RESPONSE - Community paramedicine in Wiluna - VOL 49 - The Australasian College of Paramedicine
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VOL 49 SUMMER 2022 RESPONSE Community paramedicine in Wiluna 06 10 12 14 Community Expanding The CCP/ECP Private sector paramedicine in paramedics’ mixed model paramedicine Wiluna horizons
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Contents 09 We chat with Queensland Ambulance Service Paramedic Isabella Carbone, who the College facilitated to assist St John PNG’s COVID-19 response during a surge in cases last year Up front 14 Opportunities, challenges and News & Reviews professional development in 03 Message from the Chair private sector paramedicine 25 Aphra update 05 From the CEO The College 25 Te Kaumihera Manapou Paramedic Council update Features 16 ACPIC 2021 highlights 26 How to create a self-care plan 06 Ngangganawili Aboriginal 21 College consultations and 27 National COVID-19 Clinical Health Service at the forefront submissions Evidence Taskforce updates of community paramedicine in Australia 22 C hief Paramedic Officers a Research necessity in holistically meeting 09 Queensland paramedic joins PNG’s pandemic efforts community healthcare needs 29 Talking Research: Meet the 23 C ollege awards for paramedic College Research Committee 10 Expanding paramedics’ student excellence at Flinders horizons University 12 The CCP/ECP mixed model Paramedicine Australasian College of ® BOARD OF DIRECTORS NATIONAL OFFICE ADVERTISING ENQUIRIES consequences arising from the use The Australasian College of Jonathon Tremain of information contained in this Paramedicine acknowledge Aboriginal Chair – Ryan Lovett PO Box 3229 Umina Beach NSW 2257 jonathon@tremedia.com.au publication; the views and opinions and Torres Strait Islander peoples as Vice-Chair – Marty Nichols 1300 730 450 expressed do not necessarily reflect the traditional custodians of the land Michael Smith info@paramedics.org RESPONSE is published quarterly those of the College and its Editor, and sea in which we live and work, we Simone Haigh ASM https://paramedics.org/ by the Australasian College of neither does the publication of recognise their continuing connection Dr Bill Lord ACN 636 832 061 Paramedicine. Editorial and advertisements constitute any to land, sea and culture and pay our Dr Bronwyn Tunnage ISSN 1836-2907 photographic contributions are endorsement by the College and its respects to Elders past, present Astrid Kuisavaari welcome and can be submitted to Editor of the products advertised. and future. Clive Addison MEMBER ENQUIRIES EditorResponse@paramedics.org All members@paramedics.org material accepted for publication is The College acknowledge Māori Gabrielle Follett AM COVER subject to editing. as tangata whenua and Treaty of EDITORIAL ENQUIRIES CHIEF EXECUTIVE OFFICER Ngangganawili Aboriginal Health Waitangi partners in Aotearoa Lauren Daws ©2021. The Australasian College of Service New Zealand. John Bruning lauren.daws@paramedics.org Paramedicine. All rights are reserved. john.bruning@paramedics.org The College and its Editor cannot be held responsible for errors or any RESPONSE VOL 49 SUMMER 2022 | 1
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MESSAGE FROM THE CHAIR As paramedicine evolves, so too must our definition of the profession with Ryan Lovett Developed by Liam Langford MACPara (@liamlangford), used with permission Welcome to our Summer edition of We recognise the work Response. The past decade has been of the team at Monash a period of rapid evolution for the University and their paramedicine profession, with para- drafting of a wide-rang- medics increasingly taking on a range ing definition of the pro- of duties across multiple settings in fession as a reflection of primary, community and extended the many dimensions healthcare beyond the provision of of paramedicine prac- traditional ambulance-based services. tice around the world: “Paramedicine is a Despite the continued growth of the domain of practice and profession, paramedic practice and health profession that its place within the health system was We see this shift happening today. specialises across a range of settings long defined in terms of pre-hospital In rural and remote areas, doctor including, but not limited to, emer- care. As the profession expanded to shortages and the limited availability gency and primary care. Paramedics include such dimensions as extended of community nursing staff means pa- work in a variety of clinical settings care, aeromedical, specialised op- tients are increasingly being managed such as emergency medical services, erations and referral pathways, that by paramedics, who are attending to a ambulance services, hospitals and evolved into the more encompassing variety of patient presentations, from clinics, as well as non-clinical roles definition of out-of-hospital care. critical, traumatic injury to chronic, such as education, leadership, public However, with professional maturity complex medical syndromes in aged health and research. Paramedics pos- and continued evolution into areas care facilities, mental health illness, sess complex knowledge and skills, a of practice beyond traditional modes substance use disorders, and pallia- broad scope of practice and are an es- of jurisdictional ambulance services, tive and end-of-life care. They are also sential part of the healthcare system. framing the profession as it relates to a increasingly using their experience in Depending on location, paramedics hospital is acutely limiting our ability the provision of low-acuity healthcare may practice under medical direction to reflect the full breadth of paramedic in GP and health clinics, hospitals, or independently, often in unsched- practice. urgent care centres, aged care, and uled, unpredictable or dynamic set- other key primary health care settings, While for the vast majority of para- tings.” reducing costs to the health system medics, time is spent with patients The ongoing challenge of any defi- associated with ED presentations, in the context of ambulance services, nition is to make sure it accurately improving the management of chronic and a number of those patients do ulti- reflects who we are and what we can health conditions, and reducing early mately end up receiving ongoing care and will do. It is also essential that in entry into aged care. in hospital, the continued contextual- attempting to define us and be as in- isation of paramedics in relation to a As paramedicine continues to advance clusive as possible, that we don’t unin- hospital is becoming less appropriate as a profession, we need to ensure tentionally limit ourselves in the way with every passing day. As the profes- that our definition of the profession pre-hospital and out-of-hospital does sion continues to evolve, so too must encapsulates the depth of paramed- today. Definitions can also serve to be our definition of paramedicine to fully ics’ professional experience and skills aspirational, providing the prompt to encompass the totality of current and now and into the future. We welcome ourselves, our peers, our partners and future paramedic practice, and to en- further discussion on this issue, and our regulators to provide the opportu- sure that paramedics are accepted as always seek your opinion on how we nity to chart our own path. an integral and integrated component define our profession. of the health system. RESPONSE VOL 49 SUMMER 2022 | 3
