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72ISSUE

SEVENTY TWO

EMERGENCY EXERCISE

CLINICAL SERVICES UPDATE

STAFF WELLBEING DEVELOPMENTS

PRN & RAIR UPDATE

SEPTEMBER 2016

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NSW AMBULANCE INTELLIGENCE UNIT

NSW Ambulance Informatics and Information Unit

The primary function of the IIU includes the collection, analysis and reporting of complex information, to support improved decision-making to enhance performance capability. It also provides strategic advice and contribution to major programs aimed to improve health outcomes for the community of NSW.

The main responsibilities include:

• Managing the collation, analysis andreporting of complex and operationalinformation to support reforms andthe delivery of efficient and effectiveambulance services in NSW.

• Providing accurate and timely adviceto members of the senior executiveand managers on operationalactivity and performance.

• Contributing to the managementand development of statisticalcollections and associated datasystems and recommendingstrategies to improve collection andreporting capability.

The Informatics and Information Unit (IIU) was established in August 2015, following the merger of two former units, Performance Improvement and Business Information. The newly formed IIU functions within the Business Innovation and Planning Directorate which is led by Executive Director Julie Morgan. We thought we’d take this opportunity to tell staff about what the unit is responsible for.

• Assisting in the review of alloperational programs to ensure theseare effectively meeting communityneeds and Government priorities.

• Preparation and analysis of routinereporting for operational performance

• Managing, monitoring and reportingon key operational and clinicalperformance indicators.

The responsibilities of the IIU have now transitioned toward the build and management of the Business Intelligence system capability to further enhance the dissemination of key information to managers across NSW.

Work has commenced on the development of the NSW Ambulance Intelligence System utilising the QlikView reporting tool. This work will enable NSW Ambulance to plan the decommissioning of the previous Business Objects system, primarily used for operational reporting, which has become outdated and unsupported.

CAD Operational Dashboard

The implementation of the CAD Operational Dashboard, which sources data from the Computer Aided Dispatch system, was the first phase of the overall NSW Ambulance Intelligence System project. The CAD Operational Dashboard application was completed in April 2016 and made available to senior managers in early May.

The CAD Operational Dashboard application now supports significantly enhanced management reporting, analytic capability and decision making relating to ambulance activity and performance across NSW.

Work will now continue to enhance capabilities of the CAD Operational Dashboard and planning has commenced to build complimentary reporting and analytical dashboard applications for Clinical, Workforce and Finance data.

Our Team

The IIU is based at state headquarters at Rozelle and is managed by Director Informatics and Information, Peter Payne. Peter is a career paramedic and has notched up 40 years with NSW Ambulance. He has worked across many facets of operations

including control, air ambulance, helicopter retrieval services and has undertaken many major projects along the way.

Peter is supported by a unique and specialist team who bring a wide range of necessary skills and experience to maximise the overall functions of the IIU.

Dr Harry Lai, Senior Analyst, with a background in health information management.

Jaynal Abedin, Senior Analyst, with a background in computing science and database management.

Jam Lee, Senior Analyst, with a background in business management and reporting.

Julie Yu, Senior Analyst, with a background in IT enterprise reporting and health services management (currently on 12 month secondment from HealthShare).

Bernard Cheung, Data Analyst, with a background in information technology and web design.

Shyam Sreeramula, QlikView Developer, with a background in software engineering and data warehouse design.

The IIU Team. Front row (L-R): Peter, Jam, Bernard. Back row (L-R): Shyam, Jaynal, Harry.

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PRN

PRNUPDATE

Host the team!

Remember PRN team representatives are ready and willing to join in your station meetings to share information and answer questions. Get in touch via

Getting ready for the PRN

The PRN Change Team is transitioning from the planning to delivery phase. You would have noticed that over the last year, our 11 workstreams established to design the new operational model have been sharing their progress through monthly workstream profiles in Sirens.

However from January 2017, you will see a slight change with ‘Portfolio Profiles’ to be published. These will emphasise the progress being made in ensuring NSW Ambulance is ready to begin the new operational model in metropolitan Sydney. These profiles will continue to form part of a comprehensive communications strategy already being delivered; they will also complement the ongoing engagement activities involving all levels of staff.

Zone Manager Workshops

The PRN Change Team has been meeting with zone managers to keep them informed about the program. Updates are being provided by the team on the Make Ready Model, Decision Making Support Software and control project activities. The team also sought input from zone managers into local engagement activities, superstation staff orientation plans and activities, along with insights into station culture.

Decision Making Support Software

A key PRN project involves selecting and implementing a predictive and operational decision support system. The procurement process is progressing well with a consultant engaged to scope the specific technical requirements for NSW Ambulance in preparation for a request for tender. This software will support our control centres to provide the most effective geographical cover.

