Andrew Nisbet: My Working Life as a Paramedic and Advanced Practitioner
What did you want to be when you were at school/growing up?
I always thought I would go into a banking or insurance type job. While at college studying for a business qualification, I trained as a first aider with St Andrew’s Ambulance Association to bolster my CV and really enjoyed it. I realised I could make a career out of that role by joining the ambulance service.
Why would you recommend your career to a young person?
Paramedic training and career opportunities have improved vastly over the last 20 years. When I became a paramedic in 2003 it was quite a one-dimensional job – the main focus was on attending emergency calls and transporting patients to hospital while delivering some enhanced care.
The role has developed into a much more holistic one, with paramedics exposed to a much greater variety of clinical presentations and care pathways, including mental health and frailty.
How did you train to become a paramedic?
I first trained as an ambulance technician, and then undertook further study in house with the ambulance service. Now paramedic training is delivered through a university degree programme. At that time, completion of basic training was very much seen as the completion of your paramedic training.
Now I would argue it is actually the start of your career with opportunities to develop into other clinical roles, including critical care, special operations and primary care both within the ambulance service and also the wider healthcare community.
What has been your biggest career disappointment or challenge and why, and how did you overcome it?
I failed my first pre-entry exam – an Objective Structured Clinical Examination (OSCE) style assessment – when trying to transition from an ambulance technician to paramedic.
After reflection, however, I decided that I wasn’t ready for the paramedic role yet and needed more time to consolidate my learning as a technician working alongside paramedics.
What was your best career move?
In 2014 I successfully applied for a paramedic practitioner role, this later expanded to an advanced practitioner role with prescribing rights where I rotated across primary care, remote telephone consultations and frontline ambulance duties. Being part of that team for seven years allowed me to apply for a secondment to my current role.
Can you describe your work/what you do in 1 sentence?
I support trainee and advanced paramedics in urgent and primary care in their professional development.
What qualities do you think you need to do your job well?
The main qualities are a good understanding of the advanced practitioner role and how it aligns to the Scottish Government’s strategy for redesigning urgent and primary care to ensure patients get seen at the right place and time, by the right person. It is important to be able to visualise and support improvements in practice and prioritise workload.
What are the main 3 factors that make you frustrated at work?
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Lack of time
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Lack of budget
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Poor internet connection.
What’s the best advice you’ve ever got from a patient or work colleague?
Be true to yourself.
If you could go back in time and give one piece of career advice to your younger self, what would it be?
Have the confidence to follow what you want to do, when you are young you have time and energy to study and develop — as you get older this becomes more challenging for lots of reasons.
What 3 factors make you skip into work?
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The variety of my role, no two days are the same
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The people I work with
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The opportunity to affect positive change and see the results in action.
What do you hope will be your legacy to your profession and colleagues?
I am sure I have helped a few patients over the last 20 or so years. Also, perhaps I’ve been able to motivate a few colleagues to join the advanced practitioner team.
What technological advance would have the greatest impact in your field?
A comprehensive patient record or easy access to all relevant healthcare providers’ patient records.
What do you do to relax/de-stress?
I enjoy family time, walking up hills, golf and the pub.
Who has been your biggest inspiration?
There are five or six people from within my organisation who have inspired me – I just thought, “yes, I want to be a bit more like you.”
Do you have any regrets about your career path?
No.
Your most treasured possession and why?
Family and friends are the most important things. I am married to Lynn, a cardio-thoracic nurse, and have twin boys Alasdair and Olly aged 12, who make you realise work is not that important sometimes.
If you could be health secretary for the day, what would you do?
Be honest about the investment required to provide sustainable health and social care.
On a typical day, what do you eat for lunch, where and how long is your break?
Normally a meal deal if I am out and about, 20 minutes maybe.
What is the most dangerous situation you have ever found yourself in?
999 calls that involved drugs or alcohol were always the most challenging, especially at night.
Biography:
Andrew Nisbet joined the Scottish Ambulance Service in 1995 and spent seven years working in the Ambulance Control Centre. He realised that he wanted to be out on the ambulance responding to those calls, so in 2002 he applied to become an ambulance technician – a change in career that would start him on the road to becoming a paramedic. At the time, paramedic training was undertaken in house rather than through a university degree programme.
After qualifying in 2003, he worked as part of a double ambulance crew, then on a Paramedic Response Unit in Edinburgh as a single responder and also had a secondment to the ambulance helicopter based in Glasgow. In 2014 he applied for a paramedic practitioner post, which involved completing a BSc at Glasgow Caledonian University.
This post later developed into an advanced practitioner role, requiring him to undertake a postgraduate diploma. He is still at the Scottish Ambulance Service, now working as part of a clinical lead team supporting advanced practitioners in urgent and primary care.
