The Institute talks...about becoming a paramedic apprentice

In this episode of The Institute talks, we talk about the invaluable experience gained through a paramedic apprenticeship and the range of progression opportunities available.

In this podcast, our host Fariba Carr is joined by Justin Honey-Jones, a senior paramedic and a member of our Health and Science route panel. He is also an associate lecturer in Paramedic Science at Anglia Ruskin University.

Justin speaks about his own experience from routine calls to the bigger emergencies such as Grenfell Tower and how to decide if an apprenticeship is the best path and where to apply.

He also mentions how apprentices on average gain 1600 to 1500 hours of front-line clinical experience per year, whereas university students will have 750 hours per year of frontline experience. All that experience allows apprentices to see the whole system, and as Justin stated:

“The paramedic qualification is just the start of a wonderful journey, but it's a golden ticket and it's what you do with that ticket that kind of opens up your path and your aspirations.”

Transcript

Fariba Carr

Hello. I'm sorry, Fariba Carr, head of membership, communities and events at the Institute and your host for this podcast. Today for this Employer podcast. I’m delighted to be joined by Justin Honey Jones, a senior paramedic and a member of our Health and Science Route Panel. Welcome, Justin.

 

Justin Honey Jones

Thanks for having me, Fariba.

 

Fariba Carr

So, give yourself a little bit of an introduction.

 

Justin Honey Jones

I'm Justin, I'm a senior paramedic with east of England Ambulance Service, and since the first of January this year, I started as a clinical educator with St John Ambulance. And also, I'm an associate lecturer in Paramedic Science at Anglia Ruskin University.

 

Fariba Carr

Thank you, I'm so glad that you could join me today. So, let's get started, and perhaps you could tell me a little bit about how you found your way to being a paramedic. What made you choose this profession?

 

Justin Honey Jones

To be honest, there's a few key events really throughout my life, and I've ever since a young child, it's all I ever wanted to do was to be a paramedic. I mean, there was no specific reason. But more more events that happened. I mean, 911 was a key event. I remember being the age of 15, I was doing my work experience and I was at the Fire Service Training College in South Wales. I remember literally over lunch seeing the tragic events that happened at 911. And it was the first experience of seeing quite a large-scale incident of firefighters, paramedics, police officers all working together. It was key public services and I had quite a significant impact and that was also linked with work I was doing as an army cadet at the time outside school. We were learning about first aid and developing first aid competitions and ultimately led to my sort of started my career really as an army reservist with the Royal Army Medical Corps, and I trained as a combat medical technician. That’s when I started having my first interactions with paramedics and nurses and doctors, and it kind of cemented my career. I knew that's what I wanted to do.

 

Fariba Carr

Thanks. That was really interesting to hear what inspired you. Do you feel that the career that you've had since then has lived up to what you thought you were going to be doing? Is it is it different in any ways?

 

Justin Honey Jones

You know, it's really interesting. If I think back when I was a child, you know, what you think of a paramedic was what you would see on casualty or E.R. or those type of medical programs. But it's nothing like the TV shows. To actually be a paramedic, you start to see that, you know, it's anything and everything in life. Colleagues and I will frequently say the job is about the circle of life. I remember one of my most significant shifts was when I started in the morning and we delivered this beautiful baby boy who came into the world at 7:00 in the morning, in the back of back of a taxi, which was quite an experience, if you could imagine starting the day and no coffee early. It was quite a shock with this event, and we attended numerous calls throughout the day. And then sadly, we finished off the end of the day and we had a patient that was an older patient that sadly went into a cardiac arrest and didn't survive. And that full shift is a classic example of the anything and everything that you can get as a paramedic. And that's what makes it a wonderful job is you don't know what you're going to do and you have to be prepared for literally anything and everything. It certainly keeps you on your toes, and it never disappoints.

 

Fariba Carr

That's really interesting to hear about that kind of span of activity that you're going to have from one day to another. My 16-year-old and Justin, I know, you know, this is really interested in this and I asked her a little bit about why she wanted to do it and the questions that she might have. So, some of the questions you're going to hear from me today are questions that she would like to have answers to. But I think you're right. You know, episodes of Gray's Anatomy or Casualty can sometimes be the kind of first inspiration to launch someone on their career. But it's important to understand, isn't it, that you know, those kinds of glaring and high-octane emergencies are not necessarily the bulk of what you do as a paramedic. That you attend every sector of society and all of its circumstances, and sometimes you do need to respond to that absolute emergency and sometimes it's more kind of comfort and talking and educating. Is that your experience or is that just a kind of fallacy from an outsider?

