0:00:02 > 0:00:04'Ambulance Service. Tell me exactly what's happened.'
0:00:04 > 0:00:07'It's me husband. I can't wake him up.
0:00:07 > 0:00:10- 'Just confirm for me, is he awake?' - 'He's, like, comatose.
0:00:10 > 0:00:12'I'm trying to feel a pulse, but I can't...'
0:00:12 > 0:00:14'He's on the floor, he's unresponsive.'
0:00:16 > 0:00:18RADIO: 'Er, cardiac arrest...'
0:00:20 > 0:00:22A call to a cardiac arrest.
0:00:22 > 0:00:25The paramedics have just eight minutes to get to the scene...
0:00:27 > 0:00:31..and just 12 minutes to save the patient's life.
0:00:31 > 0:00:34Do you want to do another pulse check just before we move him?
0:00:36 > 0:00:40It's a scenario that can test the most experienced paramedic.
0:00:42 > 0:00:46But what if you're a first-year student and you're new on the job?
0:00:51 > 0:00:53Meet the Junior Paramedics.
0:00:53 > 0:00:55Does this make me look vain?
0:00:55 > 0:00:57'It is quite scary and daunting.'
0:00:57 > 0:00:58I am only 19.
0:00:58 > 0:01:01You got little ticklish feet?
0:01:01 > 0:01:04When we go to a really serious job, like a cardiac arrest,
0:01:04 > 0:01:06I will have to get involved.
0:01:07 > 0:01:10You feel like you're doing something that means something,
0:01:10 > 0:01:12and it's making a difference.
0:01:12 > 0:01:14Flying around with the blue lights on, that'll be good.
0:01:14 > 0:01:15I'm not going to lie!
0:01:15 > 0:01:18MAN SPLUTTERS
0:01:20 > 0:01:22Let's go do some shots.
0:01:22 > 0:01:24The shifts are going to be hard to get used to.
0:01:24 > 0:01:26I hate mornings, I'm not a morning person, at all.
0:01:28 > 0:01:31All of the paramedics I've spoken to have said that there'll always be
0:01:31 > 0:01:33one thing, when you get there,
0:01:33 > 0:01:37you don't know why, but it affects you really badly.
0:01:37 > 0:01:40You've got to be prepared to go into someone's house
0:01:40 > 0:01:41and not be scared of the outcome.
0:01:41 > 0:01:45I'm definitely quite worried dealing with my first fatal
0:01:45 > 0:01:48or, you know, the first body that I come to.
0:01:48 > 0:01:51Being a paramedic's my dream. It's something that I've always wanted.
0:01:51 > 0:01:54Studying for a degree in paramedic science is tough.
0:01:56 > 0:01:57Failure is not an option.
0:02:01 > 0:02:04Six weeks of dealing with real people in real emergencies
0:02:04 > 0:02:06is even tougher...
0:02:06 > 0:02:09I'm yawning all the time and I'm shattered already.
0:02:09 > 0:02:11..working gruelling shifts...
0:02:11 > 0:02:12We're with you. Ambulance is here with you.
0:02:12 > 0:02:15..and being put under immense pressure.
0:02:15 > 0:02:17- Why am I doing this?- There we go.
0:02:17 > 0:02:20Why am I out in the cold at two o'clock in the morning?
0:02:20 > 0:02:23They're young. They're inexperienced.
0:02:23 > 0:02:24Oh, my God.
0:02:24 > 0:02:28And every day is a matter of life or death.
0:02:28 > 0:02:30I was like, a-a-agh! Adrenaline!
0:02:30 > 0:02:31For these Junior Paramedics,
0:02:31 > 0:02:34it's make or break on the emergency front line.
0:02:34 > 0:02:37Do you know how to open it? Stop! SHE LAUGHS
0:02:45 > 0:02:47Previously on Junior Paramedics...
0:02:47 > 0:02:50Lots of drugs problems round here, so it could be an opiate overdose...
0:02:52 > 0:02:54As they started their placements,
0:02:54 > 0:02:57all nine Junior Paramedics were thrown in at the deep end,
0:02:57 > 0:03:00experiencing real trauma for the first time.
0:03:01 > 0:03:03- Take a deep breath.- Yeah.
0:03:03 > 0:03:06Steph was given a baptism of fire,
0:03:06 > 0:03:09as she attended a suspected cardiac arrest...
0:03:09 > 0:03:11I don't think I've ever had
0:03:11 > 0:03:13an adrenaline rush like that in my life.
0:03:13 > 0:03:17..before impressing during a major road-traffic incident.
0:03:17 > 0:03:19- You haven't got any allergies at all?- No.- No.
0:03:19 > 0:03:22She did really well, I'm really pleased with her.
0:03:22 > 0:03:26Meanwhile, Lucy Mellor struggled with her bedside manner.
0:03:26 > 0:03:29- Awkward silence.- Are you busy?
0:03:29 > 0:03:32..whilst Amy was left feeling emotional.
0:03:32 > 0:03:34I feel really stupid for, like, getting teary about it,
0:03:34 > 0:03:37but it, sort of, brings it home like that.
0:03:37 > 0:03:40Although their first week might have been tough,
0:03:40 > 0:03:41that was just the beginning.
0:03:42 > 0:03:46With five weeks left on placement, and being constantly assessed
0:03:46 > 0:03:49on their performance, this is the reality of life
0:03:49 > 0:03:51when you're a Junior Paramedic.
0:03:53 > 0:03:55'Hello, East Midlands Ambulance Service.'
0:03:55 > 0:03:57'Tell me exactly what's happened.'
0:03:57 > 0:03:59'Yeah, the wife has tumbled in the kitchen...'
0:03:59 > 0:04:02'My husband's fell off a ladder outside.
0:04:02 > 0:04:05'He's on the floor and he's struggling breathing.'
0:04:05 > 0:04:08'OK, I'm organising help for you now. Stay on the line, OK?'
0:04:10 > 0:04:12At the heart of England,
0:04:12 > 0:04:14the East Midlands Ambulance Service provides
0:04:14 > 0:04:18emergency medical assistance for 4.8 million residents,
0:04:18 > 0:04:21receiving 2,000 999 calls every day.
0:04:22 > 0:04:24BEEPING AND RADIO CHATTER
0:04:26 > 0:04:28Across Northamptonshire and Leicestershire,
0:04:28 > 0:04:30all nine Junior Paramedics
0:04:30 > 0:04:33are starting their second week on placement.
0:04:33 > 0:04:37And at Mereway Ambulance Station in Northampton, 19-year-old Bryn
0:04:37 > 0:04:40and his mentor, Charlotte, are braced for their first call.
0:04:44 > 0:04:46Bryn hasn't learnt the noises yet.
0:04:46 > 0:04:49Every time it goes off he's like this.
0:04:49 > 0:04:51BEEPING
0:04:53 > 0:04:54- Enjoy.- I'll see you in a bit.
0:05:05 > 0:05:09In his first shifts, Bryn has been excelling in his new role.
0:05:14 > 0:05:15It'll go on your toe like that.
0:05:17 > 0:05:20- Oh...- Oh! No, I didn't think so!
0:05:21 > 0:05:25He's impressed his patients with his relaxed bedside manner...
0:05:25 > 0:05:30- Can you say "British constitution" for me?- British constitution.
0:05:30 > 0:05:34- Good, and "Baby hippopotamus?" - Baby hippopotamus.
0:05:34 > 0:05:36Good, you can do it better than I can.
0:05:36 > 0:05:40..has immediately bonded with his mentor, Charlotte...
0:05:40 > 0:05:41One, two, boot!
0:05:46 > 0:05:49..and he's a hit with the other students on the course.
0:05:52 > 0:05:56Most of all, he's passionate about becoming a great paramedic.
0:06:03 > 0:06:04'I want to be a paramedic
0:06:04 > 0:06:07'because I've always been interested in emergency care.'
0:06:07 > 0:06:11So, you know, when I was younger, when I first got my diabetes,
0:06:11 > 0:06:13I was introduced to hospitals and the hospital environment,
0:06:13 > 0:06:15so I was in there quite a lot.
0:06:15 > 0:06:17If I don't take my insulin then my blood sugars will go up,
0:06:17 > 0:06:19and then, if I left it for a long time
0:06:19 > 0:06:23then I'd get diabetic ketoacidosis and die.
0:06:23 > 0:06:25If I left it for a long time it could be quite bad, but, erm,
0:06:25 > 0:06:27we won't be doing that, so...
0:06:27 > 0:06:30If you're on two shifts in a row, you don't have time for a thing.
0:06:30 > 0:06:33So, what sort of thing do you eat in the middle of the night?
0:06:33 > 0:06:34Oh, Super Noodles.
0:06:34 > 0:06:36Something very unhealthy.
0:06:36 > 0:06:40'My family are quite excited for me to go down the paramedic route,'
0:06:40 > 0:06:44and hope that I can be the best that I can be, really.
0:06:45 > 0:06:47It's a big leap into the unknown,
0:06:47 > 0:06:51so I am a little bit nervous for him, but I'm very confident in him.
