A Pioneer For The Paramedic Profession
Advanced Practitioner in Critical Care, Vicki Brown MCPara, has achieved many firsts during her illustrious career. Here, she talks to Natasha Weale, Press and Communications Officer at the College of Paramedics, about her paramedic journey and the job ad which started it all.
When Vicki Brown was a little girl she always dreamed of becoming a vet. But somewhere along the way she swapped animals for humans and became one of the UK’s most accomplished paramedics, most recently becoming the first person to be registered on the Faculty of Pre-Hospital Care Register of Consultant (Level 8) Practitioners by qualifying from a purely paramedic background. It’s a remarkable achievement but then, Vicki, who lives in Gloucestershire, has spent her entire career pushing boundaries and challenging the status quo.
“I’m very driven, work-wise and I’m always looking for the next challenge,” she confesses. “I’ve been called a trailblazer but really I just want to be a good role model for the next generation so that they know what can be achieved in our profession with a lot of hard work and determination.”
Vicki, who is an Advanced Practitioner in Critical Care at Great Western Air Ambulance Charity (GWAAC), began her career as a trainee technician with Gloucestershire Ambulance Service in 2002, after seeing an advert for the job in her local paper.
“To be honest, I’d never considered a career in paramedicine,” she explains. “Before I started as a paramedic, I worked as an assistant racehorse trainer and at the same time, also trained to become an acupuncturist. I suppose it was while I was doing the acupuncture that I became more interested in helping people, and after a friend suggested paramedicine, I thought ‘why not?’”
Having successfully secured the job as a trainee technician, Vicki worked her way up to become an ambulance technician and then qualified as a paramedic in 2004, after completing a six-week course in Bolton. Between 2004 and 2006, while she was based in Gloucestershire, Vicki gained her teaching qualification and also became the station’s operational manager, proving, even in the early days of her career, that she was going to be a force to be reckoned with.
By 2006, however, she had set her sights on working for the air ambulance service, despite it being very male dominated. “I realised it was going to be tough and had been told by people I knew who worked for the service not to get my hopes up. But I’ve never been one to shy away from a challenge and became even more determined to get through the application process,” she reveals.
And succeed she did. Vicki was seconded to County Air Ambulance, now known as the Midlands Air Ambulance Charity (MAAC), which covers the counties of Gloucestershire, Worcestershire, Shropshire, Staffordshire, Herefordshire and the West Midlands for five or six shifts a month, while continuing to work as a road paramedic for Gloucestershire Ambulance Service. It was while working for County Air Ambulance that Vicki completed her HEMS Technical Crew Member Course, learning everything from aircraft safety, the weather, navigation and map-reading to helicopter inter-communications systems and the use of on-board medical equipment.
In 2009, she achieved her Post Graduate Certificate in Pre-Hospital Critical Care and three years later joined GWAAC as a full-time critical care paramedic, now known as a Specialist Paramedic in Critical Care. She admits: “I’ve always been a bit of an adrenaline junkie so I think that’s why becoming a HEMS paramedic appealed to me so much. I loved going to trauma calls as a newly-qualified paramedic and now, working for the air ambulance I get to help the most critically ill and injured patients. When these people are having the worst day of their lives, knowing that we’re doing the utmost for them, and trying to make it better for them, is something I find very rewarding.”
Working for GWAAC, which covers the areas of Bristol, Bath and North East Somerset, South Gloucestershire, Gloucestershire, North Somerset and parts of Wiltshire, means Vicki will either be on shift 7am to 7pm or 1pm to 1am. In her team, she could be joined by a critical care doctor, a trainee doctor, a Specialist Paramedic in Critical Care or a combination of all three roles. Alternatively, she could be on her own. There is a 30-strong clinical crew at GWAAC which, on average, attends five critical incidents a day. She says: “You never know what the day is going to bring but we always spend the first 15 minutes of each day preparing the drugs we’ll need for all the critical care incidents we’ll attend and checking that the equipment we require is available and in good working order.
Next, we’ll have a briefing to go through the aviation side of things and confirm that everything is prepared and operational, and then once that is over, we’ll wait for the jobs to come in. Any downtime we have is spent training, which could mean simulation training or talking through recent cases to pick up and identify any learning points.”
And learning, it seems, is at the heart of everything Vicki does. While she admits that she’s a naturally curious person, it’s her quest to broaden her knowledge, skillset, competence and ultimately, the profession itself which have propelled her into a different league altogether. Four years after completing her MSc in Advanced Practice, Vicki was appointed an Advanced Practitioner in Critical Care at GWAAC in 2020, in what was the first of its kind within the pre-hospital critical care environment. The role was developed and approved as a career pathway by SWASFT.
In order to achieve this career milestone, Vicki had to have a Masters degree, carry out a minimum of three years working in Critical Care, two of which in a Pre-Hospital Critical Care Team, a Diploma in Immediate Medical Care, a completed Non-Medical Prescribing qualification and an extensive portfolio evidencing her work. She also needed to undertake a clinical examination and interview. On her final assessment, her performance was described as a ‘demonstration of mastery’ by the examining faculty which comprised of consultant clinicians in pre-hospital care, emergency medicine and intensive care.
“That was very nice to hear,” she confesses. “But for me, the biggest thrill has been getting to the stage where I can do more for my patients because I can administer a lot more drugs now than I could before and autonomously, I can do interventions such as a thoracotomy or a resuscitative hysterotomy which I never thought I would have been able to do as a paramedic.”
Not content with everything she has achieved, Vicki has continued to smash the glass ceiling by becoming the first paramedic in the country to be registered on the Faculty of Pre-Hospital Care Register of Consultant (Level 8) Practitioners by qualifying solely from a paramedic background. She achieved her registration last December after providing evidence to the Faculty of Pre-Hospital Care of her experience and knowledge by submitting portfolios of clinical and operational experience and attending an interview.
It now means Vicki can do every intervention a doctor can do, outside a hospital setting, except for a pre-hospital emergency anaesthetic. But, of course, this is on her ‘To Do’ list, along with developing a Consultant Practitioner in Critical Care pathway for SWASFT. “That’s the next step,” she reveals. “I’d like to go into hospitals and undertake the anaesthetic competencies, as well as further in-hospital training but it’s just not possible at the moment because hospitals are too busy.”
Despite being the first paramedic on the register to reach consultant status in pre-hospital care, the role doesn’t currently exist within SWASFT so Vicki is pushing hard to get it acknowledged, with the hope that one day it will be a nationally-recognised role in the profession.
“It means having to write lots of documents and policies on what the competencies are behind this role but once I complete it SWASFT will then have a clear career pathway for all paramedics in their service and hopefully, it will inspire a future generation to reach the pinnacle of their careers,” says Vicki, who was the 2019 winner of the Paramedic of the Year award at the Association of Air Ambulance Awards of Excellence. It's clear that Vicki has certainly blazed a trail for other Specialist Paramedics in Critical Care to follow yet, ironically, she doesn’t see herself as different to anyone else. “If I can do it then anyone can,” she says. “Yes, I’m the first one but I’ve always looked at the bigger picture, about what we can achieve as a profession. I think the more you do, the more you want to do. I’ll never stop thinking about that next challenge or striving to break barriers. It’s who I am.”