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In characteristic uniforms trimmed with reflective tape, with backpacks loaded with equipment, they break records in climbing floors, constantly swear and skillfully hide emotions. A few weeks ago we applauded them, now their fists are back. A paramedic has a permanent place on the podium in the rankings of the most stressful professions. To find yourself in this profession, competences are not enough, you need physical strength and enormous mental resistance.
- When asked why they chose to work as rescuers, many answer that it is a true passion and vocation, a profession that gives a great sense of mission
- Many, despite being called, give up with time. – Running up the stairs with a 20-kilogram backpack and defibrillator, under-sleeping, under-eating and health problems decided »- says Dominik Tarnowski, rescuer from Grodzisk Mazowiecki
- As they admit, they discharge their emotions by smoking, cursing and talking about sex. This profession is mainly performed by men who admit themselves that they do not know how to talk to each other. They prefer to play tough guys, which later affects their loved ones.
- Although saving people’s lives gives them great satisfaction, they complain about working conditions: low salaries and the need to work on contracts. – There is one ambulance with a team of two in Grodzisk Mazowiecki – explains Jakub Wiśniewski. – We ride with a headache, fever, pain in the spine. If we don’t show up for work, the ambulance won’t leave
“Puls Medycyny” cites last year’s data from the National Health Fund (NFZ) determining the number of paramedics in Poland at 23. There were 419 employees on full-time jobs or contracts in emergency medical teams, of which 19 worked in emergency medical teams, and 901 in hospital emergency departments.
When asked why he chose such a difficult profession, Dominik Tarnowski, coordinator of the team of nurses and paramedics at the Hospital Emergency Department in Grodzisk Mazowiecki, replies:
– And why becomes a priest? Vocation. I have rescue in my genes, dad used to drive as an emergency doctor. I often visited him at work, I remember that I was fascinated by big Fiats with roosters on the roof, all these sounds and flashes. After graduating from high school, I went to law, but I quit when I found out that a medical emergency program was opened at the Medical University of Lodz.
I am the first year of graduates. After three years of study, I became a licensed paramedic, and in 2006 I defended my master’s degree and started working in the team in Brzeziny. The next ones were Skierniewice, and finally Grodzisk Mazowiecki, where I have been working in the Hospital Emergency Department for 14 years.
– So you’re not on the road right now?
– This decision was dictated by the harsh reality. Every day I get older and running up stairs with a 20 kg backpack and defibrillator, not getting enough sleep, not eating enough, struggling with the human factor and health problems decided that I gave up … But I will come back because I miss it. After that, I had hours on the alert, and that was a significant time professionally. One job completed the other. Earnings from two jobs allowed for a more dignified life, but at what cost? Although I would like to emphasize that it is a fantastic profession. For many of us, mission and passion.
Paramedics dream of a full-time job
On the salary.pl portal, we find data on the salaries of rescuers (January 2020). The average salary is PLN 2632 net. In turn, the lowest hourly rate for rescuers employed under civil law contracts was (in 2018) PLN 13,70 gross (Pracuj.pl).
– On April 1, the ordinance of the Minister of Health on pay raises entered into force.
Many of my colleagues believe that the basic salary should be significantly increased instead of gross salvage allowances. Undoubtedly, it is a perceptible financial injection, but some of the community resent the decision-makers about the imposed form of employment based on civil law contracts, often for a specified short period of time, e.g. a year or three at the most.
– The employer saves a lot …
– … and we break the hours, saving the system, because without us the ambulance will not go and we do not earn money without contract duty. The youngest are “bloodthirsty”, ready to work up to 400 and 500 hours a month, but this attitude passes when the family arrives. And then a problem arises, because on the one hand, the needs grow, so you have to earn, and on the other hand, you want to participate in the development of your own child.
Imagine a couple of paramedics working 400 hours a month. Where’s the time for private life? Relationships fall apart, colleagues leave the profession or emigrate. They want to live with dignity, and the system does not properly reward our effort and competence.
