St. John's Ambulance Volunteering

[Guest seonagh]

Hello all,

I'm thinking of getting involved with SJA in the local area, does anyone have any experience with them and what were your experiences?

For those that have volunteered would you class it as a good medically related experience. Medically related volunteering is very limited in my area but there seems to be a good demand for more SJA volunteers.

Seonagh

[Guest festering turtle]

I volunteered with St. John's Ambulance for years and it was a great experience. It's a good opportunity to learn about first aid, and to get a chance to deal with patients. If you get involved in teaching first aid courses it's also a good way to make money.

 

The amount of patient interaction you will get varies depending on where you are. For example, in some places St. John ambulance volunteers run an emergency ambulance service but not in others.

[Guest Elaine I]

As a point of clarification, St. John Ambulance does not run an ambulance service anywhere in Canada. (They do, however, in Germany, and possibly some other European countries - but with much, much more training than here.)

 

St. John Ambulance volunteers receive training in first aid and CPR, as well as sometimes first responder and automatic defibrillation. As far as your patient contact - that will vary depending upon what sort of events you volunteer for. If you attend a lot of sporting events, you will get lots of practice putting on splints and springs. If, however, you volunteer at home shows, you won't see too many patients.

 

While I believe St. John Ambulance to be a very valuable service, I would like to offer one point of caution. It is a common pet peeve of paramedics when SJA volunteers say that they work for an ambulance service, or say that they have equal training to paramedics. Unfortunately, these statements are ones I have heard too often from SJA volunteers, including sometimes the leaders.

 

I'm certainly not trying to say that you would be one of these people. However, I am just trying to caution you so if you hear these statements, you know that they are not true. Instead of getting caught up in the politics of it all, take the training, and enjoy the volunteering!

 

Enjoy!

Elaine

[Guest festering turtle]

Thanks for clearing that up. Years ago, when I was volunteering with them, they did run an emergency service in my community.

 

The ambulance service here is now hospital based but I had assumed that SJA still ran emergency services in some other places. Sorry for any confusion.

 

I work as a paramedic here now and still interact a great deal with members of the SJA. I wasn't aware of any tension between medics and SJA members but I guess it might be different in other communities.

[Guest RageoftheDragon]

Hey,

 

I volunteered with SJA for a semester, and that's all I could take. It might have been an isolated case to my area, but it was a terrible experience. The people constantly bitched about...hell, almost everything in life. It seemed the only reason most of them were there was to get into events for free. There was no fostering of the First Aid skills/practices. It was quite the waste of my time, as I thought I'd either be learning something, or that I'd actually help a person now and again (not wishing harm on anyone). At any rate, I would not recommend SJA as a valuable volunteer experience.

 

I have heard that ambulance ridealongs are available, at least here in S'toon, and I think that would be much better. It could give you a good view of one of the front lines of health care, such that you better understand what situation some patients are coming from once you get into the ER, etc. Also, I do not recommend volunteering simply to make your med school application look better. You may end up hating what you're doing, and get turned off volunteering. Make sure it fits what you really want.

 

RotD

[Guest ploughboy]

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Hey,

 

It really depends on the group you get involved with. As with any organization, individual SJA branches and divisions each have their own "personality". I joined a division in Ottawa that is run fantastically well (actually, all the divisions in Ottawa are pretty solid). I had a lot of fun, made a bunch of friends and got to do some really cool things that I wouldn't have done otherwise. I have since moved to a city which shall remain nameless. The SJA brigade here is going through some rough times. If I had walked in off the street to the environment here, I'd have been out the door again like a shot. It really comes down to leadership.

 

So overall, I'd recommend giving it a try. I learned a lot, and not just first-aid either. My "soft skills" really improved after a year or so with SJA - dealing with pukey, obnoxious drunks; calming down over-protective mothers freaking out 'cuz little Johnny has a bit of blood on him; calming *myself* down when a nice quiet day at a craft show was interrupted by a sweet little old lady who mentioned her equally-elderly sister was having chest pain. ("...if it's no bother would you mind having a look at her, dear?")

