Episode 6 Junior Paramedics

Ambulance service. Tell me exactly what's happened.

It's my husband, I can't wake him up.

Just confirm for me, is he awake?

He's comatose. I'm trying to feel a pulse but I can't.

He's on the floor, he's unresponsive.

ANNOUNCEMENT: Cardiac arrest...

A call to a cardiac arrest.

The paramedics have just eight minutes to get to the scene...

..and just 12 minutes to save the patient's life.

-Do you want to do another pulse check, just before we move him?

-Yeah.

It's a scenario that can test the most experienced paramedic.

But what if you're a first year student

and you're new on the job?

Six weeks ago, nine junior paramedics

took on the biggest challenge of their lives -

their first placement with the East Midlands Ambulance Service.

It is a shock the first time you actually go out

and see the first patient.

It's a job where no day is the same.

-No, no, I don't think Lucy wants you to stroke her.

-No!

The experience has been an eye opener.

We're with you, we're with you.

It's been a crazy roller coaster and my emotions have been everywhere.

These young and untested students

have dealt with real people in real pain.

I want to help more people

and do everything that I can for anybody that I can.

I felt really privileged caring for people in the community

and just helping people out.

They've coped with carnage and chaos...

There's some jobs that you go into and every pair of hands counts.

I don't think anybody knows themself well enough

to know how they'll deal with that.

..and they've even confronted death...

No-one taught me at uni how to not be frightened in that situation.

..but now, it's crunch time.

They've got one shift left to impress...

What did I want to do? I wanted to kill myself.

..before their mentors mark their performance.

I'm really, really dreading it.

So every move could be make or break...

A D minus, that's the bottom grade you can get before you fail.

..for their future as a junior paramedic.

18 more months of university study

and five more gruelling ambulance placements

now stand in the way of these nine students

becoming fully-fledged paramedics.

But before that,

they need to pass their first six week placement on the job.

We get graded on each placement

by the mentor that we've had for that placement.

We get graded today and I'm really, really dreading it.

A good grade means a good start for their professional reputation.

You want to look good for your mentor

to make sure they're going to give you a good grade.

I really want to push myself even further than I already have done.

If they fail, it could harm their future career.

I think at the moment I'm on track.

I'm hoping.

I do feel a little bit nervous

because I've worked really, really hard on this placement

and I do hope that my grade can reflect that.

Can I have backup green response, please?

Tonight is 18-year-old Steph's penultimate shift

on this placement

but she's not with her usual mentor, Sam.

Instead, she's with paramedic Chris.

Before you know it, you'll be sitting in this seat on your own

and you'll be the boss, you'll be the one making the decisions.

-Is that a scary prospect?

-Yeah.

Chris's feedback will form part of Steph's overall grade.

But tonight, he's setting his own challenge

to give her a chance to prove just how much she's learnt.

A good way of seeing at what stage you are

is for you to do a job from start to finish.

So deciding on a treatment plan,

deciding if they need to go to hospital.

And if they need to go to hospital,

deciding on an appropriate backup - green, amber or red response.

And handing over to the crew.

OK.

-Sound like a plan?

-Yeah.

High achiever Steph's six week placement

on the ambulance in Northampton

has been full-on since day one.

Take a deep breath.

She was visibly frightened on her first ever call out,

a 999 emergency to a possible cardiac arrest.

I was like, "Aah, adrenaline!"

I don't think I've ever had an adrenaline rush like that in my life.

Just a few days later, Steph's nerves were tested again

as she played a vital role attending a serious road traffic collision.

When I went, I was expecting to turn up and it be like,

"Oh, they've had a bump."

And obviously we turned up

and there was four patients spread across the road,

the car looked like someone had jumped on it a million times

and crushed it to pieces.

And if that wasn't enough for an inexperienced student to cope with,

the ante was upped even more

when Steph was called to an armed siege.

Three police cars, a fire engine. This is a big job.

-We've got a gentleman still in that house.

-Oh, OK.

He's got three lacerations that I've seen.

At the scene, Steph treated a patient in handcuffs

under police custody.

I was just terrified.

I was like, there is no way anyone is putting me

in a small, confined space with someone who's just been arrested.

Steph fought her instinct to run, kept her cool

and handed the case over to the hospital staff.

He's got self harm cuts on his left side of his neck.

On his wrist, they're quite deep.

But I think I've learnt that I'm more calm in a bad situation

than I thought I was going to be.

Your brain goes into, "It's got nothing to do with you now,

"you just need to focus on the other people that are involved."

But how will Steph handle the pressure

of taking charge of a job from start to finish?

632.

Yeah, that's all received, thank you.

Once you open that door and you go into the door of that house, chill.

You're not going to give much reassurance

to the family or to the patient if you're flapping.

It's the ambulance service.

Hiya, I'm Stephanie. What's your name?

Michael, where's your pain, what's wrong?

Were you smacked in the nose with anything or was it...?

His fist, yeah.

Yeah, have you got any other pain or anything?

Do you feel sick at all?

