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04-10-2019, 10:25   #1
Boards.ie: Niamh
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Now ye're talking - to an Intermediate Care Operative

Our next guest is an Intermediate Care Operative for the HSE National Ambulance Service. He has been working with them for 4 years now and has been working on ambulances in total for nearly 8 years as an Emergency Medical Technician (EMT). He will explain himself what an Intermediate Care Operative is when he logs on but if you have any questions, feel free to ask them now.
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04-10-2019, 11:00   #2
I'm an intermediate care operative, AMA
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Good morning folks, Happy Friday.
As Niamh has said, I've been working for the ICO service with the National Ambulance Service for 4 years now.

I'm sure some of you are thinking what in the name of god is an Intermediate Care Operative?

We're a small branch of NAS with approximately 200 staff and 50 vehicles nationwide.

Our primary roll is to transport patients between hospitals and other care facilities.
This includes hospitals to nursing homes, between regional and university hospitals, or often just to bring people home.

A large amount of our work involves palliative and end of life care, but also things such as Neonatal transport of incubators, and transport of unwell patients of all ages to a more acute setting.
We also act as a backup to the NAS emergency fleet, and respond to 112/999 calls if we are the closest available resource.

Overall it's very varied work and takes us all over the country.
I'm sure some of you have seen our vehicles chugging around the place.




So AMA!
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04-10-2019, 12:05   #3
charlietheminxx
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No questions for you, just want to say thanks for the work that you do.
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04-10-2019, 12:39   #4
The One Doctor
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Thank you as well. You and your colleagues do fantastic work.
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04-10-2019, 14:33   #5
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Do you have to be a certain type of person to be able to see so much death or near-death on a daily basis? Does any of it ever upset you? You mention that you do palliative care work too which must expose you to sensitive and upsetting family situations like tears, last conversations, old people who are suffering etc- how do you just switch off from that at the end of your shift?

And as a follow-up to that, what made you want to do this work in the first place? Thanks in advance!
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04-10-2019, 14:35   #6
miamee
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Thanks for doing this AMA. I'm curious how your working day is set up. Are you based in a specific hospital taking their patients wherever they need to be or based in maybe just a specific area and you get a list of runs/pick ups at the start of a shift?

Do you do shift work or are you more of a day time worker?

How far in advance would you know how your day or week is going to look?
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04-10-2019, 15:27   #7
 
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Thanks for doing this AMA.

What kind of training did you have to do for this role?

As a previous poster mentioned, it must be difficult dealing with some situations. Is there good support for you, some kind of debriefing to help when you have had to deal with a particularly distressing situation?
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04-10-2019, 15:48   #8
hynesie08
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Do you feel its a waste of resources when you get called out for something trivial, A broken ankle or wrist that could be a taxi instead? How do you feel when someones own stupidity causes them to tie up an ambulance on a busy Friday/Saturday night?

Thank you for all you do as well.
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04-10-2019, 15:53   #9
Damien360
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Do the crews draw straws to avoid Halloween night and Paddy’s weekend. Both look to be an absolute drain on people’s patience in the HSE services and well-being of those working those nights.
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04-10-2019, 15:56   #10
I'm an intermediate care operative, AMA
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Quote:
Originally Posted by Wanderer2010 View Post
Do you have to be a certain type of person to be able to see so much death or near-death on a daily basis? Does any of it ever upset you? You mention that you do palliative care work too which must expose you to sensitive and upsetting family situations like tears, last conversations, old people who are suffering etc- how do you just switch off from that at the end of your shift?

And as a follow-up to that, what made you want to do this work in the first place? Thanks in advance!
Tough question.

I think you definitely have to have some kind of caring aspect about you. Initially most staff will find the end of life aspect of it sad or uncomfortable, this goes for any care job be it a nurse or care assistant, but you learn to deal with it professionally over time.

It's sad when you have to deal with end of life or difficult situations but I find it helps to know you do everything you can to make the person comfortable and support the family.
Most patients and family are very appreciative and very thankful. That in itself is rewarding.

I don't really take it home with me. Sometimes you think back about the really sad cases of course, but that's only human. It helps to talk with your colleagues about it.
There are supports available to us if we ever feel overwhelmed by the work.

