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Now ye're talking - to an Intermediate Care Operative

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  • Closed Accounts Posts: 1,172 ✭✭✭cannotlogin


    Thank you.

    Can I just say if it's true that when the flashing blue lights go off it nearly always means the patient has died?

    Also, if you could change anything with how the public reaction to ambulances, what would it be? I'm sure you see the same mistakes being repeated which hamper your journey regularly.


  • Registered Users Posts: 27,983 ✭✭✭✭AndrewJRenko


    Can I ask what the view of the HSE staff is of the private operations that do similar work under outsourced contracts to the HSE? Are these seen as similar levels of quality, or yellow pack or what?


  • Company Representative Posts: 19 Verified rep I'm an intermediate care operative, AMA


    Thank you.

    Can I just say if it's true that when the flashing blue lights go off it nearly always means the patient has died?

    Also, if you could change anything with how the public reaction to ambulances, what would it be? I'm sure you see the same mistakes being repeated which hamper your journey regularly.

    When we turn off blue lights mid journey it could be for a number of reasons but generally it's not because the patient has died. It's more than likely because we were en route to a call and got stood down due to a closer resource being available or the patient not needing an ambulance etc.

    People dying IN ambulances is a very rare occurrence. If it's serious enough like a cardiac arrest we'll work it at the scene until no more can be done. But once we transport somebody we generally don't stop interventions until we get to a hospital and the doctors/nurses can make the call then.
    From an intermediate care point of view, dealing with end of life patients we encounter Not For Resuscitation (NFR) orders. Which is basically a directive by the hospital/care team and family, that if a patient in our care passes away, we're not to attempt to revive them, rather just keep them as comfortable as possible and support them.

    We tend not to transport frail, or end of life patients on blues, ever. It wouldn't be comfortable or professional. It's not an emergency as such so we drive very slow and steady.



    To answer your second question: Two things I'd change. The first would I wish some drivers would have a bit more patience when we are NOT on blues. As I said above, we regularly drive slow and steady. Some of the public have this perception that ambulances drive fast and speedy when most of the time its the opposite.
    You have a big shaky diesel van, with a sick person inside, possibly in pain or confused. So I'll be plodding along scanning and trying to avoid every pothole but I've lost count of the amount of tailgaiters and people with zero patience. But I hold my ground always.

    The second thing I'd change. I wish people would stop yielding on roundabouts or trying to get out of our way when NOT on blues.
    If I'm driving along normally, I'd prefer if others just drove normally too.
    I know people are trying to be courteous but i prefer if they'd just be predictable and not dive into the hardshoulder or come to halt on roundabouts to let me out.


  • Registered Users Posts: 2,509 ✭✭✭Purgative


    When we turn off blue lights mid journey it could be for a number of reasons but generally it's not because the patient has died. It's more than likely because we were en route to a call and got stood down due to a closer resource being available or the patient not needing an ambulance etc.



    Thank you for that. Good question. I always wondered without knowing I wondered. On the one occasion I remember it happening near me, it gave me a really odd sort of deflated feeling.



    I'm always fascinated by "paths not taken" as I nearly joined the ambulance service back in the 80s. I think what put me off was that sick feeling (maybe blind panic) that I imagined when you were the one racing to a road accident. Was I wide of the mark?


    And sorry I'll stop giving way if you're not on blues :o


  • Company Representative Posts: 19 Verified rep I'm an intermediate care operative, AMA


    Can I ask what the view of the HSE staff is of the private operations that do similar work under outsourced contracts to the HSE? Are these seen as similar levels of quality, or yellow pack or what?


    Depends on who you ask. Most of us are quite friendly with the staff of private ambulances. We know each other and have the chat or just give a salute as we pass each other on the road. I've no issue with them anyway.
    We do similar work and have the same qualifications bar a few minor differences on an internal level.
    I'd agree that it's a similar level of quality but as the old saying goes, doctors differ...


    The one thing that does tend to happen is private ambulances take public patients before NAS can get to them. We're a small service, and the private industry has far more resources than the HSE.

    In the morning we log in we could have several calls for the day, and by the time we get around to the last call its well into the evening and what happens is hospitals won't/can't wait so when we while the ICV was supposed to arrive 3 hours ago the CNM has picked up the phone and booked a private.
    The ICO service doesn't start before 8am so any early work gets outsourced.
    It's a big business and privates run a tight shop.

    Naturally this bothers some people because you hear about how many millions the HSE spend on private services and feel like things could be better organised or NAS resources could be better utilised.

    I wouldn't fancy working for the privates however. The pay is less, and the hours are longer. They often have very early starts like 4-5am and finish time is whenever their controller tells them.


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  • Registered Users Posts: 10,633 ✭✭✭✭Widdershins


    Does your crew and colleagues feel like a sort of second family? I was going to say a fraternity but I mean all colleagues male and female of course. I'm thinking this because it's so different to most other jobs, and I've heard it can feel like a different world from non paramedics/emts.


  • Company Representative Posts: 19 Verified rep I'm an intermediate care operative, AMA


    Purgative wrote: »
    Thank you for that. Good question. I always wondered without knowing I wondered. On the one occasion I remember it happening near me, it gave me a really odd sort of deflated feeling.



    I'm always fascinated by "paths not taken" as I nearly joined the ambulance service back in the 80s. I think what put me off was that sick feeling (maybe blind panic) that I imagined when you were the one racing to a road accident. Was I wide of the mark?


