Drive to succeed!
Former Naval Seaman Neil Rankin may have swapped one uniform for another, but he’s still working hard to serve his fellow countrymen.
Now an Emergency Medical Technician 1 with North West Ambulance Service, the vehicle may be different, but many of the skills required are very much the same. Could your future lie beneath the blue light too?
Having served for 12 years, ex-Royal Navy Seaman Specialist Neil Rankin, 41, left the Forces in late 2014 and is now working as an Emergency Medical Technician 1 (EMT1) with North West Ambulance Service. Following his medical discharge due to a knee injury, Neil sought to move into a career where he could put to good use his Naval experience of working in a small team, watch keeping, shift work, and comms and radio use, together with his communication skills and ability to adapt quickly to changing situations. With that background, it’s really not hard to see why he opted for a route into the emergency services!
While serving, Neil secured qualifications as an IOSH Workplace Risk Assessor and a TRiM (Trauma Risk Management) Practitioner. These certifications – along with his other skills, mentioned above – were complemented by his CTW at RNAS Culdrose, where he says, ‘It was great to get feedback on CV writing as well as putting me in touch with the whole CTP team, which helped me the most as interviews approached and I needed to complete application forms.
‘During resettlement, I also did a combined NEBOSH Certificate – covering the NEBOSH National General Certificate in Occupational Health and Safety and the NEBOSH National Certificate in Fire Safety and Risk Management – which together dealt with general, fire and environmental aspects of HSE. The course was run by OMS in Coalville. I wasn’t sure exactly what I wanted to do but my last posting in the RN saw me take over H&S responsibilities for our department – I knew I wasn’t too bad at it so I thought it would be a good course to have as a “go to” and passed both parts with Credit. I also later attended in-house training for the North West Ambulance Service (my current employer), which consisted of six weeks’ clinical skills and a three-week advanced driving course.
‘Most NHS ambulance trusts run their own training courses so, although using your ELC for emergency driving or ambulance technician courses will help if you go on to work for a private company, you will still need to undergo training periods with the NHS. With this in mind, be sure to ask the service in your area for full details.’
Neil’s own employer NWAS, for example, is – like other trusts – now offering training along the lines of that described in the accompanying box-out (‘What form does the training take?’). This is largely to reflect the rollout of a new level 4 qualification, Associate Ambulance Practitioner (AAP), of which you can find full details at www.gov.uk/government
‘There are now programmes being put in place for technicians to be supported through university to qualify as paramedics,’ Neil continues, ‘but places are limited. Technician qualifications may also be Ambulance Service dependent and not nationally recognised, so be aware of this and check out all the details carefully.’
WHAT FORM DOES THE TRAINING TAKE?
NWAS NHS Trust is embarking on a new training programme for Emergency Medical Technicians (EMTs). The training is for a 13-month period and commences with 18 weeks’ classroom-based clinical training. Successful completion of the 13-month training programme means you will hold nationally recognised qualifications.
The first 18–20 weeks’ training will take place in one of its training facilities. This includes four weeks’ emergency ‘blue light’ training. After that, you will be deployed in an EMT role and work as part of a crew. As a trainee, you will work alongside other EMT staff and paramedics initiating and delivering appropriate care and effective treatment to patients in both a hospital and pre-hospital environment. Here you will be selecting and applying appropriate skills and equipment safely while working within the appropriate level of training, competency and scope of practice for the role.
Throughout your 13 months’ training you will benefit from dedicated clinical support from your trainers, managers and crew, to help you through your training programme and successfully complete your training.
Sources: North West Ambulance Service; NHS Jobs – www.jobs.nhs.uk
Please note that, since Neil completed his training, FutureQual’s levels 2 and 3 ‘blue light’ driving courses have replaced the former IHCD D1 and D2 awards, which were phased out in 2015. FutureQual qualifications are recognised by all NHS Ambulance Services in the UK. They are listed on the QCF, which means you can use your funding towards them.
Developed in partnership with the NHS Ambulance Service Driver Training Advisory Group (DTAG), the qualifications currently available are:
- level 2 Award in Ambulance Driving
- level 2 Certificate in Non-emergency Transport Services
- level 3 Certificate in Emergency Response Ambulance Driving
- level 4 Diploma in Emergency Response Ambulance Driving Instruction.
To find out more, visit www.futurequals.com
Neil’s new day job
Having got the necessary training and qualifications under his belt, Neil has now been in his current job for just over two years – and he’s keen to give Quest readers a taste of what it’s really like to work in what is perhaps the country’s most vitally important blue-light service. ‘Although no day is ever the same,’ he says, ‘each shift starts with checking the ambulance over with my crew mate, to ensure that the vehicle, equipment and drugs are stocked up and ready for the road. We work as a two-man crew, with the paramedic as the lead clinician and I am there to support them. Once we’ve signed on to control we will be on the road responding to emergency calls.
‘Each job is different, so you could be at a road traffic collision, followed by a job covering mental health, then a cardiac arrest. We come back to the station for a half-hour meal break during the shift and, depending on the shift length, an extra 15- or 20-minute break later.’