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FROM THE CEO FROM THE CEO Leadership objectives for 2022 with John Bruning In November’s Response I focused on may ultimately end up being in the Workforce survey and the College’s efforts in advocating for allied health group, there is an oppor- career pathway our members and the profession. This tunity now to advocate for paramedi- The data on paramedicine is currently time I want to lay out what we have cine as a standalone health profession disjointed and unsuited to highlighting planned in 2022 in leading and advo- alongside medical and nursing. the important role paramedics play in cating for paramedicine. the health system. It is vital that the “ Chief Paramedic Officers College addresses this. An important focus Last year we produced our first major this year will be to clearly We will be undertaking a significant position statement as a College on workforce survey this year covering Chief Paramedic Officers (CPOs) and establish where paramed- all facets of paramedicine, all work have engaged with all jurisdictions ics fit within the health and employment areas (jurisdictional about the introduction of this role (ex- services, private, industrial, maritime, cept Victoria where one is already in system and highlight mining, events, etc.), academia, man- place). We will continue our efforts in the broader ways that agement, students, graduates, and vol- this area and advocate for strong para- unteers. Our goal is to create a complete paramedics can mean- ” medic representation. Our advocacy picture of paramedicine and provide for a CPO in Aotearoa New Zealand will ingfully contribute usable and publishable data to show start with a similar position statement, what is happening with paramedics to be released soon. and students and the work you do. Community Paramedicine The role of paramedics This data will help the College create a A key focus for us is expanding the in the health system Paramedicine Career Framework that roles and opportunities for paramed- will define pathways and opportunities Throughout 2021, as we engaged with ics outside of emergency response, for paramedics and students across all stakeholders, it became evident that mainly in primary care as community areas of paramedicine in 2023. there was no clear understanding of the paramedics. While advocating for this role paramedics can play in the wider expansion, we remain focused on the Student paramedics health system. Generally, paramedics fact that you trained to be and wanted The learning environment has been aren’t considered beyond emergency to be paramedics, so any such expan- particularly difficult for our student response, so an important focus this sion needs to retain the core aspects of paramedics in the past two years. year will be to clearly establish where paramedicine. Before COVID, there was significant paramedics fit within the health system Regarding paramedic practitioners, competition for employment with more and highlight the broader ways that while the College recognises that there graduates than available roles, chal- paramedics can meaningfully contrib- is a future opportunity for independent lenges with effective placements, and ute to the health system. paramedic practice (potentially with varied internships and development There is also debate about whether prescribing rights), there is consid- provided by employers. While some paramedicine should be in allied erable work to be done before this changes may flow from the pandemic health or a standalone health profes- becomes a government consideration. experience in these areas, we will be sion. There are some immediate ben- The College will continue to execute focused on advocating for how the pro- efits to being in allied health, but also a strategy that ensures the greatest fession sets up graduates for success. longer-term issues with paramedicine possible recognition for paramedics Stay safe and well. being appropriately recognised if we across emergency, community and are considered allied health. While we primary care. RESPONSE VOL 49 SUMMER 2022 | 5
FEATURE Ngangganawili Aboriginal NAHS is the only Health Service at the Aboriginal Medical Service in Australia forefront of community to utilise community paramedicine in Australia paramedics Wiluna Shire, Martu Country staff and on-call nurses. However, ral stations, many mine sites and two they were only able to the provide major transit and tourist routes, this In the vast desert country of central the level of care stipulated under the proved to be inadequate. Western Australia, the Ngangganaw- St John volunteer system, such as ili Aboriginal Health Service (NAHS) In response to the challenges, the the issuing of over-the-counter med- in Wiluna Shire is pioneering an NAHS adopted a community para- ications and no invasive procedures. innovative model of community medic model, encompassing emer- paramedicine that capitalises on the gency response, primary healthcare “ unique skill set of paramedics to pro- and preventive healthcare. It is the vide a more holistic and integrated The role of community only Aboriginal Medical Service in approach to remote healthcare. paramedicine is well Australia utilising community para- medics. NAHS Community Paramedic Gary established overseas and Pyle said the NAHS was contracted “The community paramedics are is one that is in great need ” by the WA Department of Health to primarily employed for emergency re- provide comprehensive accident and here in Australia. sponse,” Gary said. “However, emer- emergency services. Initially, the gency response is only a small part ambulance response fell under the St of what we do. Most of our workload John volunteer system and was pre- Given the shire’s large geographical is general clinic-based, general GP- dominantly undertaken by support area, encompassing multiple pasto- style presentations, similar to how a 6 | RESPONSE VOL 49 SUMMER 2022