 

I'd suggest going to a couple of meetings. Your experience may turn out like festering's and mine, or maybe more like Rage's (sorry to hear about that, by the way). If that's the case, see if your school has a student emergency response team, or depending on where you live try the Red Cross, Ski Patrol or maybe CASARA. Like Rage said, make sure you're doing this for the right reasons too. Medically-related volunteering is great, but if your heart's not in it the experience won't be fun, and that will likely show through come interview time. Do something you enjoy. Coach minor sports, help run a scout troop, whatever...

 

SJA Training - current rumblings from on high indicate all SJA uniformed volunteers will need to train to MFR (Medical First Responder) standards, in order to be consistent with the Competency Profiles of the Paramedic Association of Canada. That doesn't make SJA members paramedics! Like Elaine said, there's a big jump between this level of training and that of a working paramedic (50 hrs vs 2 years training, plus all the experience gained from working full-time on people who are in some serious trouble.)

 

That said, I know a number of paramedics, nurses and doctors who "moonlight" and volunteer their time with SJA. Quite a few of them started out with SJA before they became health-care professionals, and I'm sure their experience helped them make the jump. If you do join SJA, try and find these people - they're usually quite happy to talk about what they like and don't like about their jobs, and they're good about offering advice on how to get to where they are career-wise.

 

Unfortunately, as Elaine and Rage mentioned, the organization attracts its share of 'wannabes'. One silly, uninformed comment can undo a lot of hard work by a bunch of other people. Again it comes down to good leadership, reigning in and adjusting the attitude of certain...err...overenthusiastic volunteers.

 

Long story short - try it, you might like it! The most you have to lose is a few hours of your time.

 

Cheers,

 

pb

 

 

P.S. Edited to add signature...pb

 

 

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[Guest mdhopeful23]

hmm, as a SJ volunteer, i can relate to both kinds of experiences mentioned here.

 

when i first joined my local SJ brigade, i didnt like it. i thought the volunteers were clique and not too professional. i would go to meetings feeling like an outsider, often just sittin around and doing nothing...over the weeks, i noticed alot of 'new' members taking off, and i didn't blame them.

 

however, i had little to do thursday evenings, plus i didn't want to just drop out, so i kept going. i ended up making some comments about how i was feeling to the supervisor. then things changed almost immediatley. i guess the group didnt realize how their actions were reflecting to a new member like myself. they started making more of an effort to include us newbies.

 

now i totally love it. its a great way to get involved with the community. the events are fun, and now that i've gotten to know my group members, they're good people to hang with. there's more to learn than handling medical emergencies with SJ. its about teamwork, community relations, and so on. take what you can out of the experience.

 

as for any 'bad blood' between us and paramedics, its not really an issue. yes, some of my members do take themselves a little too seriously. we do not have the authority or skills to do what paramedics do. however, our training does shadow that of paramedics and other emergency workers (ie. MFR). its a great intro into the field. alot of our volunteers are applying for paramedic, firefighting, police careers.

 

i think there is some variation between different branches. this is actually the second SJ branch ive been to (i moved last year). the first one was REALLY BAD. im talking ridicuously unprofessional and immature. i didn't go back. the second time it just took a little more time for me to get into it...

[Guest daryn]

Hello there

 

I am speaking as a former member. Actually even that part is questionable because I believe they put me as auxillary...so I guess I am still a member..

 

Anyway. To tell you the truth, my experience there was not that fantastic. I joined way back in the early days of high school. It was a local cadet brigade. To make the long story short, the original members were fed up with the leaders and the organization etc and most of them left. So when I joined there were very little members. Because I had previous knowledge in first aid (lifeguarding etc) I picked up very quickly. This and the first aid competition led me to actually teaching first aid to other members. Yes that was interesting. For awhile. It seemed like I was doing the same thiing over and over again with no chance for advancement. I felt that the stuff they wanted me to teach was the same thing over and over again. (and I was learning nothing new)

 

This combined with very bad and disorganized admin. Along with everyone wanting to have some sort of a rank -- a power thing, you know? It got really tiring and very distracting from the real SJA I wanted to join. Like those before me, I got tired of it and left for an adult varsity brigade.

