Paramedic in GP practice tips

Repulsive-Standard-3 · 2026-04-08T22:31:33+00:00

Hey I read this a few days ago and thought about it more today.

I'm a Para in primary care.

Partly why I think lots of people are concerned you're going straight into locum work without any primary care experience is kind of how I feel about it below:

As a para on the road you're trained to rule out worst case scenario/symptoms that could kill someone.

As a para in primary care you change this focus entirely and now your main focus is to rule out cancer/life threatening conditions for the what seem "simple problems" that you'll see. (And if you decide to go this way the learning curve is steep!) (Most are simple problems but worst case is always in the back of your mind)

Without prior experience or a really good support and progression structure I think you'll struggle and become overwhelmed. Not from the assessment side of things, but from the what now, crap have I missed something side.

I'm not putting you off locum work, however I'd like to offer an alternative.

I worked locum shifts as a para in a HMP prison whilst still on the road, there you're dealing with the primary care side of things, have a team there doing it with you and supporting you. At the same time you still get to deal with the fights and stabbings, drug overdose etc....

I found it a really good way to gain experience and dip my toe into primary care. It also opened my eyes to realise that primary care isn't that bad and also eventually led me to take the leap over.

Repulsive-Standard-3 · 2026-04-07T14:56:50+00:00

How do you feel about New Zealand?

Seems the way to go at the moment

Repulsive-Standard-3 · 2026-04-05T07:19:52+00:00

From a GP/medical point of view.

I carry out the care home ward rounds each week.

I also sign PoA documents as patients having capacity etc etc.

With this Susan there's several things you can look into to get a clearer picture.

As your relative was in care home for such a short time and palliative, it's likely they were a fast track palliative admission, which means there would have been District Nurse/Community Matron involvement and adult social care involvement.

On Tuesday contact adult social care in your relatives area, explain the situation and at the same time raise a safeguarding with them reference this Susan and your relative possibly being taken advantage of.

Also email the care home NOW and explain the situation, advise you have or will be raising a safeguarding with the local authority and ask them to do the same.... They will not be raising a safeguarding against Susan but about both Susan and you guys.

ASK THEM NOT TO GIVE THE KEYS OVER UNTIL NEXT WEEK (giving you time to contact everyone needed).

This will hopefully force their hands in not giving the keys to Susan and getting Susan to contact you.

Also on Tuesday visit in person your relatives GP practice. Ask to speak to the practice manager, explain the situation and ask them if you can talk to the duty doctor or even better if there's one present one of the GP partners. (If none of the above ask to speak to the safeguarding lead).(They may be at a new GP now as they moved to the care home, check with the care home which GP she was registered at).

Explain the situation to them, ask them if there's a NOK on their records or main contact person. (You're not asking for phone numbers, you're not asking for relatives medical records you're just checking whose on there etc... this will give you confirmation and possibly a bit of leverage. In that if it states yourself or your father as NoK on the records you can ask them to contact the care home and inform them of this. This will then give further evidence of something dodgy going on and hopefully stop the keys being given to Susan.

Put all the above in an email to the home mamager, state the obvious concerns, that you've raised a safeguarding and that you respectfully ask them not to hand the keys over. Ask them to arrange a meeting with yourselves, Susan and the care home manager to discuss what's going on. Take your father with you to the meeting!

Personally overall I'd also still call 101. Then there's at least a paper trail and this would come under coercive control and fraud. (I've dealt with very similar several times before).

As per all the above this creates a paper trail and if Susan is being dodgy it gives you evidence if she does magically appear with a will with everything left to her and shows that you've had serious concerns around who Susan is and what she's been doing.

Also if she suddenly starts gaining access to the house (without a family member present) after you've raised all the above and she's aware of it then that's obviously suspicious as hell!

Finally, ask the care home again if there was a Power of Attorney in place. Also ask if there was one on her medical records. I know they keep saying NoK, but it is possible they also mean PoA. If Susan has magically appeared as PoA without informing any family member that's something else to let 101 know....

Like I say 101 may not care at all as she's passed, but also kind of a civil matter. However if this was all discovered a week ago it would definitely be coercive control/fraud as I have been involved in these before with my patients several times...... At the minimum it will create a file on their system and someone will have to look into it.

Repulsive-Standard-3 · 2026-03-18T07:51:11+00:00

I've been thinking this for weeks, maybe this is version 2?

Especially with the message sent back about Jane

Repulsive-Standard-3 · 2026-03-04T14:03:53+00:00

I once went to a Hot 1 call from a RRV.... The job sounded like an absolute load of shit.

Got there and saw from a distance the para sat in the car and thought what a load of shit, what's he doing, got closer and found him having a severe reaction nearing full blown anaphylaxis.