TRACS ECPs on board

The Targeted Resource Allocation and Clinical Support (TRACS) Dispatch Board project is working to finalise the implementation of a permanent dispatch board within the Sydney Control Centre which addresses functional tasking of extended care paramedics (ECPs). We are pleased to report

very promising results since ECPs have begun working with dispatchers. Recently, ECPs attended over 30 incidents, successfully treating and referring patients without the need for any emergency ambulance support.

PRN Facts & Figures

9 SUPERSTATIONS ANNOUNCED

125 KEY ACHIEVEMENTS

11 WORKSTREAMS

30 PRESENTATIONS TO STAFF AND STAKEHOLDERS

50 STAFF COMMUNICATIONS

Further Updates

• The PRN team has presented to Operational Logisticsabout readying the business for the PRN.

• The paramedic-led user group recently met to continueschematic design for Caringbah and Artarmonsuperstations, and detailed design for Northmeadsuperstation.

• Collaboration continues with the PRN team to work withthe Rural Ambulance Infrastructure Reconfiguration (RAIR)and Aeromedical Reform teams to exchange informationand share lessons.

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PRN

Education

PRN Workstream In Focus: In the eighth Paramedic Response Network (PRN) Workstream in Focus, we bring you the latest from the Education Workstream. This workstream is aligning broader state wide improvements to clinical professional development with the establishment of the PRN.

The Education Workstream involves designing and implementing a responsive and flexible clinical capability development and credentialing framework to support paramedic clinical best practice. A key objective of this work is redesigning the Certificate to Practice (CTP) framework.

CTP is about ensuring NSW Ambulance paramedics maintain cutting edge skills to provide safe and high quality clinical care in the mobile environment. To do this, CTP needs to evolve to ensure it continues to address the contemporary professional, clinical and service delivery issues of paramedics and other staff. Although CTP is adapting, the foundational structure will not change.

To guide this evolution, the workgroup identified a number of key design principles:

• Inspires: Paramedics identify value in engaging with thedevelopment as an important aspect of providing safe,high quality patient care.

• Inherently meaningful: Provides paramedics withaffirmation of capability in current standard practicewhilst creating opportunity or direction for clinical careeradvancement.

• Rewards: Promotes and celebrates excellence ratherthan compliance. Development activity is rewarded insuch a way as to reflect the relevance to paramedicclinical practice and the professional effort involved incompleting the activity.

• Capability focused: Develops and assesses capability,not just competency.

• Tailored/Flexible: Paramedics have the opportunity tomeaningfully align capability development to personalchoice, career goals, learning needs and interest orpractice gaps.

• Accessible and available: Paramedics can easily accessdevelopment opportunities in a variety of forms andcan incorporate opportunities not resident within NSWAmbulance itself.

• Simple, understood process: Easy for paramedics totake responsibility for their own development and areaware of the resources and support available.

• Involves: Facilitation of development extends beyondindividuals in formal educator roles and recognisesthe professional responsibility of all paramedics in thedevelopment of clinical capability.

• Sustainable: NSW Ambulance is able to effectivelymaintain support of CTP requirements.

• Delivers: It ensures paramedics maintain contemporarycurrency and are on the cutting edge of practice.

• Responsive: Is responsive to changes in practice,organisational priorities and needs of paramedics.Education packages can be developed and deployed ina timely manner.

What will some of these design principles look like in practice?

• The foundational structure of CTP will not change.There will still be mandatory face-to-face workshopsand the requirement to undertake ongoing clinicalprofessional development.

• There will be an increase in the frequency of shorterworkshops based primarily on simulation activity. This willresult in more regular opportunities to review aspects ofpractice with a ‘hands on’ and debrief emphasis.

• Workshops will be supported by flexible learningmaterials that will attract CTP points.

• Voluntary electives attracting CTP points will be madeavailable to support preparation for clinical careerdevelopment such as training to be an intensive care orextended care paramedic.

• CTP will have a more focused clinical emphasis andprofessional development activities attracting CTP pointswill need to demonstrate relevance to the paramedicclinical scope of practice.

• Where new practice is introduced to the paramedic scope,they will be subject to an objective risk assessment todetermine a safe and effective education strategy.

Work is continuing on the design and consultation is progressing with different stakeholders across the organisation. More details will be made available in the coming months. It is anticipated these changes will be implemented in July 2017.

The Education Project Team:

• Allan Loudfoot (Executive Director Clinical Services)Project Sponsor

• Alan Morrison (Director Education) Project Lead

• Steve Matheson (Regional Education Manager)Project Manager

• Other subject matter experts from across theorganisation.

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rair

RAIR refresher

This $122 million commitment by the NSW Government in our regional and rural stations is allowing NSW Ambulance to enhance your ability as paramedics to deliver mobile emergency medical care to your communities.

The new Wagga Wagga Station project continues to forge ahead and construction is scheduled to begin on more projects by the end of this year.