And you've got a headache now, have you?

Whereabouts is your headache?

Across the front.

Steph's history taking is confident

but she's missed out one vital question.

Did you lose consciousness at all?

'It's a little bit nerve-racking'

and I probably forgot the most important thing,

of whether he'd lost his consciousness.

It's always worse, isn't it, when the pressure is on?

I'm just going to take your blood pressure first of all.

Just pop that jacket off for me, if you can.

Now Steph has all the information she needs,

she can physically examine the patient.

132/100.

And as Steph and Chris came in the fast response vehicle,

it's her responsibility to prioritise the case

so an ambulance can be called

if the patient needs to be taken to hospital.

Given the history that we've got so far...

So we know we've had a male who's been assaulted,

he's had a loss of consciousness and he's vomited.

-So they're two red flags for us with head injuries.

-Yeah.

-Do you think hospital is a...?

-Yes.

What response do you think would be adequate for a crew?

-Amber.

-Amber. Why Amber?

Cos he's quite stable but we don't know

-if anything's going to change.

-There's potential, absolutely.

So I'll do that while you do that.

And how bad is the pain out of ten,

would you say? INTERCOM BUZZES

The patient is still being examined so Chris answers the intercom.

Is that your friend, is it, coming to check you're all right?

-You don't know who it is?

-It's not, no, who is this?

Yes, he's here with us.

He is. Who are you?

Not a very polite young man, though.

Is that the chap that's assaulted you, is it?

He knows where you live, does he?

632.

-SOMEBODY ANSWERS RADIO CALL

-Yeah, thank you.

LI don't know if you could inform the K13s

but the chap that's assaulted this patient

is now trying to get into the flats where we are.

That's all received, can you stay for the moment?

-INTERCOM BUZZES

-I'll get someone out as a priority.

Awesome. Cheers, mate.

Carry on assessing him, don't let that faze you.

As an 18-year-old junior paramedic,

this is an unusual and potentially alarming situation

to find yourself in.

What did you say the pain in your head was, out of ten?

But Steph keeps her cool

and focuses all her energy on the patient's needs.

-That's it.

-Ten.

'I've learned that I can'

walk into a situation which I'm absolutely terrified of

and appear quite calm.

You know pretty quickly whether you're going to be able to cope.

And I think that I will be able to cope.

Ten minutes later, the police arrive

but the alleged attacker has gone.

Literally about two minutes before you came here, he was still there.

-So I did answer the bell to him.

-Was he outside the door or outside?

No, outside outside.

-He was pressing on the bell here.

-I've had a look round and I can't see him.

The ambulance has also arrived.

It's up to Steph to hand the case over to their crew,

who will take the patient to hospital.

This is Michael, he's 22.

He's been assaulted about ten minutes before we got here.

He's feeling dizzy and he's clearly got a bump on his head.

His...left side of his jaw

is painful for him.

Period of loss of consciousness.

THE OTHERS TALK IN BACKGROUND

OK. Good, brilliant. OK.

'I think Steph is a good all-rounder, really.

'I don't think there's anything she's going to struggle with.'

I'm sure she'll pass all her exams with flying colours

and pass all of her placements.

The six-week placement as a student paramedic

instantly makes you realise that this is what I want to do.

You get to enter someone's life

at the time that they're most vulnerable and need someone

and you get to make a difference.

Whether it's a really big difference or a really little difference,

you make some difference.

Steph will find out how mentor Sam has graded

her performance throughout the six weeks

at the end of their last shift together.

From one junior paramedic who hit the ground running

to someone still waiting for his moment.

19-year-old Bryn's placement in Northampton

hasn't quite had the drama

some of his fellow students have experienced.

Is it OK if I just put this in your ear?

It's just going to take your temperature.

Bryn's first cases on the job were low key.

Can you say baby hitta...hippopotamus?

-Baby hippopotamus.

-Good, you can do it better than I can.

But as his placement with mentor Charlotte progressed,

he dealt with a severe ankle dislocation...

Sorry, buddy, you are going to have to get some new shoes.

..and he conquered his fear of treating babies.

You have a play with that.

Look at those flashy lights.

It's a matter of trying to find a way to keep them distracted

so you can do what you need to do.

You're trying to escape already, aren't you?

But Bryn's never had to face a serious trauma case.

The fact that I haven't been to any traumatic calls

is purely luck of the draw.

Personally I feel I'd perform well under pressure

and I'm looking forward to when I get a real emergency patient

that I arrive there

and I'm able to be put under that pressure straightaway

to see how far I can be pushed and be tested.

Tonight is Bryn's final shift

and he's about to get the challenge he's been waiting for.

I think very much because it's my first road traffic collision,

I'll be observing quite a lot of it

and just basically seeing how the whole process works.

You know, I'm excited for my first trauma case

but obviously horrible for the person whoever it's happened to.

Looks like a rear-end shunt.

Bryn's mentor Charlotte immediately assigns him a vital role.

Bryn, do you want to come and sit in the back of the car and pop your helmet on?