 

I went to only one of their meetings. It was mostly university students who wanted to pad their resume/application. I was expecting adults (older) so I can actually learn more first aid. All they wanted to do was to organize ski trips, parties etc. While I agree that bonding is very important to group dynamics, I believe SJA should offer more than this. ANd their weekly meetings.

 

I know this is only my experience and maybe other divisions aren't like that. But the ones that I had to deal with are more like boy scout groups with a ton of politics.

[Guest mying]

I could talk about this sort of thing forever, but fortunately other people have said most of what I'd say anyways. So you're all spared.

 

Suffice to say, I've been doing the St. John Ambulance thing for 9 years (as of last week), and there is enough I enjoy about it that I continue my involvement even in clerkship, as much as I can. I gained a lot from it before medical school, it made a significant difference to my medical school experience so far, and I continue to gain from it. I even get a pretty piece of metal on a ribbon next month.

 

Like any volunteer work, you have to enjoy the core goals, and have a certain passion to help the organization meet those goals, despite the politics, and you'll usually get out of it what you put into it. Sometimes there are leadership problems -- I hear about that in St. John almost as much as I hear about it in Scouts and Guides. It's too bad. If it's not for you, for whatever reason, it's just not... something else might be.

 

I've done a variety of volunteer work in my lifetime, and I liked a different thing about each of them, and gained something from each. SJA is only one of them, but it's a big one because of the wide range of opportunities and experiences to be had. I think that about sums it up.

[Guest seonagh]

Also, I do not recommend volunteering simply to make your med school application look better. You may end up hating what you're doing, and get turned off volunteering. Make sure it fits what you really want.

 

Totally agree but as an aside there are schools that require medical exposure be it volunteer or otherwise and in areas where that is not readily available SJA might be the closest one can come.

Ideally I'd be volunteering in paliative care but locally they have training only for two weeks in the fall that happens to be right in the middle of my uni's midterms and a desire to involve primarily retirees.

Seonagh

[Guest PatKarter1]

I was just curious to know if SJA covers the cost of the Basic Level course required for volunteering, or do you have to pay for it out of your own pocket?

[Guest arjuna83]

you need to pay for the standard first aid + CPR ©, which ranges from 90-140! dollars depending on the region and available resources. Once you complete that, all other training is free. Basically you need to complete another course called Brigade Training System (BTS), which is almost equivalent to the inititial standard first aid course, only that more emphasis is placed on practical skills such as making slings. Also, in order to become a patient care provider (formerly called SJA brigade members) you need to pass a written and practical evaluation called the Brigade Assessment Protocol (BAP). There are BTS training levels from 1 to 4, however I believe that they only offer 1 and 2 in Canada.

Oh, and as someone above mentioned, they're scrapping the BTS for MFR. At the moment, this course costs quite a lot. But who knows, it might be offered free of charge if it becomes the next requirement for independent patient care providers.

[Guest mying]

Whether you need to pay or not for the basic "pre-requisite" training could be negotiable, depending on what previous experience you may have and the nature of the local recruiting drive. Some communities' St. John groups will offer you free basic training in exchange for your promise of volunteer hours. All training afterwards offered as part of that area's patient care delivery (AED, driving, whatever) would be free, including recertifying your first aid and CPR if you need it for work or school. The MFR, when it becomes the minimum standard and replaces the BTS, will probably be free or the cost of materials only.

[Guest Lorae]

I volunteered with the brigade for 5 years. I agree with a lot of what has been said through this thread.

 

My experience was generally positive because it gave me very valuable experience at a young age - and this helped me learn that healthcare was indeed the area I would work in. However, the negative aspects were very prominent. The politics and power struggles were embarassingly strong. There was extreme focus places on ranks, rules, and procedures and an inability to see "the big picture" or be flexible. In the end I had to leave because as I became educated and gained experience in "real" healthcare I lost my patience for their trivial squabbles, massive gossiping, and power struggles.

 

I'm glad to hear the brigade is not like that everywhere. I'm sure it could have changed here too, all we really needed was some competent leadership.