RAIR currently includes 17 locations across the state that will benefit from an upgraded, rebuilt or an entirely new ambulance station.

Designed with input from local NSW Ambulance staff, the purpose-built infrastructure will deliver a better

As our regional and rural stations program moves ahead and more milestones approach, we have gone live with the new RAIR website and continue to recruit team members to facilitate the further growth of this important work.

working environment for paramedics. The stations will include accompanying administrative support as well as educational, fleet and relief accommodation where needed.

This 10 year program is enabling paramedics to meet the mobile emergency care needs of regional and rural communities for years to come.

Find out more

The brand new RAIR program website is now live with all the latest news on this major investment in regional and rural ambulance stations.

Check out the website at: www.mylocalambulance.health.nsw.gov.au

Featured content includes:

• program overview

• artist’s impressions and videos

• individual pages for the 17announced locations

• news and events

• milestones

Recruitment update

RAIR is recruiting! The temporary positions of Regional Operations Support Manager and Project Officer have been advertised. If you would like to join the RAIR team in delivering high quality, mobile emergency medical care to regional and rural NSW, be sure to get your application in. Keep a lookout for more secondments in the near future.

A sneak peak at the new website

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LUCAS2 in action

Presentation:

Paramedics arrived within five minutes of the initial call, where they found hotel staff performing CPR on the patient, however it proved to be ineffective as the patient was in a seated position. The patient’s wife wasn’t able to provide a comprehensive history due to the language barrier and her state of distress, however it was discovered the family had recently arrived in Australia following a long haul flight. While the patient’s wife was consoling their son in the other bedroom, paramedics utilised the hotel staff, asking them to pass on basic information and advise the family

of their treatment plan.

intervention:

The patient was repositioned to ensure a more effective CPR position and to

gain better access to his airway. As this happened, paramedics fitted the LUCAS2 external cardiac massage (ECM) machine onto the patient. This ensured cardiac massage continued, freeing up the paramedics to work on the patient. A pulseless electrical activity (PEA) was detected when defibrillation pads were placed on the patient. A laryngeal mask airway (LMA) was inserted and the patient was cannulated.

During the course of the arrest, the patient’s cardiac rhythm changed several times including VF, perfusing sinus tachycardia and STEMI. The patient received five DC shocks and was administered drug therapy including adrenaline and amiodarone. The patient was also intubated enroute. The patient regained spontaneous

respiration shortly after intubation and Return of Spontaneous Circulation (ROSC) on arrival at St Vincent’s Hospital. As the patient fell within the criteria for a process called the 2CHEER trial, the hospital was pre-warned of the case so they could prepare.

Note: all images have been taken either during 2CHEER training or a 2CHEER real time scenario. None are from the above mentioned case study.

case study

In early April this year our paramedics were called to a cardiac arrest at a hotel in Sydney’s CBD. On arrival they were confronted with a challenging scene; the patient, a French national, was surrounded by his frantic wife and 6 year old son who could only communicate in very basic English. However the outcome was positive, with our paramedics successfully utilising the LUCAS2 machine, saving the patient’s life.

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case study

About 2CHEER:

2CHEER is a clinical trial being run in conjunction with NSW Ambulance, Royal Prince Alfred (RPA) Hospital and St Vincent’s Hospital. It includes mechanical External Cardiac Massage (ECM), hypothermia, ECMO (extra-corporeal membrane oxygenation) and early cardiac reperfusion in the hope of increasing the survival rates of individuals who have suffered a cardiac arrest. The trial is being conducted from six stations in close proximity to the CBD as patients must be transported to either RPA or St Vincent’s hospitals within a predefined time frame. Intensive Care Paramedics (ICPs) have been trained to operate the machine and understand the 2CHEER trial.

The 2CHEER trial requires that the patient is in the Emergency Department (ED) within 60 minutes of arrest. Here is how this case fitted in with the 2CHEER trial:

0 minutes - initial call

5 minutes - paramedics arrived

8 minutes - intensive care paramedics arrived on scene

10 minutes - mechanical ECM commenced

11 minutes - hospital was informed patient met 2CHEER

criteria

11 minutes - LMA and IV access

12 minutes - first defibrillation

37 minutes - patient loaded and departed for hospital with code 3

38 minutes - intubation

47 minutes - arrived at hospital

Other criteria inclusions are:

• patient aged between 12 – 70years old

• arrest must be witnessed

The impressive level of seamless team work by the responding paramedics, with the addition of the control staff contributed to a

positive outcome for the patient.

Staff involved

Call taker: Hannah Binning

Dispatcher: Kate Main

DOM: Giles Buchanan

ICPs: Liam Harte and Liam McDermott

P1s: Todd Mison and Tessabelle Bartels.

• patient must receive externalcardiac compressions within 10minutes

• patient must have one cardiac orrespiratory cause

• their initial rhythm should be VF or VT

- OR they are hypothermic <32C

- OR patient had an overdosewith reversible cardiac depression

- OR patient has other reversiblecauses (PE/asthma).