military or mine site medic operates, only in a town. We also find ourselves working as an extension of the clinic staff, going out to the community and surrounding areas and providing in- home treatment, ranging from simple dressings to IV AB’s.” The benefits of this model include better community integration and continuity of care. “As we are out in the community a lot, we found that we have built a good rapport and the divide/ barrier between clinic and community is lessened. This helps a lot with health promotion, as evidenced by our higher-than-average covid vaccine numbers (more than 80% double vaccinated). When education is con- veyed via an informal chat, people are more open and receptive.” In terms of continuity of care: “Gener- stipulated by St John. Imagine if these ally, once we collect a patient, we will roles were supplemented with an then transfer them to the clinic and extended care paramedic; that high assume the role of primary treatment level of initial paramedic response provider. These treatments are gener- would be enabled on scene then con- ally at a level higher than most nurs- tinued through into the clinic.” es’ training but lower than the doctor, He said the first step would be the rec- so there is no stepping on toes.” ognition of paramedic practitioners Procedures include advanced wound as a field of specialisation, in the closing and suturing, X-rays and cast- same manner as nurse practitioners, ing, pathology collection, processing, one that is registered and regulated as its own specialty. “As many on-road paramedics will and interpretation. attest, so many calls could be easily “There is a reason the paramedic pro- treated in home and not transported, fession is the specialty field that it is.” if allowed the scope, tools and time. I “ personally believe it is inevitable that Gary said the community paramed- icine model could be replicated in There is a reason the this role will be formalised here in paramedic profession Australia soon. If so, this could pro- other parts of Australia, particularly vide an avenue for those paramedics in rural and remote areas of the is the specialty field wanting a change of pace but not ” country, providing opportunities for the expansion of roles for paramedics that it is. wanting to leave the profession.” within the health system. For students/graduates and working paramedics wanting to embark on He said that like Wiluna, many small “We already have the qualification such a career pathway, he recom- towns had small clinics or Silver and training framework available at mended exploring extended care Chain nursing posts, and experi- many universities. Once recognized, paramedicine studies available at enced the same health service chal- the role would then be able to be many universities. lenges. In the event of an emergency, a nurse from those clinics responded put forward to some of these clinics “Regardless of your current area of with volunteers to assist. The major as it is easily comparable and inter- work, you will still learn advanced as- issue, however, was the authority to changeable.” sessment tools and gain a better un- practice. He said the role of community para- derstanding of many chronic health medicine was well established over- issues and treatment pathways.” “The nurse is not cleared outside their clinic, and they are only permitted to seas and was one that was in great work to the level of the volunteer as need Australia. RESPONSE VOL 49 SUMMER 2022 | 7
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Queensland UP CLOSE paramedic joins PNG’s pandemic efforts Heeding the call for support, Isabella Carbone headed to PNG to assist St John’s COVID-19 response during a surge in cases Queensland Ambulance Service Ad- ing from backing up crews on cases, She said St John was extremely sup- vanced Care 2 Paramedic Isabella Car- aeromedical evacuations of patients portive in helping overcome those bone, who is based at Durack station in different provinces, and providing challenges. in south Brisbane, spent six weeks on education for ambulance officers on “The local ambulance officers were the frontlines of Papua New Guinea’s COVID-19, particularly in relation to very welcoming and receptive to ed- emergency medical response in mid- PPE. ucation. They really taught me about 2021 as the country grappled with a “During the period between waves, I their culture and language. Jacquie rapid surge in COVID-19. was also helping St John to complete Hennessy, the Chief of Clinical Opera- Seeking a challenge, she had re- vital projects that they had to put tions, was also available by phone or sponded to the College’s expression on the backburner during the large in person 24 hours a day if I needed of interest in facilitating paramedics COVID outbreaks.” advice about a case.” to assist St John Ambulance PNG in She said the biggest challenge was After her six-week stint, Isabella con- the provision of medical support as learning about the infrastructure and tinued to work remotely for St John rising case numbers placed growing capability of the health system in PNG while in hotel quarantine. She pressure on the medical system and PNG and how it differed from that in said her time in the country was one strained health staff and infrastruc- Australia. of her best work experiences. ture across the country. “It was fantastic being able to work “ “I jumped at the chance to travel to I jumped at the chance with not only other health profession- another country and work during the als from around Australia, but also to pandemic,” she said. “I didn’t really to travel to another work directly with the local ambu- have any expectations when I went over as everything associated with country and work during lance officers. The local community ” were very friendly and welcoming; COVID had been moving so quickly; it the pandemic. it made being away from home a lot was difficult to tell what it was going easier.” to be like when I landed.” She encouraged other paramedics to When she arrived in Port Moresby on “Their common cases were also very undertake emergency response work June 1, she found St John had set up a different to the frequent cases we in other jurisdictions. large field hospital next to its station would get at home. Traumas like as- to support hospitals in the area. It “Not only was the work interesting, saults with weapons and extremely was about to be dismantled, but as challenging and fulfilling, but learn- serious motor vehicle accidents were case numbers increased, they began ing about another culture, meeting common, as was obstetrics, so that providing COVID tests and reutilising new people, and exploring another was a challenge for me professional- the facility. country on days off was a privilege as ly, as we don’t have much exposure to well.” The work she undertook varied, rang- that work in Queensland.” RESPONSE VOL 49 SUMMER 2022 | 9