[Guest mdhopeful23]

you know, i contemplated why exactly there is so much 'politics' , gossip, and all that nonsense in SJ. in the end, i sourced it to leadership as well. the problem with SJ, is that its all volunteer based. the 'higher' officials are often volunteers themselves. now you have to think, what kind of individual is drawn to taking on a large amount of responsability with no pay...and what their level of accountability is. i recommened having paid positions for the supervisors etc. however, this is unlikely to happen as cash is limited in the organization...that was my 2cents, the idea didn't go over very well :rolleyes

[Guest Lorae]

In my area the leaders tended to be people who worked in the types of jobs that wouldn't really give them any of their own power. I don't mean to generalize, but it seemed like they were at the bottom of whatever social/political "totem pole" that existed where they worked.

 

Maybe there was a degree of "wannabe-ness" involved, maybe not. But what I saw was that they needed to exert power over the lower ranks - especially those of us who were volunteering as we worked towards our professional education in healthcare (nursing school, EMT training).

[Guest CoWind]

I have been volunteering in the SJA toronto area branch for quite a few years now, I am working in the rank of Corporal in the Brigade. Just like everyone else, I hated it at first. I've thought of quitting for many times before i was promoted and then i started to really like it. You do have to be prepared to commit a lot of your time to it since we do get weekly meetings and monthly meetings for NCOs. Although real cases with lots of blood are very rare in the Toronto area (the local ambulances grab all of those before we do), we still get to interact with a lot of people. Although a lot of the people join just to get free food and free entrance into events, there are still some who really join for the clinical expereince. If you do well in first aid, you might be taugh higher level of training involving ambulance equipments and such. SJ is a standard in first aid, although we are not as well known in the general public as Red Cross or LSS, we brigade members do get to practise and sharpen our first aid skills more through competitions and such, while if you only take a first aid course outside you might never use it. And in emergencies, you wouldnt be able to remember what you learned in a course you took 5 years ago. And in the brigade, there are such thing as footdrill, which my division emphasize on a lot. Some people love it, others hate it. Although i dont really like how the whole system is running, it is a good place to gain skills and to network with others.

[Guest leviathan]

While I believe St. John Ambulance to be a very valuable service, I would like to offer one point of caution. It is a common pet peeve of paramedics when SJA volunteers say that they work for an ambulance service, or say that they have equal training to paramedics. Unfortunately, these statements are ones I have heard too often from SJA volunteers, including sometimes the leaders.

 

Actually, once a St. John member finished all his/her training modules, they have received pretty close to the level of training of an EMT-B. They basically took the EMT-B and divided it up into about 6 modules and members eventually take them all so they can take the BTS II exam. These modules include oxygen therapy, advanced airway management, suction, transport and immobilization of spinals, advanced patient assessment, etc...

 

The major difference between a BTS II St John volunteer and an EMT-B or basic paramedic is that a St John worker does not have a tenth of the experience of an EMT...we can go through several events before seeing anything worse than a cut or a bruise. EMTs of course are out in the field every day responding to emergencies.

[Guest Elaine I]

Hi Leviathan,

 

You may be correct in your statement that SJA volunteers receive close to equivalent training as the EMT-B level; however, paramedics in Ontario receive much more. To work on an ambulance in Ontario, Primary Care Paramedics take two years of full time college (or equivalent - the exception being 'grandfathers'). Advanced Care Paramedics take the equivalent of an additional year of training. Critical Care Paramedics take a fourth year prior to being certified.

 

From a skill stand-point, you are correct that SJA volunteers perform many of the same skills as Primary Care Paramedics (with the exception being Symptom Relief Medication administration and semi-automatic defibrillation - though you may have automatic defibs). However, what is missing from the SJA training (and EMT-B training) is the knowledge of normal physiology, pathophysiology and pharmacology. These areas are key components of the paramedic program but are not (nor do they need to be) part of SJA training.

 

Being a paramedic has little to do with the skills, but much to do with recognizing sick vs not-sick, and knowing how and when to apply the skills. A paramedic can be the best intubator in the world, but if s/he doesn't recognize that a patient is pre-arrest and needs to be intubated now rather than five minutes from now, s/he is not a good paramedic. We have a very common saying, "good BLS before ALS". Treating patients is about assessment, and understanding what is wrong and how to correct it if possible (or to know when to drive quickly and notify the hospital that the patient needs more than can be provided pre-hospital, eg: multi-system traumas).

