A day in the life of a Welsh Ambulance Service paramedic

It seems that most emergency service workers have experienced some form of abuse while working, and for advanced paramedic practitioner (APP), Ema Geddes, it is no different. 

Mum of two, Ema has been with WAST for 16 years but a paramedic for 12. Having started in the Welsh Ambulance Service control room, she was inspired to take up a career on the front line. 

Now, she plays an important role in trying to reduce ambulance waits, and is tasked with responding to 999 calls on her own. 

The role of an APP, is to visit patients in the community with the aim of treating them in their own homes and avoiding trips to hospitals or long waits in ambulances outside of A+E. 

While there are occasions when ambulances are needed, during a day spent alongside Ema, she prevented ambulance callouts to three patients. 

The Welsh Ambulance Service rank their calls in categories of red, amber and green. 

Red calls are immediately life-threatening. Amber calls are serious but not immediately life-threatening but the service also blue light to amber calls.

The first call Ema received during her 12-hour shift was an amber one case of a middle-aged man with a severe cough. 

While on the way to the patient, a red call came through and the atmosphere inside the car switched. 

The blue lights came on as we raced to the scene of a child who had difficulty breathing. 

We were set to be first to the house, with an ambulance crew on their way as well. 

"Immediately, I'm thinking this is Strep A," Ema said.  "With the information, we've received, that is my trail of thought heading to the location."

Upon arrival at the house of the patient, Ema conducts relevant checks before standing the ambulance crew down and completing an assessment and prescription for the patient.

APP's can administer drugs to patients in the community to prevent hospital visits. (Image: Newsquest)

Instantly, that assessment prevents the ambulance crew from attending unnecessarily and stops another crew from waiting outside of the hospital when it doesn't need to be. 

After Ema responded to an amber call regarding a pensioner who had fallen, she felt that while it wasn't urgent for the patient to be seen at the hospital, it was necessary. 

After contacting the control room at around 4.30pm, she was told that with demand being very high, it was likely that an ambulance wouldn't be sent to pick up the patient until the day after. 

Something that doesn't quite sit right with Ema. 

She said: "It's tough when you can identify someone who needs to be in hospital and needs medical care but you can't get them there. 

"The capacity isn't there." 

Those long waits, which are out of the hands of paramedics, can often result in patients being hostile to ambulance staff upon arrival at a home address. 

Figures published by the Welsh Ambulance Service earlier this month showed the severity of assaults on emergency workers.

Assaults across Wales ranged from slapping, scratching, spitting and verbal abuse to punching, biting, kicking and head-butting. 

Something that Ema is familiar with. 

"I've been spat at and shouted at, but I'm just trying to help people," she said. "People don't realise that part of it. We're just trying to do our job, abuse shouldn't be a part of that."

Ema also revealed that there is a lot of support available from WAST following incidents like that while working. 

Despite those incidents, Ema is still extremely passionate about her job. 

She said: "I love my job and it's not very often people can say that after 16 years. 

"I love the variety of it, you meet so many different people. 

"I think you do have to be quite strong mentally to do the job, as there is lots to do when it comes to dealing with people.

"But it's just one patient at a time. If I can look after the patient, then that's my job done."

The coronavirus pandemic was an uncertain time for most, none more so than emergency workers on the front line.

The APP car (Image: Newsquest)

Ema discussed the eye-opening realities of working in the health sector during covid.

She said: “It was so hard working through covid. You watch the Prime Minister make that announcement, then we’re all back to work as normal.

“I was really worried that I would catch something and pass it on to my family and they could potentially die from it.

“All we got was PPE, which was a huge challenge.

“We had to wear masks, gloves and aprons in the heat of the summer, you couldn’t talk, you couldn’t write properly, and it led to occasions where you were close to fainting in a patients front room.”

The main difference between an APP and a paramedic crew in an ambulance is that APP’s work alone.

This means that when a red call comes through, it can be quite the challenge to switch into gear, she said: “Switching from getting to the location as soon as possible into being calm and able to communicate and assess is very tough mentally, especially being on my own.

“Generally, ambulance crews will have one driving and one preparing for the patient at the scene, I don’t have that.”

There is a form of a rush that comes through when a red call is tasked, a sense of adrenaline about what you’re potentially heading towards.

While on the day of the rideout there was no high-level red calls, Ema revealed there have been incidents that have stuck with her throughout her career.

“You certainly don’t lose the adrenaline on the way to the location, but you have an understanding of how to manage it,” she said.

“There are incidents that stick with you and there are processes in place with the trust to ensure staff deal with them and are okay.

“But you do have to be able to box incidents off and to be able to switch on to the next job.”

With the current pressures faced by the ambulance service, there is always a new job waiting.