They relieve stress with cigarettes and talking about sex
Some people cultivate their passions: mountains, traveling, cycling, gym. Others buy an expensive car. Still others resort to alcohol. The most common stress reliever method is obscene vocabulary, lots of non-parliamentary “commas”. It is an open secret that paramedics like to talk about sex, but officially none of them wants to admit it.
- “People lie because they don’t want rescuers dressed as aliens to come to them”
– Some people swear when you forget, it happens even in front of a patient – says Dominik Tarnowski. – Yes, I know, it’s unprofessional, but we’re only human.
– At home, it also happens to swear – echoed his colleague from SOR Jakub Wiśniewski. – Kids sometimes repeat, but more often they embarrass us when we hear in social situations: Dad, don’t express yourself! And they immediately explain to us that we are working in the emergency room. Such language helps when we need to be firm.
When the patient, on our “good morning”, exclaims: “bang …! Leave me ch…! ”. If someone kicks us or starts beating us, we don’t say: I’m sorry, sir, but I would like to kindly ask you not to use your fists on me, because I can’t save your life. As a professional group, we do not have psychological support, so we do what we can.
Paramedics as public officials are protected by the provisions of the Penal Code. Article 222 reads: “Whoever violates the physical integrity of a public official (…) shall be subject to a fine, the penalty of restriction of liberty or the penalty of deprivation of liberty for up to 3 years.”
Over the past three months, paramedics, like all medical personnel, have become heroes of the collective imagination. They were treated with unprecedented respect. It also got calmer at the HEDs, aggressive patients disappeared. However, paramedics say they were simply afraid to come to the hospital, and when the end of the pandemic is declared, things will go back to baseline.
This profession is mainly practiced by men and they admit that they do not know how to talk to each other. They prefer to smoke another cigarette and play tough guy. They are suffocating their emotions, which later affects their loved ones.
– Most often we impose some convention of conversation, even dirty, so as not to give in to what has accumulated in a person and to what he does not want to admit – says Dominik Tarnowski.
– Sometimes we can vent our emotions, even through tears – she adds – It also happens. Most often, however, we show nothing outside, we bite our lips, and what we wear inside is only our secret. Personally, I recommend paintball after work, we have already tried it in our department.
- “Yesterday night I went to the infectious ward 12 times”. Paramedics reveal what work in an ambulance looks like now
The human factor causes extreme emotions
Rescuers do not count how many people they saved their lives. However, Dominik Tarnowski admits that helping the sick gives satisfaction and strength to persevere in the profession, despite the lame system, calls to nonsense, demanding and sometimes insolent patients.
– Until the end of my life I will not forget this trip – he says. – The duty was quite boring, we had time to rest for a while, lie down and watch TV.
We were called to a family orphanage in a small village. A 2-year-old girl fell into a deep pond. Parents tried to revive her. Even now as I tell you this, I have goosebumps. We were driving for quite a long time, so you had time to think about what to do, how to prepare, divide the roles in the team. When we got there, our parents had been doing CPR for 20 minutes.
We took her over. Under stress, I intubated, put on an intraosseous needle, because the veins were shrunk due to hypothermia. After 5-7 minutes, the girl began to breathe and circulation was back. What a joy it was! Later a helicopter arrived. The pilot landed in a field surrounded by forest and power lines, it was a masterpiece. They took her to a hospital in Warsaw. A month later, the little girl had neurological deficits and vision problems. She heard her parents but did not recognize them. When she left the intensive care unit, her parents brought her to us. Luckily, we were on duty, exactly the same team. Believe me, I had to hide my tears. We were so happy that she survived and came to us in full health on her own. Even now, when I tell you, it hugs me.
– I have been working for 14 years and it has never happened to me that someone came and thanked me. People do not thank the rescuers – adds Jakub Wiśniewski, who combines his work at the HED with the function of the manager of the outgoing medical rescue team in Błonie.
– On the other hand, the best way to deal with ill-minded patients is to combine assertiveness with intelligence – says Dominik. – You have to remain calm in all situations.
