Early hospital ambulances often had a medically untrained driver – at Whāngārei Hospital the first motor ambulance was driven by the gardener. When the St John ambulances began, crew got first aid training. This helped them to deal with some life-threatening situations such as haemorrhage or breathing difficulties, and to make patients more comfortable and calm.
A sickening sight
In the 1960s morphine was often administered by ambulance officers for pain relief, but it could cause nausea. One officer recalled a journey where a patient was vomiting copiously. The ambulance screeched to a halt outside a church just as the congregation was coming out, and the driver emptied the brimming sick bowl into the gutter. The vehicle then sped away, having put a few people off their Sunday lunch.
Until the 1960s, however, pre-hospital treatment by ambulance staff was basic by today’s standards. One volunteer recalled, ‘En-route treatment of the patient relied heavily on ample reassurance, some oxygen, a few bandages, splints and very little else. Patients who were already suffering from shock, in some cases deteriorated considerably during the course of the trip.’1
A national training school
In the mid-1970s there was strong public criticism of the uneven standard of ambulance services in New Zealand. Brigades were under strain because of new demands, including a rising road-accident rate. Proceeds from the first national telethon in 1975, held in aid of St John Ambulance, were used to set up the National Ambulance Officers’ Training School in Auckland in 1978. The school had its government funding cut drastically in the 1980s, affecting the extent and quality of its programmes. It closed in 1999.
The new focus on ambulance services did however lead to an upgrading of ambulance vehicles and equipment during the 1970s and 1980s, often as a result of fundraising by community service groups such as Rotary and Lions clubs.
Training in the 2000s
Since 1999 New Zealand Qualifications Authority-approved training of ambulance officers has been carried out regionally in private training institutions. St John Ambulance and Wellington Free Ambulance provide training for their members, from pre-hospital emergency care (the basic qualification) up to paramedic level. Advanced paramedic training is gained through a Bachelor of Health Science (Paramedic), offered at the Auckland University of Technology and Whitireia Community Polytechnic in Wellington. All these qualifications involve extensive practical training and experience.
Advanced paramedics are qualified to administer a range of pain relief and cardiac drugs. They are also skilled in resuscitation methods, including intubation (inserting tubes into a patient’s airways to assist breathing). In 2008 there were approximately 200 advanced life-support paramedics in New Zealand – about 6% of ambulance staff. This is much lower than many other countries, where around half the ambulance workforce has advanced paramedic training.