My top ten favourite moments at work

I think it’s time for another top ten list.   This is my list of my favourite work related moments.  Not in any particular order.


  1. When we’re trying to resuscitate someone who is in cardiac arrest (not breathing and no pulse), it’s a great feeling when we get a pulse back (Return of Spontaneous Circulation (ROSC)). Even better if the person starts to breath for themselves too although this normally happens a bit later when the person is in the resuscitation room and we’ve handed over to the hospital staff.  It’s nice to track the patient’s progress through the hospital to the point where they are discharged home and back to their families.
  2. When a job flows smoothly. There is a certain flow from the point when we are given a job to the point where we hand the patient over in the Emergency Department (ED).  Sometimes the job flows more smoothly than other times.  Things can go wrong, equipment can let us down or the patient may not agree to the recommended care path way.  Sometimes it’s not easy or possible to cannulate the patient if required (insert a small tube (cannula) in the patient’s vein by inserting a needle which is encased in a plastic tube on the outside and then removing the needle leaving the tube in place).  A range of our drugs are given through the cannula (intravenous (IV) so if I can’t cannulate then I can’t give the patient any of the IV drugs or fluids.  It’s great when everything works and flows smoothly.
  3. When pain relief starts to work. Many of our jobs are people who are in pain.  This can range from sudden pain due to an injury or illness or ongoing pain caused by a long term condition which has gradually got worse to the point the patient can’t cope and calls us for help.  We have a range of techniques and drugs (analgesics) we use to relieve pain.  For an injury, eg broken limb, using a splint to immobilise the injury helps to ease the pain.  Reassurance also helps because fear plays a part in making the perception of pain worse, particularly in children.  No one likes to see another human in pain so it’s a great feeling when the patient starts to relax as the pain eases.
  4. When an unwell, scared child relaxes and starts to smile and laugh. When children are unwell or injured they are usually scared too which makes the feelings much worse. As long as the illness or injury is not time critical, we take a while to let the child get used to us.  We involve mum, dad or any other care-giver and encourage the child to show us their favourite toy or book.  It’s a good feeling as the child starts to relax and even laugh.
  5. When we can hear back up crews approaching. When we’re on a big job and have requested back up, it’s a huge relief to hear them approaching in the distance.
  6. When someone says thank you. I know it’s our job to help and it’s what we get paid to do, but we’re human too and it’s fantastic when someone appreciates the help we’ve given them and thanks us.
  7. When we get a free coffee. Very cheeky one this but some places give us free coffees while we’re on duty. Fantastic!
  8. Seeing a student progress. I’m a mentor so I quite often have a student for a year.  In the UK paramedics study at university and have frequent placements with us on the road during their course.  I love to see the student progress over the year from being nervous and confused to become a confident, competent paramedic.
  9. Hearing the relief crew arriving at the end of the shift. If we happen to be on station towards the end of the shift (very rare but it can happen) it’s an unbelievable relief when you hear the relief staff arriving.
  10. End of the shift. Home time!!

Blogger recognition award


I’m thrilled and very grateful for being nominated for the Blogger Recognition Award.  I would like to thank Noel Hartem who blogs at, with views on life expressed in powerful poetry and prose.  I’m relatively new to the blogging community and it’s fantastic that a fellow blogger thinks enough of my writing to nominate me.

The suggestions for nominees are:

  1. Thank the blogger who nominated you, include a link to their blog.
  2. Give a brief description of your blog site.
  3. Share 2 or more pieces of information for new bloggers
  4. Nominate 10 other bloggers
  5. Comment on each blog telling them you have nominated them with a link back to your award post.

My blog, rustysiren, is a mixture of my experiences from 21 years working as a paramedic in a big UK city and random views on life.  My passion is mental health; that of the patients I meet and try to help and also the work-related mental health of my colleagues.

Advice for new bloggers

  1. Work on your writing to make your content readable, interesting and compelling.
  2. Blog about the things you are passionate about. Your passion and excitement will show through your writing.
  3. Enjoy your writing.
  4. Read and comment constructively on other blogs, enjoy the comments you get in return, it’s great fun!


  1. Dr Perry at Make It Ultra.
  2. Rough Bandit.
  3. Elsie LMC.
  4. Damn Girl Get Your Shit Together.
  5. Merbears World
  6. Combat Medic
  7. On the couch
  8. Love,Nourish.Enjoy
  9. Brobeck at Homeless: Life on the Streets
  10. Emmanuel Rockan.


Letter to younger me

This is a different type of blog to the ones I usually do.  No anecdotes from the back of the ambulance.  It is a letter back in time to my younger self.  When I was younger I used to worry a lot, about everything.  A random event could set my mind racing and dwelling on all manner of future disasters.  I found a way to calm my mind by writing a journal.  Today I found an old journal and flicked through a few pages.  This letter is to the younger me who wrote that journal.

Dear younger me,

There’s no need to worry.  Every single thing you worried about worked out ok.  Either it didn’t happen at all or it did happen yet it wasn’t half as bad as you thought and you managed to cope.  In fact, some of the disasters you worried about turned out to be the best thing that could have happened.

We spent and still spend lots of time with family, and we didn’t drift apart like you worried, in fact we just get closer.  When you’re with family, in fact whatever you are doing, really focus and concentrate on what’s happening; this is how to make lots of great memories.  Some of the simplest things are the best memories.   Time has really flown and now the kids are adults. We had such a great time as they were growing and now they’re adults we are still having a great time making lots of memories.

