PARAMEDIC PARTNERSHIP

Although this partnership for the paramedic programme began in 2003, there was an existing relationship between the two organisations through the DFB occupational health at Mercer’s Medical Centre.”

D/O EMS Training Paul

Lambert and

Rcsi

Paramedic Programme Manager Patricia FitzPatrick talk to Adam Hyland about a Successful 20 Year Partnership Between the Two Organisations

Dublin Fire Brigade and the Royal College of Surgeons in Ireland have enjoyed a rewarding partnership for 20 years, and in January of this year they marked the occasion with an event to celebrate and acknowledge the work of all involved in making it such a success.

Upon completion of their re ghting training, all DFB members must complete a Level 7 Diploma in Emergency Medicine Technology through a PHECC-accredited training institution, and this is where the RCSI comes in.

Origins

Programme Manager Patricia FitzPatrick tells me: “DFB Assistant Chief Fire O cer Brian Power approached RCSI through Prof. Bill Shannon, RCSI’s Professor of general practice at the time, about establishing a partnership for the purposes of EMS education provision for DFB personnel.

e move was necessary, D/O EMS Training Paul Lambert says: “It is part of our accreditation requirement for PHECC that we are aligned with a tertiary institute, and we previously had a partnership with North Eastern University, but when they le Ireland, the RCSI were the medical school we wished to be aligned with.”

Ms Fitzpatrick adds: “We were interested in the partnership because we already had an established relationship with DFB Occupational Health at Mercers Medical Centre, which was part of RCSI, so there was an existing relationship to build on prior to our partnership.”

Benefits

e bene t to the DFB of having this partnership with an institution as prestigious as the RCSI is not just that it allows for the teaching of paramedic students to PHECC-accredited practitioners, it also serves to ensure DFB paramedics are as highly-skilled as possible.

“We have a Programme Medical Advisor at RCSI who helps give us direction whenever we need practice guidelines on how we are going to approach something from a teaching point of view,” D/O Lambert says.

“We also have a Partnership Board that brings a high level of governance to the programme, in which we have quarterly meetings and everything that is happening within the programme from the point of view of educational design to how the classes are progressing is all discussed. Because the Board is made up of some of the high level players such as the CFO, Assistant Chief, D/O Martin O’Reilly and their counterparts in the RCSI, there is very good governance and oversight to make sure we are delivering quality product.”

Ms. FitzPatrick says: “We are delighted with the relationship as it broadens RCSI interests to the pre-hospital environment. Prior to this, the main prehospital engagement would have been through GP training in Mercer Medical Centre, so it helps to close the loop in the continuum of care of the patient from pre-hospital through to physiotherapy and pharmacy at the other end.” ere are also practical bene ts to having the RCSI’s facilities available to DFB’s paramedic students.

“Our students are lucky enough to be able to use the Simulation suites within RCSI,” D/O Lambert says, “which are very valuable scenario-based and casebased learning areas where our students can interact with high-quality simulation mannequins and we can assess them to see how they would interact with real patients. ey get access to cadaver specimen labs, so they can look at all body systems up close and personal.

“ ey also get to interact with the RCSI in a formal way, because we carry out their end of process panel interviews, conferring, etc so they have to go in their full dress uniforms and go before a panel to demonstrate their knowledge and expertise, and deliver their case studies, before they are signed o with full registration. It is great for them and their families as well to be able to go into RCSI to be conferred with their educational award.”

Conferring

Regarding the conferring, Ms FitzPatrick is quick to point out that the ceremony for DFB paramedics is standalone, so it is only for the DFB members and their families.

“As they are not mixed in with other graduates, the day is more personal and we have on occasion been able to allow extra guests, which could not happen at a larger ceremony.”

As an established Medical School, RCSI attracts thousands of students from all sectors and all demographics, but Ms FitzPatrick says the DFB paramedic students stand out from the crowd.

“ ey are di erent in that most of them have lived lives before going to college. ey are not school leavers coming straight in without having developed life skills. ey would be more like graduate medical students because they would be of a similar age pro le.