What I need you to do is sit in there

and hold the head of this gentleman

Put your hands either side of his head

and keep his head nice and still. OK?

Right, sir, I'm going to hold your head. OK?

Hello, can I have the fire brigade and the K13s please?

Is somebody trapped...?

Yeah, we've got a gentleman who's going to need cut out of his car.

The man driving the car has dislocated his knee

and may have sustained a spinal or neck injury.

Your chest feels all right and everything?

Bryn has been given the massive responsibility

of holding the patient's head

to keep the man from aggravating it further.

You've got to keep somebody in a straight line

so as central as they can be.

So I was sitting there in the back, holding his head,

making sure he didn't move it.

Make sure you don't shake your head.

You keep your head as still as possible.

You're doing fantastic, Will.

The junior paramedics

are being constantly assessed by their mentors.

All right, Will, you're doing great.

The way they cope with unusual situations they're thrown into

and how they relate to the patients

affects their placement grade.

-Bryn, are you all right?

-Yeah, sure.

-What's going to happen

is there's going to be loads of things going on.

You're going to be sat here

and they're going to cover you with lots of stuff, OK?

And you're going to experience being cut out of a car.

Will, I know there's a lot of noise going on at the moment.

They're just securing the car, OK?

They're going to cut you out of the car.

They're going to take the roof off.

The atmosphere was quite tense there.

He was quite distressed by the whole situation.

Obviously just trying to talk to him and reassure him a little bit,

let him know what's going on.

-We're going to start making some noise at the back now, OK?

-Right.

It's all right, Will, you don't worry about it, all right?

You're fine, Will. They're just cutting the car.

Right, Will, this one's going to be a bit loud

cos they're taking the one off next to you. All right?

'It was really, really noisy

'cos they were basically snapping the bolts off.'

And then they cut the rest of the car off, which is...

When it's about here to your head, it's quite nerve-racking.

The roof is off but it's still vital

the paramedics keep the patient's spine completely still.

So they slide him onto a spinal board.

Ready? One, two, three, go.

You just rest your arm there, Will.

'First trauma job.'

It's definitely different to all of the medical patients that we've had.

Seeing how the fire brigade and basically all the services

work together, as well, was really good.

I felt quite in the action.

Yeah, it's pretty cool.

I'm just going to move your hand, going to listen to your tummy.

You've still got your stuff. I'll put it back in a minute.

Bryn's proved he's got what it takes in a high pressured situation.

Is that the first time you've been cut out of a car, Will?

The patient is expected to make a full recovery

so it's a job well done for Bryn.

But the junior paramedics are being graded

on their performance across the whole of their six-week placement.

So as Bryn's final shift comes to an end,

it's time for him to find out

how mentor Charlotte feels he's performed.

I definitely feel, over the weeks,

I've been able to prove myself to Charlotte.

There's still more that I'm going to learn

but I want to push myself even further than I already have.

This first grade is key for the juniors

as it establishes their reputation within the profession.

A D minus or above is a pass

but students should be aiming much higher.

How do you think your placement has gone?

From my point of view,

I think it's gone really, really well.

I've learned loads since coming out with you

and seeing what you do over the whole time.

But I don't, personally,

I don't feel like I've done as well as I should have done.

If you could have graded yourself, what would you have given yourself?

Well, I would give myself a...

-D minus?

-Yes, I would give myself a D minus.

Yeah, I knew that was coming.

A D minus is the bottom grade you can get before you fail

and you're much further ahead of that.

As well as the practical work,

the students have been filling out a portfolio

that charts all their cases and the procedures they've performed.

Their mentors add detailed comment about their progress

and this forms part of their assessment.

I've put on here that you've developed in confidence.

You fit well into the team.

I know that you'll continue to improve throughout your training

-and I've given you a C plus.

-Oh, thanks, man.

It's all right, pal. Done.

Right now, at this moment in time,

you need to stop being so hard on yourself

and actually accept the fact that you've done really well.

It was really, really nice to kind of have that feed back

and what she's written has been really positive.

I was amazed. I was completely, you know, shocked

and I was really, really happy that Charlotte gave me a C plus, really.

I wasn't expecting it.

Bryn's grade has exceeded his expectations

and before he leaves, he bumps into fellow student Ashley.

-How have you been?

-Yeah, I've been really, really good. I enjoyed it.

I was buzzing from day one.

-Has she graded you for your practice?

-Yeah.

-What did she give you?

-She gave me a C plus, which is pretty cool.

-Oh, cool. Aw-w!

-I was really pleased.

-Yeah.

27-year-old perfectionist Ashley is still waiting for her grade.

And she's got a lot at stake.

Ashley gave up an administration job in the Ambulance Service

to become a paramedic.

But on her first call out

to a homeless patient with mentor Simon,

it suddenly hit home

that it wasn't all excitement and flashing blue lights.

-Have you had anything to eat today?

-No.

Are you hungry or thirsty?

-I'm very hungry.

-You're very hungry?

-Yeah.

It's kind of been really shocking.