Don’t fear being alone.  At various times I’ve been alone and nothing bad happened.  In fact I’ve learned to love time on my own.  I love the time to read, relax and be creative; I find it calming and peaceful.  Now I’m with someone it’s because I truly want to be with them and I’m not with them just because of fear of being alone.

Trust your instincts. Every choice you agonised about and just went with your instinct turned out to be the right choice.  That instinct of yours is pretty well tuned – I trust it now.

The bad times pass.  Always.  Some of the stuff you faced is painful, no denying it.  When you have done everything possible to remove the painful thing but it’s still there, well, these are the things you just have to accept.  The pain is real and can be intense.  Resisting and wishing that the pain isn’t there or that things were different or feeling resentful makes the pain feel worse. Just accept it, keep breathing and trust me, it passes.  It passes more quickly when you accept it and don’t try to resist it.  I would say don’t be afraid to let it out and cry but I still can’t do that.  I would also say talk more to the people who care for you about things on your mind but I still find that hard too, I’m working on that at the moment.

Don’t be afraid to ask for help handling things in the bad times.  You’ve handled things fine on your own and got through but it may have been easier with help and opening up about things.  I’m still working on that one too here and now!

Maybe I’ll get a letter from an older me and he’ll say I/we/you’ve finally managed it.

That’s about all I’ve got to say for now.  Things are good here and now, very good.  Stop worrying!

With love…

One great tip to boost confidence

Most of my early life I suffered with low self confidence. What does self confidence mean? To me it is the same thing as self doubt, doubting my own judgments and ability.  Not in all areas, mainly social situations where I had to interact with people I didn’t know.  Why, you might wonder, did I contemplate changing career into probably one of the most people oriented jobs there is: paramedic.  I couldn’t have told you at the time, it just ‘felt right’.  I was in a dead end job I hated and just had to get out.  The more I researched the role of paramedic, the more it appealed.  I didn’t get too stressed through the application process because the numbers were stacked so heavily against me I didn’t seriously expect to get through; 2000 applicants for 12 places.  Amazingly I did.

Back in the day all training was in-house.  I had a six week clinical course and a two week driving course.  Then I was unleashed on the public as a trainee technician.  The plan was to work as a crew with a designated Work Based Trainer and Assessor (WBTA) paramedic for a few weeks then just work with any paramedic as required as a reserve technician.  Throughout the first year, I was rota’d on with my WBTA at regular intervals to assess my progress and identify any training needs.  Then after that first year I was a fully qualified Ambulance Technician.

That first year did not go particularly well for me.  On a good day the jobs went well enough, I generally knew what was happening with my patients and knew the correct care plans and treatments and how to assist the paramedic I was working with.  The trouble was when the patient showed any ‘challenging behaviour’, which in a big city with the accompanying social problems, was most days.  When confronted or challenged I often didn’t have the confidence to deal with it.  Some of the staff I worked with were great and very supportive and helpful, some weren’t, they made it clear from the start of the shift they did not like ‘babysitting’ a new technician.

The day came for my third quarterly assessment and my WBTA was on leave.  I was rota’d on with one of the other WBTA’s, I’ll call him Alan in this blog, it seems right to change his name.  I’d never worked with Alan up to now, I’d seen him around station and he always seemed quite brusque and impatient.  I was a little apprehensive, more than normal.  We did our first job and he asked me how I felt it went.  Before I could answer he said that I was less confident and assured than I should be at 9 months into the job.  I should be more assertive with the patients.  My heart sank.  I had given up a steady job in engineering to do this.  My family had supported me through the changes and never complained once about the dip in money coming in.  Was I about to be told I was not fit for this job and it would be best if I resigned?  This must have shown on my face because Alan suddenly smiled and said:

“Don’t panic, this is easy to put right.  You know your stuff clinically, no worries there at all, just a couple of tweaks and we’ll sort you right out”

Glad you think it’s easy I thought, I’ve been struggling with my confidence all my life.  Suddenly though I felt optimistic and good. We went back to station, back then we were much less busy and Alan asked our controller if we could go back to sort out some admin for my assessment.  Back on station, cups of tea in hand, he gave me the simple advice which has made such a huge difference to my life:

“When you walk in to a room, you’re very hunched up and your shoulders are rounded.  Without realising it you’re trying to make yourself look small.  Then with your quiet voice you start talking.  Is it any wonder some of our ‘characters’ don’t take you seriously?  You show with your body that you don’t have confidence in yourself so why should they have confidence in you?”

He showed me how I approached the patient in an exaggerated (I hope!) way and then showed me how to do it with shoulders back, head high and a projected talking voice.  Then he had me practicing coming into the room.  First he said to do it like I always did.  Next he had me practice taking a deep breath; shoulders back and head up before I entered.  Then I had to talk to him by projecting my voice as he had shown me.  I really did feel a difference.  The rest of the shift flew by with me practicing my new skill.  At the end he said he could see an improvement and he hoped I would keep practicing.  He told me:

“When you don’t feel confident you can at least act confident.  That way you even fool yourself and after practicing long enough you will become confident.”

Twenty some years later and I still clearly remember that shift and still follow Alan’s advice.  Paramedic education is very different now, university based with clinical placements throughout the course.  I’m a mentor which means each year I ‘m allocated a student and for the weeks they are on placement they work with me and my crewmate and I guide them in the practical aspects of the job.  I always pass on Alan’s advice to the less confident students.