Paul Jones will firstly introduce a initial series of posts, encouraging the CPD Community to refresh or gain new insight into topics discussed during recent conferences. The conferences include the "Emergency Services Mental Health Conference" and the "Human Factors in Paediatric Care". Please feel free to engage in discussion via this blog or via Social Media. 


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  • 01 Jan 2020 11:00 AM | Anonymous member (Administrator)

    We know we do things right, we know that those we serve and look after are getting the right deal from us for the right reasons. But in who’s eyes? I beg to challenge you to disagree with me on some key statements about care for people with mental health issues: 

    • We sometimes break the rules to do the right thing 

    • We sometimes do things because they feel morally right to do 

    • At times we are conflicted by what is right and what is legal 

    There, I’ve done it, I’ve committed myself to being honest! And I’ll try to tell you why. 

    We’ve all had that one job where we’ve just known what was needed but also known that it can’t be done: the need for aggressive end-of-life care; the understanding of why someone thinks they’ve had enough; the demand to give someone a break, a second chance. And we’ve mulled over any number of aspects before coming to a decision – what’s right, what’s in the rules, what would others think? And then we’ve made a decision, whether it’s an independent decision or a shared one, we’ve made it. And we’ve based that decision on two key factors: experience and knowledge… because both are needed for the best decision to be made, but both may also be limited when it comes to mental health care too. 

    What isn’t picked up on in the requirements set out above, is the need to consider your personal perspective in amongst all of this: what direction your moral compass points and where you place that thin line between legal, and not so legal… 

    Our own situational judgement can be pre-set and dangerous. What would we do, what do we think is right and wrong, what have we seen go well (and not so well) in the past? We have opinions, thoughts and feelings but it is essential not to let them weigh too heavily on the decisions we make about someone’s health and wellbeing. At times we are asked to make a judgement without being judgemental – but is this an oxymoron, a contradiction in terms? 

    I wonder how many people will post comments on this particular blog – I wonder about the level of acceptance from colleagues, I wonder if I’m out of touch. The bit I don’t wonder is whether or not the truth lies within us all. 

    I really do look forward to this discussion; it will be professional, it can be personal, and it must be heartfelt and honest… 

  • 01 Jan 2020 10:00 AM | Anonymous member (Administrator)

    I was part of a discussion forum recently addressing a group of entry-level students, entry level to the health service that is. They were asking our multi-professional group about how to become mentally stronger and best prepare themselves for the ‘horrors’ that they may face in the future… 

    Now I thought this line of questioning was really interesting. The group weren’t made up of college-leavers or snow-flakes as some might think, it was   made up of a combination of great humans from all   walks of life, and all sorts of backgrounds, from across   a fairly wide age-range. But they still had a fear of how they might cope – a fear that some suggested had come from a position of ignorance: via the television and social media who have told them that it’s tough out there - so obviously, it must be tough out there! And their questioning turned to me (as the Paramedic in the line-up) as I have obviously faced the worst horrors of all, and as such must be so much more resilient. They assumed that nothing could affect me! 

    Granted, certain professional elements are exposed to reality much more than others – that cannot be denied, and as emergency service personnel we are all at the sharp end of life’s worst-case scenarios with very little option of where turn to next. But the most interesting comment that came out of the discussion was this one:  

    “…can you be professionally resilient and still care?” 

    Wow, that one threw me! So, I got to thinking about what we traditionally see as resilience and thought of these examples: being able to deal with a sad situation without crying; coping with death without it making you think; seeing traumatic situations without being overcome with shockdealing with circumstances without becoming emotionally embroiled; being able to leave the jobs we’ve done on shift in our locker when we go home…

    It was mainly the final one that made me realise that the answer to the question is simply “yes, we can still care”. It’s about striking a balance. It’s about them and us. It’s about limiting the risk of psychological trauma by having ready-made coping mechanisms that work for us while we do our job in the best way we can for others. It’s about recognising the places we can go to speak safely about the work we do for those who need us. It’s about bringing some personal calm to the professional chaos. 

    So yes, we can care – we can be humans and at the same time we can do our jobs. There’s no need to put on a mask, to brave it up, to pretend everything is okay. The service-users we face in these situations sometimes want to know we care, so why try and switch from being a professional to be a real person, when the best professional  is a real person? 