“Many of them have families and other responsibilities, so they are di erent from the typical undergraduates who are coming straight from school, or the international students who are living away from home for the rst time.

“DFB students are adult learners and in that regard are more like the graduate entry medical students as they are older, have had previous careers and responsibilities and they are not school leavers. As a result, they are better able to communicate their wishes and needs, which can be di cult for younger students at times.”

D/O Lambert adds: “ e students bring the culture of DFB along with them. We are a disciplined organisation, good with communication skills as part of our training, have good technical expertise. It is a very intensive programme, so we do it full-time rather than term-time, and it is high intensity, but we feel it gives a very good education.”

Education

at high-quality education combined with the DFB mindset means that many of those who have undertaken the course have gone on to become tutors a few years later.

“It is a good indicator that all of the tutors from the last class and from the current one have all come through the programme themselves,” Ms FitzPatrick points out.

“Some of our high-level lecture material that previously we would have had to get external lecturers in for can now be delivered by our Paramedic and Advanced Paramedic tutors,” D/O Lambert adds, “so the level of knowledge and expertise they have gained as part of the partnership means they can then go on and deliver that education. We have the expertise needed to do so, thanks to the partnership.”

As any operational FF/P will know, the programme is indeed high-intensity, and is only one aspect of the overall Paramedic training requirements for DFB members.

Programme

“ e programme is 14 weeks long, and we try to blend it as much as possible by having, for example, a theory session in the morning followed by a practical session in the a ernoon, to make it as user-friendly and interactive as possible for the students.

“ ere are assessments such as MCQs and Objective Structured Clinical Exams where we look at both their knowledge and application of that knowledge, and debrief them a er every assessment to see where they can improve. We target their communication skills, get them used to medical terminology and handling patient handovers. e process of patient assessment, give them a structured approach to taking vital signs and making decisions, so they can make a clinical diagnosis and use that information to pass on to the next level of care, which is the hospital.”

“It’s frontloaded, and the students do a full work-week rather than the typical term-time week, so it is a huge amount of content in a relatively short space of time,” Ms FitzPatrick adds. “ ey then have their internships where they engage directly with patient and act on their learnings.”

D/O Lambert adds: “Once they complete their rst set of PHECC exams a er the course with external examiners making sure they are t to practice and safe to go out on the road as undergraduate interns, we put the students on an ambulance for a month supernumerary, seven day shi s and seven night shi s, with registered paramedics, where they observe and learn how to communicate correctly, so it is a safe environment for all concerned.

“We want them to learn and nd their feet, to interact with crews in a safe way, and are under no pressure to treat a patient in that time. Once we are happy with that, they go on the ambulance as second person and are fully supervised, working alongside a registered paramedic. ey are starting to treat patients with the aid of a fully registered paramedic as a safety net. During this time, they also do clinical placements which Patricia organises.” is, she says, involves attending four di erent hospital departments – adult emergency, paediatric emergency, primary care, and the maternity delivery suite – and they also spend a day on the Advanced Paramedic vehicle, amounting to around 80 hours of placements.

Both tell me that during the internship stage, the students also have to undertake case studies on patient interaction and treatments they would have engaged with, and present these before the examiners.

“ ey have two eld case studies which are based on experiences on the ambulance, and one clinical case study based on experience in a clinical placement,” D/O Lambert explains. “ ese are graded by our tutors, and once they have been completed, they complete an International Trauma Life Support programme, and prep for their Part 2 PHECC exams.” ey face the nal viva interview where these case studies are presented in full dress uniform, and upon successful presentation, are presented to PHECC for nal veri cation, bringing to an end close to two years of intense education.”

A year on the ambulance follows, where they have full autonomy, but still have to work alongside a registered paramedic, with tutors sent out to monitor them over three half-day sessions.

“We have to make absolutely sure that they are t for purpose, keep up their study, and are professional in every interaction with the patient,” D/O Lambert points out. “ ey also then have to undertake three postgrad case studies based on experience gained from being on the ambulance.

Evolution

With the ongoing developments in patient care and the roles required of DFB members, the programme has inevitably evolved since it was rst introduced as part of the partnership.