Exclusions include:

• cardiac arrest was due to trauma oractive bleeding

• not for resuscitation (NFR)

• patient has known comorbidities orlimitations.

Note: although this patient was excluded from the trial collection data due to an initial rhythm of PEA he still received the rest of the 2CHEER process and similar treatment.

Patient outcome:

The patient remained intubated for six days then was extubated and transferred to the intensive care unit (ICU). Responding paramedics visited the patient in hospital 27 days after the incident, where he was undergoing rehabilitation for a hypoxic brain injury. The patient remained in hospital for another week before returning to

France to continue rehabilitation where doctors were hopeful he’d make a full recovery. Since arriving back in France, NSW Ambulance received an email from the patient’s wife, thanking staff for helping to save her husband’s life.

Benefits of the LUCAS2:

Mechanical ECM produces a consistent, uninterrupted compression with good palpable output. This means compressions are able to be continued effectively throughout extrication and transport even in a carry sheet or stokes litter.

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In my viewPhoto taken by David Truscott during a transfer from Cobar to Orange

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I began working for the emergency services in my early 20s. I worked at the NSW Police Force for eight years in a variety of roles including the Professional Standards Command, State Crime Command and the Counter Terrorism Security Unit. After taking a break and working for Arts NSW I realised how much I missed the emergency services and the strong ties to helping the community. I then landed the role of Executive Assistant to the Director of Metropolitan Operations, back at the old divisional office above Summer Hill Station and I haven’t looked back!

Since I began in July 2012 I’ve worked in a few different roles. I am currently on a 12 month secondment from my substantive position of Executive Assistant to Executive Director Service Delivery. Working in my substantive role was great – I saw so many changes in Service Delivery over three years. I really enjoy working in a fast paced environment and waking

Project Support OfficerEmma Mathews

your story

up each day not knowing what is next. Every day is different in the Executive Director’s office; one minute you’re reviewing a briefing note with the boss and the next minute you’re re-scheduling his diary at short notice as he’s going out to support paramedics in the field when necessary.

My new role is Project Support Officer, Program Management Office (PMO) within Business Innovation and Planning. For those who don’t know, the PMO was created to coordinate, monitor and report on the portfolio of projects across the organisation. We’re a team of five people based at Rozelle HQ, led by the Redesign and Innovations Manager, Mel Willis. I really like how this role keeps me connected with all parts of the organisastion. As I’ve spent the last four years with such a Service Delivery focus, I enjoy seeing all the other work taking place across the directorates.

The same as everyone else, I find my role challenging at times. It can be difficult trying to find a balance between work, study and family. My family always come first and I make sure every night we sit down together at the dinner table and talk about our day and our dreams for the future.

When I’m not at work I like to travel with my partner and two boys. We have a list of countries we would like to visit and each year we try to tick one (or two) of them off the list. Last year we travelled to Canada and America. We visited Niagara Falls, New York City, Washington DC and Florida. When we’re on these trips (or at any time really), I take great delight in making my family line up for ‘embarrassing mum photos’. My other pastime is collecting vintage clothing and accessories. I’m part of a travel group called the ‘Vintage Gals’ comprised of about 40 ladies aged between 25 and 70 from all over Australia.

Like many of our staff members here at NSW Ambulance, there’s so much more to Emma Mathews than the role she performs at work. For the last three years Emma has been the Executive Assistant to David Dutton, Executive Director Service Delivery, but outside of work she’s a mother, busy traveller and also takes part in a vintage clothing group – among other things!

Making sure you take the time out to enjoy life is so important.

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your story

Since 2010 we have travelled overseas and throughout Australia together visiting vintage fairs, flea markets, clothing exhibitions and the odd cocktail bar. It is so much fun; we get all dressed up in our vintage clothes, hats, shoes and handbags and shop, dance and party till we drop!

I also like running, relaxing at the beach and fishing with the family (although I am not very good at fishing). Travelling and spending time with my family and friends is what makes me most happy. Cooking up a storm (I’m a pretty good cook) and sitting around chatting, laughing and sharing stories is my favourite thing to do on the weekend. Making sure you take the time out to enjoy life is so important.

Currently I’m studying a Diploma in Counselling at the Aboriginal Health College. I was driven to partake in this course as I’m passionate about understanding the mental health issues in our workforce and community and I also have very strong personal reasons to want to tackle the difficult issue and stigma around mental health related issues, particularly post traumatic stress disorder (PTSD).

Our circumstances and background may influence who we are, but we alone are ultimately responsible for who we become.

