was recently revealed that the HSE has no plans to provide paramedics with body cameras even though they are at risk of violence and aggression every day they do there job. EMTs aren’t allowed to restrain patients.
“Because I work with a private ambulance service, I wouldn’t really see much of that (violence) but it does happen that patients are aggressive [sometimes]. So you need to pick up the signs and warnings before getting them into the ambulance. If you’re not comfortable transporting them, you can request security to travel with you or refuse to bring the patient.”
She said a co-worker had been assaulted at one stage. “There’s very little you can do during incidents like those because we’re not allowed to restrain patients. It does happen, which is why during January we will be learning defence techniques called release hold. It’s a method used to push people off you without actually laying your hands on another person.”