To answer your second question: Simply put it's rewarding and interesting work. I wanted a job where I felt like I could make a difference and care for people. I was going to join the guards but I thought the ambulance service would be less hassle and more caring.



Quote:
Originally Posted by miamee View Post
Thanks for doing this AMA. I'm curious how your working day is set up. Are you based in a specific hospital taking their patients wherever they need to be or based in maybe just a specific area and you get a list of runs/pick ups at the start of a shift?

Do you do shift work or are you more of a day time worker?

How far in advance would you know how your day or week is going to look?
The ICS is a day time only service. Shift times widely vary depending on what station you work in but usually these are 8-10 hour shifts. Like 9-7 or 12-10.
There are intermediate care crews at both the university and general hospitals. They're based at the NAS hub stations. Near hospitals essentially. The more rural and small town stations don't tend to have ICV's.

Relief workers know their roster 1-2 weeks in advanced which can be difficult if you have a family and need to organise childcare. But once you get on a full timer line you'll know your roster for the year.

Last edited by I'm an intermediate care operative, AMA; 04-10-2019 at 16:13.
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04-10-2019, 15:59   #11
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Do you find the intermediate section easier then the normal call out type of work?

What's the worst case you had to deal with and how do you find de-stress afterwards as in what's the best you find to unwind after a difficult day.

When you were on the normal service were you ever attacked?

Did you get tired of seeing the same people day after day especially with drugs and that....

How many babies did you help bring into the world?

Is there a such position as an ambulance driver that isn't a paramedic?

I would love to be able to drive those around on the blues and twos....

What's the best day you've had?


Well done for all your service and thanks for coming on here.
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04-10-2019, 16:11   #12
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Quote:
Originally Posted by SirChenjin View Post
Thanks for doing this AMA.

What kind of training did you have to do for this role?
To join the intermediate care service you need to be a qualified Emergency Medical Technician. You can do the course privately which takes a few months at a cost, or like many of us we got our qualifications by working with voluntary services like the Red Cross or Civil Defense.

Once you have your EMT licence, and C1 lorry licence you can apply for the job.
If accepted you go to the national ambulance service college. You spend 3 weeks there doing some basic training and exams in the Ballinasloe college. Then do another 3 weeks advanced driving in the Tallaght college.
They're basically just making sure you're a competent EMT and showing you the ropes. A lot of what you learn won't be until you actually get on the road.

Quote:
As a previous poster mentioned, it must be difficult dealing with some situations. Is there good support for you, some kind of debriefing to help when you have had to deal with a particularly distressing situation?

There's a whats know as "Critical Incident Management System". This is basically nominated peer support workers you can go to if you're having a hard time after a call. If needs be you can go to the occupational health department, and get further help organised. But thankfully I've never had to avail of it.
For most of us, I think the best support after a bad call is to just have a talk with your colleagues. Get a good 3-4 of ye together, have a chat and a laugh or a sigh. It's like an informal debriefing.

Unlike the emergency ambulance service with paramedics, the real traumatic calls aren't as common and the type of work is slightly different in the ICS. But they do happen from time to time.

I remember after one particularly bad emergency, our station ORM (manager) stood the crews down, got a few plates of sandwiches from the hospital catering. And we all went back to the station, and had a big debrief in the kitchen while having a tea and food.

Last edited by I'm an intermediate care operative, AMA; 04-10-2019 at 18:40.
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04-10-2019, 16:26   #13
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Quote:
Originally Posted by hynesie08 View Post
Do you feel its a waste of resources when you get called out for something trivial, A broken ankle or wrist that could be a taxi instead? How do you feel when someones own stupidity causes them to tie up an ambulance on a busy Friday/Saturday night?

Thank you for all you do as well.
Well in the ICS our work is more pre-booked transfers than emergencies. But we do respond to 999's or do emergency transfers also but most of it you're looking after stable non urgent patients.
Some staff do get very bothered by the seemingly trivial calls. That includes transfers.

Some days can be very routine and you're simply providing transport from A to B with no interventions required. You can spend the day hopping from nursing home to nursing home, or either bringing people to specialist appointments. Has to be done too.
We're there to free up the frontline paramedics so they're able to respond to 999 calls.



The next person asks something similar to your second question.