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On Station with

MurwillumbahThe tourist brochure says:

Murwillumbah is a bustling regional centre in north eastern NSW, a perfect base from which to explore nearby Mount Warning and Nightcap National Park. Set on the Tweed River, there are shady parks for picnics, fishing and boating and an excellent golf course. Be sure to explore the World Heritage Rainforest Centre, which documents the wildlife and botanical splendours of the region's national parks. As well as having many fine old buildings, Murwillumbah is home to the Tweed River Regional Art Gallery. The richest portrait competition in the world is held here each year.

The staff at your station say:

Murwillumbah is a great spot to live and work. Being close to the Queensland border Brisbane’s not too far away and we also have great selection of beaches and bushwalks. The team is close knit and gets along well.

Most common jobs around your area?

We see a lot of rural and industrial incidents such as machinery, tractor and mower rollovers. Motor vehicle collisions (MVCs) are common and we also receive a large number of

calls to assist elderly and mental health patients. Going back about 15 years ago we would attend many MVCs on the infamous Burringbar mountain range on the old Pacific Highway. But now a new and much safer stretch of road has been built, most vehicles use that which results in far less MVCs in this area. In recent years the north east corner of NSW has developed into a large urban area comprising of the Tweed and Byron shires. This means that paramedics are quite busy and often work together across the areas of Tweed Heads, Murwillumbah, Kingscliff, Byron Bay and Mullumbimby.

How many staff at your station?

Murwillumbah is currently staffed by eight paramedics, seven of those with intensive care qualifications.

What geographical challenges do you face?

There is a mountain west of Murwillumbah called Mount Warning and although it is a beautiful spot, it keeps us very busy as we regularly respond to lost or injured hikers. We as a station have acquired our specific set of rescue and survival gear and skills to deal with these cases and work closely with other emergency

services, specifically the Tweed District Volunteer Rescue.

What do you enjoy most about working in your area?

The sub-tropical climate is great, although it can get uncomfortable in the summer months! Beaches and World Heritage areas are close at hand too. Murwillumbah is in close proximity to Brisbane and the Gold Coast so that is a great advantage. As a rural community, Murwillumbah also has a wide variety of local industries including beef, dairy, sugarcane and bananas. The population is also very diverse; there is a large Indian and Hari Krishna population and being close to Nimbin there are also some very interesting and colourful people around town.

What are some of the station’s most memorable jobs?

Recently we had a memorable case where paramedics Peter Larsen and Rob Byrne responded to an injured walker at Mount Cougal on the NSW/Queensland border. This was a tough job, lasting for more than 20 hours. Our paramedics spent the night in the bush with the patient who was then airlifted out the next day.

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on station with

Any staff news from your station?

Tony Brown recently headed off to Moree station, as his partner got a job working as a vet in Goondoowindi. Good Luck out there bud! Tony has been replaced by ‘Magic’ Mike Haynes who arrived here from Tumbarumba. Mike’s dusted off the snowflakes and has settled in well as one of the team. Well done also to Mike and his wife Stacey who are expecting a baby in November, but it looks like the little one will be born at John Flynn Hospital in Tugun (across the border), so it’s a shame he or she will have that QUEENSLANDER tag!

Peter Browning is also getting a bit of a reputation a ‘Master Barra Slayer’ of the fishing world although in reality he

on station with

We see a lot of rural and industrial incidents such as machinery, tractor and mower rollovers.

is a catch-and-release man. He has recently completed a four-wheel-drive and fishing trip to remote areas WA, in particular Cape Leveque and the Horizontal Falls. Peter is the patriarch of the station with 36 years’ service, making him one the longest serving officers in the Northern Rivers.

Rohan ‘The Red Baron’ Miller has recently fulfilled one of his bucket list items by obtaining his pilot license. Rohan has also been heading up the Northern Rivers’ immunization program so he’s been heading out to various stations to ensure staff get the jab.

Station Officer Grant Prendergast also recently was named Emergency Services, Officer of the Year for NSW Ambulance at the 2016 Rotary NSW State Emergency Services Awards. Well done!

If we look after each other most other things will look after themselves.

What’s your station motto?

Murwillumbah is a close knit team so our motto goes something like this: If we look after each other most other things will look after themselves.

Every month the Healthy Workplace Strategies team brings you updates about physical and mental health. This month, we’ve got a wrap of the recent R U OK? Day and also a piece on the late paramedic Paul Rossington.

healthy workplace strategies

Paul Rossington honoured

On 8 September former paramedic Paul Rossington was honoured with a posthumous Australian Bravery Award. Paul tragically died whilst off duty, trying to save the life of his girlfriend. Chief Executive Dominic Morgan joined with Paul’s family at Government House to honour the occasion.

Paul’s most recent posting was at Barraba Station in New England Zone. Barraba is a small, close knit-community, with only five paramedics based at the station, so his death had

R U OK? Day

Recently, NSW Ambulance took part in R U OK? Day; a time for everyone to stop and check in with colleagues and start a conversation. Although this is a very important day, we want to encourage staff to take time to ask ‘are you okay?’ at any time.