0:06:51 > 0:06:55I think that he will be loving it, which makes me feel a little
0:06:55 > 0:06:58bit better, because if he's happy then I will be happy as well.
0:06:59 > 0:07:03'So I do a bit of a range of sports.
0:07:03 > 0:07:05Coming to uni, I've picked up lacrosse.
0:07:06 > 0:07:08It's quite a fast game.
0:07:08 > 0:07:10You know, it's a contact sport as well,
0:07:10 > 0:07:13so it's good to get a bit of aggression out.
0:07:13 > 0:07:14You get tired out.
0:07:20 > 0:07:23I feel ready to become a Junior Paramedic,
0:07:23 > 0:07:27so, I feel prepared theoretically,
0:07:27 > 0:07:30but it's another thing being mentally prepared and then actually
0:07:30 > 0:07:33physically being in that situation and having to deal with it.
0:07:38 > 0:07:41As temperatures plummet in Northampton,
0:07:41 > 0:07:44Bryn's been attending a series of low-key jobs,
0:07:44 > 0:07:47so he's desperate for some action.
0:07:47 > 0:07:49RADIO BEEPS 534?
0:07:58 > 0:08:00Not a problem. Thank you very much.
0:08:04 > 0:08:06His moment has finally come,
0:08:06 > 0:08:09but will he be able to cope under the pressure?
0:08:09 > 0:08:12So, what's really important with an ankle injury?
0:08:12 > 0:08:13What do we need to do to assess it?
0:08:13 > 0:08:16Er, expose it first of all, so if he was, I don't know,
0:08:16 > 0:08:18say, if he was playing football or something...
0:08:18 > 0:08:21- So, expose and examine, yeah?- Yeah. - But what are we comparing it to?
0:08:21 > 0:08:23- The other ankle.- Yay.
0:08:26 > 0:08:27After racing to the scene,
0:08:27 > 0:08:29they discover that, to get to their patient,
0:08:29 > 0:08:32they need to drive straight on to a busy football pitch.
0:08:32 > 0:08:34Do you think I'm going to get through that?
0:08:34 > 0:08:36I don't know. Yeah, you might do!
0:08:37 > 0:08:39As they arrive, they discover
0:08:39 > 0:08:42an amateur footballer lay on the ground,
0:08:42 > 0:08:43who is remarkably calm,
0:08:43 > 0:08:49considering his foot is pointing 90 degrees in the wrong direction.
0:08:50 > 0:08:52How much pain out of ten?
0:08:52 > 0:08:54If you could score it out of ten. A four.
0:08:54 > 0:08:57Just get you on some gas and air for a minute.
0:09:00 > 0:09:03Does it hurt at the moment? Maybe you've turned it a bit. No.
0:09:03 > 0:09:05It's an horrific-looking injury,
0:09:05 > 0:09:10which could distress any Junior Paramedic, yet Bryn is unfazed.
0:09:10 > 0:09:13If you hold that to your mouth and just take some deep breaths in.
0:09:16 > 0:09:19- Have you ever had this before, buddy?- No.- You haven't.
0:09:25 > 0:09:27My gut feeling is that it is dislocated.
0:09:27 > 0:09:31This doesn't look deformed in the fact that it's broken, and it looks
0:09:31 > 0:09:35that your ankle's come out of place, so I'd say it's more dislocated.
0:09:35 > 0:09:36The injury looks severe,
0:09:36 > 0:09:40but Bryn and Charlotte still need to expose and examine the ankle,
0:09:40 > 0:09:41to see the full extent of the damage.
0:09:41 > 0:09:44Sorry, buddy, you are going to have to get some new shoes.
0:09:44 > 0:09:48- Can you feel me touching your foot and everything?- Yeah, I can, yeah.
0:09:49 > 0:09:52If the dislocated bone stretches the flesh too far,
0:09:52 > 0:09:55the patient could get critical skin,
0:09:55 > 0:09:57where blood vessels are strained so much
0:09:57 > 0:10:01the blood supply to both the skin and the limb could get cut off.
0:10:11 > 0:10:13The critical skin is minimal,
0:10:13 > 0:10:17but the patient will now need urgent medical attention at hospital,
0:10:17 > 0:10:20since extreme cases can lead to amputation.
0:10:22 > 0:10:23Yeah, 534, can you give me a heads-up
0:10:23 > 0:10:25when the crew are about five minutes away,
0:10:25 > 0:10:27so I can get someone to come and meet them?
0:10:34 > 0:10:36Yeah, no worries, thank you.
0:10:37 > 0:10:40The ambulance being delayed is a huge blow.
0:10:40 > 0:10:44Bryn and Charlotte must now do all they can to keep the patient stable
0:10:44 > 0:10:45in the rapidly-falling temperatures.
0:10:45 > 0:10:49- Are you freezing cold? - I'm getting pretty cold.- Yeah?
0:10:49 > 0:10:51I'm going to pop this here, cos that'll keep you warm,
0:10:51 > 0:10:55I know you look a bit silly, but it'll keep your head warm.
0:10:57 > 0:11:01As everyone starts to struggle with the cold, Bryn starts to realise how
0:11:01 > 0:11:05the most simple of tasks can become difficult with freezing fingers.
0:11:05 > 0:11:08My hands were so cold, I just, I couldn't get packets open
0:11:08 > 0:11:10and things like that, so I couldn't really...
0:11:10 > 0:11:12I should have been a bit quicker
0:11:12 > 0:11:14just getting that pain relief as soon as possible.
0:11:14 > 0:11:17I'm going to give you some morphine now, all right, mate?
0:11:17 > 0:11:19'It makes it more difficult when you have to do things,
0:11:19 > 0:11:22'and it was kind of fiddly things, like Charlotte put a cannula in.'
0:11:22 > 0:11:24'For her doing that, it's quite a fine procedure,
0:11:24 > 0:11:27'and when your hands are freezing cold that must have been really difficult.'
0:11:27 > 0:11:29Luckily, I don't have to do that yet!
0:11:29 > 0:11:32You're quite a fit guy, so it'll probably heal quicker.
0:11:32 > 0:11:34LAUGHTER
0:11:34 > 0:11:36Oh, brilliant(!)
0:11:36 > 0:11:39As Charlotte squirms with embarrassment...
0:11:39 > 0:11:41Brilliant. CHARLOTTE LAUGHS
0:11:41 > 0:11:43..the ambulance finally arrives,
0:11:43 > 0:11:47and since time is of the essence, Bryn takes charge of the situation.
0:11:47 > 0:11:50We've got 29-year-old Ivor, he's, uh...
0:11:50 > 0:11:52Looks like a dislocation to his ankle,
0:11:52 > 0:11:55it's quite obviously deformed.
0:11:55 > 0:11:57It's his first handover,
0:11:57 > 0:11:59but with the patient's condition deteriorating,
0:11:59 > 0:12:01there's no time for nerves.
0:12:02 > 0:12:06OK, we're going to lift on "lift." Ready, brace, lift.
0:12:23 > 0:12:25Having experienced his first dramatic incident,
0:12:25 > 0:12:28Bryn now feels ready for anything.
0:12:28 > 0:12:31He just needed pain relief, that's why I was going...
0:12:31 > 0:12:32I know, I was taking for ever.
0:12:32 > 0:12:34We need to get him some... No, don't worry.
0:12:34 > 0:12:38My hands were so cold, I was like that, I can't actually get this out!
0:12:40 > 0:12:41I felt so sorry for this guy
0:12:41 > 0:12:44cos all he was doing was just training for a match, probably,
0:12:44 > 0:12:48but he dislocated his ankle and then later we found out
0:12:48 > 0:12:50he'd actually broken his tibia and fibula.
0:12:52 > 0:12:56I think this chap actually was quite lucky in the fact that,
0:12:56 > 0:12:57when he had got seen,
0:12:57 > 0:13:01he had managed to just about get there in time to save the skin,
0:13:01 > 0:13:03so he wouldn't have had to have a skin graft,
0:13:03 > 0:13:06but it is an emergency situation if somebody has this critical skin
0:13:06 > 0:13:09where it has gone really, really white.
0:13:09 > 0:13:12- I embarrassed myself with that bunch of lads, as well.- Why?
0:13:12 > 0:13:16- Oh, when you called him fit. - I didn't mean it like that.
0:13:16 > 0:13:18I was like, "Oh, no, I'm blushing now."
0:13:18 > 0:13:21"You just called me fit. Brilliant, thank you."
0:13:21 > 0:13:24It's so embarrassing, I didn't mean it like that.
0:13:33 > 0:13:36Over at Gorse Hill Ambulance Station, another Junior Paramedic
0:13:36 > 0:13:39starting a nightshift is 19-year-old Lucy Wright.
0:13:41 > 0:13:43- Hello!- Hello, evening. All right?
0:13:43 > 0:13:45- Yeah, you?- Yes, fine, thank you.
0:13:46 > 0:13:50Like Bryn, Lucy's proven to have a solid understanding of both
0:13:50 > 0:13:53medical procedure and the technical aspects of the job.
0:13:54 > 0:13:58- Well done.- Brilliant.