They don't have anything and they probably never will

and there's nothing to support them.

Witnessing such social deprivation

made Ashley open up to mentor Simon

about whether chasing a new career had been a mistake.

Why am I doing this?

Out in the cold at two o'clock in the morning.

This is potentially my life.

Suddenly I missed everything I'd left and you think,

"Oh, do I really want to be going to somebody

"who doesn't have anyone and they have nothing?

"Do I want to see this?"

Don't you worry.

Ashley turned to her nan, a former hospital ward clerk.

It's a very emotional job at times.

You will see awful things

but you're there to help because without you,

what would they have done?

Then on an emergency call out,

she made a vital diagnosis that helped her remember

why she had chosen the paramedic path.

I spotted that she was having an MI,

which is a myocardial infarction, it looked like a heart attack.

I was really chuffed that I was able to interpret that

and be really confident in interpreting that.

And that was like a real turning point for me.

That was a real positive.

And when Ashley was called to a house fire,

it fully reignited her passion for the job.

You step out and it's like blue lights, you know,

from us, police, fire.

You're nervous because you have a jacket on

that doesn't indicate that you're a student.

But in a really strange way, you're really excited to be there.

What's wrong?

What's wrong? What's wrong?

Are you all right, Chris? What's wrong?

Talk to us, Chris. Talk to us.

'That's, I think, your fight or flight moment

'on how do you as a person suddenly cope with that.'

And that really, for me, was, "Yeah, you can do this."

Ashley's had a bumpy road.

But will it have affected her first placement grade?

So today is my final day and we get graded today

and I'm really, really dreading it.

I'm really anxious about being graded by Simon.

And mentor Simon's a little nervous too.

She's been good to work with

but I think the grade that I'm going to give

reflects on where she should be at this stage of her career.

Well, Ashley, it's the end of the placement.

How do you think you've got on?

I've enjoyed the whole experience and I've tried to be honest.

So although one of my areas for marking is motivation,

when I've had a down day, I've tried not to lie about it.

What sort of grade do you think you're going to get?

I would hope for an average grade.

I don't think an A or a B

is where you should be for your first placement

cos you need things to improve on.

So I'll grade you as a C plus.

Super, I'm very pleased with a C plus.

-Thank you very much.

-You're welcome.

You've worked really hard.

You've shown me that even after a little wobble

that you are determined

and have the initiative to put that behind you and move on.

I'm definitely the sort of person who is never happy.

I always want that bit more.

I always want the A.

But I'm OK with this one because I think a C is really fair,

actually a really good grade.

So Bryn and Ashley have both achieved a C plus,

a solid grade for their first placement

and one that will stand them in good stead for the future.

At Gorse Hill in Leicester,

it's the start of Lucy Wright's last shift with mentor Nathalie.

We've got one Narcan and one Amiodarone. Is that...?

Yeah. That's fine, yeah.

When Lucy's placement began,

the 19-year-old found it difficult to relate to the patients.

The only thing I struggle with being a student paramedic

is the interaction with people.

If it's an elderly person, I'm really, like, withdrawn

because I don't want to offend this person.

And then if it's the same age as me,

you can't always assume that they're going to relate

in the way you want them to.

But she's watched and learnt from her mentor.

We're going to get her on the ambulance

-and I'll let you know what hospital we're going to.

-Thank you.

-Are you going to be all right?

-Yeah.

My mentor's always said that I need to chat to people more.

You need a lot of pushing to approach the patient.

She criticised me in a way that wasn't harsh

but she kind of pushed me.

So it made me better talking to people,

even when I didn't want to.

With Lucy's grading just days away,

she's about to get a chance to prove to Nathalie how far she's come.

Yeah, that's all received. Thank you.

So it's an unknown aged male,

said to be not fully alert, with a head injury.

Fallen over, bleeding,

intoxicated, feeling cold.

It's 9:05 in the morning.

That's interesting that he's intoxicated.

Carl, take a seat.

You need to tell us what we can do for you this morning,

how we can help you.

Cos you're a bit unsteady, aren't you?

Look, what I want to do is...

-..I want to kill myself.

-Oh, dear. Why is that?

It's because I've got so many problems.

What do I do?

Are you all right if we just check you out?

We'll do your blood pressure and blood sugars and things.

No, no, no.

-I want to end life.

-Well, are you going to let us check you out?

-No, no, no.

-If you're refusing...

-Oh, well, bring the fucking...

-Keep your voice down.

Come on, don't raise your voice to us.

I'm sorry.

-I apologise.

-It's OK.

Are you going to let us check you over then?

-Yes.

-Lucy's going to do it.

I'm going to do your temperature, just in your ear.

Yeah!

Can you get it in the whole way?!

34.7.

As the patient has told the paramedics that he wants to

end his life, they have a duty of care to either take him

to hospital or call his local GP.

Leaving him alone is not an option.

Carl, do you want to come to hospital, or not?

I do want to go to hospital.

Let's get going before you change your mind.