“It started as a six-week course,” Ms FitzPatrick tells me, “but Clinical Practice Guidelines have changed signi cantly since then, and the programme has had to adapt and

THE STUDENTS BRING THE CULTURE OF DFB ALONG WITH THEM”

change to incorporate all of these. at has mostly been done by Paul and the expert tutors working with him, because while we have a lot of medical expertise in RCSI, none of them are paramedics.”

“ ere have been a lot of additional medications added to the scope of practice for paramedic practitioners,” D/O Lambert adds, “additional equipment, new clinical practice guidelines, so we need to make sure the paramedics can operate each of these guidelines to safely treat patients.”

“ e job is therefore very di erent from what it was when the course rst started,” Ms Fitzpatrick says.

Now there is a vast range of medications that can be given to treat a patient pre-hospital.”

Anniversary

In terms of the 20th anniversary event itself, Ms Fitzpatrick tells me it was a very informal gathering, but it was held in very high importance by all who attended, with all RCSI tutors past and present invited, as were all Gold Medal students from the past two decades.

“It is an achievement for the partnership to have grown over the past 20 years,” she tells me. “RCSI’s Deputy Vice Chancellor for Academic A airs, Professor Hannah McGee, spoke on behalf of the RCSI, and CFO Keeley spoke from the DFB side, so their presence indicates how important it was. But we just wanted to celebrate the partnership, and got to look back at all of the events that have developed over the years. It was also great to invite retired A/C/F/O Michael Walsh, who was involved from the beginning, and Professor Shannon, and it was nice for them to see where the programme has come to since it was rst started. It was a very heartfelt occasion for both organisations.” e idea to start such a daunting but rewarding project began earlier in FF/P Donovan’s career.

While Dublin Fire Brigade has a long and rich history, and those who have served within the organisation have many memories to share, it is not always easy to preserve those stories once members retire, or a er time has passed. However, FF/P Darren Donovan of D Watch Dolphin’s Barn, who has been in the Brigade for 20 years, has begun a project that aims to change all that, by compiling, digitalising and sharing DFB photographs from days gone by to the present day.

“I was in Dolphin’s Barn when DFB historian Las Fallon was on C Watch, and he had gathered and put up a lot of photos from the station, and I came up with the idea to put up a display cabinet to house them,” he tells me.

“Las had a lot of printed photos so we added them to the display, and the idea for the project grew from there. It is still very much in the development stage, but I approached all Watches and the senior re ghters at Dolphin’s Barn, and they provided a lot more photos.

“I also spent a few days with Brigade Training O cer Brendan Carroll at the Training Centre going through photos, but there are thousands out there that have to be scanned and digitalised, and it is a major challenge to get the names to put to the photographs… otherwise they are just photos.”

Growing Plan

e initial display at Dolphin’s Barn soon proved too small for the number of photos coming in, so FF/P Donovan came up with the idea to preserve them all.

“ ere is only so much wall space,” he says, “so the idea to digitalise them all came next. I got talking to Paul Hand at the

Training Centre Museum while doing a course, and he told me there were thousands of photos in the Museum. I told him what I was doing at Dolphin’s Barn and we went from there. I scanned lots of photos and saved them so that we could display them on a screen at the station.” is proved very popular at Dolphin’s Barn to start with, FF/P Donovan tells me.

“We put the rolling photo slideshow on during the day and A Watch came in a er us, and when I came in the next morning, they were cursing me because they found themselves taking the chairs out of the kitchen and sitting down in front of the TV for hours! But it’s a good complaint, and it shows that it is of huge interest to DFB members.” e idea for the rolling display has spread to the Training Centre, where a TV has been installed in the Museum for display purposes, and the plans are to have a larger TV installed in the main hall at the Training Centre, and in the canteen, as a way of displaying the ever-growing number of photos that are being gathered and preserved.

“BTO Carroll told me that even the photos of each recruit class are so important to keep hold of and remember,”

FF/P Donovan says, “and the TV is a new way of displaying everything in one space the size of a TV, rather than across every wall. It’s something that just wasn’t being done and it would be a shame if the history and legacies weren’t preserved.”