 

I commend you for the work you do as a SJA volunteer. I do believe that the organization does good work. Please understand that it is our professional pride that makes us not like to hear that people who attend training one night of the week (albeit good training) are as well trained as us. (This statement is not directly to you, but more to some of the people who I've dealt with in the past, including in the days when I volunteered for SJA.) The same goes for physicians not wanting to hear paramedics say that they could do their job just because they may be more proficient at a few individual skills (for example, a paramedic is probably better at intubating than a family physician who doesn't work in an ER on a regular basis, but a family physician has much, much, much more knowledge about patient assessment and care). Instead, we all need to recognize our niches, and work/volunteer together for the better of all patients.

 

Elaine

[Guest mying]

Instead, we all need to recognize our niches, and work/volunteer together for the better of all patients.

 

Amen.

 

I had to comment on this, just because it's so very true, and goes far beyond this discussion on the difference between the average St. Johner and the average Ontario PCP.

 

It applies to the RRT and the RN and the NP and the CNS and the clinical clerk and the PSW. If you understand Elaine_I's point, I think you'll have a much healthier respect for the roles of all the health care providers. It's something that is a very important thing to understand for those entering their clinical clerkship, where it seems like the lines dividing the niches and roles, yours in particular, are extremely fuzzy.

 

From a St. John point of view, the one thing I've always stressed to my new volunteers and students, especially as we train more and more people in the new MFR program, is to always respect their place as the best damn pre-ambulance service in the world, and not to try to be something that somebody else is already doing.

 

The SJA Patient Care system is the best example of pre-ambulance care. Actually, it's the best example because it's really the only example. SJA works in the same paradigm of pre-ambulance, auxiliary EMS, and mass-gathering medicine, in all the countries that have St. John Ambulance volunteers. Since USA is one of the few that does not, it's a niche often overlooked in Canada as well.

 

I don't think there is another organization, army medics notwithstanding, that can prepare its volunteers nearly as well to transport critically ill patients out of dense crowds to a waiting ALS medic or physician, and also to change a dressing on a bed sore on a nursing home resident evacuated during a flood.

 

A good example of the unique role of the St. John volunteer could be seen a few weeks ago at Toronto's Caribana, where at any given time average St. Johners were changing beds in the medical tent, helping nurses start IVs, dressing wounds that had just been sutured, taking vitals, doing triage and paperwork, handing out bandaids and bottled water, helping ACP and CCP bike medics transport critically ill patients, assessing unresponsive people found incidentally, and responding to 911 calls in the thick of the parade.

 

Trying to compare against paramedics or EMT's isn't always fruitful because it's missing the greater point, and usually involves a lot of misunderstanding of what the differences actually are, including what exactly the average EMT-B actually learns and knows.

[Guest leviathan]

Hey, Elaine

 

There is in fact a Pathophysiology module and a Pharmacology module after you complete your BTS II exam. Still, the point stands that we do not have half the experience of an EMT-B because we are only working at stationary events. Also, the meetings are once a week, but for the training modules to which I've discussed, they are usually 6-9 hours each plus an average 50-100 page pre-reading accompanied by practical questions before you attend.

 

Take, for example, the O2 module I just recertified in. The pre-reading goes through the basic physiology behind breathing, the driving hypercapnic forces, the alternative theoretical hypoxic drive in COPD patients, all the info about flowrates, delivery devices, and then the majory respiratory problems we might encounter (asthma, copd, CHF and pulmonary edema, CO poisoning, pneumothoraxes)....then there is the training module which consists of applying our knowledge to scenarios as well as further training inside the class for placing OP airways and suction.

 

Now, just understand that I'm only defending my own credibility, not trying to compare myself to paramedics. After reading your post I can clearly see the difference. I'm in the process of taking the PCP course at the paramedic academy in BC so that I can work as a paramedic, anyhow. Maybe after I can tell you how much more I learned from where I am right now.