You can read an hour-by-hour breakdown of Neil’s typical working day in the accompanying panel, ‘The everyday working life of an EMT1’.
Pros and cons
Asked what he particularly likes about his current role, Neil responds: ‘the sense of achievement, meeting people from all walks of life and working under pressure in a small team’. Otherwise, at the top of his list of career-related positives comes a better work–life balance. Other important factors that make this a desirable role for ex-Forces personnel include the fact that it is a profession, says Neil, where you will find a number of other Service leavers. Soft skills are also recognised, ‘like working under pressure, difficult situations, thinking on your feet and teamwork. These all help to make the transition a lot easier.
‘Then there are drills, drills, drills – just like in the military – where we learn skills so they become second nature to us – almost automatic. Things like working on ambulance skills, such as CPR, all follow a systematic approach, and learning and then adopting these drills is no different to stoppage drills on the range.
‘As I said before – but I can’t emphasise it enough – every day is different and no one job is the same. And that means every day you learn a new skill or get the opportunity to develop your clinical skills further.
‘More practically, the job brings access to NHS discount and car lease schemes (depending on the Trust you work for), and continuing professional development (CPD) is actively encouraged.’
Having been happy to tell us about the positives he finds in his job, Neil does have a few dislikes too, which may come as no surprise to most of us: ‘nightshift and the lack of time for a brew’! And shift work, he says, ‘although similar to watch keeping, can be difficult to get into at first.’
Other challenges Neil highlights include the fact that ‘initially, most staff end up on a relief rota, so you will know your shifts only three weeks in advance, which can be difficult at first – especially if you have young kids at home or want to plan a holiday. Holidays have to be requested and booked about 12 months ahead (there is no stand-down period like there is at most military establishments), and if you have children, you’ll find it can be difficult to get the school holidays off. So a certain amount of planning is required as there can often be childcare issues to consider.
‘As mentioned earlier, my employer’s training was made up of six weeks clinical and three weeks driving, but – having said that – there is nothing that can prepare you for social and mental health calls: it’s a very steep, on-your-toes learning curve. And I quickly realised that it’s vital not to take the job home with you. Some days you can see or treat things that you have to learn not to take home. It’s important to be able to put your hand up and say to your line managers or crew-mate, “I need a chat.”
‘Another challenge – particularly for ex-Forces personnel – is to forget all the three-letter acronyms you already know and learn some new ones! A lot of new ones … ‘Although there is a greater deal of autonomy than I had in uniform, there is also plenty of ongoing learning to be done.
‘Then there’s the paperwork: something that was either typed up or handled by someone else when you were in the military now has to be done by you. When you work on an ambulance, each patient has paperwork that must be filled in accurately and neatly (a tough call in the back of a Fiat doing 60 mph). Paperwork was something I didn’t have to do a lot of in the Royal Navy, so it’s been a challenge for me to learn and adapt to that.’
Neil has also found the reduction in pay he’s had to accept a ‘challenge’ – well, let’s face it, a negative. However, he does point out that overtime is always available, and ‘although my pay is lower, my work–life balance is better and we can now plan as a family. Plus I also get paid for late meals and finishing work late.’
‘There is a good cross-over between the Services and the Ambulance Service,’ says Neil. ‘What I have found helps more than anything is the ability to work under pressure in tricky situations, so while driving a RIB in the Gulf at two in the morning in rough weather is a million miles from attending a traumatic cardiac arrest, the feeling of confidence in drills and procedures makes situations like that far more manageable. There are ex-RAF, Army and Royal Marines all working within my group, so there’s still a healthy amount of banter to be had in the crew room.’
Sound advice to smooth your transition …
Neil has some useful advice to pass on to you, ‘things to consider’ for your own transition to a career in the Ambulance Service.
‘In terms of finding a work placement, I was very lucky. I contacted the RFEA in Manchester, which had a contact in the Ambulance Service. After an initial chat I was able to do four shifts on the road, which was eye opening and made me realise I could probably do the job.
‘As for driving qualifications, you will need C1 on your licence as almost all ambulances are over 3.5t so a C1 is required.
‘And don’t be put off if you’re from a non-medical background – the clinical skills are easily taught. This job is all about communication and teamwork.’
In terms of your resettlement in general, Neil advises: ‘Use CTP and RFEA. I found their advice on interview techniques and mock interviews to be invaluable. Also engage with your career consultant as soon as you can. RFEA in particular were excellent. I made contact and arranged a meeting for when I moved up to Manchester. Things moved so quickly, though, that it turned out I didn’t need the meeting as, after they had put me in contact with the Ambulance Service, I got a job offer about four weeks later.
‘My CTP adviser couldn’t help me enough, from proofreading and helping with my application forms to, even more importantly, getting me ready for interview. I was most anxious about that stage but we arranged a mock interview over the phone (which left me sweating!), but the feedback and the structure is as good as it gets. It meant that, on the day of my actual interview, I was relaxed and had my answers ready – and it paid off!’
Thinking of following in Neil’s footsteps?