Memories

e importance of preserving these images is something that he feels very strongly about, because he recognises that memories fade, especially when a member retires.

“ e way I look at it, these re ghters have spent a huge amount of their lives, 30 or 40 years, working with DFB,” he tells me, “and then they retire. ey are not forgotten by those who know them, but others might not remember them when their presence and their service is no longer in front of you, and I think it is important to retain that and have it on record for all to see. So, this is a good way to remember people and what they have done in their time in DFB, because it is a big chunk of their lives, away from their families.

“Also, many times the families of members who pass away could come across a box of old photos and they throw them out, but if we can get them instead that would be great, because it would be a shame for so many vivid memories and stories to be thrown out, as so many probably have over the years.”

FF/P Donovan says he has always been interested in hearing these stories and having photographic records of times passed really brings DFB history to life.

“I have always been into the Fire Brigade itself and have read all the books by Tom Geraghty and Las Fallon,” he tells me, “but just hearing the senior re ghter’s stories when you sit down for a cup of tea in work, or when you go out on a social night, I just became very interested in that, and this is just my way of trying to preserve the past and bring it into the future, for all to see.”

Information

As FF/P Donovan mentions, getting the names, information and context behind some of the photos has proven to be the most challenging aspect, but he has received great support and assistance.

“I enjoy scanning all the photos because I love looking back at the old photos, and I have been in contact with a lot of retired members and senior men who are all very eager to get involved, and a lot of them can really help with putting names to the pictures and giving all that information that would otherwise one day disappear,” he tells me.

“Las Fallon, Paul Hand and James Leigh on Facebook have been great. e Museum, retired members, the DFB social media, people at the station, they have all been very useful sources, but I really want to get my hands on the older stu . Hopefully the displays will be a combination of old and new.

“James is going to give me access to his huge amount of photos, and the idea will be to set up a Facebook chat group where I can put up a picture, and if I need help with the information or context behind it, hopefully someone can provide that information. BTO Brendan Carroll and ABTO Willie Maher have been very supportive too.

“ ere is also a lot of interest from retired members. I have the contact details for a number of them who I am very keen to talk to because I know they will have a lot of photos, but at the moment it is just about nding the time to talk to them properly.

“We have very good records of the modern times in DFB thanks to Trevor Hunt and Ray McMonagle, but the older stu is really great to get hold of too.”

Interest has already come not just from DFB members but from the families of retired members, keen to source a photo they can keep as a memento, and FF/P Donovan wants to be able to provide them with those memories, and to present them for all DFB members past and present to see.

“People spend so much of their lives in DFB, and we don’t want their memory to fade, they deserve more than that,” he says.

Assistance

He is putting the call out for anybody who has photos, or information about photos, to get in touch and help build on the digital archive.

“It would be great for anybody who has some old DFB photos to get in touch with me. e photos will be well looked a er, scanned and returned to you. I have an email set up that people can send the photos through to if they have them on a drive or on their phone. Las, Paul, John McBride - all those guys can give their knowledge - but if anybody else has info that would help, it would be great to hear from them.” e current plan is to have the photos presented on a rolling slideshow at the Training Centre’s main hall on an 80 inch TV, as well as in the Museum and canteen, with a very ambitious long-term plan in the works too.

Aims

“ e end result for me would be if we could get the whole archive and photo database incorporated into the Museum,” FF/P Donovan explains, “so that if someone were to come in and say that their father or grandfather used to be in DFB, we could type in the name and see what photos of them come up, so we could give them to family members. It would be a great interactive feature to have.”

He also sees the digital archive of photos as a way to show a nice touch to retiring members, with the ability to nd all photos including or relevant to that person and have them on a rolling display on a TV at their station on the day they retire.

“ at’s the importance of getting the names associated with the faces in the photos, to get as much information as we can about our members past and present, because we want to be able to remember them and their experiences.”

CONTACT:

If any DFB members or their families want to get in touch with FF/P Donovan with photos or information about photos, you can contact him at dfbphotosdfb@gmail.com

FF/P Alan Sexton climbed Mount Kilimanjaro to raise funds for a great cause in February