The paramedics have already contacted a member of the patient's

family, who will meet them at the hospital.

Can you pop your legs up for us on the stretcher?

Swing your legs up, Carl.

Pop your legs up.

-I've got my slippers on.

-It doesn't matter.

In the ambulance, mentor Nathalie holds back

and gives Lucy a chance to prove how much she's learnt.

I do not want to be...hospital.

I want to go home.

I know but we've got to sort you out.

You said you wanted to come to hospital with us.

We're going to take you.

It won't take that long.

It takes many, many hours.

It's not that bad now.

If you do have to wait hours, it's to sort you out

and to make you better.

It's worth waiting, even if it is a long time, isn't it?

For us it is.

You might not think so, but we need to get you sorted out.

It's quite good to see Lucy with a patient like this cos now

I can see how much she's improved.

She was chatting to him, she was involving him,

she was just listening to him and she was very respectful

and did everything that he asked.

Right, what would you like to know?

If you want to tell me anything, you can.

It's up to you, Carl.

I'm impressed that she's managed to turn it so quickly around.

When you do get criticised, it sticks in your mind.

You do think about it and it does make you a better paramedic.

Where am I going to?

The Leicester Royal.

And...where?

In A&E.

-And why?

-Because you need looking after.

OK.

A few days later, it's time for Lucy to find out just how far

mentor Nathalie feels she's come over the last six weeks.

Right, end of placement now. Last shift's been completed.

How did you think it went? How did you feel?

It went well, yeah.

I think I could have been more confident.

At the very start of the placement,

I found that you took a step back,

you were a bit more of an observer than being as part of the team.

But now it's the end of the placement,

I'm really happy how you've progressed.

Particularly with that drunk male we went to,

who refused to go anywhere.

I didn't really have to do a lot, you did,

and you did all the communicating, and that was really great to see.

I've been really happy with you, actually.

I've done your grading and I can say you've passed.

I've given you a C minus.

A C minus is well into a pass.

It's really good.

Obviously, in your next placement, if you start getting high Cs,

into Bs, you can see yourself that you've progressed.

Did you have an idea what you might have got, or where you were?

Pretty much what I thought. I was expecting a C, so...

A C would be good for me, so, yeah, thank you.

OK.

Really happy with the feedback she gave me

cos she did evaluate me really fairly as well.

It's helping me to build upon myself and it is good.

I'll be sad to lose her as a mentor as well.

Lucy Wright's hard work to improve her relationship with

the patients has really paid off.

And it's also crunch time for Lucy Mellor.

It's her last shift and by the end of the night she'll know what grade

mentor Alistair has awarded her performance across the placement.

I'm hoping just to get around a C, really.

It sounds like that's just settling for middle, but for me, getting

a C would recognise that I've built in confidence over the six weeks.

When 18-year-old Lucy started her Junior Paramedic

journey in Leicester,

her bedside manner left a lot to be desired.

Awkward silence?

And even her basic medical knowledge was questionable...

-Is it this one?

-No, that one.

Is it on?

Not seen these before.

The first few shifts,

you do feel like a bit of spare part at times, cos you're still

learning where everything is and how everything works.

So you do feel a bit stupid - you're constantly asking, "Where's this?

"Where's that?"

But the trust she's built up with mentor Alistair has allowed

her basic medical skills to blossom.

When I'm doing things that I'll be a bit nervous about or not used

to doing, I don't feel like on edge.

Alistair puts me at ease.

I just need to take a tiny little drop of blood from your finger.

It's going to be a little sharp scratch.

-Ah!

-One second. That's it - all done.

She's been doing observations and she's got really confident

with that now, so she can do it without me having to guide her.

Relax your arm down. Just keep it really still

and straight for me, yeah?

It won't be tight for long, don't worry.

And when she was called to a cardiac arrest, Lucy stepped up

and took on the huge responsibility of applying chest compressions.

When we got there, started CPR

while Alistair got the bag and mask

and started doing the airways.

When it gets to 20/30 minutes,

and there's no change in the rhythm, which there wasn't, everyone

has to make a call and agree, and unfortunately, he passed away.

Lucy's come on leaps and bounds

and tonight she's got one more shift left to shine.

But it's one of the quietest she's experienced so far.

POP MUSIC

Look at that - the mood just picks up instantly.

THEY LAUGH

MUSIC: "Blurred Lines" by Robin Thicke featuring TI and Pharrell Williams

SIREN WAILS

So Lucy's last shift has been a bit of a disappointment,

but now it's over, it's up to mentor Alistair to reveal how

he thinks she's progressed over the last six weeks.

At the end of the placement, you've got all your elements done

and signed off. You meet all the criteria.

You've achieved everything you've needed to.

Everything that I wanted to achieve, I've definitely achieved.

That's what I, kind of, wanted to get.

-I've decided to award you a grade C.

-Oh!

I'm pleased with that.

That's what I was wanting.

I wasn't sure if I would get that.

You've achieved everything quite comfortably as well,

so I think you get a C quite easily.

-Thank you.

-It's all right.