‘I had no medical background,’ says Neil, ‘but have found the transition easy with a switch of uniform. Many of our Forces skills – time-keeping, personal standards, courage, physical stamina, a can-do attitude and all the other core military values – are essential in this job. It is highly rewarding, especially when you get letters of thanks from a patient or from management, thanking you for your efforts and a positive outcome.
‘To sum up, I would say, go for it!’
To find out more about working in the UK’s emergency services, take a look at our in-depth article at www.questonline.co.uk/careers/career/emergency-services
THE EVERYDAY WORKING LIFE OF AN EMT1
Shift 1400–0220, Greater Manchester
1345: Arrive at work and get a vehicle. We work as a two-man team: a paramedic as lead clinician and me as the technician supporting them. We take turns driving and attending in the back of the ambulance, unless it’s a complex or unstable patient and then the paramedic will always travel. Today there is no vehicle so we must wait for an off-going crew to finish before we can get started …
1430: Sign on with control, and complete drugs and red checks* of all essential equipment to deal with incidents such as a cardiac arrest or major trauma.
1455: First job – middle-aged male who has a history of irregular heartbeat. Once we assess him it’s clear he needs to be transported to the nearest A&E for treatment. He has an unsustainably high heart rate. We radio control and pass on his details as he will be taken direct to Resus rather than being triaged. This allows us to travel with blue lights, and alerts hospital staff we are coming in.
1555: Clear at hospital after handing over the patient. Call control and head off to get fuel.
1620: Next job – an emergency transfer for a paediatric patient from our local A&E to the main children’s hospital.
1740: Hand over our patient and wait for our next job. Complete second equipment and drug checks.
1742: Next job is an assault – it’s graded a ‘Green 2’ (not life threatening). En route we are retasked to a ‘Red 2’, which requires an eight-minute response (see box-out: ‘999 call response times’).
1805: Arrive on scene and a bit of detective work is required – the gentleman is in his nineties and not sure why we have been called. I speak to out-of-hours nurses and get a history while my paramedic conducts some checks. Our patient is stable but the nurses have told us that he has very abnormal blood tests and requires urgent admittance to hospital.
1900: Arrive at the closest A&E – it’s busy but we are seen in triage straight away. While waiting for a bed, our patient has his bloods taken and it’s decided we should move him to Resus.
1915: Meal break due. Head back to station and pick up a sandwich on the way. (We get one half-hour break on this shift.)
2000–2030: Meal break.
2045: Another call – a Red 2 for a what is being queried as a heart attack.
2054: Arrive on scene and met by the patient. A quick assessment reveals that thankfully it’s not a heart attack but our patient has complex mental health issues. After a full assessment, which reassures them, we decide to transport them to A&E so further tests can be conducted and they can be seen by the on-call mental health team.
2145: Arrive at A&E and hand over.
2200: The best message of the day from control: ‘Thanks for today RTB, and goodnight.’
2210: Back at the station, we hand over our vehicle to the oncoming crew, file our paperwork and head home.
*All ambulance crews are expected to perform checks on their vehicles; these are separated into the categories red, amber and green. At the start of a shift, they are required to perform a ‘red check’ on their vehicle; this includes checks of medical equipment, drug supplies and basic vehicle checks, including wheel pointer alignments. It is estimated that a red check should take no more than 10 minutes.
IOSH Workplace Risk Assessor
Trauma Risk Management (TRiM) Practitioner
NEBOSH National General Certificate in Occupational Health and Safety
NEBOSH National Certificate in Fire Safety and Risk Management
WHO RUNS THE AMBULANCE SERVICE?
Both NHS Ambulance Service Trusts and Private Ambulance Services (PAS) provide ambulances and staff to deal with medical emergencies
999 CALL RESPONSE TIMES
999 calls to the Ambulance Service are prioritised into two categories to ensure life-threatening cases receive the quickest response …
1. Immediately life threatening
Red 1: 75% of Category A Red 1 calls (the most time critical, where patients are not breathing or do not have a pulse) to be responded to within 8 minutes.
Red 2: 75% of Category A Red 2 calls (still serious, but less immediately time critical, like strokes or fits) to be responded to within 8 minutes. The clock starts ticking up to 60 seconds after the clock for Red 1.
A19: 95% of Category A calls to be responded to within 19 minutes.
2. All other calls
· For conditions that are not life threatening, response targets are set locally.
‘There is a good cross-over between the Services and the Ambulance Service’
‘What I have found helps more than anything is the ability to work under pressure in tricky situations’
‘There are ex-RAF, Army and Royal Marines working within my group, so there’s still a healthy amount of banter to be had’
‘Don’t be put off if you’re from a non-medical background – the clinical skills are easily taught. This job is all about communication and teamwork’
‘Many of our Forces skills are essential in this job’
Private Ambulance Services
All NHS Ambulance Service Trusts in England and Wales recruit on an individual basis and advertise on the NHS Jobs website: www.jobs.nhs.uk
For Scottish jobs, see www.scottishambulance.com
For Northern Irish jobs, see www.niamb.co.uk
There is also a great deal of useful information in the ‘Ambulance’ section of the NHS Careers website: www.nhscareers.nhs.uk
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