Reflections on Shadowing Welsh Ambulance Crews

Posted by: NHS Horizons - Posted on:

Originally published by Ian Baines – 21st October 2019

On 1st October at 7.30am my colleague Lynsey and I found ourselves in a draughty ambulance service station in the centre of Cardiff, about to shadow crews for a shift. We were nervous, and wondered what the day might bring.

We were instantly put at ease by Rob Brunnock, the Cardiff Locality Manager for WAST who talked us through some of the basics in terms of what we could expect during the day and the ‘do’s’ and ‘don’ts’ of accompanying the crews. 

I think I should point out that neither Lynsey or I have any form of medical training – thus we were happy to observe and be directed by the crews to undertake anything non medical in nature. 

Rob also gave us a tour of the ambulances and rapid response vehicles before introducing us to our crews for the day. My crew were Justin and Craig – two paramedics that had been working together for a number of years and clearly had an understanding how each other worked as well as a bit of banter to keep them ticking over.

Our first call was a cyclist who had come off her bike besides a busy Cardiff commuter road. Clearly concussed and with a potential broken arm, the paramedics carefully got her onto the stretcher and into the ambulance ready for the trip to the emergency department. 

On arrival at the hospital we saw a number of ambulances already waiting, so we knew it would be a while before we were back on the road. Throughout the day the handover time varied enormously according to how busy the accident and emergency department was. At this point in the morning the emergency department was already full, with the hospital’s capacity stretched. 

Clearly handover delays are a real source of frustration for all involved, be it the ambulance crews or the hospital staff. The time waiting to hand over the patient was passed with regular checks on the patient, discussion with colleagues and even a bit of CPD. Thankfully after an hour or so capacity eased a little and we were able to handover our patient and get back on the road.

I won’t describe every call that we responded to – they were a mix of suspected stroke, chest pains and falls – but I will describe the care given. I guess I was struck by the professional thoroughness of the crews in looking at the patient’s health and vital signs, as well as questioning the patient about their symptoms, medication and past care. The crews were always looking to build up a complete picture of the circumstances and condition of the patient whilst administering the care and conveying them to hospital.

The crews showed a willingness to talk to other professionals including GPs, community first responders, rapid response colleagues, care home staff and of course family members. 

I saw compassion in dealing with distress, patience in dealing with dementia and thoughtfulness beyond care including asking for patient belongings and possessions necessary for a stay in hospital. 

I saw other skills beyond care and clinical competence – a willingness to look after each other in difficult situations, and of course the skill of driving a large vehicle at high speeds across rush hour traffic with sirens flashing.

Lynsey spent her shift with Vick and Kev, a brilliantly talented and welcoming team who responded to a mix of patients in various circumstances. Lynsey was consistently impressed by the amazing teamwork, care and compassion that was shown for each patient. 

The first call out of the day for Lynsey’s crew was a very distressing one that involved a young child. The way the team worked together with other responders and members of the Welsh Ambulance Service (WAST) made a significant impression on Lynsey. The kindness, empathy and camaraderie that the team displayed after the traumatic call out being particularly pertinent, and their support of one another.

Witnessing a distressing call out also reinforced for both Lynsey and I how important wellbeing is to ambulance staff. It is vital that teams can come together and talk and share how they feel. As part of #ProjectA a virtual collaborative has been established that has an aim of focusing on a specific of creating safe spaces for ambulance staff to talk about their experiences. 

WAST does this brilliantly; whilst the circumstances were difficult Lynsey experienced how well the staff are looked after and supported after witnessing and being part of a difficult call out. 

As well as the difficulties around handover we also witnessed first hand some of the frustrations of the ambulance staff in Cardiff. It would be fair to say that the Blackweir ambulance station is really showing its age, although excitement is brewing about a potential site that could be developed in the near future. 

Other frustrations included paperwork and the desire to move towards a more modern means of recording interventions and care when attending patients. Electronic pens had been tried but their reliability was called into question by crews and the general consensus was a desire to move towards tablets or iPads where integrated records could be shared.

Lynsey and I kept in contact with each other throughout the 12 hour shift and we also crossed paths at the drop off area at the Emergency Department checking in with each other and offering one another support. 

When we returned to the station, we took an obligatory selfie in front of an ambulance with both of us looking very excited and rather tired. It has to be said that we were both exceptionally proud to have been part of the WAST team for the day.

Our huge thanks to everyone who made our shift possible


I am absolutely convinced that the day spent with WAST shadowing a full shift was invaluable to #ProjectA. I base this around two factors –

  • It helped give a small insight into the daily lives of paramedics and other ambulance professionals, their experience, their professionalism, their frustrations and their humour. I would hope therefore that we both have a greater appreciation and empathy for their work and can bring this into what we strive to achieve through #ProjectA.
  • It has given a further stimulus to our own motivation to continue to give #ProjectA the support and impetus it needs. Re-energised is not the right phrase as our motivation for #ProjectA is high; however the rideout gave us a sense of how important it is that continued work in all its forms to make the ambulance service as good a place as possible to work. Compassion, diversity, health and wellbeing, career support and improvement opportunities are essential components of a strategy that values its workforce.    

Finally I was asked a number times would I consider a change in career to a paramedic? No, is the honest answer – I’m a bit too old now and having been through one career change I think that may be enough for me. I did though reflect that I have a young daughter who at some point in the next few years will be considering career options. Who knows, the ambulance service? I would certainly be proud of her if that was a path she wanted to take. Amazing and rewarding work, incredible people.

It helped give a small insight into the daily lives of paramedics and other ambulance professionals, their experience, their professionalism, their frustrations and their humour