0:13:58 > 0:14:01However, Lucy has struggled to communicate with some patients,
0:14:01 > 0:14:03often finding it difficult to reassure them
0:14:03 > 0:14:05and make them feel at ease.
0:14:05 > 0:14:07There we go.
0:14:12 > 0:14:15But she knows that, if she can improve her bedside manner,
0:14:15 > 0:14:18she'll be on course to become a success.
0:14:20 > 0:14:22A lot of my friends were shocked when I said I was
0:14:22 > 0:14:25going to be a paramedic, they thought I was a bit crazy.
0:14:25 > 0:14:27"Why the hell would you want to do this for a living?"
0:14:30 > 0:14:32My dad was quite poorly a while ago.
0:14:32 > 0:14:34That was when I decided to get involved
0:14:34 > 0:14:35with the care and stuff like that,
0:14:35 > 0:14:39and it really made me want to, like, chase what I wanted to do.
0:14:44 > 0:14:47I would describe myself as a geek, definitely.
0:14:47 > 0:14:49Going out for me is not a big thing.
0:14:49 > 0:14:53I really like gaming, so... Playing games like zombie games.
0:14:53 > 0:14:57- I haven't been out with you yet. - Yeah, we have.- No, we haven't.
0:14:57 > 0:15:00- You were begging me to get drunk. - You weren't drunk, you stayed here.
0:15:05 > 0:15:08The thing that I'm most dreading is having the awkwardness
0:15:08 > 0:15:11of talking to a patient when I'm not really prepared to,
0:15:11 > 0:15:14so I won't know what questions to ask and how sensitive to be.
0:15:14 > 0:15:17I need to actually talk to patients more, which is
0:15:17 > 0:15:18the thing I'm most dreading.
0:15:18 > 0:15:21Certain things come natural and certain things don't.
0:15:28 > 0:15:30'Ambulance, tell me exactly what's happened.'
0:15:30 > 0:15:32'Hello, calling from LeicesterCare Lifeline,
0:15:32 > 0:15:36'got a 67-year-old female with breathing difficulties.'
0:15:36 > 0:15:38SIREN WAILS
0:15:40 > 0:15:44On shift in Leicester, mentor Natalie is keen to see Lucy progress
0:15:44 > 0:15:46if she's going to pass her placement,
0:15:46 > 0:15:49so the time has come to push her harder.
0:15:49 > 0:15:52We'll let you lead this one. See how you go.
0:15:54 > 0:15:56Remember your questioning, A-B-Cs.
0:15:57 > 0:16:00Natalie wants Lucy to deal with the patient directly,
0:16:00 > 0:16:03ascertain her medical history, and assess her condition.
0:16:06 > 0:16:11Hello? Hello, I'm Lucy, I'm a student paramedic. How are we feeling today?
0:16:13 > 0:16:17However, once inside, they find the patient is gasping for air.
0:16:17 > 0:16:19We're going to have a listen to your chest.
0:16:21 > 0:16:26- Have you got asthma? - COPD!- COPD, right, OK.
0:16:26 > 0:16:29Since the patient is in such a distressed state,
0:16:29 > 0:16:33Natalie has no choice but to step in and take control.
0:16:33 > 0:16:37Have you had a nebuliser before? Yeah.
0:16:37 > 0:16:38PATIENT SPLUTTERS
0:16:38 > 0:16:40Shall I put this on you?
0:16:45 > 0:16:47The patient's breathing problems are
0:16:47 > 0:16:51a symptom of chronic obstructive pulmonary disease - or COPD,
0:16:51 > 0:16:55which is often caused by lung damage as a result of excessive smoking.
0:16:57 > 0:16:59No, don't worry, you don't have to talk.
0:16:59 > 0:17:03- You just concentrate on your breathing.- It's 39.- 39.- Yeah.
0:17:05 > 0:17:07Right, Ann, we're going to be really mean,
0:17:07 > 0:17:10cos you've got a really, really high temperature.
0:17:10 > 0:17:15So I'm going to take this off, and just put your dressing gown on.
0:17:15 > 0:17:16I know you're really cold,
0:17:16 > 0:17:20but it's because you've got a really high temperature.
0:17:20 > 0:17:23Whilst Natalie goes off to chat with the patient's husband...
0:17:23 > 0:17:25So, these are all the ones that she takes?
0:17:25 > 0:17:27That's the ones she starts the day with, yeah.
0:17:27 > 0:17:30..Lucy begins to carry out general observations...
0:17:30 > 0:17:33Try not to move them too much, you don't need to move too much.
0:17:33 > 0:17:36..a series of tests monitoring blood pressure,
0:17:36 > 0:17:37blood sugar level and pulse.
0:17:43 > 0:17:47It's also Lucy's job to keep the patient calm and reassured
0:17:47 > 0:17:49at all times.
0:17:51 > 0:17:53But shyness has got the better of her.
0:17:58 > 0:18:01As another ambulance arrives to take the patient to hospital,
0:18:01 > 0:18:04Lucy has a chance to earn some brownie points,
0:18:04 > 0:18:08if she can successfully perform a case handover to the new crew.
0:18:08 > 0:18:12Do you want to tell Shab what's been going on, Luce?
0:18:12 > 0:18:14Er, this is Ann, she's got COPD.
0:18:14 > 0:18:17Erm, she's just struggling to breathe at the minute,
0:18:17 > 0:18:19we've given her Salbutamol.
0:18:19 > 0:18:21Erm...
0:18:21 > 0:18:24Basically, she was feeling unwell earlier.
0:18:24 > 0:18:26Erm, her husband wanted to ring her in...
0:18:26 > 0:18:30Remembering every detail of a patient's medical history is tough,
0:18:30 > 0:18:31so despite her best efforts,
0:18:31 > 0:18:35Natalie has stepped in to help Lucy complete the handover.
0:18:35 > 0:18:40- That's it, throw me your legs round. - That's it, well done, Ann.
0:18:40 > 0:18:42I know, you're all puffed out, aren't you?
0:18:44 > 0:18:46As the patient is taken to the waiting ambulance,
0:18:46 > 0:18:50Natalie takes the time to reassure her worried husband.
0:18:51 > 0:18:55She's going to be fine, it's just taken hold of her a little bit,
0:18:55 > 0:18:58- so we've obviously got the nebuliser going...- Yeah.
0:18:58 > 0:19:02..and that's helping her a little bit, she's calmed down a little bit.
0:19:02 > 0:19:04For Lucy, it's the perfect demonstration
0:19:04 > 0:19:06of good bedside manner.
0:19:06 > 0:19:08We're going to get her on the ambulance and I'll come back
0:19:08 > 0:19:10and let you know what hospital we're going to.
0:19:10 > 0:19:13- Are you going to be all right?- Yeah. - All right. Just grab the stuff.
0:19:16 > 0:19:18Back in the fast-response vehicle,
0:19:18 > 0:19:21Lucy's mentor gives her some feedback.
0:19:21 > 0:19:24You need a lot of pushing to approach the patient.
0:19:24 > 0:19:26You said at the very start of this placement that you do
0:19:26 > 0:19:29struggle to speak to people, or some people.
0:19:29 > 0:19:31That is evident, because obviously
0:19:31 > 0:19:35one of the biggest things about this job is communication,
0:19:35 > 0:19:38and it doesn't have to be on a clinical basis.
0:19:38 > 0:19:41I'm just scared of offending people, mainly. Cos I'm so young,
0:19:41 > 0:19:44especially, like, elderly, I don't want to say anything wrong,
0:19:44 > 0:19:49and I just don't know how to chat as such, but I hope I'll get used to it.
0:19:49 > 0:19:50It is only small talk.
0:19:50 > 0:19:55Erm, it's not important when it comes to your university,
0:19:55 > 0:20:00you know, doing your exams, doing your practical examinations,
0:20:00 > 0:20:01things like that.
0:20:01 > 0:20:05It's something that you need to master when you become a paramedic.
0:20:13 > 0:20:17Although Lucy needs to concentrate on building her confidence,
0:20:17 > 0:20:21she's not the only Junior Paramedic feeling out of their depth.
0:20:22 > 0:20:24I'm going to pop this on your finger, is that all right?
0:20:24 > 0:20:27In the first week, every little call that I got made my heart stop.
0:20:27 > 0:20:29I was like, "What's happened?"
0:20:29 > 0:20:30I'm doing the whole handover here.
0:20:30 > 0:20:32There are times when they're like,
0:20:32 > 0:20:35"Oh, do you want to do this handover in A & E?" And I'm like, "No way."
0:20:35 > 0:20:38Because inside I'm just thinking, "I can't do that."
0:20:39 > 0:20:42No, no, OK, just try to breathe normal.
0:20:42 > 0:20:45I've learned, if a patient sees a panic on your face,
0:20:45 > 0:20:48that must mean that it's gone really bad, and it's time for them
0:20:48 > 0:20:50to be panicked, which isn't going to help them.
0:20:50 > 0:20:55- Hello.- Hello! My name's Amy and this is Shay. How can we help you today?
0:20:55 > 0:20:57'Both my mentors now have started
0:20:57 > 0:20:59'to let us take a bit of history from the patient.'