She's done fantastic.

If she carries on at this level and just builds on everything,

she'll do really well and make a good paramedic.

Just can't wait for the two years to be done and to be out there.

When I do know everything that I need to know, I can't

wait to say that I am a paramedic.

The junior paramedics' assessments will help them

identify their strengths and what they need to work on for the future.

19-year-old Max hasn't always been the most diligent of students.

He's the only junior paramedic to arrive late to a shift...

Fell back to sleep after my alarm went off.

..so mentor Chris laid down the law.

You're two and half hours late.

You're going to have to come in Sunday to make your hours up.

And when Max was called out to a patient with hygiene issues,

he didn't exactly show a rookie's enthusiasm for the job.

If I get fleas, I'll be severely unhappy.

But once again, his mentor kept him in check.

Can't pick and choose who you treat.

-You can't go to the nice pink fluffy ones.

-No.

However, from day one on the job, Max's biggest

strength has been his confidence with the patients.

You got ticklish feet?!

From treating babies with bronchiolitis...

You're in an ambulance, mate!

Mum will remind you of this when you're older.

..to elderly ladies who've had a fall...

-Have a feel of your hips, Doreen?

-Ooh, that's nice.

..Max's manner has put the patients at ease

and a smile on their faces in an otherwise alarming situation.

-Can Max just do your blood pressure? Is that OK?

-Yeah.

And when Max was given a vital role at a road traffic accident,

his easy charm kept the patient calm.

Have you got any tape just to strap his head on?

I didn't realise it was that bad.

I found being a little bit cheeky is quite good.

-At least you shaved your chest, eh?

-I have done, yeah.

Most of the time it puts them at ease.

They do appreciate it.

-Take care.

-OK, cheers, mate.

-See you later, mate.

Max's first placement has had its highs and lows,

but with his grading looming, can he make his last shift count?

He and his mentor Chris have been called to a see a 21-year-old male.

Only a few years older than Max, the young man has an extremely

rare respiratory syndrome that leaves him permanently bedridden.

But tonight, his parents have noticed he's having regular rigors -

violent shakes that could be a sign of infection.

The tremor's mostly in his legs, isn't it?

Yeah.

Seem like it's giving him quite a bit of grief.

Besides the rigors he's got, is he his normal self at the minute?

-He is? Do you want to do a blood pressure and ECG?

-Yes.

Even though the patient cannot answer him back, Max talks him

though the basic observation tests step by step.

I'm just going to take your blood pressure.

I'm just going to put this cover round your arm.

There's certain situations where you've got to take

into consideration the patient, like respect for them and their dignity.

Just going to put this on your finger.

Obviously he's still alive, he's still human and you can't just

ignore him and do your observations without talking to him.

Cos he could still hear me,

so I wanted to make sure he knew what I was doing and why I was doing it.

Obviously he wasn't talking back, but it's easier for him to know

what I'm doing so he feel more comfortable.

I'm just going to take some blood out your finger,

so you're just going to feel a slight prick. One, two, three...

The patient's rare syndrome means any medication needs to be

cleared with a doctor first, so only half an hour after arriving,

Max and Chris hand the case over to the local on-call GP.

This is the man in question - Mohammed.

Over the last two hours, he's been having rigors to the left leg.

This particular case has really hit home for Max.

Erm...

Yeah. That's...

..quite a difficult one.

'I don't get emotional very often,'

but things will hit you and they'll hit you hard,

but you just have to deal with it.

It was a bit of a difficult job, to be fair.

But fair play to you, you did engage with him

and you did treat him with respect and you did speak to him.

Yeah.

And took into account, because he's got that syndrome

and he's unwell, he can hear still, and he does deserve to be spoken to.

-Yeah.

-So, yeah, well done.

You did really well on that one. And onto the next one.

Max's natural rapport with the patients has

shone through once again.

Hi, Max. Take a seat.

But his final assessment with mentor Chris isn't such an easy ride.

Let's have a look at this empty portfolio.

Max hasn't filled in the portfolio, that's a key

part of the grading process, and his mentor isn't impressed.

-Where's all your elements?

-I've not handed them in yet.

That all needs to be completed.

Once you've done all your elements, then I'll do my bit,

-but you have to pass it on to me.

-Yeah.

And you can't just give me a day.

It's not going to take just five minutes.

-You need to give me a few days to complete it.

-Yeah.

So you've got an extension.

And until all that's completed and we've completed the paperwork

correctly, then I can't give you a correct full grade.

Mm.

Max is the only student so far to finish his placement ungraded.

It is a hard course

and you've got to be able to hack everything that comes with the job.

It's not just dealing with the patients,

it's the long hours, driving, doing the paperwork.

I'm not making excuses for myself, I knew what the course would entail.

This is what I chose to do so I have to do it.

I'll have my work done in the next week.

For 25-year-old Vick, who's also been stationed in Leicester,

the idea of not doing her homework would be completely alien.

Vick is desperate to realise her dream of becoming a paramedic.

I do see paramedics as everyday heroes.