Our Healthy Workplace Strategies team were very busy on R U OK? Day. Staff attended hospital Emergency Departments, stations and offices around the state to stop in and say hello.

A BBQ was held at Rozelle HQ, with various other events taking place right across the state. Thank you all for being a part of this important day!

a significant impact on staff and members of the public. Paul’s legacy lives on at the station, a plaque with his details adorns the station wall and the ambulance vehicle number plates are his initials. Barraba Station Officer William Rixon said Paul was a much loved member of the team.

“To this day I am still asked by locals about Paul and there’s always kind words said about him. This just shows that if you’re a nice, caring person, you make a difference in people’s lives even if you don’t realise it. That was a big part of Paul’s humble personality and his patients and fellow health workers loved him for it,” Will said.

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healthy workplace strategiesThe community thinks you’re super heroes …

.. but we know you’re human too.

Ask R U OK?

Listen

Encourage action

Follow up

1

2

3

4

Staff support options:

• View the intranet for options of support, including our Peer Support Program, Chaplaincy and Grievance Contact Officers

• Employee Assistance Program

• Mental Health Line can be contacted on 1800 011 511

• Lifeline can be contacted on 13 11 14

• Contact your local GP

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28 NSW AMBULANCE

Minute with ... Fiona GwytherParamedic at Marrickville Station

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What would be your top three tips to living a healthy lifestyle?

1. Being healthy is not only about the physical, but also about your mental state. Set realistic goals, break them down into sub goals, then break them down into smaller ones if need be. It’s important to make your goals obtainable, no matter how menial they may seem.

2. Routine is key. Once you’re in a routine it’s hard to stop and once you lose it, it’s hard to get back. I know it’s not easy having a routine with shift work, but finding one that suits you can be very helpful.

3. Bring healthy food to work. This will give you the energy and support you need to get you through those long shifts and hopefully decrease the 3am cravings!

Fiona stands with her basketball team, second from the right, number 9.

Do you think being healthy is easy or is it something that you’re used to doing?I am lucky as I grew up in a very active family, so when I was younger I played sport six nights a week. However, when I hit my late teen and early twenties, social life seemed to get in the way of health and fitness! Combine this with shift work in my mid-twenties and you have me, who always had a distant goal of being healthy, but most of the time, it was never really obtainable! It’s only now, six years after becoming a paramedic that have I found it easier (easier, not easy) to be healthy. I’ve also learnt that physical health goes hand in hand with mental health.

What’s an exercise or leisure activity you enjoy doing and why?I have a very cute dog who I take for morning walks and when shift work allows, I play basketball. Waking up to a fluffy puppy at the bottom of your stairs makes it easy and enjoyable to head outside and be amongst nature. I have grown up playing team sports, so my social basketball team is a great outlet and good opportunity to catch up with friends.

Do you set fitness goals for yourself and if so, what’s your current target?My days of bench pressing and chin ups are far gone, so now my focus is really about being physically active every day, whether it be a walk, basketball game or just getting out and about.

Have you always been into fitness or has it been a challenging ‘relationship’?Being active has always been a part of everyday life for me from a young age but now I need to really make sure I incorporate into my lifestyle.

Talk to us about diet, do you have any tips or magic secret recipes?At the moment I am attempting to decrease the amount of sugar I consume each day. But that great, sweet tasting additive just seems to be hiding in everything! To get my head around how much I am ingesting, I convert the sugar content to teaspoons (4g per teaspoon). When you start seeing products in this light, eating excess sugar is not so appealing.

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In June this year, Oak Flats paramedic Paul Norwell passed away after battling with cancer, leaving behind a loving family and a group of devoted colleagues. To show support for their friend, earlier this year Paul’s colleagues surprised him and his family with a visit from Channel Nine’s TODAY Show, which presented him with the ‘Knock of Cash’ – a gift given to a deserving member of the community. Although Paul is no longer with us, his colleagues have got behind him yet again, writing this piece – a tribute to their workmate.

We lost a beloved member of our NSW Ambulance family in June this year. Paul put up a monumental battle dealing with his terminal illness, making sure his immediate family as well as his extended ambulance family was okay and coping. Paul joined NSW Ambulance 13 years ago and worked at Fairfield, Bomaderry, and Dapto and Oak Flats stations. For those of you who didn’t have the privilege of meeting Paul, he was a self-effacing, good-humoured, hard-working, surf loving and guitar-playing lump of a good bloke. His passing will have an indelible and profound effect on many within the NSW Ambulance community of the Illawarra and beyond. The way Paul dealt with his terminal illness was inspirational. At the beginning of 2016 Paul was told he had a tumour on one of his kidneys but the following tests and subsequent prognosis were always more sinister than the last. When a mate asked him how he was going to deal with it Paul grinned and told him “I’m going to push through.”Towards the end of Paul’s illness and numerous presentations at the emergency department at Wollongong, a work colleague asked Paul for a hug. She told me it wasn’t really for Paul, it was for her. That was Paul, giving his all to the last. If there was a Standard Operating Procedure or Skill Sheet on how to ‘Live Life and Die with Dignity’ it would have Paul Norwell’s name written all over it.Working in the emergency services we rely on our work partners and colleagues to have our back and that was one thing you could rely on if you were working with Paul. We also shared very raw moments of life, death, comedy and tragedy and developed more than just a work relationship. This support was evident when a tribute and fundraiser was arranged for Paul and his family in June this year and a considerable amount of money was raised.

