By Dr Giselle Roberts
Paramedic and senior lecturer, Dr Susan Furness, calls them “her people”: the businessman who got hit by a car while crossing the road, the guy in the red shirt who fell off the roof, and the elderly woman who died in her sleep. The golfer who did not finish the last nine.
“I never saw the faces of some,” she says, “and others are so clear in my mind that I cannot forget them. I no longer try. They are symbolic of the pain and tragedy that is part of being human. And they have given me the gift of accepting the process of death as part of life.”
A paramedic for over 15 years, Furness has seen the hardest edges of human existence: car accidents, strokes, overdoses, suicides. Her stories are a complex mix of grace and misfortune, where medical intervention made all the difference, or none at all.
Today, Dr Furness is training paramedicine students who, like her, will routinely enter that precarious space between life and death. What’s needed? Resilience, and plenty of it.
GISELLE ROBERTS: Susan, tell me about your life. What made you decide to become a paramedic?
SUSAN FURNESS: I wanted to become a paramedic from the age of seven. I used to watch an American TV show called Emergency. The firefighters and paramedics of LA County became my heroes and the idea of saving lives really struck a chord with me. I wanted to be just like them. At that time, though, Ambulance Victoria did not accept women because of restrictions on lifting. So I became a registered nurse instead. I worked in Melbourne hospitals for six years then, in 1997, I saw an advertisement for an entry-level position in the service. I heard they were now accepting women and I applied. There were 400 applicants for three positions. At the psychological testing session I remember sitting in a room with engineers and scientists and thought, ‘I am never going to get one of these jobs.’ To my complete surprise, I did.
GR: After all those years dreaming of a career as a paramedic, did it live up to your expectations?
SF: Actually, it did. I was trained in-house by Ambulance Victoria, then sent to Swan Hill. I was the only female paramedic at that branch for five years. It was a very male-dominated culture but I absolutely loved it. My colleagues became my second family. We shared some terrible experiences but we had some incredibly rewarding times as well. Back then we worked with only basic life support and, as things changed, I embraced every professional development opportunity available to me. I completed an advanced life support course and moved into training first response teams, then worked as an intensive care paramedic.
GR: And a new career pathway emerged.
SF: Yes. Later I became a clinical support officer, overseeing the emergency response for the Southern Grampians region. I also did some sessional academic work, so when the paramedicine lecturing position at La Trobe Bendigo was advertised, I was ready. I knew that if I moved into academia, it would be hard to continue to work as an operational paramedic. But I realised that this was my opportunity to influence hundreds of students, to serve them well so that they were better equipped for a career in paramedicine. That was ten years ago.
GR: I imagine that paramedicine is a dynamic field that is constantly responding to advances in medicine and changes to healthcare delivery.
SF: Yes, that’s true. When I started, we were still called ambulance officers and were part of the emergency response division, along with police and firefighters. Today, paramedicine sits at the interface of public health, health care and public safety. Paramedics specialise in advanced medical techniques, have over 35 drugs in their toolkit and some can prescribe medications. There are a range of specialisations from mica paramedicine to community paramedicine. While I was trained by an apprenticeship model, I now educate university students who are required to obtain professional registration after they graduate.
GR: What’s special about the course at La Trobe?
SF: It’s the only four year program in Victoria. We offer students over 600 hours of clinical placements. Second year students start with non-emergency patient transport shifts to familiarise themselves with the back-of-the-van environment and patient communication. Our third and fourth year students are working in emergency ambulances, undertaking aged care shifts, and completing mental healthcare placements. But what’s unique about our program is our small cohort of students. We aim for 40-45 students per level. We know our students by name, we know when they are struggling and when there are doing well. And that’s critical when we are preparing them for a career as a paramedic.
GR: So how do you teach students to respond to emergencies of every possible kind, where the variables and context are always different?
SF: That’s something I ask myself all the time. We all know that students need training in pathophysiology and anatomy, disease and drug knowledge. Then there’s the law, ethics, judgement calls, clinical decision-making and problem solving. Although we can’t prepare students for everything, we work on building resilience and teaching them to become reflective practitioners. I want them to have the practical skills and emotional intelligence to help them to cope on the day, for example, when they have to tell a mother that her child has died. I can teach almost anyone the medical techniques but it is the nebulous elements – empathy, compassion, communication and understanding – that are critical to paramedics when they are called to respond and take control of situations where there is no control. Control, after all, is an illusion. I have been to jobs where I’ve worked my hardest to save a person’s life, have done everything I possibly could, and it hasn’t worked. Other times, it does.
GR: You no longer save lives directly, but you have a great impact on the profession itself.
SF: Thank you, I hope so. Our graduates have an excellent reputation within the ambulance service. I am so proud of that and it challenges me to do my best in the classroom every single day. One of the most satisfying moments is when a former student contacts me and says, “Gosh, I did this job the other day and I remember what you said, I heard your voice in my ear as I was working.” The community needs skilful, compassionate paramedics. I have an incredible job. I get to educate them.