0:20:59 > 0:21:01Is that all right to do some observations on you?
0:21:01 > 0:21:04But I definitely wouldn't want to be in that situation on my own yet.
0:21:06 > 0:21:08You've got to be able to hack it.
0:21:08 > 0:21:11It's not just dealing with the patients, it's doing the long hours,
0:21:11 > 0:21:13going into hospitals, doing the handovers,
0:21:13 > 0:21:15and I think you need to be confident in everything.
0:21:15 > 0:21:18Just push through it, really. Just man up.
0:21:18 > 0:21:21Eat a Snickers. Drink some Red Bull.
0:21:21 > 0:21:25- Oh, it's hurting again!- You can lean on me, that's all right.
0:21:25 > 0:21:26That's all right.
0:21:26 > 0:21:30Confidence is key, and that's something Junior Paramedic Ashley
0:21:30 > 0:21:32has never been short of.
0:21:32 > 0:21:36And having previously worked in the Ambulance Service as a coordinator,
0:21:36 > 0:21:39she has an idea of what the job entails.
0:21:41 > 0:21:44My name's Ashley, I'm 27 years old.
0:21:44 > 0:21:46I think I am really caring, erm,
0:21:46 > 0:21:49but I am really ambitious and very competitive.
0:21:51 > 0:21:53Hello, can you hear me? Can you open your eyes?
0:21:53 > 0:21:57Yeah, there's a response, now I'm just going to listen for heartbeats.
0:21:57 > 0:22:01I have a boyfriend, his name is Jamie, and he is a paramedic.
0:22:01 > 0:22:03Do you think you could work with me?
0:22:03 > 0:22:06- I don't think so.- I don't think I could ever work with you,
0:22:06 > 0:22:10because I think we're really similar characters, and I think I would
0:22:10 > 0:22:14think I was right, and you would insist that you were right.
0:22:14 > 0:22:17- OK, I'm going to go now.- OK, darling.
0:22:17 > 0:22:20The relationship with my grandparents is great.
0:22:20 > 0:22:22I've always been really close with them.
0:22:22 > 0:22:24I've grown up with them, and actually,
0:22:24 > 0:22:28before coming to university, I've probably seen them every single day.
0:22:28 > 0:22:33- Bye!- All her life, she's always had loads of energy, hasn't she?
0:22:33 > 0:22:36She's always full of enthusiasm.
0:22:36 > 0:22:38- Nothing really fazes her, does it?- No.
0:22:40 > 0:22:42I think doing my previous job
0:22:42 > 0:22:47and having friends and my partner in the industry, it definitely helps.
0:22:47 > 0:22:50Would you have any advice for me for my first placement?
0:22:50 > 0:22:53First placement?
0:22:53 > 0:22:56Hmm, make sure you make a good cup of tea.
0:22:57 > 0:22:59'I am highly driven,
0:22:59 > 0:23:01'and I want to achieve something'
0:23:01 > 0:23:03that I'm proud of, that isn't easy,
0:23:03 > 0:23:07that is going to challenge me daily, that's going to have highs and lows.
0:23:07 > 0:23:09I want to do something that means something
0:23:09 > 0:23:11and I want to make a difference.
0:23:22 > 0:23:26Since starting her placement in Northampton, Ashley's been eager
0:23:26 > 0:23:28to roll up her sleeves, don the rubber gloves,
0:23:28 > 0:23:30and get involved on every call.
0:23:33 > 0:23:35THEY CHAT
0:23:36 > 0:23:39So I need to change the green, cos that's compromised.
0:23:39 > 0:23:42Good girl, well spotted. On the ball this morning.
0:23:45 > 0:23:47Hello, it's the police.
0:23:48 > 0:23:51But Ashley and her fellow Junior Paramedics have been shocked
0:23:51 > 0:23:54by the level of social deprivation they've encountered
0:23:54 > 0:23:56in the first days of their placement.
0:23:58 > 0:23:59Why can't I just put them in order?
0:23:59 > 0:24:02Many of their patients face day-to-day hardships
0:24:02 > 0:24:05such as poverty, poor living conditions,
0:24:05 > 0:24:08or ill health through substance addiction.
0:24:12 > 0:24:14If Ashley is to succeed as a paramedic,
0:24:14 > 0:24:16dealing with social deprivation
0:24:16 > 0:24:20and learning to cope with such vulnerable patients is essential.
0:24:34 > 0:24:39It's 1:30am, and Ashley and mentor Simon's next patient
0:24:39 > 0:24:42is taking shelter in a local kebab shop.
0:24:49 > 0:24:54- Hello, mate. Have a sit down, me old buddy.- Thank you, thank you.
0:24:54 > 0:24:57- How you doing? - Not too good.- Not too good.
0:24:57 > 0:25:00- I met you the other night, didn't I?- You did.
0:25:00 > 0:25:04It's a homeless man known to many of the paramedics in Northampton.
0:25:04 > 0:25:07So, what have we been called for tonight?
0:25:07 > 0:25:11Right, how long's it been like this for?
0:25:12 > 0:25:13A couple of days.
0:25:15 > 0:25:17OK, did you see... Have you seen your doctor?
0:25:19 > 0:25:21The patient's complaining of difficulty in breathing,
0:25:21 > 0:25:24but when you talk to him, he's just so cold, he's so cold,
0:25:24 > 0:25:26he doesn't know what to do, he has nowhere to go,
0:25:26 > 0:25:28and he's just really hungry.
0:25:28 > 0:25:31- Have you had any drink, any alcohol?- No.- No?
0:25:31 > 0:25:33All right, buddy.
0:25:33 > 0:25:36What are we going to do with you tonight, then?
0:25:36 > 0:25:38A bit cold out there, innit?
0:25:41 > 0:25:44I think really he just needs somewhere for the night,
0:25:44 > 0:25:47and we have a duty of care, we can't just leave a vulnerable person
0:25:47 > 0:25:50who's complaining of not feeling good.
0:25:50 > 0:25:52Do you mind if I just check your pulse?
0:25:52 > 0:25:54Just need to touch your wrist if that's OK.
0:25:56 > 0:25:57Thank you, my love.
0:25:57 > 0:26:00Although his situation is upsetting,
0:26:00 > 0:26:03Ashley and Simon can only take a patient to hospital
0:26:03 > 0:26:04if they are actually ill.
0:26:06 > 0:26:08He's probably fought for his country
0:26:08 > 0:26:10and he ends up sleeping on the streets.
0:26:10 > 0:26:12Just another side, how people do live,
0:26:12 > 0:26:15is quite heartbreaking to see sometimes.
0:26:16 > 0:26:22- Have you had anything to eat today? - No.- No? Are you hungry or thirsty?
0:26:22 > 0:26:26- I am very hungry. - You're very hungry.- Yeah.
0:26:26 > 0:26:28'This placement is an eye-opener for me,
0:26:28 > 0:26:32'although I think I have got some good life experience.'
0:26:32 > 0:26:34It's kind of been really shocking.
0:26:34 > 0:26:37And it's kind of been more some of the social issues,
0:26:37 > 0:26:39such as people who don't have any family, any friends,
0:26:39 > 0:26:42any home, anything.
0:26:42 > 0:26:45That's kind of hit home a little bit more.
0:26:45 > 0:26:49Do you want a tissue? I'll get you a tissue if you like.
0:26:52 > 0:26:54Ashley and Simon's examination
0:26:54 > 0:26:58reveals the patient has developed a respiratory infection.
0:26:58 > 0:26:59Since he has a genuine complaint,
0:26:59 > 0:27:02he will spend the night in hospital after all.
0:27:08 > 0:27:10There's a step. Yeah.
0:27:13 > 0:27:14Don't you worry.
0:27:21 > 0:27:23'They don't have anything and they probably never will.
0:27:23 > 0:27:26'And there's just... There's nothing to support them.
0:27:29 > 0:27:31'And that's a really sad prospect.'
0:27:37 > 0:27:40Ashley's already learning that there's more to being a paramedic
0:27:40 > 0:27:43than just tending to the sick and the injured.
0:27:43 > 0:27:46It involves acting as a medic, a social worker and,
0:27:46 > 0:27:48most importantly, a Good Samaritan.
0:27:52 > 0:27:55It makes you realise how lucky you are, I suppose.
0:27:55 > 0:27:58It's just sad that he doesn't have anyone, as well.
0:28:12 > 0:28:16Let's see if you've remembered anything. What is this?
0:28:16 > 0:28:18Oh, I can't say it.
0:28:18 > 0:28:22The University of Northampton's Paramedic Science course
0:28:22 > 0:28:25is incredibly tough to get on, and no-one is more aware of this
0:28:25 > 0:28:28than 25-year-old Vicki.
0:28:28 > 0:28:31She's desperate to become a paramedic,
0:28:31 > 0:28:34but she failed to get on the course four times
0:28:34 > 0:28:36before finally being accepted this year.
0:28:38 > 0:28:40It's massively important to me.
0:28:40 > 0:28:44I've never stopped trying to develop myself for it and be ready for it.
