Paramedic marks 40 years
This month, St John Taupo¯ intensive care paramedic Keith Fischer marks 40 years since he joined the ambulance service. He talked to LAURILEE McMICHAEL about making a difference in people’s lives.
The perception of an ambulance officer’s job is that the worst thing is dealing with lots of blood.
But the most difficult situations Keith Fischer’s had to deal with in 38 years with the ambulance service haven’t involved any blood.
It’s treating patients at an accident scene who are frantically asking after their parent, husband, wife or child, when you know their loved one is dead. It’s heartbreaking.
“Having to tell someone that a loved one or friend has died, is one of the most confronting things we have to do,” says Keith. “But with compassion and empathy, we have courageous conversations with people.”
That is a downside of a job that swings wildly between highs and lows, tedium (station duties, restocking and cleaning equipment, studying, waiting for the next callout) and frantic activity at emergency scenes or responding by road and helicopter.
Keith says the best thing about his job is that ambulance officers make a difference, whether it is making someone with a broken leg comfortable enough to be moved or helping somebody who’s had a medical event. It’s not just about saving lives.
“We make a difference just by turning up and being nice to people, a person who’s fallen at home and can’t get up. After you have checked them over and bandaged any wounds, helped them up, little things like cleaning up their cup of tea that they spilt when they fell over, cleaning up the blood on the floor and the carpet are where you make a difference.”
The downside — “You are exposed in some part to the very worst things that can happen to people.”
Dealing with people in pain, and grief and sense of loss at a fatal incident affects everybody involved and it is part of caring.
“Normal people exposed to very abnormal events are affected by association, and events coming back to mind at the wrong time. This is post-traumatic stress disorder, the reaction of normal people to a very abnormal event. Over time the flashbacks diminish but if not, or it’s affecting your life we have peer assistance programmes, counselling etc — there is support. Making a difference in people’s lives outweighs the bad by 95 per cent. That’s what makes it a good job.”
It’s making a difference that has kept the Taupo¯ St John Ambulance intensive care paramedic involved, and this month marks a special anniversary for Keith — 40 years since he joined the ambulance service. With a two-year break in the early 80s, he has notched up 38 years on ambulances and seen massive changes in the way the service operates.
In 1978 the 21 year old had just qualified as a motor mechanic when he started a new job as an ambulance officer.
He moved away from machines towards a people-orientated occupation and he applied after seeing an advertisement in the local newspaper.
When Keith joined the ambulance service in Invercargill it was run by the local hospital board which had ambulances crewed by two trained officers. Initially training was on the job, accompanying other ambulance officers.
It was also that year that the New Zealand Ambulance Transport Advisory Board, with funding from New Zealand’s first Telethon, set up the National Ambulance Officers Training School.
Keith’s on-the job experience was followed by six weeks study at the National Ambulance Officers Training School in Auckland, followed by a week of in-hospital experience. He then became the senior officer on an ambulance, with a newcomer of his own to train.
Nowadays, regional control centres answer 111 ambulance calls, then ambulances are dispatched from stations with 24-hour shift cover but back then officers worked from 8am to 5pm and took the ambulance home. After hours 111 calls went to the hospital switchboard which would transfer the call through to the home phone of the ambulance officer on duty.
“You’d answer the phone at 1, 2 or 3am and you’d get an announcement from the operator saying, ‘it’s a 111 call, go ahead caller’ and then you get someone screaming at you on the phone. It could be a car crash way out in the boondocks of Southland or ‘my baby’s not breathing or has died’, and you’d have to get dressed, get in your ambulance and respond.”
Keith returned to the National Ambulance Officers Training School again, attaining the intermediate care ambulance officer qualification (now paramedic) in 1983 then left the ambulance service to work as a medic on an oil rig. He worked as a tutor on a young people’s work skills scheme and then as an engineering sales rep before being appointed to an ambulance officer’s job in 1985 in the Waikato.
Keith gained his intensive care paramedic qualification in 1988 while working in Hamilton and has been based at the St John Taupo¯ station from 2001, with a two-year stint in West Auckland in 2010.
Paramedicine is a career that’s constantly evolving. The minimum qualification is now a bachelor’s degree in health science (paramedicine) and a postgraduate qualification to be an intensive care paramedic.
“We’re talking about a career where you start off doing ABCs, oxygen, splinting — basic but important stuff. It’s evolved now to doing quite a bit that’s generally the domain of doctors. We are required to undergo continuous clinical education twice-yearly.
“The surgical interventions and most drugs we use as ambulance officers primarily maintain airway and breathing and circulation of blood in a patient, the aim being to get them quickly to hospital for definitive care.”
For an intensive care paramedic, the next step is rapid sequence intubation training, which qualifies a paramedic to administer drugs to, anaesthetise and intubate (place a breathing tube in the trachea). The training is a post graduate university paper and a pass of at least B+ is required.
But Keith has taken a different step, enrolling to study theology through his church, St Andrews in Taupo¯ .
“A question we often ask ourselves is, ‘where God is in this?’ Tragedy, incidents, big small or major disasters. I believe God is in the people that come to help, first responders ambulance fire and police, first aiders. Doctors, nurses, radiographers, social workers, chaplains and other hospital staff. God uses all, Christian, Jew, Muslim, any faith or no faith at all, to bring love and care into that situation.”
Keith has no regrets about that decision to swap a mechanic’s toolbox for a paramedic’s kit.
“It’s been a wonderful career. You literally come to work, and you’ve got no clue what you’re going to do. You could be tidying up someone’s poor old nana who’s fallen over, or in a wrecked car down a bank. There’s no two days the same.”