Hi, I am Nikki, and I am a Paramedic in an NHS Trust in the UK.
Working in pre-hospital emergency care, I meet a variety of service users, many of whom experience communication and/or learning difficulties or disabilities. In medical practice, the first and most important rule of patient care is INFORMED CONSENT. This means that before any treatment or assessment takes place, the clinician must explain what will happen, verify understanding and seek consent from the service user. With persons who do not have English as a first language, the Ambulance Service have an on-call interpretation line.
What struck me was that in the ambulance service there is no provision for communicating with people with learning and/or communication difficulties – a whole demographic being unable to speak for themselves whilst having full capacity to make their own decisions.
I formalised my Makaton qualifications by completing all 4 levels throughout the summer/autumn of 2020. In discussion with attendees on the various courses, and of course, my amazing tutor and Makaton Ambassador, Nic Pike, it quickly became apparent that this lack of communication provision in pre-hospital care was being experienced across the country.
I wrote directly to the CEO of my Ambulance Service Trust, highlighting this huge gap in our service. I was delighted when he immediately replied to me in full support of my idea and put me in touch with the Equality and Diversity lead for the Trust. I put together a full business proposal for the implementation of Makaton across the Trust and secured funding to realise this dream.
My trust sponsored me to undertake my Makaton Tutor Training course in May of this year and I am currently awaiting the outcome to find out if I have successfully passed all elements of the course. Once I am successfully qualified as a Tutor, I will be tasked with providing training to all frontline emergency staff to enable them to provide a fully inclusive service to ALL demographics.
The Makaton language program is unlimited and impartial – I have successfully used Makaton signs and symbols to communicate with people who are deaf, elderly persons who are hard of hearing, patients with dementia and patients recovering from Strokes – Makaton can be used in all kinds of environments.
There is one supported accommodation that I go to where the only form of communication used is Makaton. The first time I visited and communicated directly to the service user, the staff were stunned that I could use Makaton – they had become so used to being the “voice” and for the service user becoming frustrated at not being able to communicate their needs to the ambulance staff.
Having an ambulance crew turn up is unnerving as it is, without the added anxiety of not being able to understand or communicate. In addition, there is a dedicated unit in my locality where BSL is used – when I visit, I explain that I can use Makaton, and as Makaton is derived from BSL I am then able to communicate with the BSL users directly. In the ambulance itself, there is a whiteboard where I can draw Makaton symbols to show a “now and next” format for what will happen – used in conjunction with signing and the Healthcare cards I keep on a lanyard, I have found that the service users appear calmer and at ease with the situation due to these simple but effective communication aids.
These are just a few examples of the many times that I have implemented Makaton signs and symbols in the pre-hospital environment – there are so many more! It is such a powerful and versatile communication program.
With communication, dignity and respect being the foundations of pre-hospital care, it seems to me that the utilization of the Makaton communication program in pre-hospital care will enable so many people to speak for themselves where they have previously not had a voice. My Makaton journey has been and continues to be so rewarding. I am excited for myself, for my Trust and for the service users who will benefit from this addition to pre-hospital care!