0:28:44 > 0:28:47Finally this year, I managed to get my place at Northampton.
0:28:49 > 0:28:51What's the problem? What have you called for?
0:28:51 > 0:28:54Since starting her placement, Vicki has found the reality of the job
0:28:54 > 0:28:57to be far more demanding than expected,
0:28:57 > 0:29:01and at times has struggled to absorb essential information
0:29:01 > 0:29:02provided by patients.
0:29:02 > 0:29:06Should that fill up with blood? What should that fill up with?
0:29:06 > 0:29:08- Faeces.- Right, OK.
0:29:08 > 0:29:11It's taken me a while to sink things in.
0:29:11 > 0:29:12I know it's only my first shift,
0:29:12 > 0:29:15but I don't want to just stand there and do nothing.
0:29:15 > 0:29:18She's bonded well with her mentor George,
0:29:18 > 0:29:20but Vicki is her own biggest critic,
0:29:20 > 0:29:25piling the pressure on herself to make the grade on placement.
0:29:25 > 0:29:27This is all the drugs. I'll test you now,
0:29:27 > 0:29:31- see if you can remember where everything is.- Oh, God!
0:29:31 > 0:29:33SIREN WAILS
0:29:38 > 0:29:41There you are. You've now got to go up the stairs with that.
0:29:41 > 0:29:43Today Vicki and George are one of the teams
0:29:43 > 0:29:45covering the Leicester area,
0:29:45 > 0:29:46where they've been called to help a man
0:29:46 > 0:29:48who seems to have fallen in his flat.
0:29:50 > 0:29:53But when they arrive, getting access to treat the patient
0:29:53 > 0:29:55is far from straightforward.
0:29:55 > 0:29:59- Is he up again? Did they say...? - Have you got a key to his house?- No.
0:29:59 > 0:30:00Has anybody?
0:30:00 > 0:30:05- Just a minute.- He has. Have they? - Oh, here he is.- Oh, brilliant..
0:30:05 > 0:30:07- Hello.- Have you got the key?
0:30:10 > 0:30:13Do you have the key? The key?
0:30:13 > 0:30:16- No.- No?- I show you the key. - Oh, can you let us in?- Yeah.
0:30:16 > 0:30:20- Ambulance.- All right.- Out of breath.
0:30:20 > 0:30:22Having no idea what condition the patient is in,
0:30:22 > 0:30:24time is of the essence.
0:30:24 > 0:30:28But getting the front door opened is proving to be a frustrating task.
0:30:28 > 0:30:31Have you found it? Are you looking for it?
0:30:31 > 0:30:34- Can't find it.- He can't find it.
0:30:34 > 0:30:37Have you got your key in there? Can you pass it to me?
0:30:39 > 0:30:40Oh, that's not it.
0:30:40 > 0:30:44- He's here on the floor.- Behind the door?- Yeah, well, he's trying...
0:30:44 > 0:30:46He's making his way to try and pass me the key.
0:30:46 > 0:30:49Just take your time. There's no rush.
0:30:49 > 0:30:53- Is he crawling?- He's scooting on his bum.- Aw, that's all right.
0:30:53 > 0:30:55We'll probably get the keys at the same time.
0:30:55 > 0:30:56Have you got it? Thank you.
0:30:56 > 0:30:58- Have you got it?- Yeah.
0:30:58 > 0:31:01Are you going to scoot back, so I don't open the door on you?
0:31:01 > 0:31:04- Just pass it through the letter box.- Take your time.
0:31:04 > 0:31:06I've got it. Thank you.
0:31:08 > 0:31:09Hello.
0:31:09 > 0:31:14- I can't get up.- It's OK. No worries. That's what we're here for. It's OK.
0:31:14 > 0:31:18Since Vicki's already spoken to the patient, she continues to
0:31:18 > 0:31:21take the lead, hoping to prove to George that she's up to the job.
0:31:21 > 0:31:26- Are you hurt anywhere?- Hit? - Hurt. Are you sore? Aching?
0:31:26 > 0:31:28Yeah.
0:31:28 > 0:31:30Grab my elbow. There we go.
0:31:34 > 0:31:36- That's OK.- Are you up?- OK.
0:31:36 > 0:31:40- There you go.- That's OK. - Give us your hand.
0:31:41 > 0:31:42There you go.
0:31:42 > 0:31:45Just when everything seems to be under control, the situation
0:31:45 > 0:31:47takes a sudden turn for the worse.
0:31:47 > 0:31:48What happened then?
0:31:48 > 0:31:50MAN GROANS
0:31:55 > 0:31:58We're with you. We're with you.
0:31:59 > 0:32:02The patient is having a seizure and although drugs can be
0:32:02 > 0:32:05administered to ease the severity, it's often best
0:32:05 > 0:32:09to make sufferers comfortable and reassure them until it's over.
0:32:09 > 0:32:12We're with you. Ambulance is here with you.
0:32:15 > 0:32:17Crew required, please. You come round here.
0:32:17 > 0:32:20I'll go round there. He's stopped fitting now.
0:32:20 > 0:32:24- But he's not come round any. - 'It's a little bit surreal,
0:32:24 > 0:32:28'cos he literally was talking to us and then he just went
0:32:28 > 0:32:30'and I just talked to him cos I know that they can panic'
0:32:30 > 0:32:33when they come out of it and they are confused.
0:32:33 > 0:32:37So I just thought talking to him might give him a bit of reassurance.
0:32:37 > 0:32:39Relax, it's OK, we're the ambulance.
0:32:39 > 0:32:41Although he's mid-seizure,
0:32:41 > 0:32:43Vicki and George still have procedures to follow
0:32:43 > 0:32:46and take all the patient's observations
0:32:46 > 0:32:48before the ambulance arrives.
0:32:48 > 0:32:52- Relax. It's OK. It's OK.- Hello. Hello.- It's OK.- All right. All right.
0:32:52 > 0:32:53Ambulance.
0:32:53 > 0:32:56Hello. Hello.
0:32:56 > 0:32:59We're here to help you. Leave it in. Leave it in.
0:32:59 > 0:33:03- Take the nasal thing out, or...? - Yeah, probably just... He'll be all right.
0:33:03 > 0:33:08He's not fitting, so we can take it out. Take it out. That's it.
0:33:08 > 0:33:11- He's coming round. - Just relax. Just relax.
0:33:11 > 0:33:15At this stage, it's impossible to diagnose the reason for the seizure
0:33:15 > 0:33:17since the symptoms could be indicative
0:33:17 > 0:33:20of anything from epilepsy to a stroke.
0:33:24 > 0:33:2720 minutes after collapsing, the patient already seems to be
0:33:27 > 0:33:29regaining full awareness.
0:33:29 > 0:33:34Minute by minute, Vicki's confidence also seems to growing.
0:33:34 > 0:33:38Just stay there for now. Just relax there. OK.
0:33:38 > 0:33:42- Hello.- Are you all right? - I'm all right, thank you.
0:33:42 > 0:33:45The second paramedic team arrive to take over
0:33:45 > 0:33:47and transport the patient to hospital,
0:33:47 > 0:33:50leaving Vicki and George to reflect on
0:33:50 > 0:33:51a job well done.
0:33:51 > 0:33:53Vicki handled herself really well.
0:33:53 > 0:33:55I did say, "Oh, he's fitting," but the dynamics changed
0:33:55 > 0:33:58and she just went into, "Right, let's get on with it.
0:33:58 > 0:34:00"Let's deal with it." That's what you need as a paramedic.
0:34:00 > 0:34:03Things change all the time and you need to make plans,
0:34:03 > 0:34:06new directions and think about what you're doing.
0:34:06 > 0:34:08No rush. Take your time.
0:34:08 > 0:34:11By using her initiative and getting us into the flat quicker,
0:34:11 > 0:34:12it was really important
0:34:12 > 0:34:15because that was the difference of us being with the patient
0:34:15 > 0:34:18and managing his seizure, and managing his airway,
0:34:18 > 0:34:19to him doing that without us
0:34:19 > 0:34:23and, potentially, could have had life-changing effects for him.
0:34:23 > 0:34:27Despite continuously putting herself under pressure to do better,
0:34:27 > 0:34:31Vicki's starting to feel like she's making some real progress.
0:34:31 > 0:34:33The more you go out, the more confident you get.
0:34:33 > 0:34:36I definitely feel from day one of placement that I've grown
0:34:36 > 0:34:41and developed, particularly confidence-wise, I've come on.
0:34:41 > 0:34:43But there's a hell of a long way to go
0:34:43 > 0:34:46and, particularly, not having a backup behind you of a mentor
0:34:46 > 0:34:48is a scary thought.
0:34:48 > 0:34:51SIREN WAILS
0:34:56 > 0:34:59It's inevitable that every paramedic will face moments
0:34:59 > 0:35:02where they question whether they're really cut out for the job.
0:35:05 > 0:35:08After being shocked by the amount of social-deprivation cases
0:35:08 > 0:35:11and the long working hours, Ashley is already wondering
0:35:11 > 0:35:14if she was right to chase a new career.
0:35:14 > 0:35:17Why am I doing this?
