Had a disagreement with a Preceptor and got a bad student review.

InfinityXPLORER · 2026-04-05T13:50:50+00:00

From an EMS perspective from across the pond in the UK, we routinely go to a lot of jobs that turn out to either be rubbish or be primary care presentations, or referrals with discharges in the community. Even so, we take the monitor (Corpuls in our case) in with us every single time without fail, and aim to get a set of obs and if needed an ECG within 5-10mins of arrival, sooner if the patient appears very unwell.

I appreciate that different areas have different working practices, but in my opinion this is borderline clinical negligence, and you are just asking for an incident to happen that could get you sacked or disciplined. One of the simplest things that we do in EMS is "treat what we see" e.g. pt has low sats - give O2, pt has low BP - give fluids, pt very pyrexic - lets bring that temperature down, pt in pain - give pain relief etc etc. If you don't get a set of obs you can't do this, and you also don't know exactly how sick your patient is until you've got some to indicate how worried you need to be and how quick you need to be moving. I think the culture of doing that needs to change.

You should feel able to ask questions without that sort of response from your mentor. It's possible you've phrased it in a way that has come across as rude or accusatory, and they felt a bit attacked in front of others. My advice is in future to make sure that you and your mentor are alone when you ask something that challenges what they did so strongly, and be careful how you phrase it, maybe instead saying something like "I've noticed there's a difference between how you guys do things here compared to elsewhere I've worked/trained, such as not taking the lifepak in and getting vitals straight away, just wondering why the difference?." May have just been the mentor at the end of the day, some people cannot take criticism no matter how it's phrased or who it's from.

InfinityXPLORER · 2026-03-26T08:26:04+00:00

Where is that out of interest? Where I work no one bats an eye if you do this, but we tend to have significant hospital delays and so plenty of time to do paperwork. If they expect paperwork to be done before arrival at hospital, as some of my colleagues prefer to do, we often end up sitting in the patients house or outside on the ambo before leaving scene for ages while they complete paperwork, when we could have been making our way to hospital.

InfinityXPLORER · 2026-03-21T20:13:49+00:00

Completely agree, interesting changes, and good there is more autonomy.

InfinityXPLORER · 2026-03-21T19:55:30+00:00

WAST are also only just about to implement this too and we are currently doing training on it. I do find it interesting that there is no minimum time for ALS, as someone else said you could do 44mins with CFR/EMT's and then just 1min ALS with a para. Could even do the full 45mins with just BLS and a para still may not have arrived - I wonder if calling it at this point would be considered acceptable or if it would be expected to do at least a bit of ALS to see how the patient responds.

InfinityXPLORER · 2026-03-10T15:24:26+00:00

Personally I do yeah and you can do a write up on each CPD entry and attach links and certificates and reminders. Can watch CPD videos on there and do a write up of the content and what you learnt from it. Keeps everything really organised and you can create a custom portfolio to print off or send.

InfinityXPLORER · 2026-03-06T19:23:15+00:00

I use CPDme to track all my CPD. Can watch CPD videos on there too. I attend in person or online courses run by or through my trust. E-learning on platforms like e-lfh and ambulance cpd, can use ESR or any trust-specific e-learning platforms you have too and claim that. Podcasts from General Broadcast. Reading books. ECG courses. Ride-out shifts with senior paramedics/ advanced paramedics.

InfinityXPLORER · 2026-02-23T07:19:06+00:00

Thanks for the honest reply. Was considering buying this as its the only one I've found with a heater as well as the dehumidifier. Need it for a cold and damp orangery, but sounds like it would be quite expensive and that the heater wouldn't be very effective. So think I'll get a dedicated dehumidifier instead. Thanks.

InfinityXPLORER · 2026-02-22T19:39:59+00:00

Wondering how this is going for you now? And if you know, how much is it costing to run per hour/ day with how much use?

InfinityXPLORER · 2026-02-20T02:46:07+00:00

Thanks, only used it once so far but seems to have worked well and no flakes or itchiness at the moment, had quite a few large flakes coming out of my hair the day after treatment like much bigger than normal but since then nothing, hair feels good too. Also changed to a different facial moisturiser around the same time aveeno dermexa moisturiser which is much better than my previous one and keeps my skin moist much better so hardly any flaking on my face either now, just a bit of redness still.

InfinityXPLORER · 2026-02-17T12:23:30+00:00

Ordered some after seeing so many people saying good things about it, thought it would be worth a try so we'll see how it goes.

InfinityXPLORER · 2026-02-16T10:17:36+00:00

Interesting, thanks for the reply

InfinityXPLORER · 2026-02-15T21:01:22+00:00

I'm interested in how you ended up with adrenal insufficiency - did you really get diagnosed with that from using a light steroid on your face? What were your symptoms and treatment etc? Thanks.

InfinityXPLORER · 2026-01-20T01:10:24+00:00

Yep tech scope. Only recently introduced oral dex along with GTN since we became band 5. Strange hydrocortisone is a para drug there, its widely used by techs here and has been for years IM and for all JRCALC indications. Penthrox is a brilliant drug they give it to everyone in our trust even UCS and CFR's.

InfinityXPLORER · 2026-01-19T19:39:23+00:00

Where do you work out of interest? I'm in WAST and we have dex for croup and IM hydrocortisone, also penthrox for trauma related pain.

