There are different rankings
Health professionals in the emergency medical field are often classified (by the public) as paramedics when, in actual fact, that’s not the case. There are different ranks of emergency medical care which all depend on the qualifications you possess. If you want to be the highest ranking paramedic (ECP specifically), for example, you need to study and obtain a four-year Bachelor of Emergency Medical Care degree.
Basic Life Support (BLS): The role of BLS is to provide immediate emergency medical attention to prolong life before the emergency medical practitioners arrive on the scene. BLS medics are qualified to keep the heart and respiratory problems under control in the case of an emergency.
Intermediate Life Support (ILS): These are qualified first responders who, much like BLS, are able to control the heart and respiratory conditions on arrival but have more skills and protocols available to them than BLS. They’re still, however, not qualified as paramedics.
Advanced Life Support (ALS): If you want to be called a paramedic, you need to qualify as an ALS. Advanced Life Support itself is divided into separate rankings which qualify you to perform certain skills and protocols. There are Critical Care Assistants (CCA) and Emergency Care Technicians (ECT) who are registered paramedics with the Health Professionals Council of South Africa (HPCSA). CCAs complete a no NQF, nine-month short-course while ECTs complete a three-year course. These practitioners are both qualified to practice advanced emergency medicine while ECTs are qualified to do more than CCAs in terms of rescue, anatomy, ambulance technology, chemistry and physics.
ALS Emergency Care Practitioners (ECP): Another branch of ALS that you’ll find on the roads today are your ECPs. They have the highest EMC qualifications which make them the only practitioners qualified to perform Rapid Sequence Induction (RSI) protocols and Advanced Cardiac Life Support (ACLS). They call themselves paramedics because it’s easier to explain the job title, but they’re (technically) Emergency Care Practitioners (ECP) and the most qualified to do their job.
How the shifts work
As an EMC student, you would have work a couple of shifts on the road and in the hospitals already. But it’s nothing quite like when you are an independent practitioner and you’re working for the government – the shift experience is quite different. First of all, you won’t be needing to work any ICU or theatre shifts. You’ll be working from the base and be sent out on calls and transfers as they come in.
The shifts are full 12-hours long, from seven to seven and your handover happens 30 minutes before your shift starts. There’ll be no leaving early like you do in your student days so prepare for the long day and night shifts. You will be placed within a cycle of shifts that, in the Western Cape specifically, are on a rotation of four days on (usually two day and two night shifts) and five days off, followed by five days on (usually three day and two night shifts which also alternate to two day and three night shifts within the cycle) and five (sometimes four) days off.
This gives EMCs enough time off to recover from night shifts, make up for Sundays and public holidays missed and the 12-hour shifts. Being a paramedic takes tons of effort and personal sacrifice but, most of the time, the off days make up for that. If you’re about to graduate, you may want to start looking for Western Cape department of health jobs and start getting your name out there for future considerations. Other provinces in South Africa don’t work with the four-on five-off, five-on five-off cycle.
Another thing to know about WC paramedics is that there is an almost 100% chance that you will be sent out on a call into a dangerous area. There have been too many news reports about ambulances and paramedics being attacked. To the point where police escorts are now a requirement before EMC services are allowed to travel to one of those dangerous areas. But, regardless of police presence, there are still stories of gang shootings happening one street away from where paramedics are treating a patient.
To put your mind slightly at ease about this fact, EMCs are trained to put their safety first. After all, if they aren’t able to perform at their best, they aren’t able to do their job.
Not for everyone
As you start the process of obtaining your EMC qualification, you’ll realise very quickly whether this career is for you or not. You will be exposed to incredible traumas, be overworked and exhausted at the end of every shift, miss out on the smaller things such as weekend events with friends and family, and you’ll have cases that hit close to home.
It takes a strong-willed, self-motivated, courageous, quick-thinking, non-squeamish and emotionally stable person to fulfil the role of a paramedic. It’s not a job for everyone, but the rest of the Western Cape is extremely grateful to our emergency medical care practitioners.