0:35:17 > 0:35:20Why am I out in the cold at two o'clock in the morning?
0:35:20 > 0:35:22This is potentially my life.
0:35:24 > 0:35:26So she's off to see her nan,
0:35:26 > 0:35:29a former ward clerk in a hospital emergency unit,
0:35:29 > 0:35:30to ask for some advice.
0:35:32 > 0:35:38- Hi, Nan.- Hello.- How are you? - I'm fine. Lovely to see you.
0:35:38 > 0:35:39- Yes.- Lovely to see you.
0:35:39 > 0:35:42- How long are you here for? - Oh, not too long.- Yeah?
0:35:43 > 0:35:46So, how have your first few shifts been?
0:35:46 > 0:35:49Are you getting really into it? Are you enjoying it?
0:35:49 > 0:35:50It's been really good,
0:35:50 > 0:35:54but I wobbled a lot sooner than expected.
0:35:54 > 0:35:57With the big jobs I've been OK.
0:35:57 > 0:36:00It's some of the other things that you think, "Oh,"
0:36:00 > 0:36:02- cos it's sad to see how people live.- Mm.
0:36:02 > 0:36:04It's a very emotional job at times.
0:36:04 > 0:36:10You will see awful things, but you're there to help.
0:36:10 > 0:36:13Because without you, what would they have done?
0:36:13 > 0:36:17I did go to one job. It was a patient with no home.
0:36:17 > 0:36:20They were clearly homeless. And I found that it really got to me.
0:36:20 > 0:36:22You're there to help and you think,
0:36:22 > 0:36:24"I don't know how to help you. I don't know what I can do."
0:36:24 > 0:36:27Because they're still suffering,
0:36:27 > 0:36:31whereas a dead person is now at peace.
0:36:31 > 0:36:34The person that you'd seen, who was cold and had nowhere,
0:36:34 > 0:36:37he still had to go on that night.
0:36:37 > 0:36:39There are lots of people
0:36:39 > 0:36:41who I think lead really, really good lives
0:36:41 > 0:36:43and people have real bad fortune.
0:36:43 > 0:36:47When it's a social issue, it makes it much more complicated.
0:36:47 > 0:36:49You have to think about all sorts of other dynamics.
0:36:49 > 0:36:51What's the standard of living, you know?
0:36:51 > 0:36:54Are you observing anything that's concerning, you know?
0:36:54 > 0:36:57There's just all these other things. It's not straightforward.
0:36:57 > 0:37:02It's compassion for people like that, and you have to keep that.
0:37:02 > 0:37:04The more you get involved in your job,
0:37:04 > 0:37:09the more you'll love it. You'll just come home and think, "Wow!
0:37:09 > 0:37:12"that was a great job I've done today.
0:37:12 > 0:37:15"I've helped somebody who needed my help."
0:37:15 > 0:37:19Her nan might have offered some encouraging advice,
0:37:19 > 0:37:23but will it be enough to lay Ashley's doubts to rest?
0:37:25 > 0:37:27SIREN WAILS
0:37:29 > 0:37:33- Hello.- Evening. Are you all right? - Yes, fine, thank you.
0:37:33 > 0:37:36As Lucy starts her night shift in Leicester,
0:37:36 > 0:37:37a call comes in to control.
0:37:47 > 0:37:49SIREN WAILS
0:37:49 > 0:37:52Lucy, mentor Natalie, and paramedic Naomi
0:37:52 > 0:37:54are immediately dispatched to the scene.
0:37:56 > 0:37:58We're going to a 28-year-old male.
0:37:58 > 0:38:01It's come through as a male on the floor not responding.
0:38:01 > 0:38:05- The patient is on the pavement. Querying maybe drink.- Right. OK.
0:38:05 > 0:38:10So this is going to be our first drunk young person, so...
0:38:10 > 0:38:13Drunken patients can often be a struggle to deal with,
0:38:13 > 0:38:16particularly when you're a 19-year-old junior
0:38:16 > 0:38:17who's new to the job.
0:38:17 > 0:38:20Some people can be so drunk that no matter what you do,
0:38:20 > 0:38:22they just don't come round.
0:38:22 > 0:38:26And it's strange because it is literally just drink-related.
0:38:26 > 0:38:27A lot of them are absolutely fine,
0:38:27 > 0:38:30but some people don't really want you to help.
0:38:30 > 0:38:33They're very unpredictable. So we still have to be mindful.
0:38:35 > 0:38:39Lucy's been making a more concerted effort to interact with her patients
0:38:39 > 0:38:42but now she'll need to toughen up, take control
0:38:42 > 0:38:43and be prepared for anything.
0:38:43 > 0:38:47Oh, he's up. He's looking quite good for being unconscious. He's there.
0:38:52 > 0:38:53- Is it this gent? - This gentleman, yeah.
0:38:53 > 0:38:57Medical conditions such as epilepsy or diabetes
0:38:57 > 0:39:00can display symptoms that suggest a sufferer is drunk.
0:39:00 > 0:39:02Shall we get you on the ambulance then?
0:39:02 > 0:39:04So Lucy and Natalie can't make any assumptions
0:39:04 > 0:39:07about the patient's state until they examine him.
0:39:07 > 0:39:09Wait for us to get the ramp down.
0:39:10 > 0:39:12Whoa, whoa, whoa. Wait a second.
0:39:12 > 0:39:14HE MUMBLES
0:39:14 > 0:39:16Yeah, well, you'll fall over, won't you?
0:39:16 > 0:39:18Right, up on there. Take a seat on the seat for us.
0:39:18 > 0:39:20What's happened?
0:39:23 > 0:39:25You've had an epileptic fit?
0:39:26 > 0:39:27And you got scared.
0:39:29 > 0:39:30Oh, the guy got scared.
0:39:32 > 0:39:34You've got a sore head. Shall we have a look at it?
0:39:34 > 0:39:36Do you want to take his hat off and have a look?
0:39:36 > 0:39:38- MAN:- It's nothing to do with it.
0:39:39 > 0:39:41No. Sit up. Come on, sit up.
0:39:42 > 0:39:45- Watch your language, one... - Am I allowed to take your hat off?
0:39:45 > 0:39:47We'll take your hat off and take a look at your head.
0:39:49 > 0:39:50No neck pain?
0:39:51 > 0:39:53No?
0:39:54 > 0:39:55Around this side?
0:39:58 > 0:40:02- Sit up. Come on, sit up. - How much have you had to drink?
0:40:04 > 0:40:05Two pints. How many...
0:40:07 > 0:40:11No, you shouldn't. How many fits do you normally have?
0:40:13 > 0:40:16About three a week. Watch yourself. Come on, sit up.
0:40:17 > 0:40:21- You're not BLEEP...- 'Ey, 'ey, 'ey, calm down. Just watch him.
0:40:21 > 0:40:23- Just calm down. What's up? - It's all right.
0:40:23 > 0:40:26Don't hit yourself in the head. Come on.
0:40:27 > 0:40:31Suddenly Lucy and Natalie are in a potentially volatile situation.
0:40:31 > 0:40:33They need to keep the patient calm
0:40:33 > 0:40:36whilst making sure they don't put themselves in harm's way.
0:40:39 > 0:40:40Come on.
0:40:40 > 0:40:43Calm down. Come on, calm down.
0:40:46 > 0:40:48Let's take this... Uh-uh, come on. Come on.
0:40:52 > 0:40:54Well, we know you're not going to hurt us,
0:40:54 > 0:40:56but we don't want you to hurt yourself.
0:40:58 > 0:40:59Why wouldn't I like you?
0:41:00 > 0:41:02You've not done anything to me.
0:41:02 > 0:41:05Lucy still needs to carry out basic observations
0:41:05 > 0:41:07but, on such an erratic patient,
0:41:07 > 0:41:10she is going to have to communicate with him
0:41:10 > 0:41:14and keep him reassured - the two skills she lacks confidence in.
0:41:14 > 0:41:17Do you want to keep yourself sat up for me?
0:41:17 > 0:41:18I don't want you to fall over.
0:41:25 > 0:41:30- The green? Do you like it? - Suits us.- It does suit us.
0:41:30 > 0:41:33As the patient continues to recover from his seizure,
0:41:33 > 0:41:37he seems keen to prove that he's a lover and not a fighter.
0:41:40 > 0:41:41You've got a fan, Luce.
0:41:42 > 0:41:43Thank you.
0:41:45 > 0:41:46Thank you.
0:41:51 > 0:41:54- It comes natural.- She's just got a pretty face, obviously.
0:41:54 > 0:41:57She has got a pretty face.
0:41:57 > 0:42:01- Um, no. Not right now. - You can't stroke people.
0:42:01 > 0:42:05No, no, no, no, no. I don't think Lucy wants you to stroke her.
0:42:07 > 0:42:09- That's enough.- There we go.
0:42:09 > 0:42:12Lucy has successfully coped with an unpredictable patient
0:42:12 > 0:42:14in a rapidly-changing situation
0:42:14 > 0:42:17by being adaptable and able to communicate -
0:42:17 > 0:42:20essential skills needed by every paramedic.