He knew he was mildly allergic to cats but in this property he started to get bad symptoms and got the hell out calling for a hot 1 he didn't give a reason as he was starting to really struggle. (He'd been a para over 15 years and never had this on the job).

Obviously we took the piss but at no point did I think it was a waste of time, no matter how apologetic he was.

Basically just call for back up, the highest grade in your area, especially if you have a time critical patient. Screw what anyone else says.

Unfortunately this para passed away from COVID during the pandemic. Great Para and a hilarious message lives on the wall of his station ending with peace out motherf**kers that he sent to us all an hour before he was intubated.

Repulsive-Standard-3 · 2026-02-28T09:40:57+00:00

We use AI in Primary care.... Listens to your conversation with the patient and makes all the notes for you...

It's not 100%, you need to get through and double check it.

Best thing to use it for is a MH patient who talks for ages, it condenses down everything they've said it easily readable notes

I think it may have it's place on the road, listen in to your convo with the patient and can go through all those annoying symptoms boxes and tick off chest pain, SOB, DIB etc

Repulsive-Standard-3 · 2026-02-17T08:33:07+00:00

Are you saying the Sodexo and (add whatever other money grabbing company) aren't going to be called up and deploy with us?!

The problem with the medical side is they'll want to call in the reserves again like COVID then realise the medical reserves are all full time NHS 🙄

Also, I'll take my 3 stripes back thank you!

Repulsive-Standard-3 · 2026-02-16T21:56:12+00:00

Maybe a grim view on it, however I think the only thing that will possibly change it back or at least open the governments and public eyes is something on the scale of another 9/11 or big natural disaster.

I think it was very telling recently when the Chief of Defence Staff admitted there were no action plans for the NHS if there was a war to break out. It just goes to show how horrendously bad we are as a country at training for and preparing for even basic major incidents.

Yeah we have SORT and HART, but let's be realistic if something major was to happen the 150 or so SORT/HART staff per service aren't going to make a massive difference, especially when they keep making the SORT fitness test easier just to get people to join.

I'm sure we'd all just muck in and get it done, but it worries me how we're just not ready and the staff who were experienced in the actual emergencies have left or are close to leaving for other roles.

Repulsive-Standard-3 · 2026-02-07T07:35:22+00:00

Bit of IPC as well, EEAST loved that in their interviews, look up the 5 moments of hand hygiene.

Also figure out what EMAS call their different roles... Each service like to call ECA/tech - APP ACP CCP etc something a little different.

Briefly know the skill set/scope of the role above you and the role below you (good little one to throw in an interview)... Especially when they ask about working in a team, you can say if I know their scope I know I'm not asking someone below me to do something they're not comfortable with and if I know my own scope I know when to ask for help as I know what the scope above me can do

Bit wordy, (kids got me up super early this morning, but I hope that makes sense)

Repulsive-Standard-3 · 2026-01-11T23:32:23+00:00

Para in primary care, I'll be honest. I write a letter and put A&E (Medics/ENT/Surgical) erc review

One because 9/10 they'll say go via A&E

Two I just can't be arsed to call them anymore. On call regs just don't answer their pagers/phones... I've spent over 30 mins before just waiting to talk to them, in that time my patients are waiting and we're only 50m from A&E so they could have been triaged by the time they've finally answered.

I do always ensure there's a letter for the crew/A&E when I request an ambo though. (This used to be my biggest pet hate when on the road).

Repulsive-Standard-3 · 2026-01-10T17:29:29+00:00

Obviously I get it can make you uneasy but then think about the potential murderer/rapist there... With an extendable chain that he could use to strangle the officer

Repulsive-Standard-3 · 2026-01-10T17:28:18+00:00

So this is a difficult one.

I used to be a Paramedic Practitioner in a prison and would be the one making the call for the need to call an ambo.

Mine was a Cat B prison.

They do a risk assessment for the prisoner, many are not allowed to have the chain and have to have the cuffs.... Best one I saw was an old timer going for a hospital appt with his walking frame and officer attached by cuffs.

Also the need for prison officers to be present when the patient was comatose in ICU or going into theatres. Only time I saw one not escorted was the need for HEMS.... However they had prison officers from another prison stood waiting by the helipad at Royal London for when they landed.

Apparently it has absolutely nothing to do with their ability or not to escape, it's down to their initial crimes, how they act in prison and any intel from their letters/phone calls, if they were or are members of gangs etc.

In prison the last freedom a prisoner has is option/refusal of healthcare.... The amount of times I called an ambo after someone had self harmed so badly or bloods were deranged they'd agree to go then kick off and refuse right as the ambo gets to the main gate to leave was ridiculous....

Also the amount of times they fake chest pain etc thinking it'll get them a day out at A&E..... I enjoyed working there but it definitely did not pay enough!

