Article Text
Abstract
Introduction The evolution of the paramedic role over recent years has changed dramatically, with an increased emphasis on treating more patients in the community rather than conveying to hospitals unnecessarily. Paramedics see and treat a diverse range of patients from acute events to chronic conditions, many patients have co-morbidities and polypharmacy in an aging population. Thus, the modern paramedic must be equipped with holistic clinical skills over a wide variety of specialties.
Multi-disciplinary working in hospices is well established but does not typically include paramedicine. Paramedicine has changed in recent years extending beyond the typical emergency response model to encompass community paramedicine with paramedics working in primary care but the role within hospices is still to be developed.
Method Paramedics draw on a multitude of skill sets from symptom management, physical assessment, signposting, referrals and many more, and are adept at talking and communicating with people in the very worst of situations showing empathy and care, a baseline for all palliative care. My role as a paramedic in the hospice team is to conduct assessments, using my experience of visiting patients within the community and deciding on a course of action/referral or input required.
Outcomes Mountbatten Isle of Wight has seen two paramedics integrate well with the community palliative care team. Paramedics have been able to give IV infusions to patients within their homes to help avoid clinical environments. Paramedics have extensive patient assessment and diagnostic skillsets and these have been added to by in-house training on catheterisation/advance care planning and end-of-life care supplementing the care provided by nursing staff within the community team.
Conclusion The role of the paramedic within hospice community teams is still in its infancy. We know that hospice services work differently across the country and therefore there are no hard and fast rules for what a paramedic may do.