FEATURE Expanding paramedics’ horizons Paramedic David McLeod is advocating for greater scope for the paramedicine profession Sydney, Gadigal Country As an advocate for the expansion of roles for paramedics beyond tradi- tional ambulance-based duties in Australia, Paramedic David McLeod, Clinical Governance and Medical Response Manager with Crown Resort Sydney, is keen to see the development of more specialisation pathways to enable the profession to better respond to health system needs, gaps, and priorities. David said paramedics had the capa- bility to reduce pressure on both the health system and on other health- care professionals by utilising their extensive out-of-hospital experience in reducing patients’ reliance on the hospital system, and by becoming part of multidisciplinary medical teams that would improve patient health outcomes. “ It’s amazing the misunderstanding that still exists throughout the healthcare industry works (PHNs) in reviewing current undertake clinical assessments and on what paramedics are after-hour services and examining provide emergency and non-emer- ” capable of doing. new models of care. Initially, the gency treatment. majority of the work was focused on “It’s amazing the misunderstanding In the past 12 months, he has been educating healthcare managers and that still exists throughout the health- involved with Primary Health Net- senior clinicians about the ability of care industry on what paramedics are paramedics to safely and effectively 10 | RESPONSE VOL 49 SUMMER 2022
FEATURE capable of doing, as well as the edu- “Even post-registration, there is still assessment and commencing refer- cation and training the paramedics an internal struggle about the defini- rals isn’t new to our profession. undertake compared to 20 years ago,” tion of paramedics and still the belief “Let’s take this a step further; while he said. that paramedics ‘scoop and run’ to paramedics are doing those tasks, hospital. Some of our own clinicians “Once these misunderstandings were they’re uploading this information to still believe that all patients are better dismissed, healthcare managers and the medical centres’ patient records cared for in hospitals and that para- clinicians rapidly opened up to look- and requesting pathology (even radi- medics are only capable of ‘using ing at where paramedics can fit in ography if needed), all in the comfort diesel’ when providing care. How do to assist with after-hours services in of the patient’s home. The next day, we expect other healthcare profes- metropolitan, regional and rural ar- their regular GP is notified that there sions or policymakers to understand eas. It quickly became apparent that are notes and results to be reviewed. that paramedics are capable of work- due to the unique training, education ing outside of traditional roles if we “GPs review those results in conjunc- and experience of paramedics, they continue to struggle with the idea tion with the paramedics’ clinical, had the potential to offer improved ourselves?” ADL and environment assessment patient assessment, treatment and are able to tweak the patient’s and referrals within the after-hours He said support was also needed from treatment plan or medications. What setting.” academia to undertake research and impact could this have on the patient? studies on the ways in which para- He said these sectors were entering a It could improve quality of life, reduce medics can reduce pressure on the modernisation phase in the way they potential hospital admissions, reduce healthcare system, and in ensuring provided contemporary healthcare, pressure on emergency services, and that paramedics have the necessary with growing recognition that para- assist in ensuring that the correct skills and capabilities to safely and medics were well-placed clinicians multidisciplinary care is being pro- effectively treat patients in primary able to provide primary healthcare vided to the patient. This is just one heath and community settings. Doc- services to the aged care and dis- idea of how one model of community/ tors and nurses could also assist in ability sectors, brought unique clin- primary health paramedicine can advocating in both the public and ical experience to multidisciplinary have a positive impact on the wider private sectors. healthcare teams, and could assist healthcare system, and most impor- in providing advanced autonomous “Having the support of associations tantly on patient outcomes.” clinical care in patients’ homes, par- like the Royal Australian College Paramedicine education was also ticularly after hours. of General Practitioners will have a evolving to encompass more profes- sional specialisation pathways, with “ a number of universities shifting from There is still an internal struggle about the an emergency clinician focus towards definition of paramedics. ” the development of all-round under- graduate clinicians, and postgradu- ate courses similarly were starting to His advocacy work and discussions offer Extended Care and Community massive impact on future policy and with PHNs have resulted in para- Paramedicine courses as they adapt- legislative changes that could impact medics being included in modellings ed to the changing needs of patients. primary health paramedics.” of remote and rural primary health “Continuing to make changes in not services outside of the traditional With that support, he said those dif- only the course context but also in jurisdictional ambulance service set- ferent models of care could easily be assessment scenarios will help de- ting, and has begun to challenge the replicated throughout metropolitan, velop well-rounded clinicians and thinking of policymakers. regional and rural Australia with help with the internal sigma of para- minimal modifications to meet juris- However, he said that before ap- medics only being skilled to work for dictional needs. proaching government and pushing statutory services.” for professional practice changes, “Imagine paramedics being embed- there was a need for internal advo- ded into medical centres and under- cacy and re-education within the taking home visits. The experience paramedicine profession on the roles that paramedics have in assessing paramedics could play within the patients in their homes and initiating community. treatment while undertaking an ADL RESPONSE VOL 49 SUMMER 2022 | 11