 

Justin Honey Jones

No, to be honest I think that's a perfect description of the role. You do deal with trauma, you do deal with medical emergencies, but you do also deal with the social aspects of society where perhaps other services haven't been as effective. Some people do slip through the net and we deal a lot with patients who may be experiencing a mental health crisis, for example. Or, you know, you may have a young mum or dad that just need help, they want to speak to somebody. And 999 is that number that they know that when they dial those digits, that someone will come and help, and that will be they at their time of crisis. So, you do you literally deal with all parts of society and, you know, from trivial problems through to serious problems and it's one of the attractions to the role, it always keeps you on your toes.

 

Fariba Carr

And do you work quite a lot with other emergency services?

 

Justin Honey Jones

Massively. I mean, you know, daily you'll be working with the police. Doing my time with London Ambulance Service Unit, I'll be working with the Metropolitan Police Service or Hertfordshire Constabulary, but I work with my current trust. But you work with the fire service, and you work with other services, whether it be, you know, maternity services or maybe social services, you're always working as part of a multi-disciplinary team. We can't do our role without that. We have a wonderful relationship with our local GP surgeries and we'll make referrals of their patients to them, and we're working with other different organizations in the community. We’ve got wonderful charities as well as other public services. So it's all about literally everybody working together for the best interest of patients.

 

Fariba Carr

I have a friend who did her paramedic training in Birmingham, and I think she would say that there was a fair amount of crime involved in the call outs that she had, and I wondered whether you have any training that helps you know, how to deal with volatile situations or violent situations? Or do you trust that the police will be on hand to support you in that?

 

Justin Honey Jones

We are we are trained in conflict management and as part of our apprenticeship program, we undertake education and conflict management at both the theoretical side as well as the practical side. We undertake regular refresher training in those skills. But I think one of the key features of being a paramedic is one of your best tools is the ability to communicate. Often there are conflict situations and an often unnoticed because someone may feel that they are not being understood or their needs are not being met. And I found with my seven years’ experience of being on the frontline is that sometimes it's just talking and sometimes it's just listening to what the patient is saying in front of you. More often than not, you can prevent a lot of situations from them from escalating into conflict. Having said that, I've had my full array of conflict situations during my career. Some of it I am fully aware of because the information is on my screen telling me what I'm attending. But sometimes I attend an address and I'm presented with conflict that you have to suddenly deal with. Now we've got this wonderful safeguard of our magic red button on our radios. And you know, if the time came that we needed immediate police assistance, you press that button and you know, I'm reassured because I've had to press it once that every police officer will come from every direction to our aid, and the time I get a press it. I had eleven police cars from every direction around. Come and help me at my time of need. There's only so much you can do as a paramedic, and we are aware in the news of the situations of conflict and difficult circumstances were presented with. But we couldn't do our job fully without knowing that the police would be there if we ever needed them.

 

Fariba Carr

Oh yes, absolutely. It's clear to me that what you do day to day can be really stressful, and we've talked about some of those crisis incidents. And I know that a large part of your job is to look after the health of the patient until they're delivered to a longer-term care or facilities to manage their care. So, you won't always get to hear the outcome of your interventions. And I know that your job must be really stressful at times. How do you deal with that?

 

Justin Honey Jones

It is. You are right. It's extremely stressful, and it's one of the difficult aspects because every shift you may deal with, you know, between eight and ten patients per shift, and it's it's very difficult that once they hand it over, you know, legally, you have no right to know any further information about that patient's progress. They enter the other aspects of the wonderful parts of the NHS and some patients they may be called to see again, you know, several weeks or sometimes several years later, and that's when you find out their progress. But there are challenges. And you know, one of my worst ever calls were what every paramedic grades was being called to a baby in cardiac arrest, and we successfully resuscitated the baby, but he was very poorly. But to this day, even several years after the event, I don't know whether that little baby is alive or not. And that does play on your mind because it's there. It's you are a human being doing this job, and it's a hard aspect that you just want answers sometimes. This is why your colleagues are really key that you can talk about those experiences. And you know, if things are on your mind that you can speak to colleagues, we have lots of support available. And you know, if you need counselling, you can have counselling. We've got a wonderful team managers that look after us and we've got wonderful services as well that we can access through, you know, the blue light program. So, there's lots of support available should you need it. I think it's key that you do keep busy, but you do reflect. If certain things are playing on your mind, it's important to talk to somebody about it. And that's really key with my training that we do that.