    Remember, it’s okay to not be okay… 

  • 01 Jan 2020 9:00 AM | Anonymous member (Administrator)

    Maybe you thought this post was about the acceleration prowess of the latest response vehicles. But I think that 0 to 100 has a far more valuable context – within the next 25-years it could be the 'normal' lifespan of a human! And during that lifespan, those humans will face quite a few challenges. Many of the physical ones will be dealt with admirably and this could be the reason that life expectancy is increasing: evolving drug therapies; excellent surgical techniques; improved emergency care; improved understanding of life-restricting activities; and such things as organ donation and replacement. But the aspects that are not understood so well or taking such drastic and forward-thinking steps relate to the mind: that great unknown. 

    Adult mental health and wellbeing is becoming better funded, more researched and accepted as a necessity in modern society. All emergency services personnel (and many other healthcare providers) are becoming more and more attuned to the needs of those with psychological disorders or challenges. And this is a really good start, no issues here – but what about those service-users who sit at either end of the age spectrum? What about children and young people, and the elderly? I don’t mean those who are unfortunate enough to have recognised, diagnosed issues such as autism or dementia, I mean the ones who have acute challenges such as stress, depression, anxiety or loneliness. Where does our understanding go for those individuals? 

    Well, it could be me, but I think we have a tendency to try and push that worry aside in general. Either on to someone else or alternatively back to the individual: to label it as something else or suggest it isn’t within our remit. Too many of the most vulnerable in society (and by this I mean old and young) are continuing to suffer psychologically as we put their situation down to it just being their age, or the fact that we live in a ’snowflake’ society (I personally hate that word...), that someone is grumpy, or ‘just’ a teenager… But mental health and wellbeing diagnoses for these age-groups is on the increase, and we as the front-line connectors need to be ready for this. 

    Are we trainedare we educated, do we know, are we ready!? So many questions. But there are so many more – are we bothered, is it our problem, is the problem real, are the issues just a representation of something else? I could go on… 

    We live in an ageing society where acuity continues to reduce year by year, but also a society where children and young people are seen more and more as being at risk of mental health problems, and I suggest that what we do in order to know best how to help is far from adequate. We do our best, we try to do no harm, but we can’t do what we don’t know. 

    So what’s the answer? 

  • 29 Dec 2019 9:00 AM | Anonymous member (Administrator)

    Mental Health and Wellbeing has, for many years – maybe even centuries – been seen as a complex set of conditions which are challenging to suffer from, live with or manage. 

    In the broad context of easing the feelings that people have when suffering, and the treatment that they may (or may not) need or receive, there remains the individual, the person, the patient/ service-user/ client (delete as appropriate). I smile to myself as I wonder if we spend more time worrying about what title to use than we do deciding what best to say to them… 

    Anyway, I digress, in amongst all of this there emerges one group of individuals that I suggest we, as emergency healthcare providers, do not fully understand. A group of individuals who we may see through narrowed and ignorant eyes, a group of individuals who have historically been mislabelled as ‘attention seekers’.

    Those are the people who feel the need to self-harm, the people who cannot see a way out of the mire that is their life, those that cut, burn and scar themselves, those that feel so desperate that they need to remove themselves to a quiet place and end their life.

    Do we fully understand them? We may be able to sympathise or even empathise with their circumstances – you, like me, may have been close to the edge when all else seemed lost. But what do we do – our best!

    CPDme have a series of presentations from a recent conference event which focused on mental health and wellbeing and the emergency services. Some of the speakers who offered their time to this cause are remarkable, others are just fantastic. They made me want to pose some questions though – and as such, over the next couple of weeks that’s what I’m going to do through the power of a blog – feel free to reply and let’s get talking…

    My first question would be: as we exit the festive period where (most of) the developed world had decked their halls, sang carols, shared gifts and spread love and happiness why do some people still feel the need to engage in ‘self-injurious behaviours’? Is there a need, is there a gap in the system, is it just the way it is, is there a solution, is there something that society or just each of us can do?

    That wasn’t one question was it, and nor do I expect there to be answers – but I look forward to some discussions… 

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