FEATURE The CCP/ECP mixed model Aotearoa New Zealand “I struck up a conversation with him about having a Critical Care/Extend- Advanced Health Care A fortuitous meeting in the middle of ed Care Paramedic mixed model the night during Aotearoa New Zea- Practitioner Jack Faxon land's first lockdown in 2019 lay the staff member in his clinic as part of a multidisciplinary team. He loved the Jr pushes for a new groundwork for the development of a new direction in paramedicine in the idea, and it grew from there.” direction for the para- country. Jack submitted a proposal, and he, Dr Patel, City Medical General Manager medicine profession in Jack Faxon Jr, then a St John Inten- Leanne Mandeno and Clinical Nurse sive Care Paramedic, was waiting in Aotearoa New Zealand the carpark at Hawke’s Bay Hospital Manager Rowan Plater then worked to make the concept a reality, con- about 1:45am while his partner sulting with their Board of Directors, finished paperwork when hospital other clinic staff and doctors across consultant Dr Umang Patel, an Aotearoa New Zealand, and research- emergency physician and Medical ing other countries' programs. A year- Director at urgent care centre City and-a-half later, he began work at Medical, came outside to say hello. City Medical as an Advanced Health Care Practitioner. 12 | RESPONSE VOL 49 SUMMER 2022
“My current role is that of a Critical now well accepted in his role and is Care and Extended Care Paramedic. treated equally as a colleague. We decided on the term Advanced Jack is eager to see the Advanced Health Care Practitioner with the Health Care Practitioner model rolled hopes that this will become the stan- out across the country to benefit the dard for the paramedic practitioner in national health system. He said a pa- the country. per was recently submitted to Interim “Although there have been a few reg- Health New Zealand that focused on istered nurses who have cross-trained the incorporation of paramedicine as paramedics/ICPs and the odd ECP, into all facets of healthcare, which to my knowledge this is the first clinic was met with positivity and was in in Aotearoa New Zealand to develop the process of being discussed. the CCP/ECP mixed model.” In the interim, opportunities for It was a concept that he became inter- paramedics to undertake different ested in exploring in his postgraduate roles in the paramedicine profession studies at Auckland University of in Aotearoa New Zealand remain lim- Technology while studying commu- unwell, I am to diagnose and treat ited. Some paramedics were working nity and remote paramedicine. them as I previously had in the ambu- in GP and urgent care clinics, some in lance service. I am also able to help palliative care, and some in emergen- “There was a group of us that all of the nurses and doctors if they need a cy departments, although most were a sudden had all of this knowledge hand with anything. not being used to their full potential. and ability, but due to practice lev- els changing, we weren’t allowed to “I still see the same patients as in an “ practice any of the treatments we had ambulance, just in a different setting. learned.” I have everything available to me I’m hoping this will in the clinic: Nurses, doctors, labs, create a set standard ” x-rays, additional medications, and a that we all work to. “ To my knowledge, pharmacy on site. A big difference is that I only work eight-hour shifts. Tra- this is the first clinic in ditional ambulance staff in Aotearoa Aotearoa New Zealand New Zealand work 12 hours. This has “With registration only being new been great for family life, and the fact here, I think there will be a national to develop the CCP/ ” I don’t work nights I think has added shift to fill gaps that paramedics are ECP mixed model. about another 15-20 years to my life.” qualified for but have never been considered for. With specialist reg- The shift to this mode of paramedic istration set to happen in the near practice has not been without its future, I’m hoping this will create a The chance meeting with Dr Patel challenges, including accepting a set standard that we all work to.” enabled his vision to take shape. In larger amount of risk when treating his position as Advanced Health Care and discharging patients, and discov- Jack has offered his assistance and Practitioner, he is responsible for ering areas in which his knowledge guidance for other paramedics, assessing and treating patients that is lacking due to a lack of exposure students and graduates with similar present to the clinic. to such things as interpreting lab aspirations. results and converting that informa- “Dr Patel and I decided that I would “Umang, Leanne and I have agreed tion into diagnoses. To overcome the not just pick patients that I could treat that if someone is in need of advice or challenges, he has worked closely within my scope of practice, but that I a discussion about some of the chal- with the clinic’s nurses and doctors would see all patients who presented. lenges, we're keen to help where and and furthered his education through This has helped with expanding my when we can.” extensive research. assessment in the low-acuity space, Jack can be reached at ahcp.jfaxon- and if a patient presents and I need And while he said the nurses and jr@gmail.com; Leanne at leanne@ a hand with medications or a diag- doctors he worked with or to whom citymednapier.co.nz. nosis, I discuss it with the doctors on he referred patients initially were duty. If a patient comes in critically hesitant in trusting his abilities, he is RESPONSE VOL 49 SUMMER 2022 | 13
Opportunities, challenges and professional development in private sector paramedicine After graduation, paramedic Georgia Sirec is honing her skills in private practice Sydney, Gadigal Country After graduating from Western Syd- ney University with a bachelor’s degree in Health Science (Paramed- icine) in January 2021, paramedic Georgia Sirec has embarked on a career in the private sector as part of the Cynergex Group’s Safety and Emergency Response Team, a profes- sional trajectory that has proved both challenging and rewarding. Georgia, who currently works across two sites at the Star Sydney casino complex and the DP World Port Bot- any terminal, began her job search in 2020, initially seeking work through NSW state service recruitment, but found that opportunities were limit- ed. She turned to more general online job sites, searching for paramedic and graduate paramedic positions. 14 | RESPONSE VOL 49 SUMMER 2022