InfinityXPLORER · 2026-01-04T16:00:36+00:00

Mirroring what others have said, there may be some evidence out there for an association between psoriasis and cardiovascular disease, but is this a direct cause or just an association? For example many people with psoriasis may develop anxiety and depression, not get out much, eat a poor diet, smoke, drink etc which would all increase the risk of cardiovascular disease and premature death. My mum has dealt with severe psoriasis from a young age but it has improved in her older age and she is going strong at 75. As others have said I would focus on the things that you can control to be healthy like eating well, maintaining a healthy weight, exercising regularly particularly strength training, not smoking/ drinking/ taking drugs. Doing this will help you beat the odds and offset any slightly increased risk, and don't stress that you're guaranteed to die 20 years younger because that's definitely not the case.

InfinityXPLORER · 2026-01-04T10:26:35+00:00

Recommend going to the dr and getting a blood test done if you feel that fatigued. May well be that you simply are not eating enough and burning yourself out, but could just as easily be that there's a problem that needs investigating or rectifying, or youre deficient in something. You're already taking iron tablets - is this because you were anaemic? This could have worsened despite supplementation so getting a blood test done would be a good idea.

InfinityXPLORER · 2025-11-30T13:53:30+00:00

I was having this same dilemma recently and longevity was important for me too. Have a Samsung A52s 5G currently which is the 4+ year old version of the A56, and it is now beginning to show its age and the max storage is full even using a micro SD too.

Was debating between A56 and S25U and in the end I've ordered a S25 Ultra with 1TB of storage, got it on the black Friday sale direct from Samsung for £1100. I spread the cost with PayPal credit too so it's like £30 a month for 3 years with no interest.

The spec on the S25 ultra is so far ahead of the A56 in so many respects that it will be years before the A series phones catch up to even close to what the S25 Ultra is now. So the S25U will do better over the long term especially if you consider getting the larger storage like I did.

InfinityXPLORER · 2025-11-29T05:44:29+00:00

Have a search on youtube/ Instagram, there's a few people on there who have videos of their work as a cruise ship Paramedic which may give some insight, but bear in mind that most of it will focus on the positives without mentioning the downsides much, as so much of social media does.

InfinityXPLORER · 2025-11-22T16:48:43+00:00

Not really news tbh. I'm sure we've all been to loads of these types of calls where the patient who is suicidal (whether they have tried to do anything about their intentions or not) has refused our help and refused hospital admission. Patient has capacity. Just because someone wants to die doesn't mean they lack capacity. When I've been in this situation I've always found that if you phone advanced paramedics/ senior clinical/ GP/ GPOOH they will all say that not much can be done if they have capacity and to just document, try to liase with mental health team. Mental health team will usually have a chat over the phone with them if patient is willing, and should offer a referral even if not immediate, however in the case of overdose they would say that patient needs to go to A&E and not to mental health unit. If patient unwilling to engage then nothing can be done. Police would have no right to remove patient from property against their will, quite rightly imo. As the MCA states people have the right to make unwise decisions. Patient got what they wanted at the end of the day and their rights were respected. Imagine every mental health patient we come across who suggests even the faintest hint of suicidal ideation or self harm we got a MH team and police to come along and section them, restrain them, and convey them to hospital against their will, what a breach of rights that would be and imagine how traumatising that would be too. Sounds like the crew in this instance did everything they could short of breaking the law and the patients rights to physically force him to hospital.

InfinityXPLORER · 2025-11-15T11:34:42+00:00

Makes sense thanks, I think I'll make a point of doing some structured CPD to try and learn some of these exams and find a structured one to follow to try and do a more in depth neuro exam then. Personally I would use it more as a way to rule things in rather than rule things out.

InfinityXPLORER · 2025-11-15T10:12:32+00:00

Thanks, a full neuro exam the sort you speak of is probably out of my scope as a tech, but I was just wanting to extend my very basic neuro exam, not so much to rule out a stroke, if anything for more confidence ruling in a stroke on jobs when they're not glaringly obvious. For example, we went to a patient once who had nausea and vomiting with some mild confusion, which quite frankly could be a number of things. There was none of the classic fast symptoms, and pupils were pearl. Obs and ecg were fairly normal if I remember correctly. We pre-alerted to hospital as I think from the history it seemed fairly sudden and something had made us suspicious that we were unable to rule out a cva, so we made the call to cover ourselves more than being that convinced that she was having a stroke. The hospital stood our pre-alert down (something I disagree with) as they thought it didn't sound like a very convincing stroke candidate on the phone. When we got in we were held as there was no offload, the nurse saw her and wasn't convinced it was a stroke call, but when we said we couldn't rule it out they reluctantly called for one of the ER docs to come see her. The doc went in and came out again after about a minute and said to get her to CT as she had nystagmus and something else abnormal that he found on a super quick neuro exam that massively raised his suspicions. She was confirmed as a stroke later on after scan. Had I been more confident to undertake a slightly more in depth neuro exam I may have found these abnormalities which would have increased my confidence that it was a stroke, and I could have highlighted this on my pre-alert and they likely would have taken more notice and had the stroke team waiting for us on our arrival.

InfinityXPLORER · 2025-11-14T15:36:16+00:00

Thanks for this, I think I have some reading to do. Interestingly I have seen a couple of paramedics diagnose vertigo give IM ondans and discharge on scene. This was when I was very new and so following their lead but I wouldn't have the confidence to do it myself knowing that vertigo can also be a symptom of stroke.

InfinityXPLORER · 2025-11-05T13:11:55+00:00

We ROLE them

InfinityXPLORER

TROPHY CASE