 

Fariba Carr

Absolutely. And do you think you learn a little bit to compartmentalize and to box off a little bit the experiences that you've had during the day so that they don't carry with you when you set foot over the threshold of your own house?

 

Justin Honey Jones

I wish I could say it happens all the time. You know, a lot of my shifts. It becomes, you know, like a normal working day. You get used to a similar pattern of calls. But there's always those unique calls which do unfortunately, they do come across the matter of your front door because you do bring them home and they do play on your mind. But this is where in my case, I'm very lucky. My wife has been with me all the way through my entire journey. Sometimes you come home when you just need to talk about it. You know, something is playing on your mind. But at the same time, it's how you use that experience. And, you know, quite frequently with all of my students, you know, I use these examples to make our training become real because we're educating our apprentices and all of our students to enter the real world. And we want to give them that context that this is theory, but this is how the theory applies in that practical context. It's quite good sometimes to actually bring the learning experience alive and actually get questions from your students. Well, what did you do? Why did you do that? And it really helps their learning experience. That's why I find that's really quite useful, because you never forget every patient. Every patient is a unique human being that crosses our path, and we cross their path and they all leave a little memory in you. So, you know, every I could be walking down the street, a certain smell, I could go into a certain building, and I've got a memory of some sort of some patient interaction that I've had. So, so every patient touches you literally in a different way.

 

Fariba Carr

Justin, I love that you shared that with us because I think it's very authentic, and I think it will really help those people listening to our podcast who are thinking, how will I know if this is the career for me? And I guess when I think about my 16 year old, I mean, thank goodness we my son did have a pretty spectacular accident a couple of years ago, and I think maybe that's shaped her thinking about what she wants to do. But there'll be a lot of young people who haven't had to experience trauma and thank goodness they haven't. And they might be thinking, OK, how will I know whether I'll be able to cope? Is there a point at which you can say fairly early on, this is really not going to be for me or the in your experience? Do you find that students who step forward are able to kind of dig deep into their resilience so that they're able to manage the stresses of the day to day?

 

Justin Honey Jones

Do you know Fariba that's a really interesting question, and it's something I'm asked quite a lot of by my students quite early on in their careers, and really the only answer is your apprenticeship experience prepares you for that real life journey because someone said to me the other day, You know, when you work in the NHS, you're doing a normal job just like others, but you're doing it in an extraordinary set of situations. And they are some extreme ends of life with some of the things that you see. But because of that experience that you experience those calls with another person, and you have that bond that you share that relationship and that experience wave. And you know, still to this day, if I think of one of the most ever challenging circumstances I ever attended, it was Grenfell Tower. And you know, I was watching when I when I wake in the morning, I asked, you know, I wake up at half four for my shifts and my shift will be at 6:00. And I was literally watching having my breakfast, the TV and I could see the awful events of what was happening on my first call as I arrived on station was to Grenfell Tower. And I'm still to this day I remember looking up at the building, I can still picture those horrendous scenes, but I was with my crew mate and the both of us experienced that together. And you've got that unique bond with the people that you work with so closely. And that's invaluable. And whether you're a student on their apprenticeship journey or a student at a university, you've got their support because you're working with your practice educators, and you help share those stories. You've got time to debrief is what's what we call a hot debrief right after every incident. We effectively strip it back and we look at what we did and what was good. Is there anything that we could have done better? Were there any training needs? You know, how's our mental health? And if there are any issues, we then start access and all of that wonderful support that's freely available through the ombud service itself. So, you develop your resilience bit by bit and every job that you attend will support that resilience development. I think a lot of it is also what you do outside of your role. For some people, you know, fitness is really key for some people, you know, mindfulness is really key, you know, concentrating on their breathing whether it's, you know, reading books or having some quiet time walking their dog. Everyone's got their unique way of coping with the role. It's really comforting to know that if the time ever came that, you know, personally, if I was never coping and I know there's lots of expertise available that I could access to help me get me back on my feet. So, you know, so well, I'd say to anybody who's wondering if this is the career for them and you know, can they be resilient enough? The answer is yes. Yes, you can. And you develop it bit by bit. And you know, I'm a living example of that.

 

Fariba Carr

That's fantastic to hear just in, and I think it will be very reassuring to people who may be a teetering on the brink a little bit and thinking it's something they'd love to do, but will they be able to cope? Can we talk a little bit more now about the career of being a paramedic? Because again, I think when Phoebe and I talked about it, she was interested in How do you progress? And it seems to be more obvious in other parts of health care. So, you start as a nurse, and you can become a nurse in charge of ward sister and matron. What is the progression for a paramedic? You're a senior paramedic, but what does that mean?