“At the time, only a few roles came needed to explicitly request items vided a range of professional devel- up, but I applied for them,” she said. and inform them of plans of action. opment opportunities and the chance “I mostly got calls asking whether to work in different settings. She said “You must move away from the use of I had registration yet; as I did not, most companies offered a variety of jargon and used closed loop commu- most said contact us when you do. in-house training and had a prede- nication. This is very different from Cynergex, however, invited me for an termined scope for different levels of how we train at university; the major- interview and clinical assessment. training. For volunteering opportuni- ity of the time we’re paired, and ev- After successfully completing those, ties, she highly recommended St John eryone has the same knowledge. It’s they held a position open for me Ambulance. a big adjustment, but I have become to start after the completion of my better at bystander management and “I joined in 2020 and it has been a course.” have stronger situational awareness great experience thus far, both for my as I need to know what everyone is clinical skills but also for networking. doing. “ “Most companies understand that Our skill sets can be “In my role, we generally respond the private sector is not your big plan, used in a variety of set- with a backpack that carries first aid but ensure you make the most of your tings… with registration equipment, a defibrillator and ob- experience. Any clinical experience is ” servation gear. We also have oxygen, highly favoured on a resume, and you we can branch out. masks and igels. This means that must have a good reference to accom- while we are well equipped, we do pany it. Every opportunity you get is have limited equipment at the point a great chance to learn. Think outside of care, so we must be resourceful traditional paramedic roles. Our She began in a part-time role before when treating patients. If a patient skill sets can be used in a variety of quickly progressing to full-time needs something I can’t provide, I settings, including first aid training, employment, with her job predom- have to either call an ambulance or in-school health clinics, in a primary inantly focused on work-related refer them to an appropriate service. care setting, GP clinic, even risk-man- injuries, from strains and sprains This is also a change to how we were agement roles. With registration we through to major trauma events such trained; at university we had a set can branch out.” as falls from heights. Working at an scope, so moving away from what international shipping terminal, she Georgia is also currently studying was considered standard is difficult.” also responds to shipboard incidents, “ and her work at The Star Sydney sees In addition to her professional her providing care for all patrons and growth, she said the benefits of hav- Every opportunity staff on site. ing paramedics on sites as “an extra you get is a great ” triage step” helped to alleviate pres- “This can be incredibly challenging sure on ambulance services and the chance to learn. as it's possible to have more than one broader healthcare system. patient at a time. You see everything here: Strains/sprains, burns, suspect- “We are qualified to decide whether at Western Sydney University for a ed drug overdoses, cardiac arrests, this person needs an ambulance, can Master of Research in paramedicine even minor electrocution. With the make their own way to hospital or be degree, and has completed a Certif- pandemic and many lockdowns, referred to their GP. Additionally, with icate IV in Leadership and Manage- we have also seen a spike in mental work-related injuries we have the op- ment and is working on completing a health-related presentations.” tion to refer them to a physiotherapist Certificate IV in Training and Assess- or a healthcare provider specialising Working individually also proved ment. Her future career aspirations in occupational injury management. challenging, but she said it enabled are to become a qualified paramedic This also helps to alleviate the bur- her to build confidence and learn to researcher and working towards a den on the healthcare system. trust her instincts, and had bolstered PhD, an Extended Care Paramedic or her communication skills. This was “Having a paramedic on site that has Paramedic Practitioner, and taking particularly important in her duties referral capabilities allows the staff to up a training role either as a clinical at The Star Sydney, where she worked have any injury assessed immediately educator or a university academic with a security team when respond- and minimise long-term complica- in paramedicine or broader health ing to incidents. While staff generally tions from not being quickly seen to.” sciences. had a first aid or advanced first aid She said a career in private sector certificate, good communication was paramedicine was an option that pro- RESPONSE VOL 49 SUMMER 2022 | 15
WRA PU P ACPIC 2021 What will you decide? #ACPIC2021 74 SPEAKERS The second annual ACP International Conference was held in a hybrid format from 25-26 November. We welcomed more than 400 online attendees, as well as 71 PRESENTATIONS delegates who joined us in person on day two in Hobart and on the Sunshine Coast. 35 RESEARCH PRESENTATIONS This year’s conference theme, “What will you decide?”, provided attendees with a range of presentations to challenge thinking, explore changes in practice, and 13 POSTER PRESENTATIONS showcase the latest in pre-hospital research. The conference started with keynote speaker Ant Wil- liams, who has swum 223 metres on a single breath, “ freedived to 100m, and held his breath for eight min- The knowledge and experience of utes. Ant’s keynote session discussed techniques for the speakers complemented each other performing under pressure. well. Their passion was contagious, Day two started with the “Best of the Best” research and I felt so inspired and excited about presentations and was followed by in-person presenta- tions in Hobart and on the Sunshine Coast (which were paramedicine as a growing profession also livestreamed). The program covered a broad range after hearing them speak. Love them of paramedic practice with presentations, workshops and discussions featuring clinical and operational all and love what they do. I could have ” topics such as ramping, referral pathways, critical liter- listened to them for hours. – Attendee ature appraisal, health system pressures, and a variety of interesting and unique clinical case studies. 16 | RESPONSE VOL 49 SUMMER 2022