0:42:23 > 0:42:26Finally her confidence is starting to grow.
0:42:27 > 0:42:32I don't really feel vulnerable on my own, but I am wary.
0:42:32 > 0:42:35But you've just got to handle it, be responsible,
0:42:35 > 0:42:37and look out for yourself as well.
0:42:49 > 0:42:52All across Leicester and Northampton,
0:42:52 > 0:42:54there's an eerie chill in the air.
0:42:54 > 0:42:57The junior paramedics are preparing for a truly gruesome event
0:42:57 > 0:43:00that will leave some dazed and confused -
0:43:00 > 0:43:02it's the Halloween fancy-dress party!
0:43:02 > 0:43:07# What's that coming over the hill Is it a monster?
0:43:07 > 0:43:10# Is it a monster... #
0:43:10 > 0:43:12- Happy Halloween.- Yay.
0:43:12 > 0:43:15After working extreme hours and dealing with shocking situations,
0:43:15 > 0:43:17it's inevitable the junior paramedics
0:43:17 > 0:43:19will need to let their hair down.
0:43:19 > 0:43:21ALL: Cheers!
0:43:21 > 0:43:23# ..Is it a monster? #
0:43:23 > 0:43:25All of us on the course, we do enjoy going out
0:43:25 > 0:43:27and socialising with each other,
0:43:27 > 0:43:30that's one of the great things about it, because you're so close -
0:43:30 > 0:43:32there's such a small amount of people on the course.
0:43:32 > 0:43:36- What are you today, Amy? - I'm supposed to be Jigsaw, so...
0:43:36 > 0:43:37- I get it.- Can you not tell?
0:43:37 > 0:43:41- Yes, I get it.- I'm just missing the little tricycle.
0:43:41 > 0:43:44It will definitely be nice, a bit of a release,
0:43:44 > 0:43:46you know, to just go out with my friends maybe,
0:43:46 > 0:43:49like, the day after I've had, like, quite a rough shift
0:43:49 > 0:43:52and just so I can switch off and just forget about it.
0:43:52 > 0:43:54You have to have that release, I think,
0:43:54 > 0:43:57it's really important, otherwise you'll just go insane.
0:44:00 > 0:44:03However, there is one student who is a little less excited
0:44:03 > 0:44:05about a night on the blood-soaked tiles.
0:44:05 > 0:44:09I don't mind having a good time and I'll do it once in a while,
0:44:09 > 0:44:11but I prefer to go back and do work and that.
0:44:11 > 0:44:16I know it comes across as a bit sad, but that's what I'm there for.
0:44:16 > 0:44:19I'd be drunk off one vodka - a cheap night.
0:44:19 > 0:44:25DISCO MUSIC
0:44:25 > 0:44:27If I work hard, I can party hard later.
0:44:31 > 0:44:35One junior paramedic who hasn't made the party is Ashley,
0:44:35 > 0:44:37she's on a late shift and still having doubts
0:44:37 > 0:44:40about whether she really wants to be a paramedic.
0:44:42 > 0:44:44The downside in this job,
0:44:44 > 0:44:45you can be pretty down,
0:44:45 > 0:44:48so you have to be quite resilient
0:44:48 > 0:44:52and not let that be a bit of a deadweight to you.
0:44:52 > 0:44:55I think, otherwise, that can really affect you, not just in your job,
0:44:55 > 0:44:57but you can really take this job home.
0:45:00 > 0:45:02Although her nan provided some encouragement,
0:45:02 > 0:45:04Ashley needs to regain her belief
0:45:04 > 0:45:07that she can still make a positive impact
0:45:07 > 0:45:08on a patient's life.
0:45:12 > 0:45:15But while she contemplates where her future lies,
0:45:15 > 0:45:17Ashley has to put any doubts behind her
0:45:17 > 0:45:19as she and mentor Simon
0:45:19 > 0:45:22go to an elderly lady who's apparently had a fall.
0:45:25 > 0:45:27Oh, we are helping you. I just can't rush anything
0:45:27 > 0:45:31because we want to make sure that you're OK before we move you.
0:45:31 > 0:45:34On arrival, they find their patient, Gwen, on the floor
0:45:34 > 0:45:35behind the bedroom door.
0:45:36 > 0:45:39- Have you got any pain in your chest?- No, I did have.
0:45:39 > 0:45:43When? OK. But nothing at the moment?
0:45:43 > 0:45:45All right.
0:45:48 > 0:45:49I need to get you up onto your bed.
0:45:49 > 0:45:55Then we can have a proper look at your heart.
0:45:55 > 0:45:58Can you jump on the bed and get across to the lady's legs?
0:45:58 > 0:46:00I just need to get an ECG on her.
0:46:00 > 0:46:03Ashley heads into the bedroom to comfort Gwen
0:46:03 > 0:46:05whilst the ECG monitors her heart.
0:46:06 > 0:46:10But when Simon passes the results to Ashley to analyse,
0:46:10 > 0:46:12she makes a vital discovery.
0:46:15 > 0:46:19I spotted that she was having an MI, myocardial infarction,
0:46:19 > 0:46:20looked like a heart attack.
0:46:21 > 0:46:23That's like BAD.
0:46:25 > 0:46:27Need to get a line in ASAP.
0:46:27 > 0:46:29Can you get me an IV kit?
0:46:29 > 0:46:34A myocardial infarction, or heart attack as it's more commonly known,
0:46:34 > 0:46:37is often the first stage of a cardiac arrest.
0:46:37 > 0:46:40Ashley and Simon now fight to keep Gwen alive.
0:46:40 > 0:46:44Stay with us, sweetheart, OK? I'm going to have to cut this nightie off you.
0:46:46 > 0:46:49The job changed very quickly.
0:46:49 > 0:46:52We need to get the de-fib pads on because she could go,
0:46:52 > 0:46:55so, yeah, like, adrenaline.
0:46:56 > 0:47:00Suddenly, Gwen starts to lose consciousness.
0:47:00 > 0:47:02Staying with us? Gwen?
0:47:06 > 0:47:09Gwen, your heart's not working properly at the moment.
0:47:09 > 0:47:10All right?
0:47:13 > 0:47:16I know you do, sweetheart. Your heart's not pumping properly
0:47:16 > 0:47:19and you've got a blockage in one of your coronary arteries.
0:47:24 > 0:47:26Not while you're with me, darling.
0:47:30 > 0:47:32How long have you had chest pains for?
0:47:35 > 0:47:37All right, sweetheart.
0:47:37 > 0:47:39I don't know if this is the sickest patient I've seen,
0:47:39 > 0:47:41but we're catching this patient in the process
0:47:41 > 0:47:45and that, kind of, makes the process completely different.
0:47:45 > 0:47:49Gwen? Excuse me. Gwen.
0:47:49 > 0:47:53Come round the back of me. Gwen? Stay awake. Stay awake.
0:47:53 > 0:47:55If you go to someone and they're dying
0:47:55 > 0:47:57or they're in cardiac arrest, or something,
0:47:57 > 0:48:01that process has happened and you're just intervening and you've missed that.
0:48:01 > 0:48:04When you go in and see someone have that deterioration
0:48:04 > 0:48:07and then suddenly you kind of see that process,
0:48:07 > 0:48:09it's completely different.
0:48:09 > 0:48:12The feelings, the anxiety, the pressure -
0:48:12 > 0:48:15"Oh, my God, this is really serious."
0:48:15 > 0:48:16Are you all right, Gwen?
0:48:16 > 0:48:18Gwen needs to get to hospital urgently
0:48:18 > 0:48:21and when more paramedics arrive, she is soon on the move.
0:48:21 > 0:48:25How are we doing? Stay with us. Keep talking to me.
0:48:26 > 0:48:30But her condition continues to deteriorate rapidly.
0:48:30 > 0:48:33We've got the patent on the ambulance. We're just trying to stabilise
0:48:33 > 0:48:36and she's going to be taken to hospital as quickly as possible
0:48:36 > 0:48:38because she's having a heart attack.
0:48:38 > 0:48:40It's very serious
0:48:40 > 0:48:43and she's very on the brink of having a cardiac arrest.
0:48:46 > 0:48:49Gwen is rushed to Kettering General Hospital
0:48:49 > 0:48:52where she is diagnosed with having two blocked arteries
0:48:52 > 0:48:54but is now on the mend.
0:49:00 > 0:49:03By noticing the irregularity on the ECG,
0:49:03 > 0:49:07Ashley's attention to detail helped save Gwen's life.
0:49:07 > 0:49:10I was really chuffed that I was able to interpret that
0:49:10 > 0:49:13and be, like, really confident in interpreting that,
0:49:13 > 0:49:17that was a real turning point for me, that was a real positive.
0:49:17 > 0:49:19Gwen's close call has reminded Ashley
0:49:19 > 0:49:23exactly why she wanted to be a paramedic in the first place.
0:49:23 > 0:49:26And I got to stay to see her into hospital
0:49:26 > 0:49:31and see her perk up and start being the person she was
0:49:31 > 0:49:34before she was suddenly in this really horrendous place.