She applied for the course four times before she was accepted,

so passing with flying colours is top of her priority list.

It's taken me four years to get on, and all

I want to do is prove to myself that I can do it and do it well.

Failure's not an option.

Vick's high expectations for herself means

she takes every opportunity to broaden her medical knowledge.

Got a little notepad so I can take notes after the job.

But retaining the information hasn't come naturally.

Haven't got a clue on 99% of the medicines.

I've started to pick a few up, but I just can't remember them.

What do you think?

Don't know.

And when she has made mistakes on the job...

Should that fill up with blood?

-What should that fill up with?

-Faeces.

..she's put even more pressure on herself to do well.

Now I'm here, it's more about not just scraping through.

I want to be the best.

With her last shift over, it's the moment of truth for Vick.

She's about to get a grade for her first ever paramedic placement.

I do feel like I've improved, but I never know how much I am improving.

So I'm always trying to push myself rather than be content with

what I've done.

I think, at the moment, I'm on track.

I'm hoping.

But will mentor George feel Vick's hard work has been enough?

Has this placement been what you've expected?

It has been what I've kind of expected.

I think I'm come on a little bit more than I've expected.

You're where you should be at the end of your first placement.

You use quite a lot of different skills -

we have had a variety of jobs.

And the jobs that we've done and the way you've reflected on them

when we've talked about them, you can see that next time you go

to a job similar, you'll be able to draw on that experience

and put it into place.

I've awarded you... You can see there - a grade B.

-I think you've done really well.

-I am chuffed with a B.

It gives me something to aim for next placement and work off.

Yeah, so I'm happy with B.

I can see the progression that she's made from six weeks ago when

we first started, she's not the same person she was when she came in.

She's really pushed herself.

Like I've said, she's took on board anything I've said

and she tries to use that the next time we go to a job.

I am chuffed with a B, purely because of how long it's taken me

to get on the course.

It supports all that effort that I've put in.

Vick's hunger to excel has really paid off.

She's got the highest grade of the group so far and when she gets

back to the university halls, she delivers the good news to mum Julie.

-I've got my practical grade.

-And?

She's give me a B.

-I am happy with a B.

-I should hope you are.

No, I am.

It's going to sound backwards,

but with it being first placement,

I've heard a lot that you don't tend to get higher than a C,

so I've got to work extra hard to keep with that B next placement.

And super-hard to progress to a B plus or an A minus.

-Just be happy.

-I am happy with it.

I am happy with it.

It's something from a very young age that you've wanted to do.

You've tried so hard to get in uni over the years,

and now you're there, hopefully you're fulfilling your dream.

And to see you now there at university,

we're just so proud of you.

Aw!

Just enjoy it and make the most of it.

Get as much out of it as you can.

I will.

A junior paramedic's relationship with their mentor is a key part

of their placement experience.

And one pair have forged a bigger bond than most.

Can you see me under the hood?

24-year-old Nick has looked up to mentor Jonny since day one.

I've never seen my mentor stressed or panicked.

I think that he is exceptionally good at his job.

Their bromance has blossomed throughout the six weeks with

Nick playing Robin to Jonny's Batman.

I'd really love to wear my helmet...

If you want to wear your helmet, by all means do so.

-Can you wear yours as well?

-No.

Oh!

But Nick's sidekick status means he always takes a back seat on the job.

In emergency situations where every second counts,

you do have to strike a balance of, is this a learning curve,

or is my slowness going to impact on survival?

Tonight is Nick's final shift in Leicester.

With his grading just around the corner,

will he have built the confidence to take the lead?

The patient has been found in a caravan park.

The police were first on the scene

and the man is lying in the back of their van.

We thought he was just intoxicated, but then we got him down here and

he's vomited in the back of the van then he's stopped breathing.

Two caravans down knows him, says he uses needles,

-takes all sorts of drugs.

-Right, OK.

And he actually stopped breathing for a short time.

He's a known drug user.

He's in a state where he can't manage his own breathing

or his airway, so OPA'd and NPA'd him -

that's tubing in the throat and in the nose.

Had we not intervened, he would have aspirated on his own vomit.

Now the patient's airways are cleared,

Nick gives the man a saline flush.

Just 12 minutes on the scene and Nick

and Jonny have saved the man's life.

Nick might not have taken the lead,

but they've worked seamlessly together, barely speaking a word.

It's been a tough experience on the road, but also an amazing one.

Towards the end of the placement, I was gaining a lot of confidence

and actually doing some of the things without being prompted.

This has been true teamwork,

but when it comes to the dirty work,

Nick's under no illusion who's the junior paramedic.

I don't think I'll be having stew for a bit.

Or chicken and mushroom pie.

As well as dealing with 12-hour shifts,

six of the junior paramedics have also been coping with

the pressures of moving out of home for the first time.

And it's been particularly hard for Geordie lass Amy.

Amy has struggled to keep a lid on her emotions.

Born and bred in Newcastle,

she's travelled the furthest of all nine students.