 

Justin Honey Jones

If you if we think back, if we go back 25 years ago, paramedics were effectively ambulance drivers and our role was to pick a patient up and take them to a hospital on blue lights and then a doctor and a nurse would do the assessment and the treatment. Fast forward to where we are and you know, the paramedic profession, even though it's cold, you know, the baby of all medical professions, we've proven ourselves to be able to respond to all sorts of incidents and the training has evolved with it and how you qualify. I mean, now we know the routes that we have today will be or whether it's a paramedic apprenticeship degree or whether it's a paramedic degree itself. They are golden tickets because what that paramedic status does is it allows you to look at very different avenues. Everyone, first of all, gets their experience on a frontline emergency ambulance. They will attend 999 calls and as part of that apprenticeship journey, they will experience on average about 6500 to 17 500 hours of front line clinical experience per year of that apprenticeship journey. University students, on the other hand, will have 750 hours per year frontline experience, and that experience allows you to see warts and all, you know, the whole, the whole system. Now, once you qualify, you can continue on frontline emergency ambulances, gaining more front frontline experience and you can progress into different areas. After you're two years post qualification, you can then apply to to follow the different strands. The College of Paramedics called Callister for the four pillars, but we've got we've got a research element, we've got a management element, we've got a clinical element and then we've got an education element. The clinical examples will include working on the Hazardous Area Response Team. You know, these are clinicians who are trained to work in dangerous environments, and they go to, you know, Cox Buildings. They will go to terrorist incidents, they will go to patients that may be collapsed and under rubble, buildings or major trauma or major traumatic incidents and you can then progress and you've got advance paramedics in critical care and they do specialist training and they will they will train to deal with the most critically unwell, injured patients, and they've got extended training and extended equipment and drugs to be able to keep that patient alive and work with other colleagues. But if trauma is not for you, there's options to work in primary care. So, for example, you could be a primary care paramedic working in your local GP surgery, or you could work in an urgent care centre, or you could work in A&E. And there's lots of different roles available. And you know, you've got the prison service, for example. They love paramedics, you've got your local police stations, you as paramedics to look after the two detainees. But it doesn't just end on the clinical side. You've got wonderful roles in terms of teaching. We've got fantastic roles as research paramedics finding out about the latest drugs and finding out about the latest innovations that can be used to improve practice. And then we've also got management roles, whether that's being an incident commander responding to serious incidents, supporting colleagues all the way through up to being a chief executive. You know, the paramedic qualification is just the start of a wonderful journey, but it's a golden ticket and it's what you do with that ticket that kind of opens up your path and your aspirations. And what I'd say far above the final part is you don't have to stay in one of those pillars. You can do a combination of those pillars, for example, I do the clinical pillar and I do the education pillar. Some may do management and clinical, some may do just research or just teaching. It's lots of opportunities depending on your career, your path and your interests.

 

Fariba Carr

Wow. That you've really shared with me some things that I didn't know that, and I think that will really excite a lot of people who are thinking ok, once I've once I've started that, what opportunities might there be? one of the questions that my daughter asked, and everywhere we go just in, you know, we get this, what kind of salary can a paramedic? And then maybe all the way up to a consultant paramedic expect, is it very much the same as you might expect in nursing? Tell me a bit more about that.

 

Justin Honey Jones

To start off with so paramedic when they qualify, they will start on band five, I don't have the exact figures to me, but a typical salary will be around about 25,000 plan to start with then on start in Band five and it's probably similar to nurses. But the difference with paramedics is we will become a band six paramedics within two years of qualifying, so jump quite a big payback. And within two years, your pay is then around the 36,000 pound mark. And if you wish to progress, you know, to go through the system and become a consultant paramedic, then their salaries of the sort of the 75 to 80,000 pound mark. So there's quite a difference and there's lots of different positions and there's lots of different roles. And you know, if you wanted to work, for example, in the GP surgery that's normally paid about seven rates, which usually starts at around about 40,000 or so, and that can be undertaken usually after a few years of qualifying as a paramedic. So, lots of opportunities and lots of this and wonderful. Opportunities ahead. But financially, you can get remunerated for your experience, for your qualifications and your commitment. But it's a progressive salary as well that increases with your experience and your commitment to the role.