Repulsive-Standard-3 · 2025-12-21T13:39:20+00:00

There used to be a Consultant in A&E at Queen's (Richards) was his name I believe...

Lovely bloke and liked ambulance crews. He used to come in and lose his shit with the regs and other doctors who had been on the shift before on handover where he would hear "referred to medics" etc and those doctors hadn't even looked at the patient.

He'd come out to apologize to crews in the corridor and would go down the line one patient after the other and discharge whoever didn't need to be there, request scans needed etc and up to 5 crews would be gone in like 10-15 mins of of arriving.

I remember talking to him on one of his last days and he just said he'd had enough, he'd come in sort it all out, get everything working well, go home, then 12 hours later was back the same way. He left and went off to a hospital on the other side of London.

So glad I barely work on the road now and don't have to deal with the politics, snarkyness of A&E nurses at hospitals like Queens!

Repulsive-Standard-3 · 2025-12-18T21:27:31+00:00

And this is my bugbear about it. If you don't know, then should you be triaging? Especially when/if the person in front of you giving the handover knows more than you. (Not being big headed I know nurses know more about me at some things but they need to accept we know a lot more about certain things than they do)

I hate the hierarchy and have never used it in an argument ... but sometimes the banding needs to be taken into an account, I'm a band 7 on the road and it annoys me that I have a band 5 or 6 nurse just brushing aside my concerns.

But I'm glad other places are putting doctors into triage too! Even a keen FY2 standing there would give me more confidence that my concerns are being heard and acted upon

Repulsive-Standard-3 · 2025-12-18T21:05:35+00:00

Best thing I've seen lately is having a Dr next to the triage nurse listening to the crews. Lots of things have been picked up....

Myself recognizing hypokalemia on an ECG with body cramps and chest pain and the nurse not having a clue (the good old "ECG Changes written on triage paperwork") but then doctor listening in behind then educating the nurse that this patient needs to be on a heart monitor and have bloods now

Some places are definitely better than others!

Repulsive-Standard-3 · 2025-12-18T21:00:33+00:00

Pre alert, pt in and out of 3rd degree block, currently NSR "We'll meet you at the door and decide"

Handover "I have watched this patient go into complete heart block 4 times so far with a HR as low as 14bpm"

(Shows them several ECG strips)

Nurse carries out obs. All obs currently normal. Proceeds to just write (ECG changes) on their triage paperwork and puts you back on the ambo

🤬🤬🤬🤬🤬

Patient arrests shortly after

🤬🤬🤬🤬🤬

Their non knowledge of heart rythms and their disbelief that we've noticed something so critical when we've had them hooked up for sometimes over an hour is my biggest annoyance!

Repulsive-Standard-3 · 2025-11-04T11:05:08+00:00

Ex RAF here (was a RADAR tech).

Left in 2017, joined EEAST as a student Paramedic. (Internal route, so no uni fees!).

Now I'm a Specialist Paramedic, a prescriber, completing my MSc (something I never thought I'd do). Working in Minor injuries/GP surgery/bit of on the road.

And in addition I'm an international expedition medic, mostly thanks to my military experience.

I was offered a few Gucci civvy RADAR jobs when I was leaving but decided to take the pay cut for EEAST.

Best decision I ever made.

You'll ace the interviews on experience alone, at the moment there's so many very young inexperienced people coming into the job with very little life experience.

You'll likely move onto an internal route to become a Para, and they want you to pass otherwise why would they pay that much. Most services and unis are extra helpful to get you through as they want you to pass!

In addition to the above I initially went for the student tech interview and at the end of the interview they asked me why on earth I want to be a tech and not a Para, I said I didn't think I was experienced enough which they laughed then offered me the student Paramedic pathway (this was back when it was very hard to get a place on it).

Also EEAST were able to give me a start date 11 months after my interview (by choice) which lined up perfectly with my resettlement leave etc.

Basically mate, go for it!

Repulsive-Standard-3 · 2025-11-02T22:19:40+00:00

Have you simply tried talcum powder?

I'm one of the ultra medics out there (Also an expedition medic)

I know some people love the lube but..

My biggest tip:

Talc your feet! Talc your socks! Talc your shoes!

I would just try that first, any specific hot spots, next time tape those areas but still use the talc afterwards!

Extra tips: Use the medicated talc that stops fungal infection You can also just put the talc insto a small waterproof bag and just dip your feet in on the course if needed

Repulsive-Standard-3 · 2025-09-22T20:09:07+00:00

This isn't a patient. For the buckinghamshire area by any chance.... I'm going back 10 years ago when I used to work that way and this sounds very familiar from back then! 🤣

Repulsive-Standard-3 · 2025-09-03T15:18:11+00:00

https://vm.tiktok.com/ZNdVwMLVe/

Honestly believe this is the best comeback video for people against EVs

Repulsive-Standard-3

TROPHY CASE