This show of support was also evident at Paul’s funeral with the most senior management of NSW Ambulance to more than 200 hundred paramedics and other members of the allied health and emergency professions attending. We would like to take this opportunity to say thank you to Paul’s immediate family; his wife Lisa and children Brandon, Danielle and Georgia, for allowing us to share Paul with them during the last thirteen years. Paul was a part of our community, and also we’d like to impress upon them not to hesitate in asking for our assistance in the tough times ahead. Paul Norwell exhibited some admirable qualities that us mere mortals can only aspire to. He was courageous, modest, funny, warm, a brilliant father and husband and a most sought after workmate. Paul didn’t achieve accolades such as a world surfing title or play in a world class band but in our minds he thoroughly deserves the title of world-class human being. Paul, you will be missed but not forgotten. Rest in peace Brother.

A tribute to a workmate

30 NSW AMBULANCE

in the mediaAugust’s media coverage was filled with some great proactive news stories featuring paramedic and patient reunions, a cardiac arrest survivor, and a brave teenager who received a NSW Ambulance Star Award.

media update

CARDIAC SURVIVOR

Tabulam cardiac arrest survivor Chris Hill and wife Bev (centre) join with Bonalbo and Casino paramedics who helped save Chris’ life after a cardiac arrest.

ROADSIDE DELIVERY

Overcoming his own fear of blood, Tim Case helped deliver his son Levi with the assistance of NSW Ambulance Call Taker Ellen Wetzler and Paramedics Sarah Hardy and Mark Doran.

SAVING MUM – TWICE

Thirteen-year-old Michael Free was presented with a Star Award by Albury Paramedics Matthew Bolonis and Bernard Meares, in recognition of him assisting his mother through two medical emergencies in 2013 and 2015.

REUNION AFTER 21 YEARS

On the morning of 28 June 1995, Else Britt Roland-Lai was hit by a car outside Artarmon Railway Station, leaving her with critical brain injuries, a punctured lung and multiple leg and rib fractures. 21 years later, 7News covered her reunion with NSW Ambulance Paramedics Phil Clark and Michelle Clarke who treated her on scene that morning.

HEARTENING RESULTS

In a joint effort with the Hunter New England Local Health District, NSW Ambulance gathered positive media through a release highlighting the success of a program where paramedics administer clot-busting drugs to heart attack victims before they reach hospital.

SIRENS 31

SOCIAL MEDIASocial media for August saw us post a variety of photos, informative text and captivating news articles.

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Remember, we would love to see your photos, email: socialmedia@ambulance.nsw.gov.au or text: 0427 488 239 with a brief explanation about what is happening in the picture and we will endeavour to post it on social media and marketing channels.

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32 NSW AMBULANCE

I was unfortunately involved in a motor

vehicle collision with a drunk driver. The

police attended the scene as well as

two NSW Ambulance Paramedics, due

to being in a lot of shock and also

scared for my wellbeing after being

threatened by the at-fault driver and his

passenger. I forgot to get the names of

the two paramedics who attended the

scene. I would like to sincerely thank

them both from the bottom of my heart

for looking after me and being so kind,

compassionate and caring. NSW

Ambulance should be aware of the

amazing work these two gentlemen did

and the support, kindness and care that

they both showed me.

I would like to thank Todd (George Clooney) and Susie who took care of me this evening during one of my usual epileptic seizure episodes while getting off the bus at the QVB building. In my two years that I've been travelling to the city to uni, Todd has taken care of me in seven of my episodes. Todd's humour has always taught me to look at the brighter side of life especially when I feel low after a cluster of seizures.

I just wanted to send a letter of appreciation to two

paramedics at Muswellbrook who attended my 80-year-old

father who was suffering from multiple myeloma which had

been escalating into myelomic jerks and shakes with added

confusion and delirium. Phil and Brook arrived on the scene

and immediately took the pressure off us by dealing with dad

(who can be difficult!!) in such a caring and calm way. They

treated dad with respect and dignity and I can't thank them

enough for their reassurance and professionalism. I felt a

weight being li fted off my shoulders knowing that he was in

their care. Unfortunately after a long week in hospital, dad

passed away. Even though this is very sad we feel humbled

that he had the best treatment possible along the way. I feel

paramedics such as Phil and Brook don't get enough praise in

these situations and go casually about their job every day,

but I'd like them to know their attitude made a difference.