    And sorry I'll stop giving way if you're not on blues :o


    I've never felt sick going to a call. Anxious yes, if the radio rings and a nasty surprise comes through and adrenaline starts flowing. But that's only human and if you didn't feel that way there'd be something wrong with you! But blind panics aren't helpful. Most staff will get over the panic/worry part of it and learn how to stay calm....but not all do!


  • Company Representative Posts: 19 Verified rep I'm an intermediate care operative, AMA


    Does your crew and colleagues feel like a sort of second family? I was going to say a fraternity but I mean all colleagues male and female of course. I'm thinking this because it's so different to most other jobs, and I've heard it can feel like a different world from non paramedics/emts.


    There's absolutely a strong sense of community in the service.
    There's so many great people and camaraderie to be had. I suppose we bond over the kind of work we do especially if it's a hard call, colleagues can be very supportive and kind through everything.

    There's great craic to be had and you meet some characters (staff and patients!).
    Naturally you won't get along with everyone, there are disagreements like in any workplace and staff relations can vary from station to station but by and large things are good.


    Might be controversial to say this, but I think in the ICO service we have a tigher knit community than the paramedics on the frontline vehicles do as we're a smaller group.



    For me it's less like a family, and more like a (very) big group of friends, like back being back in school. :D
    The door of station is always open. Retired staff still visit, people come in on their days off to do a bit of work, or stick on the kettle. Its a home away from home for some.
    Others are allergic to coming near the station unless they have to :pac:


  • Registered Users Posts: 196 ✭✭Scienceless


    The ICO service doesn't start before 8am so any early work gets outsourced.

    Do you think the ICO service will ever operate on a 24/7 basis?


  • Registered Users Posts: 10,633 ✭✭✭✭Widdershins


    Do you all receive many thank you gifts or notes to the station? Any memorable ones?


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  • Company Representative Posts: 19 Verified rep I'm an intermediate care operative, AMA


    Do you think the ICO service will ever operate on a 24/7 basis?

    Good question. It's been talked about for years and I keep hearing it's coming down the line for us but that's all rumours. I've seen nothing concrete to suggest management are going implement it anytime soon.

    Staff won't let it happen easily however.
    When you look at the paramedics getting flogged round the clock and getting burnt out with the constant nights it doesn't look appealing, especially the ones who are in their late 50s and 60s.

    So many paramedics are trying to get back into the ICS to escape that, but aren't allowed for a number of reasons. There's no direct pathways between the two roles.

    It would also mean we'd have to be paid shift allowances and night bonuses and I don't think the HSE want the extra expense.

    There are talks (rumours) that the ICO service will be amalgamated into the frontline and instead of us being a separate branch we'll have mixed EMT/paramedic crews that will be rotated onto the ICO . But again I'll believe nothing until it's in writing.


  • Company Representative Posts: 19 Verified rep I'm an intermediate care operative, AMA


    Do you all receive many thank you gifts or notes to the station? Any memorable ones?


    All the time!

    They're mostly just general thank you letters saying "thank you to the crew who helped my father last week" etc. Sometimes they'll say name of the crews or come with a box of roses.
    Come christmas time the stations do be inundated with chocolates and gifts from all sorts. People are so good to us.

    I've lost count of the amount of ill or elderly people I've brought home who try and gift us in cash. Which is heartbreaking, a lot of the time these people are living in isolation or poverty too. So we always refuse.
    A simple thank you is enough for me.

    I think the most memorable was a card we got from the parents of a palliative child we brought home. I'll never forget that.


  • Company Representative Posts: 19 Verified rep I'm an intermediate care operative, AMA



    What's the best day you've had?


    Getting back to this.

    I had to think long and hard about the best day, and to be honest I don't think I can pinpoint a single best day.
    I've had many really great days and experiences as an ICV so I'll list some of the ones I've been remembering since you've asked this.



    1. I brought a very ill woman up to the Matter hospital for a lung transplant a few years ago. Transplants are so difficult to get and most people who end up on transplant lists don't get them. The patient knew this and the outlook wasn't good.

    About 6 months later I was drinking a coffee in a hospital cafe when someone tapped my shoulder and said do you remember me? To be honest I initially didn't but as soon as they told me who they were I remembered.
    Turned out they got the transplant and it was successful.

    I didn't even recognise her because of how healthier and well she looked. That was an amazing feeling even though I didn't really do anything other than bring them to the hospital that day.


    2. Similar story again, but we assisted a frontline crew with a patient who suffered a stroke while driving. Fully FAST positive, facial droop etc.

    About a month later we were tasked to bring a patient from a ward to a rehabilitation unit and it turned out to be the same person.
    They had extensive loss of their mobility, feet, hands, speech, eating. Everything. Nearly totally bed bound.

    To cut a long story short, we ended up bringing him in and out of the hospital/rehab unit over the space of a year. It was amazing seeing them recover and go through rehabilitation. The nurses and physios in those places do amazing work.
    I'd always poke my head in while passing to see how he was getting on and then one day he was just gone!
    Gone home that is. Near full recovery.

    There's many many stories like this that make the days just the best, but I'd be writing way too many paragraphs if I told them all! :D


    3. Bonus: Best feeling post call was the first time I used naloxone on a person that wasn't breathing. That was something else! Ever see the nicholas cage film, Bringing out the dead? :pac:



  • Boards.ie Employee Posts: 12,597 ✭✭✭✭✭Boards.ie: Niamh
    Boards.ie Community Manager


    This has been a really great AMA, thanks to OP for taking the time to do it and for all of the questions.

    Closing this one up. If any of you fancy doing one yourselves, please PM me or email me niamh@boards.ie :)


This discussion has been closed.
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