It has been really tough being away from home and my family.

I have missed going home and seeing my boyfriend.

While dealing with all that emotional pressure off shift,

Amy also wore her heart on her sleeve from day one on the job.

Her first call out with mentor Shay was to an elderly gentleman

who'd been bitten by a spider.

-This is where you got bitten?

-That's where I was bitten.

And you can see my hand's swollen up.

But when the patient opened up about how his wife had died,

Amy had to fight back the tears.

It's something I'll never, never, never get over.

I'll never get over losing her.

The shock of that, a blood vessel burst in my brain.

And that's how I lost my sight.

Very, very hard.

I was welling up and I could feel myself going to cry

and I was trying my best to hide it by looking at the ground.

And after a terrifying situation with an unpredictable patient...

-He's about to kick off, that guy.

-Isn't he?

He was definitely going to kick off.

..Amy found herself contemplating her future on the job.

It makes us worried about being in a car by myself

and being put into situations like that when I'm going to be on my own.

But sticking with it has taught her a valuable lesson about herself.

One of the things that I've learned from this is that

I do get really emotional, but I do have a bit of a thicker skin

than what I thought and I do handle things better than I thought I would.

So I'm really happy with that.

With her final shift in Wellingborough now over,

it's down to Amy's mentor Shay

to grade her overall performance across the six weeks.

I think I've worked really hard

and I've pushed myself outside my comfort zone in a lot of situations.

And I do hope my grade can reflect that.

Amy, that's the end of your six-week placement on the road.

How do you think it went?

Erm... I think it's been brilliant.

I've learnt so much. It's just been an experience second to none.

-Couldn't have wished for more.

-You still want to be a paramedic?

Definitely. Even more than I did before.

In the short period of time - six weeks - you've come on so far.

-Yeah.

-And it really is noticeable.

I really do feel like my confidence has grown so much.

I think, with all the jobs we've been to,

over the past six weeks and the way you've performed,

I'll give you a grade of a B, which is well-deserved.

-And you can just build on that.

-Thank you very much.

-That's OK.

-I'm happy with that grade. Thank you very much.

It's made my day!

This is the job for me.

It's an amazing job and a worthy job,

and I can't wait to get out on my next placement and do it all again.

Amy's happy with her grade.

And Steph's last shift is also over.

But how will mentor Sam, gauge her performance?

You got in there straightaway on the first shift,

and over the six weeks, I think you can do all the things

quite easily now without supervision.

So I thought I'd give you a B.

When I was looking through the descriptors,

it was the one that suited you most, cos B minus

is quite well motivated, but B is very well motivated.

-I hope you're happy with that.

-Yeah, thank you.

She has come on so much once the first day.

It's been really nice to see her develop.

She's really quite confident now -

you wouldn't think she was a first year, to be fair.

If you get an A, it's saying you can't improve

and you always need to be able to improve.

In your second year you want to be getting As,

cos you've got to go out on your own, but I'm happy with a B.

And in Leicester, how has mentor Jonny graded Nick?

B minus. Happy with that.

You should be.

You worked hard for it.

-It's deserved.

-It's been fun.

-Good.

I shall see you about.

Handing over at the hospital.

-I'll be listening!

-Handing over to you!

Yeah.

And it's also good news for Max.

After he handed his completed paperwork to mentor Chris,

he passed with a D minus.

The next two years are going to be tough.

I've got so many shifts to do, so much work to get done.

When I do qualify, I'll be proud of myself

and feel privileged to wear the uniform and just get on with the job.

MUSIC: "Heroes" by Tinie Tempah

With thousands of hours of experience between them,

and stories to last a lifetime, all nine junior paramedics have

come to the end of their first

placements of their paramedic career.

The whole placement was completely different to what

I expected it to be like.

From the first day, it was hands-on instantly, and getting involved,

which I was really pleased about cos for me that's the way I learn best.

The most rewarding thing about doing the job is helping people.

That's awesome, that is.

What I've enjoyed the most is being a trusted member of society.

Can't wait to be a paramedic and be out on the road

and I truly think it's the best job.

I could be offered all the money in the world

and I think I'd still want to do this job.

It has been rewarding.

You're making a massive difference to someone's life.

The ones that have been rewarding are

the elderly person that's said "thank you" to you,

or the character that's really accepted you as a student.

I would quite happily not get paid for it for the rest of my life.

It's that kind of career that you just enjoy it so much

that the reward is actually doing the job itself.

Felt really privileged to do what I've been doing.

Just caring for people and making sure

they're all right, you feel special.

It is a really rewarding thing to do and the placement

has opened my eyes to what is out there in the world.

And it's a bit shocking sometimes, but it makes you

reflect on what the world's like, not as a paramedic, as a human.

The last six weeks have taught me that this what I want to do

and where I want to go with my life.

In 18 months, I'll be able to stand there and say,

"I'm a registered paramedic." That's my title. That's my career.

Even though it's quite scary,

I think it's going to be a fantastic career to say,

"I go out and help people every day, and potentially, save lives."