WRA PU P Some of the most interesting sessions were: To our in-person moderators: Alex Ball, Lucy Oatley, Hay- ley Grant, Stuart Cook and Kirsty Mann. • Industrial action and “controversial” service policy in the context of professional responsibility under registra- Finally, a huge thank you to Lead Event Manager Georgia tion, by Ruth Townsend Coetzee, supported by our College staff. • The hijacked ambulance – amygdala activation in para- Thank you to our event partners Laerdal and Guild In- medic care, by Sunny Whitfield surance, and our event sponsors Edith Cowan University, Charles Sturt University, Zoll, Noble Oak, and Medical • Adverse events from nitrate administration during right Developments International. ventricular myocardial infarction: A systematic review and meta-analysis, by Matt Wilkinson-Stokes MISSED THE CONFERENCE? THANK YOU Session recordings are available on the College website under Online Courses. Recordings are free for College We would like to acknowledge those who made this event members: https://paramedics.org/courses possible. Thank you to the conference organising committee: Jamie EVENT PARTNERS EVENT SPONSORS Rhodes-Bates, Lucy Oatley, Alannah Morrison, Andrew Odgers, Craig Campbell and Tim Andrews. To the Scientific Research Committee: Dr Linda Ross, Dr Louise Reynolds, Dr Nigel Barr and Harry Reeves, as well as all the abstract reviewers. To our session chairs: Michelle Murphy, Lindsay Mack- ay, Brendan Shannon, Robin Pap, Tim Andrews, Lauren Clothier, Louise Reynolds, Linda Ross, Laura Wirth, Stuart Cook, Paul Simpson, Sascha Baldry, Lucy Oatley, Alecka Miles and Hayley Grant. To our facilitators: Levi Karschimkus, Andrew Odgers, Julie Johnson, Laura Wirth, Kirsty Mann, Chris Campbell, Alex Ball and Alannah Morrison. RESPONSE VOL 49 SUMMER 2022 | 17
ACPIC ACPIC 2021 2021 AWARD WINNERS What will you decide? #ACPIC2021 The College is committed to supporting and promoting paramedic research, and it was pleasing to see more than 30 research sessions presented at this year’s conference, as well as a portfolio of research posters that are available on the conference platform (https://paramedics.org/acpic2021/ posters). We extend our congratulations to all who submitted abstracts and delivered their research. We would also like to congratulate the following research award winners: BEST RESEARCH POSTER BEST 5-MINUTE THESIS PRESENTATION PRESENTATION Brian Haskins – Caitlin Wilson – Cardiac arrests in Enhancing pre-hospi- general practice tal feedback for emer- clinics or witnessed gency ambulance staff by emergency medical to promote workforce services: A 20-year wellbeing and patient retrospective study safety: A mixed-meth- ods multiple sub- study PhD project BEST ORAL RESEARCH BEST OF THE BEST RESEARCH PRESENTATION PRESENTATION Tegwyn McManamny Matt Wilkison-Stokes – Pre-hospital health – Adverse events from initiatives to reduce nitrate administration the potentially during right ventricu- preventable hospi- lar myocardial infarc- talisation of older tion: A systematic people in rural and review and meta-anal- regional Australia: A ysis. As the Best of growing opportunity the Best winner, Matt is able to present his research at this year’s EMS999 conference. 18 | RESPONSE VOL 49 SUMMER 2022
Alisha McFarlane Over 500 online courses
RE-ENTRY TO RE-ENTRY TO PRACTICE PRACTICE (PARAMEDICINE) RE-ENTRY TO PRACTICE (PARAMEDICINE) (PARAMEDICINE) RE-ENTRY TO PRACTICE (PARAMEDICINE) This course is suitable for those who have graduated for more than two years and not This course is suitable for those who have graduated for more than two years and not practiced, if your registration has lapsed, or you are still registered but have had a break practiced, if your registration has lapsed, or you are still registered but have had a break from the workforce, This course is suitableor shifting for thosefrom whoone have area of practice graduated for to another. more than two years and not from the workforce, or shifting from one area of practice to another. practiced, if your registration has lapsed, or you are still registered but have had a break from the workforce, OVERVIEW This course is suitableor shifting for thosefrom whoone ASSESSMENTS have area of practice graduated for to another. more2022 INTAKE than two years and not OVERVIEW ASSESSMENTS 2022 INTAKE practiced, To prepare forifpractice your registration this eight- has lapsed, Formative andor you areMCQ, summative still registered Course but have 1: 7 Feb - 1 had April a break To prepare for practice this eight- OVERVIEW Formative ASSESSMENTSand summative MCQ, Course 1: 7 Feb - 1 April 2022 INTAKE fromcourse week the workforce, enables you or shifting and to build week course enables you to build from one short areaassessments. answer of practice to another. Course and short answer assessments. 2: 2 May - 24 June Course 2: 2 May - 24 June your knowledge, skills, experience Clinical competency of Course 3: 18 July - 9 Sept To prepare your knowledge,for practice this eight- skills, experience Formative Clinical and summative competency of MCQ, Course3:1:18 Course 7 Feb July--19April Sept and may help you prepare to meet psychomotor skills, tasks and safe Course 4: 10 Oct - 2 Dec week and may OVERVIEWcourse help enables you you prepare build to meet and short psychomotor ASSESSMENTS answer assessments. skills, tasks and safe Course Course 2: 4: 10 2022 INTAKE 2 May Oct - - 224 DecJune the requirements of registration as competent practice of clinical yourrequirements the knowledge, skills, experience of registration as Clinical competency competent practice ofofclinical Course 3: 18 July - 9 Sept a To paramedic prepare forinpractice Australia. This this eight- simulations. Formative and Theoretical summative MCQ, 1: 10 7 Feb and may help you prepare a paramedic in Australia. This to meet psychomotor simulations. skills, tasks and Theoretical safe Course 4: Oct- -12April Dec course week will include course enables a combination you to buildas of assessment and short will answer beassessments. undertaken Course 2: 2 May - 24 June the requirements course will include of registration a combination of competent practice assessment of clinical will be undertaken LOCATION online your and on-campus knowledge, learning skills,learning experience online, Clinical while all practical competency of skills and LOCATION Course 3: 18 July - 9 Sept a paramedic online in Australia. and on-campus This simulations. online, while allTheoretical practical skills and including and may practical help skills, you skills, prepare to meetof clinical scenarios psychomotor willtasks skills, be undertaken and safe Notting Course 4:Hill, 10Victoria Oct - 2 Dec course including will include practical a combination assessment clinical will scenarios be willundertaken be undertaken Notting Hill, Victoria simulations, the requirements and assessments. of registration face-to-face. LOCATION online and on-campus simulations, and assessments.learning as competent online, whilepractice face-to-face. of clinical all practical skills and a paramedic including The course in Australia. practical will cover the This skills, following