Dan Smith – Advanced Paramedic Practitioner
As I approach my three-year anniversary working as an Advanced Paramedic Practitioner within the Community Specialist Palliative Care Team at Compton Care (the hospice in Wolverhampton), the opportunity to write this blog has allowed me to reflect on the time and my experiences and achievements.
I had been working for the ambulance service for 8 years and when a new challenge and the opportunity to specialise came up, I jumped at it. The first few months were a tremendous learning curve getting to grips with symptom management, advance care planning and a whole new environment and I continue to learn things each and every day.
One of the most valuable resources for learning during these early stages was the West Midlands Palliative Care guidelines. The book would probably be one of the best ten pounds I’ve spent during my career. I still use it daily albeit it is looking a little bit more battered than when it arrived.
It was interesting to reflect on how little I knew at this point regarding how natural dying looks and how education around this subject within the Paramedic profession is lacking. This continues to be a goal of mine to improve, and it has been uplifting to see Paramedic students from a local University spending time with our team as a part of their placements.
It is great to see during my three years with Compton that the team has grown to include 5 further Paramedics working within both our Planned and Responsive Care Teams. We have demonstrated a wide variety of transferable skills including physical assessment, strong clinical decision making and being comfortable working in the community.
We were welcomed warmly by the Clinical Nurse Specialists and Doctors within the team. The support and mentoring we were provided has been invaluable and allowed us to grow as specialist clinicians. We have taught them a few things along the way too!
We are all incredibly proud of the service we are able to deliver providing responsive specialist palliative care to the people of Wolverhampton and South Staffordshire across 7 days, including overnight. This level of responsiveness allows patients and families increased access to specialist palliative care helping to ensure their symptoms are managed in a timely manner and that their preferred place of care and death is achieved.
Our growth as a team has been supported with investment in our education. I recently completed my prescribing course with support and mentoring from Dr Fran Hakkak. It was a new experience for both of us and it bought some new challenges and conundrums. Prescribing is a relatively new addition to the Paramedic profession having been rolled out in April 2018. At this time, there was little opportunity for Paramedics to work outside of the ambulance service and it wasn’t felt that there was a need for the prescribing of controlled drugs therefore it was not written into legislation. 5 years later, the profession had evolved, and we were sat discussing how this legislative challenge would affect me in an environment where controlled drugs are a large proportion of the medications used to manage symptoms.
Luckily, thanks to the tireless work of the College of Paramedics, legislative changes occurred at the start of 2024 allowing the prescribing of a limited selection of controlled drugs which has certainly helped to provide responsive specialist palliative care to my patients. Working as a Prescriber has added a new element to my clinical practice and has certainly made me aware I still have a lot to learn.
I have had an enjoyable three years working within Specialist Palliative Care. I have a job that I see as a privilege to be able to do and it provides me with tremendous satisfaction. I am lucky to work in a team that is passionate about patient care and is filled with incredibly caring and highly skilled individuals. I have had some new and exciting opportunities such as being able to showcase our work by attending the Nursing Times Awards and submitting a poster to the Hospice UK Conference.
It has been an interesting three years and there is certainly more hard work to be done!
Fran Hakkak – Consultant & Medical Director
It’s a scary fact but I have worked in palliative care for over 20 years! I did my palliative medicine registrar training in the West Midlands and took my first consultant job at Compton in Wolverhampton in 2009, working mostly in the community. I moved into the Medical Director role in 2018 but still maintain some community clinical work – community is my first love and remains my favourite setting. I have supported and mentored clinical nurse specialists through their prescribing course in the past, but supporting a paramedic was new to me, and as Dan has said, brought interesting challenges for us to overcome in terms of what our paramedics would actually be allowed to prescribe. Thankfully the legislation is catching up with what’s needed in the real world and Dan is now able to fulfil the role he has worked so hard to develop within the team.
When I look back on how much our community services have evolved in the last 15 years, they are now unrecognisable from back then. The team has expanded significantly and is much more diverse, with nurses joining us from increasingly varied backgrounds e.g. ED, as well as the paramedics coming on board. These different practitioners have brought with them unique and varied attitudes and skills, essential to really developing our rapid response team, our out of hours provision, and most recently, our virtual ward.
It has been a real pleasure to mentor Dan, and so lovely to see the whole team develop and grow. Who knows what the next 20 years will bring – anything is possible!
See more about Compton Care here – Compton Care | Care & Support for families living with life limiting conditions
You can connect with Fran on X @virgilsbees