0:49:34 > 0:49:39One of those jobs you'll remember - "My first MI, I'll remember that."
0:49:39 > 0:49:43It seems Ashley's "wobble" is over,
0:49:43 > 0:49:45but not all patients are as lucky as Gwen.
0:50:00 > 0:50:03# Even though the dancing's done
0:50:03 > 0:50:06# The night is young
0:50:07 > 0:50:10# Who cares where we go We're ready for the afterglow... #
0:50:12 > 0:50:15It's been a long and eye-opening week for Lucy
0:50:15 > 0:50:18as she's finally started gaining some much-needed confidence.
0:50:18 > 0:50:23# ..Afterglow We're ready for the afterglow. #
0:50:23 > 0:50:26From being held back by her own shyness
0:50:26 > 0:50:30to successfully dealing with potentially volatile patients,
0:50:30 > 0:50:32Lucy's growing into her new role.
0:50:32 > 0:50:34If it's a cardiac arrest,
0:50:34 > 0:50:38I'll start compressions and you can manage the airway.
0:50:38 > 0:50:39So check the airway,
0:50:39 > 0:50:42make sure it's not obstructed or anything like that.
0:50:42 > 0:50:45It's got no saliva or blood in...
0:50:45 > 0:50:48However, she's about to face the biggest challenge of her life
0:50:48 > 0:50:51as she and her mentor Natalie race to help a man
0:50:51 > 0:50:54suffering a suspected cardiac arrest.
0:50:56 > 0:51:00Does he suffer with anything that's been causing him to be unwell?
0:51:00 > 0:51:03- No.- OK. Do you want to just stop for a second?
0:51:03 > 0:51:07Inside the house, the patient's son has been carrying out CPR
0:51:07 > 0:51:08but without success.
0:51:08 > 0:51:10OK, you need to step back,
0:51:10 > 0:51:13because I need to shock him. OK, Lucy, he's in VF.
0:51:13 > 0:51:18All right. I'm just going to charge. Keep everything away.
0:51:18 > 0:51:20OK, I'm going to shock.
0:51:22 > 0:51:24Nothing. Right, back on the chest.
0:51:24 > 0:51:26- Lucy, do you want to take over and let me do it?- Yes.
0:51:26 > 0:51:32It's a critical situation and the man's life is now in Lucy's hands.
0:51:32 > 0:51:34She must continue to pump the man's heart
0:51:34 > 0:51:37and keep blood moving around his body
0:51:37 > 0:51:39to have any chance of reviving him.
0:51:39 > 0:51:42- Do you want me to take over and you do some bagging?- Yes.
0:51:42 > 0:51:46Obviously keep his airway nice and... Pull his airway up.
0:51:46 > 0:51:48Stop.
0:51:48 > 0:51:51As more paramedics arrive,
0:51:51 > 0:51:55every effort is made to restart the patient's heart.
0:51:55 > 0:51:57He was in VF so I shocked him once.
0:51:57 > 0:52:00- Quite a bit of saliva. - We'll do a bit of suctioning.
0:52:00 > 0:52:04- Do a suction?- Yes. Put your finger over. That's it.
0:52:04 > 0:52:06Suction what you can see.
0:52:11 > 0:52:15Not long ago, Lucy was studying for her A-levels,
0:52:15 > 0:52:19now she's experiencing the most dramatic situation of her life.
0:52:19 > 0:52:21How's it looking for cannula?
0:52:21 > 0:52:24It's mad to be doing this at such a young age, 19,
0:52:24 > 0:52:28but you've got to be a certain type of person to do it.
0:52:28 > 0:52:30Lucy, we're looking at reversible causes,
0:52:30 > 0:52:33so what do we need to be looking at?
0:52:33 > 0:52:35Um...
0:52:35 > 0:52:36Hypoxia.
0:52:36 > 0:52:39Even in tense situations such as this,
0:52:39 > 0:52:43mentors keep pushing the junior paramedics
0:52:43 > 0:52:45to test their medical knowledge.
0:52:45 > 0:52:49But Lucy's proving to be capable and in full control.
0:52:49 > 0:52:53- Hypoglycaemia.- Yes. - Hypovolaemic. Toxicity.
0:52:53 > 0:52:56Fantastic.
0:52:56 > 0:52:58Suddenly there's a sign of life.
0:52:58 > 0:53:00- Has he got a pulse?- Yes.
0:53:00 > 0:53:05- OK, right.- Charge up.- Charge it up. - Just take the oxygen away.
0:53:05 > 0:53:11- Just pull that off.- That?- Just pull it up and then don't touch him, Lucy.
0:53:11 > 0:53:12Stand clear.
0:53:12 > 0:53:14As his wife watches on,
0:53:14 > 0:53:16the patient is given another massive electric shock
0:53:16 > 0:53:18to try and restart the heart.
0:53:18 > 0:53:21Lovely. Back on the chest.
0:53:21 > 0:53:22But it's not working.
0:53:23 > 0:53:27Feel the pulse. There's the fluid. Just feel for a pulse.
0:53:30 > 0:53:32- No, he's not got a pulse. That's gone VT, hasn't it?- Yes.- Yeah.
0:53:32 > 0:53:35- Right, we need to shock him again. - Stand clear.
0:53:35 > 0:53:37- Yeah.- Lovely.
0:53:37 > 0:53:42OK, that's four shocks. He's had that now, hasn't he?
0:53:42 > 0:53:43Despite their best efforts,
0:53:43 > 0:53:48Lucy and the paramedics are losing the battle to save their patient.
0:53:48 > 0:53:50And in consultation with his wife,
0:53:50 > 0:53:52there's some tough decisions to be made.
0:53:52 > 0:53:55- His heart's not beating. - Would you prefer us to just stop?
0:53:55 > 0:54:00- Well, I... I don't want him suffering.- No.
0:54:01 > 0:54:03I think we're just going to stop.
0:54:05 > 0:54:07The family said that they don't want him to go to hospital,
0:54:07 > 0:54:10they prefer him to just stay here.
0:54:10 > 0:54:12It's left to Lucy to check the patient's eyes
0:54:12 > 0:54:14for any last sign of life.
0:54:17 > 0:54:19They're fixed and dilated, yes?
0:54:19 > 0:54:25So we'll go with the family's wishes. They want him to stay here.
0:54:27 > 0:54:30Lucy's just witnessed her first death
0:54:30 > 0:54:32since becoming a junior paramedic.
0:54:49 > 0:54:54- I feel really emotional. I feel emotional for once.- Do you?- Yeah.
0:54:54 > 0:54:56What do you feel emotional about?
0:54:56 > 0:54:59I just feel sad. It's the end of his life
0:54:59 > 0:55:04and he's been suffering for a very long time, by the sounds of it.
0:55:04 > 0:55:08- And...- Yeah. - He wasn't in, you know...
0:55:08 > 0:55:11He was in pain anyway, but...
0:55:13 > 0:55:17This is it, you know. Like I said.
0:55:17 > 0:55:19His wife, as well, doesn't want him to be in pain.
0:55:19 > 0:55:22- No.- I think, you know...
0:55:22 > 0:55:26And the doctor had obviously heard her.
0:55:26 > 0:55:28It's not like a complete shock,
0:55:28 > 0:55:30- but, still, it isn't nice.- No.
0:55:30 > 0:55:32It is very shocking still.
0:55:36 > 0:55:39Having previously struggled to engage with her patients,
0:55:39 > 0:55:43the man's death is a major turning point for Lucy.
0:55:44 > 0:55:47I think, yeah, it's good that you do feel something.
0:55:47 > 0:55:49I think a lot of paramedics will say the same. No-one's a robot.
0:55:49 > 0:55:53Everyone has feelings, it'll affect you eventually.
0:55:53 > 0:55:56I feel a bit more human than normal.
0:55:56 > 0:55:59I'm just really sad. I've got a heavy heart now, so...
0:56:06 > 0:56:07SIREN WAILS
0:56:07 > 0:56:10Next time... The long shifts begin
0:56:10 > 0:56:13to take their toll on the junior paramedics.
0:56:13 > 0:56:15I'm too tired to talk.
0:56:16 > 0:56:19They are pushed to the brink with some traumatic cases.
0:56:21 > 0:56:23He was about to kick off, that guy.
0:56:23 > 0:56:27It was the first situation when I actually genuinely really
0:56:27 > 0:56:29shit my pants.
0:56:29 > 0:56:31And Max shows nerves of steel...
0:56:31 > 0:56:34- Are you all right? Are you staying with us?- Yeah.
0:56:34 > 0:56:36..in his first major road accident.
0:56:36 > 0:56:40I've got to keep calm and kind of get the job done.
0:56:40 > 0:56:45# If you gave me a chance I would take it
0:56:45 > 0:56:48# It's a shot in the dark but I'll make it
0:56:48 > 0:56:52# Knowing no way you can shame me
0:56:52 > 0:56:56# When I am with you There's no place I'd rather be
0:56:58 > 0:57:01# No place I'd rather be
0:57:01 > 0:57:05# No, no, no place I'd rather be
0:57:05 > 0:57:08# When I am with you There's no place I'd rather be. #