simulations. clinical Theoretical scenarios will be undertaken Notting Hill, Victoria The course course will simulations, will cover include the following assessments. of a combination andFoundations, assessment face-to-face. will be undertaken eight modules: COST eight onlinemodules: Foundations, Cardiology, Respiratory,learning and on-campus Trauma, CLASSES online, while all practical skills and LOCATION COST The course Cardiology, will cover Respiratory, the following Trauma, CLASSES including practical Medical, Paediatrics skills, and clinical scenarios will be undertaken $2650 Notting Hill, Victoria eight modules: Online theoretical classes will be Medical, simulations, Obstetrics, andFoundations, Paediatrics Transition and assessments. to Practice, face-to-face. Online CLASSES theoretical classes will be $2650 COST Cardiology,Transition Obstetrics, Respiratory, Trauma, to Practice, held Monday to Thursday, while Completing the Re-entry to Practice SWOTVAC and Final Assessments. held Monday to Thursday, while Completing the Re-entry to Practice The SWOTVACcourse Medical, willFinal Paediatrics and coverAssessments. the following and practical classes will be delivered $2650 (Paramedicine) course may help Online theoretical practical classes willclasses will be be delivered (Paramedicine) course may help eight modules: Obstetrics, Foundations, Transition to Practice, online and face-to-face every Friday prepare COST you to meet the registration held online Monday CLASSES to Thursday, and face-to-face while every Friday prepare Completing you to themeet Re-entry to Practice the registration Cardiology, and SWOTVAC Respiratory, Trauma, Final Assessments. from 10am-3pm. requirements and practice as a PREREQUISITES practical from classes will be delivered 10am-3pm. (Paramedicine) requirements and course practicemay ashelp a Medical, Paediatrics and Online theoretical classes will Friday be $2650 paramedic in Australia. PREREQUISITES online and face-to-face every prepare you paramedic in to meet the registration Australia. Obstetrics, Transition to Practice, held All applicants must hold a Bachelor from Monday 10am-3pm. to Thursday, while Completing the requirements andRe-entry practicetoasPractice a SWOTVAC All applicantsand PREREQUISITES mustFinal holdAssessments. a Bachelor REGISTRATION practical classes will be delivered of Paramedicine or Bachelor of REGISTRATION (Paramedicine) course paramedic in Australia. may help of Paramedicine or Bachelor of online and face-to-face every Friday prepare you to meet the registration Nursing/Paramedicine or monash.edu/medicine/spahc/paramedicine/short- All applicants must hold Nursing/Paramedicine or a Bachelor from 10am-3pm. equivalent. monash.edu/medicine/spahc/paramedicine/short- REGISTRATION requirements and practice as a of Paramedicine equivalent. PREREQUISITES or Bachelor of courses courses Contact Us paramedic Nursing/Paramedicine or ContactinUsAustralia. monash.edu/medicine/spahc/paramedicine/short- Professor Brett Williams, All applicants must hold a Bachelor equivalent. courses REGISTRATION Professor Contact Brett Us Williams, brett.williams@monash.edu of Paramedicine or Bachelor of brett.williams@monash.edu Nursing/Paramedicine or Ph: 03 9904 4283 monash.edu/medicine/spahc/paramedicine/short- Ph: 03 9904Brett Professor 4283Williams, equivalent. courses brett.williams@monash.edu Contact Us Ph: 03 9904 4283 CRICOS provider: Monash University 00008C. Professor Brett Williams, CRICOS Monashprovider: Monash College Pty University 00008C. Ltd 01857J. monash.edu/medicine/spahc/paramedicine/home Monash College Pty Ltd 01857J. brett.williams@monash.edu monash.edu/medicine/spahc/paramedicine/home Ph:provider: CRICOS 03 9904 4283 Monash University 00008C.
COLLEGE CONSULTATIONS AND SUBMISSIONS ADVOCACY The College regularly engages in government and industry consultations to represent and advance the interests of the paramedicine profession. This behind-the-scenes work is often a result of the ded- ication and hard work of our College’s advisory committees and special interest groups. The College will provide updates on future consultations and submissions as they occur. 2022 SUBMISSIONS/CONSULTATIONS Submission/Consultation Organisation/Body Date submitted SA Ambulance Service Resourcing Parliament of South Australia 14 January 2022 The College made a submission in response to House of Assembly Petition No 84 of 2021 – SA Ambulance Service Resourc- ing. The submission focused on four system-wide recommendations to address the issues of ramping and access block within the South Australian health system. The recommendations spanned the wider implementation of Community/ Extended Care Paramedics, more comprehensive telehealth services, expansion of the Urgent Care system, and the in- troduction of a Chief Paramedic Officer to oversee better utilisation of the paramedic workforce within South Australia. The College looks forward to appearing before the Legislative Review Committee to speak to our recommendations. 2021 SUBMISSIONS/CONSULTATIONS Submission/Consultation Organisation/Body Date submitted Australian Commission on Safety Low Back Pain Clinical Care Standard 19 April 2021 and Quality in Healthcare Targeted consultation on draft amendments to Health Chiefs Executive Forum 20 April 2021 Health Practitioner Regulation National Law Regulatory Guide chapter re Procedural Fairness Ahpra 21 April 2021 Public consultation on revised regulatory Ahpra 19 May 2021 principles for the National Scheme English Language Skills Registration Standards Ahpra 26 May 2021 Revised code of conduct Ahpra 5 July 2021 Primary Health Care Reform Primary Health Reform Steering Group 27 July 2021 Developing the next National Plan to Reduce Department of Social Services 30 July 2021 Violence against Women and their Children Ambulance Victoria Strategic Plan Ambulance Victoria 26 August 2021 Inquiry into the provision of GP and related Senate Community Affairs primary health services to outer metropol- 30 September 2021 References Committee itan, rural, and regional Australians Opioid Analgesic Stewardship in Acute Australian Commission on Safety 5 October 2021 Pain Clinical Care Standard and Quality in Healthcare Inquiry into the delivery of ambulance Legislative Council Committee 28 October 2021 services in Western Australia Office of Western Australia Future focused primary health care: Australia’s Primary Primary Health Reform Steering Group 9 November 2021 Health Care 10 Year Plan 2022-2032 Consultation Draft For more information, contact the College’s Policy and Project Officer Rachel Shanahan at rachel.shanahan@paramedics.org RESPONSE VOL 49 SUMMER 2022 | 21
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