To become a fully qualified Paramenace I need to do over two and half years with the service.  This involves 22 or so weeks in the classroom at the start followed by the fear and realism of being on the road with real patients from then on.  There are several exams and learning en route and the whole thing is topped off with the obligatory “bag” training – eight weeks back in the classroom with several subjects we need to cover – each with the inevitable exam process to allow you to progress onto the next stage.  Quite a bit of pressure to say the least.

After this you do a month of Hospital placements and then you’re back on the road.  Mentored at first until your registration comes through – and then, you’re on your own!

I’ve completed my first week of my Hospital placements in A&E'Accident and Emergency'. Accident and Emergency department of the Hospital. Where patients will end up if conveyed by an ambulance. This is the part of the Hospital you will possibly wait a long time before being seen – and no, going by ambulance DOESN’T mean you’ll be seen any quicker if you’re injury/illness is NOT life threatening. In fact, for those who call an ambulance in the vane belief that they will be seen quicker (and are trying to jump the queue) you will more than likely have to wait longer than everyone – probably in thankful payment for costing the British tax payer well over £500 for your efforts. where I’ve had to gain experience in cannulating'Cannulate' When a patient needs to be able to take drugs via their veins (a little like when a drug addict injects heroin into their veins). We place a “cannula” into one of their veins in their arm (ideally) so that they can recieve either drugs or fluids . . . or both . . . but not heroin – sorry..

I thought I’d be good at this straight away as I’ve had previous medical training which covered cannulations.  And, even though, during “bag” training, the tutors had to hold my hands and help guide the needle in, I thought I was doing fairly good.  Well, I say good, but I did find it strange that after several failed attempts I was asked to “go buy some milk for the mess room” – especially as the fridge seemed to be full of milk.  I imagine they thought my arms must be getting tired and needed a rest.  Very thoughtful.

But then it came down to real patients with real veins . . . and to say I needed practice was an understatement.

My first day ended with my feet aching incredibly. This was due to lots of standing around hoping to be of some use to the busy staff there – and they were very busy!  Whenever I offered to help anyone it suddenly appeared to get even busier.  They would all sink further into their paper work or rush away to see if their patients were ‘doing ok’.  Their hard work can never go unappreciated.

But, by the end of second day I’d managed to do ten cannulations.  Sadly, only the first was a success.  The others had spectacularly failed in a variety of different ways.  Mainly due to me bursting their veins in some way.  The most spectacular was saved till last when I tried to cannulate a poor old lady who had all her family present.  Their eyes burrowed into the back of my head as I attempted to cannulate her tiny shrunken veins.  I stuck the needle into her arm and after about five minutes of digging around trying to find a vein a doctor entered and immediately suggested I stop and let him do it.  Very modest of him I thought – and he was probably right in suggesting it as I think it was starting to cause the poor woman a little pain (and we never want to do that to the patient!).  So, after slipping on the large pool of blood that had gathered on the floor from my attempt I moved away to let the doctor try.  With one swift flash of movement he literally threw the cannula in first time.  And, after patching her up, offered me to do the flush (a simple saline solution injected into the vein to “flush” through everything) as a consolation prize.  Knowing I now had the simplest of jobs to do I stuck the syringe into the cannula and injected the water.  But, for some reason I used all my strength to do so.  The result was a massive explosion of blood and water all over the patient and myself after bursting their vein – which was now rapidly swelling and turning blue as the patient bled into their own tissue.

I personally thought the patient had taken it well.  She looked at me, with blood and water dripping from her face, and sighed, through what seemed to be, gritted teeth.  The Doctor, obviously thinking of future matters, sent me away quickly – I imagine because my skills were desperately needed elsewhere.

The next day there seemed to be a a complete lull in patients needing cannulations.  Which is a bit strange really, as I’m sure I saw lots of nurses and doctors collecting all the items needed to perform this task and disappearing off to into the cubicles with the patients.  I found it also a little strange that whenever I offered any help in “potential” cannulations the hospital staff tended to become nervous and agitated and pointed me elsewhere to help with someone else.  I can only imagine that the department was so busy that they simply could not give me enough time to help with training.  I saw this as incredibly selfless and on many occasion I was nearly brought to a tear as I thought how strong they were to show such commitment and enthusiasm to their work.

I was later offered to practice my cannulations again in the afternoon on inanimate objects.  I did however, find it rather strange that they offered me to practice on a large garden hose pipe.  But, never one to complain and always one to participate I dived in and got involved.  I find the A&E nurses’ patience above the standards of superhuman when I missed the hose on several “first” attempts.  They would stop me after only a couple of goes and rush off to try and replace themselves with another nurse who could help me.  Albeit I could never hear their discussions I could see that they would become heated at times with lots of gesticulations and open hand gestures in my direction.  I imagine this was probably down to them trying to utilise all the best teaching styles they had to offer and as a result a warm feeling spread throughout my body as I realised that they were willing to give me such attention in my learning.  I think eventually sending me off to make several cups of tea – in another department – was probably reflective of how busy they were becoming and I’d like to think it showed their skill and knowledge in keeping me busy in those periods where they couldn’t offer me the full support they so desperately wanted to give.  However, I’m not overly sure of why they asked me to stand in the far corner of their department toward the end of the day.  And to face the wall not speaking whilst doing so was a little strange.  I can only imagine it was one of the A&E’s little “in-jokes” that I constantly failed to understand.

However, by day five I’d managed to gain all my recommended cannulations, plus others!  And, after a rather tearful goodbye (mainly on my behalf – I believe the nurses and doctors were so overcome with their own emotion that pretty much all of them decided not to say goodbye to me at all) I left and went home.

I write this now at home, sitting with fond memories of my experience with A&E.  The connections and bonds I have made will remain with me for a long time.  I’m sure I have left a professional mark on them and have represented the ambulance service well.  I believe whole heartedly that our relations with them will be better for my services rendered over the week.

Next week I’m in the paediatric and obstetric departments.  I will of course, write my experiences with them in full.

Binder