– If someone has a finger to sew, he wants the procedure to be performed within 15–30 minutes. – Mr. Jakub begins. – Unfortunately, this is not possible, because the priority of the emergency department is people in a state of sudden health and life threat. People somehow don’t want to understand it. They believe that if they pay premiums, they shouldn’t wait. Most often we hear that we have to take care of them immediately, because “we are like d * pa from sh * n”. And the diagnostic, accommodation and mainly personnel possibilities of SORs and admission rooms are different.
We cannot convert 150 people at once, and this is the average number of people who report it a day. Moreover, most patients should go elsewhere, mainly to their GP. If someone calls an ambulance for the proverbial abscess on the butt, they can’t get to the hospital faster than a person with a heart attack, and it happens.
I had a similar situation myself. Departure to the patient in code 2., i.e. the time of departure 2 minutes. The ambulance is not on the signal, just like any other car. The patient lives on the other side of the city, distance 8 km. Halfway up, we hear on the radio that a cardiac arrest has been reported near where we are stationed. And what? Thread. Then we go to the abscess, and the team from the base 10 km away rushes headlong to the man with SCA. It can’t be like that! Not only that, the patient with an abscess is completely resentful, because he deserves it. We ask: since when do you have it? And he has been saying for a week. He did not bother to see a primary care physician for a referral for surgery …
– I don’t understand, why didn’t the dispatcher reassign you while you were there?
“We sometimes laugh that the dispatcher is like a pelican.” He catches the fish, that is, phone calls, writes down the address and sends the team. He does not collect a decent interview (too many summons), because if something happened, he cannot count on any support. These people work on contracts and can be held financially or even criminally liable. The patient can claim enormous damages from a civil action, so they are simply afraid in the world. To protect themselves, they send teams in first order. The only priority is the rank of the summon. Cardiac arrest, chest pain or an accident, you know, the team is sent on signal, and for abdominal pain in code 2. However, it often turns out that epigastric pain is an acute coronary syndrome.
Waiting for the act on the paramedic profession and the self-government of paramedics
On the website of the Central Statistical Office of Poland we read that in 2018 we had 1541 medical rescue teams, 230 hospital emergency departments and 21 bases of the Air Ambulance Service. There were 3,1 million trips to the scene, up to 3,2 million people (70% of patients received help at home). 4,6 million people benefited from emergency aid in emergency rooms or hospital emergency departments.
– We hear about the ideas of extending our competences, but there is silence about the increases – says Dominik Tarnowski. – Everyone now looks at their work through ones and zeros. We, too, are beginning to see our profession not through the prism of service, but through earnings. And I am sure that in the near future there will be a shift of competences, especially soft ones. Our country suffers from shortages of staff, including doctors, so some of their tasks have already been taken over by nurses and paramedics at ZRM. The next step in this respect is the SRD, and there will be further ones.
- How much do nurses and paramedics earn? There was a specific amount
And what do you miss in the professional field?
– Many of us lack faith that we will not have to work several hundred hours a month to live with dignity. In a moment there will be another change of power and new ideas for health care, including medical rescue, so let us wish you wisdom and peace.
– There is one ambulance with a team of two in Grodzisk Mazowiecki – explains Jakub Wiśniewski. – It protects the city and surrounding villages, that is about 2 thousand. residents. So the rescuer’s illness is not an option. We ride with a headache, fever, backache. If we don’t show up for work, the ambulance won’t leave.
Do you have any influence on your position in the healthcare system?
– In talks with decision-makers at the level of the Ministry of Health, we are represented by associations, councils, various trade unions, etc., but we are still fighting for the establishment of a paramedic’s chamber similar to that of a doctor or nurses and midwives. This is a matter of political decisions, we have to convince the decision-makers in the Ministry of Health, although, as an environment, we also have a lesson to do. The chamber would give us greater independence and independence, we would have a chance to influence our rescue community. It would also take care of a code of professional ethics that should be created – replies Mr. Dominik.
Lifeguards compare our health care system to an old car. If you move one screw, everything will fall apart. If they said enough! We will not be working 400 hours a month, but like every 160 full-time employee, the system will fail. There will be no staffing of ambulances, there will be no rescuers at SOR. However, everyone knows that they will not leave their patients’ beds. For them, the situation is deadlocked.
Read also:
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