Phone a Friend: the proficient paramedic

In Mentorship by Gerhard Dashi1 Comment

Editor’s Note: This series was created by third year medical student Gerhard Dashi and will highlight the important work that our interprofessional colleagues do.  Keep your eye open for more “Phone a Friend” articles and if you would like to be featured or know a colleague that should be highlighted follow this link to complete the questions on a google form. 

Background on the “Phone a Friend” Series

This is the second interview in the “Phone a Friend” series. This series aims to give our interprofessional colleagues another chance to remind their Emergency Medicine peers, especially the juniors ones, what they do and how we can most effectively work together.

For our first interview with pharmacist Dr. Bryan Hayes, click here.

Although we have sent requests to some of our favorite healthcare professionals, we would love to hear from you or someone you know. Please send us the questions you would like answered or your own answers to the following questions. We hope to feature your heroes and your responses on upcoming posts.

The Proficient Paramedic

Ian Drennan PhD(c), BScHK, ACP (@IanR_Drennan) completed his undergraduate degree training at the University of Guelph and his Primary Care Paramedic diploma from Humber College. He has been a paramedic in southern Ontario for six years, obtaining his Advanced Care Paramedic diploma from Durham College. Ian also holds part-time faculty positions in the health sciences department at both Georgian College and Centennial College. Ian

Furthermore, Ian is a PhD candidate at the Institute of Medical Science, University of Toronto and Rescus at St. Michael’s Hospital. His thesis is focused on the development of clinical prediction rules and the treatment of out-of-hospital cardiac arrest patients early in the post-arrest period as well as other aspects of cardiac arrest care. Ian is also involved in the development and implementation of initiatives aimed to examine the impact of community paramedic interventions.

In addition to his PhD work, Ian is a member of a number of committees related to EMS practice and research including the steering committee for the Canadian Paramedic Research Network, a peer reviewer for a number of medical journals, and a writing group member for the 2015 American Heart Association Guidelines for CPR and ECC.

Profession/current job title: Paramedic/Clinical Researcher

Years of practice: 7

Country of practice: Canada

Practice setting: Pre-hospital medicine

How does your work impact patient care? 

As pre-hospital providers, we have unique interactions with our patients in that we have limited time and diagnostics, but can in some instances have a critical role in outcomes. The biggest impact I have on patient care is by always acting as a patient advocate. This involves treating patients to the best of my abilities; respecting their wishes, and treating them medically when I can and is appropriate. I need to be an advocate for my patients and provide them with the best treatment I can, even if the hospital is just a short distance away. For me, I always go the extra distance and put in the extra effort to treat my patients the way I feel is best. Furthermore, advocacy for my patients in the hospital can have an enormous impact on their care by pushing for a bed when I feel my patient is acutely ill.

What is the most common misperception about your role in the the treatment of the acutely ill? 

The misconception that still follows paramedics is that we are all still very technician-based. Paramedics today have higher and higher levels of training, enabling them to think critically and fulfill the role of a clinician. My hope is that paramedics will continue to become more valued members of a healthcare team.

How can the ED utilize your skills more effectively? 

Paramedics do not play a large role in ED care in most centres. I think the relationships that we have with all levels of ED staff are improving and are for the most part professional. The interaction between paramedics and ED staff when medics first arrive in hospital and during patient transfer of care can make a large difference in patient care. This is where I think other health care professionals can use the paramedic’s skills effectively, by listening to the report and treatment provided so far.

What is your favourite part about working in an interprofessional environment? 

Working in an interprofessional environment allows for professional growth and development by working and learning from others around you that have experience and expertise in different areas. Each profession brings different strengths and weaknesses that can accelerate learning and promote excellence.

What is the most difficult aspect of working in the ED? 

Most difficult part of working in an interprofessional environment is working among the complex relationships with different individuals and different providers.

What can be done to improve interprofessional practice in the ED?

Again, our interprofessional interactions are limited in the ED, however I think that ensuring appropriate communication during patient handoffs is important to ensuring good patient care. As paramedics we often have pieces of the story/history that were gathered in the pre-hospital setting that are important for patient care. We also have experience dealing with acutely ill patients and make sound clinical judgements in these situations.Something what I think would also be beneficial in improving interprofessional relationships is to train as we practice. Incorporating more training, rounds, simulation that used paramedics with the ED staff would help to overcome some barriers that currently exist.

What is your biggest pet peeve when you are working in the ED? 

My biggest pet peeve inside and outside the ED is not being listened to. Spending time gathering information, treating a patient, and building a rapport with the patient only to not be listened to when transferring care to the ED really hurts interprofessional relationships. I make sure that I make an effort in my practice to listen to others whom I interact with in this same respect.

What is the aspect of your job that you are most proud of?

The thing I am most proud of in my career is my continued work to increase the level of care provided by all paramedics in the pre-hospital setting. This includes, increasing the skillset of medics, increasing fundamental knowledge and clinical decision making, increasing the education and research capacity of paramedics and finally improving the interprofessional interactions that occur between paramedics and other healthcare providers as we become more respected members of the healthcare community.

Can you provide an example of an optimal patient interaction (e.g. one in which you used all of your training to positively impact the outcome for a patient)?

For me, optimal patient interactions are ones in which I have helped patients to make decisions regarding their healthcare. In the prehospital setting, this often involves decisions around whether or not to go to the hospital – for example, a patient with new onset rapid atrial fibrillation, chest pain, and mild shortness of breath who refuses to go and get examined at the hospital. Being able to sit with these patients, to discuss their situation and what might happen if they don’t get treated, and to help them come to the right conclusion is extremely rewarding.

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Gerhard Dashi

Gerhard Dashi

Gerhard Dashi is an Emergency Medicine at the University of Toronto. Having just read “Kitchen Confidential”, he now self-identifies as the “Anthony Bourdain of Wellness”: blunt, disgruntled, refusing to conform with the field, but still willing to accept all of it’s benefits. Especially a travel deal.
BoringEM
BoringEM has been 'bringing the boring' to emergency medicine since 2012. In 2016 this Canadian blog brought its content to CanadiEM.
BoringEM
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