Emergency nurses and paramedics need to walk in each other’s shoes, says Mike Brady
Paramedicine is a profession that is in its infancy and one that is often shrouded in public misconceptions, similar to that of long-running television programmes. In reality, as emergency nurses know all too well, the delivery of emergency care has changed dramatically over the last decade.
The profession once deemed solely as a transportation arm of the NHS, much in the same way nurses were once seen solely as doctors’ assistants, is expanding both its scope of practice and the education that underpins it. Now predominantly at university level, it aims to match the constantly changing demographics of an ageing and increasing population.
The developing similarities between paramedicine and emergency nursing are perhaps not well known. The two professions that arguably need to approach emergency and unscheduled care in a cohesive manner, need to do so by sharing interprofessional education, and the abolishment of any potential tribalism or professional demarcation. This may only be possible through a better understanding and appreciation of the challenges faced by the other: “A shift in their shoes.”
“I question whether emergency nurses fully appreciate the dynamics in which paramedics work”
By perhaps leaving one’s professional comfort zone and trading proverbial Crocs for steel toe caps and vice versa, we can comprehend both the systematic and political constraints within which each practitioner both works and practices. With a modernising NHS faced with swathing financial constraints and increasing workloads, it is unsurprising that unnecessary accident and emergency admissions by emergency services are met with frustration and fatigue, coupled also with financial implications.
Solutions such as increasing education and interprofessional collaboration have thrown forth the availability of alternative care pathways, and while I recognise that more can be done by individual paramedic practitioners to reduce admissions, I question whether emergency nurses fully appreciate the dynamics in which paramedics work.
Biomedically, without the luxury of fully autonomous professional medical backing, supported by haematology, medical imaging, urinalysis and computerised patient information, paramedics work within the limitations of basically over-the-counter diagnostic equipment.
Psychosocially, often the location and condition in which we respond to our patients coupled with overloaded social and crisis teams, the inability to do anything but admit a patient to an A&E department is unavoidable. While paramedics should have to justify admitting a patient to A&E just as much as one does when providing an alternative pathway, both they and emergency nurses perhaps need to comprehend the limitations and frustrations faced by each other.
Whether it’s through better communication, appreciation, education or even trading places for a shift or two, we as professionals and practitioners need to learn and better comprehend the ways in which we both work, in order to both identify ways in which we can improve but to fundamentally provide joined-up, consistent patient care, in an ever-increasing professionally and economically challenging workplace.
Mike Brady is a graduate paramedic