The Australasian College of Paramedicine
The Australasian College of Paramedicine
Kerbside Conversations: Jessica Wissa
Welcome to Kerbside Conversations – the College’s podcast capturing authentic voices and stories from across the world of paramedicine.
In this conversation, Jessica Wissa, a critical care paramedic from Metro Brisbane, shares her experiences working in both urban and rural settings. She discusses the unique challenges faced in rural emergency services, including limited resources and the need for community engagement. Jessica highlights the importance of developing skills such as leadership and communication, which are essential for effective patient management in isolated areas. The conversation also touches on the lighter side of paramedic life, including guilty pleasures during night shifts.
Laura Hirello:Alright, so why don't you tell me what your name is, where you're from, and what your current primary role is.
Jessica Wissa: Cool. So, my name is Jessica Wissa. I'm a critical care paramedic in Metro Brisbane. I mainly work out of Metro South, so I work for Woodridge or Logan District.
Laura Hirello: And so you're critical care, but like on road, like on. Rather than the flight, I feel like we mostly hear from flight.
Jessica Wissa: Yes. No, so I'm an on road critical care paramedic. So yeah, definitely started, I guess my career obviously as advanced care paramedic working out in the bayside. I did a lot of work on the bay islands, so like Macleay, Russell Island and a few of those. And then yeah, eventually got onto the internship and then became a critical care paramedic and then been on road since.
Laura Hirello: And the islands are quite rural?
Jessica Wissa: Yes, in regards to like resourcing and accessibility, definitely. Yes, so you've either got a ferry to interchange between getting from the island to mainland and definitely distance I guess via that to a tertiary hospital is at least a good maybe hour and a half to two hours and then obviously for those really critical patients you're looking at flight to get anywhere on those islands. They maybe have one GP clinic with maybe one to two doctors on site and maybe a nurse. Some of those islands don't have any medical resources like you've got Lamb and Coochiemudlow who may have just maybe a nurse but otherwise no medical resourcing so everything then sort of has to come either come from mainland or they have to be taken to the mainland to get that. Again, when it comes even to other emergency services, it's very limited with resourcing, so all the firies and emergency services are mainly volunteers as well.
Laura Hirello: And so sorry, did you start like at the very beginning of your career in those remote areas or did you work a little more?
Jessica Wissa: I worked maybe my first grad year in metro, in Bayside, and then once I qualified, I started working immediately.
Laura Hirello: What was the most sort of shocking or surprising thing about making that transition? Because I would imagine it would be just a huge change.
Jessica Wissa: Yes, it was not having backup or in a reasonable time. So for example, there was one patient that I went to that was sort of a domestic situation that needed QPS support and everything like that and in the metro area that can generally happen very quickly. There's no sort of delay to care and everything. With this situation I had to wait for mainland QPS to come along. So it took about an hour before we were able to sort of even get to the patient to then help treat them and manage them. So very isolating. It takes a long time to get anything and to be able to treat or manage anything.
Laura Hirello: And so like how does that change that sort of like knowing that essentially you're it for the next hour, two hours, whatever. How does that change sort of how you do things or how you assess patients or how you think about sort of next steps for patients?
Jessica Wissa: Yeah, so now you've got to think five, six steps ahead. So now it's not just the getting there and just managing really quickly and then getting them to the hospital. It's like, okay, what resourcing am I going to need? How early do I need to get in contact with those resources? Because I know it's going to take a long time. And then it's looking at how I'm going to manage that patient. So with this intervention, do I do it right now or do I wait a little bit because of how long I'm going to be with that patient? Like for example pain relief, how am I going to give it, how much am I going to give it, you know, you tend to maybe be a lot more aggressive in a metro area where you've got shorter distances to hospital, but for example I know now that I'm going be with this patient for maybe two hours, so I'm going to spread it out or you know just give it differently, so even down to things like that, it takes a lot of management and planning to think about those things.
Laura Hirello:And do you feel like there were skills that you learned in that rural area that maybe you wouldn't have gotten as fast in the metro area?
Jessica Wissa: 100%. 100%. So, being in that rural area you learn, I guess, how to do everything on your own. Obviously here we work definitely in teams and everything but learning how to work on your own, the people on the island, in those rural areas everyone's very connected and you know if for example your car gets stuck you know there's John down the road that we all call because he's going to be the one that's going to pull the car out of the yeah the road and it's like entrusting then the community as well for help and support in those things everybody knows each other everyone wants to help so that's very good. But yeah, it's learning how to use different things and different people. Whereas before, you never let anybody from the community hand. We can do it, we'll do it ourselves. But it's, guess, allowing other people in and learning how to, guess, teach the community how to give us a hand as well, in a safe way.
Laura Hirello: I love that. I love that sort of, yeah, being in these sort of small isolated places with limited resources forces you to really rely on the community that's around you to get everything done.
Jessica Wissa: Absolutely, yes. And you build these relationships with community members, plus then if there is a doctor or other allied health on scene, you build a really close relationship with them. And a lot of the time you end up integrating with them with regards to how we're gonna manage those more chronic patients. So instead of taking this person on to mainland every time they have something, it might be called to the GP who by the way lives on the island and is available to call 24 hours a day and happy to. So maybe giving them a call and making a joint decision on how we're going to manage that person, and whether or not they can stay here. Is there something else that we can do for them while we're here? The doctor might even come to the patient while I'm there. And we work really well with those of our allied health, a lot more in those rural areas than we would in mainland.
Laura Hirello:And do you feel like those skills helped you when you sort of transitioned into critical care?
Jessica Wissa: Absolutely. So, learning to work by myself was really good and then also it helped with that leadership. Yeah it really helped with that. So being able to, like I said, using the community members and things like that, it helped me develop my leadership skills, my communication skills, working with the allied health really closely again helped with that sort of leadership perspective as well. It probably was the biggest thing that it helped.
Laura Hirello: Yeah, that totally makes sense. I never thought about the leadership side of it, but yeah, sort of like learning how to sort of step back and be like, here's what I need. And now I have to find a way to get it from the people.
Jessica Wissa: Exactly and changing how I communicate between different people. People that might understand some medical stuff, people that don't as well and being able to change how I speak and communicate to those different people but still manage the scene and manage the patient.
Laura Hirello: Even judging other people's capacity for help of like what I think they'll be able to handle versus like what might be too much.
Jessica Wissa: Exactly, Obviously, you know, 80 year old Beryl who's come to give us a hand is not going to be helping us carry the patient down, you know, the stairs or anything like that versus, you know, the 20 year old tradie that's awesome.
Laura Hirello: But you know that Beryl knows everybody.
Jessica Wissa: She definitely knows everybody. She probably knows where they were born and everything.
Laura Hirello: Can give you a full history.
Jessica Wissa: Absolutely.
Laura Hirello: Yes. that's great. Well, thank you so much for chatting with me today. I have one final question, unrelated to Urban vs. Rural. What is your guilty pleasure on night shifts, either on the shift or after the shift, to make you feel just a little bit more human?
Jessica Wissa: Definitely a hash brown.
Laura Hirello: Okay, at any particular time?
Jessica Wissa: After 2 p.m. No, after, sorry, 2 a.m. After 2 a.m. calories don't count, hash brown it is.
Laura Hirello: Sounds great. Thank you so much and enjoy the conference.
Jessica Wissa: Thank you for inviting me.