Community Specialist Paramedic, Rebekah Gunn Monday I begin my week working a shift, working out of Sharston Ambulance Station. It’s been a few weeks since I’ve driven an ambulance but my colleagues are very accommodating, plus it helps me get to grips with the local area, which is still fairly new to me. I learn the handover procedures at Manchester Royal Infirmary (MRI), Wythenshawe and Salford Hospitals and manage to have a quick chat with other crews as well. Tuesday I always happy to develop my skills and I have been advised to attend a motivational interviewing course, as part of my CSP role. Motivational interviewing is a technique whereby the patient is encouraged to talk more than the healthcare professional and ultimately take responsibility for their own health. Our role as healthcare professionals is to encourage this responsibility utilising a variety of techniques. Although not wholly applicable to those with a genuine emergency, in an ambulance service where 90 per cent of our workload is urgent care work, this technique can be applied successfully to a number of our patients and when used well, could reduce future calls. The day was delivered by two ladies with a nursing background, with not a power point slide in sight. A really thought provoking day and I take away useable skills and techniques. Wednesday Today I am driving an RRV, spending the morning observing with the Children’s Community Nursing Team. The team promote a lot of early discharges from ED at MRI, they have an excellent skill remit and are very knowledgeable. They undertake home visits and clinics for a number of paediatric conditions and support inhaler therapy through acute onset respiratory conditions such as bronchiolitis and exacerbations of asthma. The team encourage the patients and parents to follow a plan of action and are available from 8.00am until 10.00pm every day. I am keen to look at any opportunity whereby NWAS could link into this team for our paediatric patients eliciting pathfinder amber outcomes. In the afternoon I met with one of the two nominated GPs at Chorlton Family Practice responsible for care planning. We have agreed to start by creating a Community Care Plan (CCP) for every care home resident in the two care homes attached to the surgery. Thursday This morning I attended the weekly Chorlton Good Neighbours meeting which is a local charity and successful Neighbourhood Care Group looking after mainly older people in our community, including the wards of Chorlton, Chorlton Park and Whalley Range, Manchester. The volunteers work to ensure elderly people do not become isolated, encourage socialisation at ability level and provide for basic health needs through invitation of opticians, podiatrists, nurse clinics etc. The group have been fundraising for and have purchased an AED, so the group would like to know the best location for storing it. I consult with Dave McNally for advice and feedback to the group and I’ve agreed to deliver AED and CPR training, along with a presentation about pathfinder and possible ambulance call out outcomes. Next week, I’m going to observe ACM Janet Martin within the group’s drop-in session. The session enables attendees to approach the nurse with questions relating to increased falls, medication queries and blood pressure checks. The session is exceptionally popular and successfully averting predictable deteriorations through early intervention. There is scope for me to become a second clinician at this clinic setting. I spend the remainder of the day completing CCP’s and being available to respond to 999 calls. Friday Embedding myself within the local community is a key aspect of my role and the time spent this week observing and meeting with healthcare colleagues and groups is crucial to my role. Today, I observed with the Intermediate Care Community Assessment Team. The team have a bed base at Gorton Parks for those who cannot be at home independently due to a temporary recent decline in functioning but whom do not need to be hospitalised. The team also has a community assessment element, whereby they receive referrals from GPs, Social Workers, families and NWAS to conduct an assessment and implement any aids that may be required to improve wellbeing, such as, physiotherapy, lifeline pendants, grab rails or perhaps a step-up to the bed base unit for up to six weeks. The team is already known to local crews as they receive our falls and diabetes referrals, they are an excellent team due to the thoroughness of the assessment conducted on their visit. In the afternoon, I’m available to respond to RED1 & RED2 calls within a two mile radius.