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.

Waikato News - - FRONT PAGE -

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.”

Photo / Laurilee McMichael

Keith Fis­cher says the va­ri­ety is part of what’s made his am­bu­lance ca­reer so won­der­ful. “You lit­er­ally come to work, and you’ve got no clue what you’re go­ing to do.”

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