On behalf of my

family, I want to

express my deepest

gratitude for Mel and

Wayne of Blacktown

Ambulance for the

care and compassion

they demonstrated

while taking care of

my sick Nana. She was

quite ill, but Mel and

Wayne never gave up

on her.

I would like to thank the paramedics from Nana Glen who took care of my daughter. I don’t know his name, but I hope you can track him down based on the information I have. My daughter had traveled to Australia as a member the United States 16-U polocrosse team and was participating in a tournament in Coffs Harbour. She and her horse went down in an early morning match and she was knocked unconscious. As a parent who was thousands of miles and many hours of travel away from my daughter when she fell, I am so grateful for the excellent care your paramedics provided at the field. It is every mother’s nightmare to receive that phone call and to feel so helpless being so far away. In the US we do not always have a paramedic at the field. I was so thankful to find out that he was there caring for my daughter until she arrived at the hospital. He even talked with her at another tournament later in her trip.

The police called the ambulance to attend to me as I wasn't doing well mentally. The paramedic in the back of the ambulance with me was kind and caring. He was very compassionate and kind of kept me on level mentally. It was lovely to also have him walk me into the hospital.

SIRENS 33

I was unfortunately involved in a motor

vehicle collision with a drunk driver. The

police attended the scene as well as

two NSW Ambulance Paramedics, due

to being in a lot of shock and also

scared for my wellbeing after being

threatened by the at-fault driver and his

passenger. I forgot to get the names of

the two paramedics who attended the

scene. I would like to sincerely thank

them both from the bottom of my heart

for looking after me and being so kind,

compassionate and caring. NSW

Ambulance should be aware of the

amazing work these two gentlemen did

and the support, kindness and care that

they both showed me.

I would like to thank Todd (George Clooney) and Susie who took care of me this evening during one of my usual epileptic seizure episodes while getting off the bus at the QVB building. In my two years that I've been travelling to the city to uni, Todd has taken care of me in seven of my episodes. Todd's humour has always taught me to look at the brighter side of life especially when I feel low after a cluster of seizures.

I just wanted to send a letter of appreciation to two

paramedics at Muswellbrook who attended my 80-year-old

father who was suffering from multiple myeloma which had

been escalating into myelomic jerks and shakes with added

confusion and delirium. Phil and Brook arrived on the scene

and immediately took the pressure off us by dealing with dad

(who can be difficult!!) in such a caring and calm way. They

treated dad with respect and dignity and I can't thank them

enough for their reassurance and professionalism. I felt a

weight being li fted off my shoulders knowing that he was in

their care. Unfortunately after a long week in hospital, dad

passed away. Even though this is very sad we feel humbled

that he had the best treatment possible along the way. I feel

paramedics such as Phil and Brook don't get enough praise in

these situations and go casually about their job every day,

but I'd like them to know their attitude made a difference.

On behalf of my

family, I want to

express my deepest

gratitude for Mel and

Wayne of Blacktown

Ambulance for the

care and compassion

they demonstrated

while taking care of

my sick Nana. She was

quite ill, but Mel and

Wayne never gave up

on her.

I would like to thank the paramedics from Nana Glen who took care of my daughter. I don’t know his name, but I hope you can track him down based on the information I have. My daughter had traveled to Australia as a member the United States 16-U polocrosse team and was participating in a tournament in Coffs Harbour. She and her horse went down in an early morning match and she was knocked unconscious. As a parent who was thousands of miles and many hours of travel away from my daughter when she fell, I am so grateful for the excellent care your paramedics provided at the field. It is every mother’s nightmare to receive that phone call and to feel so helpless being so far away. In the US we do not always have a paramedic at the field. I was so thankful to find out that he was there caring for my daughter until she arrived at the hospital. He even talked with her at another tournament later in her trip.

The police called the ambulance to attend to me as I wasn't doing well mentally. The paramedic in the back of the ambulance with me was kind and caring. He was very compassionate and kind of kept me on level mentally. It was lovely to also have him walk me into the hospital.

SIRENS 35

Queanbeyan Station Office Kristy Armstrong smiles with her niece Cleo after a recent visit to the Jerrabomberra Playschool.

Lake Cargelligo 557 with the little Royal Australian Air Force C-27J Spartan flying over.

(L-R) Paramedics Sally Stoyles, Simon Obrien and Andrew Wood at the finish line medical centre for City2Surf in Bondi.

(L-R) Zone Manager Tim Collins, Official Secretary Governor of NSW Michael Miller, Paramedic Nathanial Smith and Zone Manager Brad Goodwin attend Aboriginal Leaders event.

Ralph Black from Albury Station celebrates 40 years of continual service with NSW Ambulance.

We see lots of things! This photo snapped at Box Hill in Sydney’s north west after attending a job.