EBME Forums Forums Free discussion Free discussion Extinction or Evolution?

It’s been obvious for years that every in-house biomed shop should have an equipment trainer on the team. In smaller hospitals, this person could be a tech willing and able to perform the training function for (perhaps) half of the time. But, what about funding? Surely it can be easily shown that such an approach should save money (eg, less equipment down-time, fewer call-outs etc.)?

Richard’s right, the training has to be structured, documented and repeated (over and over). And the trainer himself (herself) must be trained to train, and have both the aptitude and attitude required to successfully carry out the task (as always, in fact).

But what about treading on the toes of nurse trainers? Well, if they’re doing a good job already, fair enough. If not, push them aside (as it were). Perhaps I really mean, be proactive – it’s the future of the department that’s at stake, after all.

Come to think of it, this could give a new lease of life (last gasp, more like) for me and my old-timer buddies! After all, most of us did the Arborfield "Methods of Instruction" course (good enough, surely?). Remember … "demonstrate, pause, nominate"! You know where to find us.

I think there's a vacancy just up your street at Pennine Acute Healthcare NHS Trust, in Manchester, Geoff.

Band 6 - Medical Devices Manager.

It will involve developing and maintaining policy, equipment and training databases (EMAT as far as I'm aware), also governance and clinical training issues. Incident reporting, liaison with regulatory people and stuff like that, I believe.

If you go to www.pat.nhs.uk and click on the job opportunities (16th April) you'll find it in the pdf that pops up.

What we need is someone who's a "database guru". We're still waiting for EMAT to be installed on our site after about 2 years but I guess after this post is filled it will be installed very quickly indeed by the "expert" that's appointed.

No doubt there is someone out there just made for the job, who's been waiting for this sort of opportunity for a while.

Just up Joe Emmerson's street I would have thought, if he wasn't already in a plum-job!

No doubt some lucky chap (or chap-ess) will be able to cruise to retirement in that one, eh Richard? But it’s hardly likely to be me, is it? What do you think I am, Mate ... some sort of drone?

As I’ve probably inferred before, I don’t really see myself on the staff of the NHS. My inclination is more toward the freelance, consultancy, one-off special task (and dare I say it, entrepreneurial) style of working, preferring to get on and do something useful, rather than wasting time with endless politics. If anybody needs help from me, my contact details are well known.

But why the long delay in installing a decent database system? Why not get it done straight away? And, yes, I reckon that Joe is already sitting in clover!

I think that we will be required in a more hands on roll. i.e. The ebme tech in the future will be expected to deliver training, assist setting up equipment with the clinical users, and investigate mishaps. I think managers will be expected to procure equipment with clinical involvement, rather than the way most places do it at present, clinical users often buying kit with insufficient input from ebme. Will equipment eventually be maintenance free? I believe it will reach that stage. I was on a vent training course last week and the equipment can do some very high tech clinical stuff but i could train my 15 yr old son to do a PM inspection in 20 mins. Manufacturers don't want big service teams, hospitals don't want big service teams - we need to adapt to our changing environment. Some depts are now employing nurses rather than technicians to carry out the training role.

Nicely summed up, John. But I would say that biomed techs have always being doing all the things you mention! You could be right about "maintenance free" – just look at the service intervals on modern motor cars. But whether "monkey see, monkey do" or not, we (monkeys?) are still going to be needed to carry out PM (in whatever form it takes) when it eventually becomes due. Not to mention carrying out repairs (or at the very least, arranging repairs), as we may be assured that users will continue to accidentally drop, misuse, or even abuse the equipment we all love so much!

Better change that "Be Proactive and Reactive" motto to "Adapt and Survive", I reckon. It was ever thus.

But here’s a question for you. Who makes the best trainer, the equipment-trained nurse (lab-tech, radiographer etc.), or the nursing-trained tech?

In my humble opinion, the "best" trainer is someone with a technical background, who has also some degree of clinical knowledge and preferably has teaching experience.
Such a person understands how a device works, can explain this and relate it to clinical practice in a succinct and clear manner.
If there is a lack of knowledge or skill in any one of the three areas then that person will not be fully effective.

Geoff, I have to agree with Kawasaki.

I think a tech with in-depth knowledge of the kit will be able to 'drive' the equipment better than a nurse...

and will therefore make a better 'driving instructor' but would require some clinical knowledge of the equipment to interact and understand the needs of the medical staff.

Unfortunately it doesn’t matter who does the training or how often it is repeated, I still keep meeting existing members of staff, new staff and bank staff who haven’t had training on the equipment they are using.

Lee

Just as an example of the sort of training that may be required how should the issue of clinical alarms be dealt with? If there are excessive alarms is it a clinical or technical issue - who should advise on setting of vigilance alarms.

If asked by a nurse what alarm limits should be set up on a multiparmeter monitor connected to a patient or whether latching/non-latching alarms should be configured (and for which parameters) what would your advice be?

Another example - for electrosurgery, if asked for optimum settings for a particular type of surgery, using a particular model of device, what would your advice be? Would you advise on the optimum placement of a dispersive plate, if asked by a newly qualified nurse or ODP in theatre, for example?

Where's the line between technical advice & support and clinical training?

I would say that all three examples are clinical issues, Richard. I for one would not feel comfortable advising on any of them. I could give opinions only, but have found in the past that it's best not even to offer those, as they can be taken by a nurse as "gospel". Sometimes, there's a lot to be said for not saying a lot!

Where's the line? It's in cases where you're trained and paid to do it!