“Life doesn’t require that we be the best,
only that we try our best.”
H Jackson Brown Jr
For Joe and Alex
Your unwavering encouragement, constant support, brave and open honesty, laughter and love makes the world a great place.
Why This Book
And Why It Matters
Thank you so much for choosing to read this book, a work in progress over a period of four years, finally on paper, much to my surprise after all this time!
It has been written specifically for paramedics, by a paramedic, but with the combined thoughts, words, ideas, tips and opinions of at least one thousand others. I have tried counting the number I have worked alongside, trained with, taught, spoken to, listened to, observed or connected with throughout my career, that helped to form each chapter, but I can only estimate.
Something that I have never, and will never, claim to know, is what actually makes a good paramedic. Like everyone, I have my own personal ideas around how that looks, but it’s simply not my place to define this. Instead, it’s up to each of us to identify what makes us feel like we’re giving our best, and that will differ for everyone.
The good, bad and ugly sliding scale of The GBU Approach, therefore, is designed to illustrate to us, as individuals, where we’re at, just like the pain scale. Using this, we can visualise our habits, picture our behaviours and ascertain how good, bad, or ugly our paramedic practice may feel, on any given day.
As in many aspects of life, the moral dilemmas we face throughout a prehospital career, may often be related to our own personal behaviours. We undoubtedly find ourselves on a continuous journey, therefore, of self-reflection, in order to feel satisfied, successful and safe.
Away from the ambulance, even writing this book throws up the types of ethical quandary that can threaten those needs. What if someone gets annoyed about the bad habits being highlighted? How will I feel if all of my colleagues disagree with what they read? Am I risking industry wide scorn by putting these words on paper?
I almost ditched the entire project several times, but then, at the insistence of my youngest son (the one who always reflects my conscience right back at me, much to my frustration), I began to test the waters by talking about the book concept to some of my peers.
It was suddenly fascinating to hear comments that some are embarrassed by their behaviour, but the longer they leave it, the harder it becomes to make a change. Several described the desire to provide their absolute best to patients, but brought to light the difficulties around maintaining this in the long term. Others mentioned bad habits that they’ve developed, or how their standards have dropped, but outlined the easier path of taking shortcuts.
To my horror, I also heard from some peers that they feel caught up in bad behaviours, because they form part of their connection with groups of colleagues, or have shaped their work persona around such attitudes, therefore it’s too late to change. Hearing the open, honest and brave words from those paramedics, about their self-loathing, or their desire to wipe the slate clean with a fresh approach, makes it easy to maintain my conviction in delivering a book that encourages all of us to simply reassess.
With questions such as “Why bother when so many others don’t?” arising in so many conversations, I decided that I’d rather face some negativity, than ignore the potential to encourage a little positive change.
Like everyone else in the world, I am not perfect in any of my roles, either personally or professionally. I will never claim to know what’s the best thing to do in any situation, or have all of the answers, and some of the good, bad and ugly examples that follow, I confess that I have engaged in myself. What I have learned from these situations, however, is that I regret bad or ugly actions, or inactions immediately.
This regret has occasionally kept me awake at night, particularly at the beginning of my career, when I felt like I let down my patients, my colleagues or my family. If they trust me to do the right thing, simply because I say that I will, it’s vital that I continually aim to meet the expectations that I have set.
I still catch myself now, in situations whereby I’m not proud of particular behaviours, but I have learned, over time, that there’s only one way to stop myself falling into repetitively bad habits. Continual self-reflection around everything that I do, whilst I’m doing it, so that there’s no need to think about it once I’ve stepped in the car to come home.
I have also learned, unfortunately, how uncomfortable it can feel to speak up in challenging situations, rather than sweep them under the rug, and this simply does not get easier over time. Knowing that other paramedics support and believe in best patient care, safety and overall professionalism, however, makes it worth stepping into that discomfort when necessary. With this in mind, encouraging some readers of this book that they’re not alone, when the need arises to discuss such challenges with their peers, may go some way towards providing that support.
All of the examples in the scenarios you’re about to read have actually happened. I have either witnessed them in action, acted them out myself, or heard of them from others, so it’s as realistic as it can be within a written format. For this reason, I have refrained from quoting any specific situation, conversation, phrase, or story in its entirety. If any reader feels that they can identify themselves somehow, they can rest assured that they are not alone. There is no scenario included as a “one off” example. The only inclusions are those that have come up on multiple occasions, therefore rendering them worthy of discussion.
Prior to publishing, it’s been a privilege to have such a kind and generous group of beta readers, willing to read and critique this book. Some new to their role, some with decades of experience and some non-paramedics included. I am full of respect and admiration for each of them. That honest, open, thoughtful approach, causing some of them discomfort in order to provide the truth, provides the ultimate tool for me to improve, both my writing, and my practice.
To every single paramedic I have encountered over the years, I am grateful for your part in shaping my career. Jess, Maxi and Kirstin, your listening ears and wise words over the years are appreciated, and I am full of admiration for the care you provide in your roles. I wish I could credit each person for their part in shaping this book, but there are just too many to mention. For those who have spoken openly about work related behaviours, shared stories of frustrations and successes, made positive changes and talked about the experience, mentored, tutored, educated, supported or challenged me, I am eternally grateful.
As a side note, on the day that this book was due to arrive in the inboxes of the kind and generous beta readers, I found myself putting it all on hold. Confined to medical facilities, I was observing healthcare behaviours firsthand, as one of my children had been electrocuted and rendered unconscious.
Whilst my family have been ill and injured before, it was the first time as a parent, and paramedic, that I found myself fully dependent upon the hope that he would be treated just as well as the caregivers’ families hope for. Despite the friendly, compassionate approach of some, the remainder left us frustrated, confused and dismayed. It was an extremely unpleasant eye opener for me. Stark evidence of how the demeanour, tone of voice, actions and inactions of medical professionals can either positively, or negatively, impact upon those who trust in our care.
This is not meant to be a resentful or vindictive addition to the book. I have included it simply to highlight the words of my son when we came home. “I’d rather be electrocuted again, than ever feel as worthless and annoying as I have over the past two days.” Poignant timing to make me more determined than ever to publish.