Quote:
Originally Posted by Damien360 View Post
Do the crews draw straws to avoid Halloween night and Paddy’s weekend. Both look to be an absolute drain on people’s patience in the HSE services and well-being of those working those nights.
The likes of Halloween and St Patricks day don't bother us too much. We're tipping away between hospitals and aren't too effected by the hassle. Not to say it won't happen, but we're safer than the emergency ambulances. It's when they start to get strained that we'll be used.
Some things can feel like a total waste of time but we still have to motor on and treat the person and bring them to hospital. When that radio rings you never know what's going to come through just don't get too complacent.
I have dealt with plenty of hassle but it's usually far and few between thank god.

The thing that drives most staff up the wall is calls where the person or family is fit, mobile, and theres 2 cars in the drive.
The job is what you make of it. I don't see the point in getting mad about these things. You can't blame a lot of the general public, a lot of them ring their GP or the ambulance unsure and in need of advice. They'll be sent an ambulance no matter how minor so most are quite happy to wait when the voice on the phone tells them to.
There are cases of people taking the total mick however. Doesn't happen too much.

Last edited by I'm an intermediate care operative, AMA; 04-10-2019 at 16:31.
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04-10-2019, 18:28   #14
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Quote:
Originally Posted by punisher5112 View Post
Do you find the intermediate section easier then the normal call out type of work?

What's the worst case you had to deal with and how do you find de-stress afterwards as in what's the best you find to unwind after a difficult day.

When you were on the normal service were you ever attacked?

Did you get tired of seeing the same people day after day especially with drugs and that....

How many babies did you help bring into the world?

Is there a such position as an ambulance driver that isn't a paramedic?

I would love to be able to drive those around on the blues and twos....

What's the best day you've had?


Well done for all your service and thanks for coming on here.

1.For the most part, the intermediate work is far more relaxed than the emergency ambulances. There are so many paramedics that would love to drop back for a change of pace and less hassle.

But the ICV service has its cons too. You spend less time in the station, and more time on the road.

2. I'd rather not go into explicit details about the bad things, due to patient privacy, and it's just not something that we in the service like to talk openly about as such.
From the ICV perspective the thing that upsets me most is sick kids. I've had a lot of very unwell children over the years, cancer, accidents, mistreatment. It breaks my heart.


3. I've had a couple of scuffles with agitated, or aggressive patients. I've never been seriously assaulted but some patients can be very difficult. Often it's not their fault either if they are post-ictal, or have serious mental health problems or have vascular dementia.

4. You'll see a lot of the same faces. There are a very select few that take the mick and yeah it's a bit tiring but as long as they don't give me any grief I don't mind. I just get on with it. Drug addicts aren't the worst in my books, I have a lot of sympathy for them. A lot of my colleagues are fed up with them though. The public perception of drug addicts/alcoholism can be similar.

5. No babies delivered and I hope it stays that way!

What we do get a lot of is post-partum hemmorhage mothers that need to be transferred to a university hospital. We also get a lot of babies and neonates 1-4 weeks old. Incubator transports or retrievals. Believe it or not the babies are usually the quietest patients we have. I think the movement of the vehicle keeps them asleep.
But to be fair it's largely down to the wonderful nurses and doctors in Special Care Baby Units that have them so well prepped and comfortable for a journey.

6. Well ICO's are mostly EMT's. There's no Ambulance Driver role as such anymore. There's a few minibus drivers still working with NAS. The EMT's that drive the Neonatal Intensive Care and Critical Care ambulances are solely in a driving roll, but they're still trained EMT's at the end of the day.

7. Driving on blues is always a bit of fun, but it takes a lot of concentration and energy. It's also risky and you need to be very clued in and use your training. Still we try avoid it unless absolutely necessary.

8. My best day... hmm I'll have to think about that one and come back to you.
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04-10-2019, 18:39   #15
punisher5112
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Very informative and much appreciated...

I understand on patients confidentiality and all that so fully get that and respect that.

What's the best ambulance to drive in your opinion?
Ford or Mercedes-Benz.

How hard did you find the training?

I'd like to know why better working shifts can't be in place as I'll be blunt you see many overweight and this is a lot down to the shifts and unpredictability of the shift pattern...

I've suffered terrible from this in shift work I do myself so fully understand how difficult it is....

Do you see yourself sticking it out or would you like to move on from the driving part.
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