 

Fariba Carr

Thank you. And just we've touched on going straight to university to do a degree in paramedic science and we've touched on during an apprenticeship, and I suspect a lot of listeners will be thinking, wow, apprenticeship, all of those extra clinical hours you earn as you learn. But how does somebody go about finding one of those?

 

Justin Honey Jones

So, with all of the apprenticeships so you can start your journey as part of the role and now every ambulance trust across the country has a slightly different terminology. But for my trust with the east of England and service, the ad will say Apprentice Emergency Medical Technician. So, if you go on their website, it will say that they are recruiting for apprentice emergency medical technicians. And that's the start of the journey. And it's the route that I started with the London Ambulance Service. And you undertake that apprenticeship, which typically takes between 18 and 24 months and you're right, you get paid as you learn and you're paid a band full salary whilst you're learning, which APR is about 18 to 20,000 pound per year plus you get all of that experience. You get all of that mentoring and working with a qualified member of staff. Before you do your end point assessment, and you qualify as an emergency medical technician in your own right with all your qualifications. But once you've completed that apprenticeship, you can then apply for the new paramedic apprenticeships, which launched last year. And now that that means that you wanted to take your apprenticeship with your employer, you normally go four blocks of learning for 42 weeks at a time, which will be in partnership with a university. And then you go back on the road practicing those clinical skills with your practice educator for a further two years. And then on qualifying you, you start on your Band five salary, which I mentioned was around the 2420 5000-pound mark. And then after two, after two years, you qualify as a paramedic, you become a Band six commission and a your golden ticket for your career. So ultimately, the journey could take anything from a roundabout sort of four to five years, from starting as an apprentice emergency medical technician to qualifying as a paramedic with a full degree. So, there's lots of opportunities, but it's looking at if the local ambulance services website and seeing what opportunities that they have, but they do recruit very regularly.

 

Fariba Carr

Thank you. And how would that differ if you went to university to do a degree in paramedic science? Do you still need to do the emergency technician? How does that work?

 

Justin Honey Jones

So, you don't? If you apply direct to the university, you will do a three year degree in paramedic science. And during that course you would complete the element of an emergency medical technician, which is a new one. And then the paramedic element is usually you two and three, though you do qualify quicker by going to university. But the university fees and living costs, you know, my students say to me, you know, their average debt at the end of university will be around the 50,000 pound mark. Whereas, you know, when I did my apprenticeship, for example, I don't I didn't pay anything for my qualifications and I got paid a salary all the way through. So you've got to weigh up what's best for you. You know, if you if you want to qualify as a paramedic quicker and you want that university lifestyle and the experience, then in three years, you can be a paramedic. But if you want to earn while you learn, if you want to access more experience, if you want to have more one to one time and learn over a slightly longer period, then that apprenticeship is that that better option for you. But it's weighing up what your aspirations are because, you know, I think personally that it's all about how you learn and what you want to be as an individual and you've got to look at what opportunities are best. And for me, the apprenticeship journey was like for me. But equally, the university experience is right for others, so it's looking at what's best for you and your circumstances. And if you are in doubt, what I'd recommend is that you, you know, go to these universities, see what they have as part of their offering as part of their open days. And if in doubt, find your local ambulance trust and ask them about their own apprenticeships and see what they think, what they say, and try and reach out and find people who've done an apprenticeship and listen to their journey. At least that way, you can make a good. Informed decision.

 

Fariba Carr

That's hugely helpful, thank you for those insights and can I just confirm my own understanding. So, before you can apply either for the apprenticeship route or for the university route, you must have had a full clean driver's license for at least twelve months. Is that right?

 

Justin Honey Jones

It is. I mean, it's really important to check the recruitment information because every trust may be slightly different, but I'm aware of my own trust that you have to be driving for a minimum of twelve months. And it's always advisable to have your C one category on your on your driving license. But a lot of ambulance trusts would be happy if you've got the provisional status and they will either pay or you can pay, and then they pay you back apart, apart fee every single month. So effectively, it's like they pay you back in instalments, but they will. They will pay the full C1 license for you. So, every trust is different and it's important just to check and what they're able to offer.

 

Fariba Carr

That's really helpful, thank you, Justin. I feel very sad that we have run out of time now because I think that we could have at least another couple of hours and carry on what has been an incredibly interesting and useful conversation. But sadly, I think we have run out of time. So, I wanted to say an enormous thank you to you for taking the time to join me and for sharing your insights and your experience to all of the listeners. Thank you for listening and look out for the next episode. Goodbye to everybody.