Above: QAS's Patient Transport Service officers Dan and Adrian.
Queensland Ambulance Service’s Patient Transport Service (PTS) officers describe themselves as our Health System’s “quiet achievers”, ferrying patients to and from our hospitals.
While their style may be a little calmer than that of our higher acuity teams, our Patient Transport Officers (PTOs) play a key role within the QAS and our health system, providing excellence in patient care and ensuring equity of access to health care for Queenslanders.
Our PTS teams are masters of scheduling logistics, factoring in patients’ needs, destinations, traffic jams and appointment times to ensure they receive the transport care they need.
Our PTS comprises around 250 on-road officers delivering a service to approximately 900 patients a day from Monday to Friday (less on weekends) across the state.
Behind the scenes in our Operation Centres is a team of professionals supporting our PTOs, comprising EMDs, Operation Centre Supervisors, Operations Supervisors and Managers.
These teams are responsible for managing all service requests, hospital and facility collaboration and the logistics to ensure our PTO teams can get their passengers to their appointments on time and their days run as smoothly as possible.
QAS Insight’s Caroline Page jumped into a passenger seat with one of the PTS crew for a shift.
Chermside Station’s Daniel Essex and Adrian Lockhart introduced themselves as my PTS crew for the day, which also happened to be their final day of working on road together over four months before taking on separate mentoring roles for new graduates.
We were on the “late shift”, so with coffee in hand, the radio was switched on at 9.30am, opening the gates to a flood of “pings” heralding our jobs for the day.
In between swigs of his coffee, Dan said he’d been with QAS for just over seven years, and after a few years of working as both an Emergency Medical Dispatcher (EMD) and graduate Advanced Care Paramedic (ACPII), he had taken on a PTO role, where he’s remained ever since.
“I wasn’t enjoying my work as a paramedic as much as I thought I would, so I moved into PTS to take a step back to figure out what I wanted to do next,” Dan said.
“It turned out I loved coming to work and I really, really enjoyed this role so I stuck with it.
“I just love spending time with our patients, getting to know them and being there for them.
“In our PTO roles we’re able to build relationships not only with our patients as we see many of them regularly, but also with the hospital staff too.”
Dan said their regular patients might include people receiving radiation or chemotherapy for cancer over a set period, or people needing dialysis who they’ll often see up to three times a week over many years, or for the rest of their lives.
The teams also transport patients as part of hospital transfers or for one-off appointments from their homes.
“The PTS dynamic is completely different to QAS’s higher acuity work, and the way we interact with our patients is quite different too,” Dan said.
“While we don’t carry the same medication and equipment as the higher acuity teams, we do respond to higher acuity jobs if we’re close by until other teams arrive.
“During our normal shifts, our patient care is based more on our social interactions; we try to ensure our passengers’ travel experiences are a bit more enjoyable and less stressful, as it can be quite daunting especially for those who are going to their first appointments.”
Dan was behind the wheel on our way to The Prince Charles Hospital for our first pick up while Adrian was in a passenger seat – he’d take over driving during the second part of the day.
Dan said the later shifts weren’t as easy to anticipate as the earlier morning starts.
The regular patients were usually transported earlier to ensure they reached their destinations in time for their appointments, and additional jobs came through as hospitals discharged patients during the day.
At 30 years old, Dan is one of the newer generations of PTOs and he said QAS pathways have changed over recent years.
“Traditionally, the older or longer-term ACPIIs or higher acuity staff have taken on PTS officer roles as they’ve moved towards the end of their careers – effectively allowing them to wind down a bit with their work and see out their retirement plans,” he said.
“But we have also had a lot of staff who have been working in PTS for decades – they discovered early on these roles are one of the QAS’s best kept secrets!”
The PTS fleet has varied seating and stretcher arrangements to cater for patients’ needs and abilities – some are more like a minibus with seats only, while others have a combination of seats and stretchers.
Dan and Adrian’s truck has seating and stretchers to cater for most peoples’ abilities and needs and could transport five to six people at a time.
Dan said these trucks also provide an opportunity for patients to chat – an often-unexpected treat for passengers, especially those experiencing some social isolation.
“We’ll have days when the same regular patients travel with us and while they might start out a little uncertainly, when they start discussing their conditions with each other and what they’re going through, they find they can relate to each other and then the chatter really gets going.
“You’ll hear them giving each other advice and encouragement and it’s quite heart-warming to hear them talking about what they’re going through with others who are in the same position.”
When we arrived at our first stop at Prince Charles, its Transit Lounge was bustling, but I later discovered this was normal – every public hospital we visited was the same.
The team was greeted with bright big smiles, not only from the nurses in the lounge, but also from their regular patients, family members or carers, and Adrian said it was always like this.
“The staff here are always happy to see us as we’re here to help lighten their load and get their patients home safely,” Adrian said.
A lady standing beside her elderly mum greeted the team with a huge smile like a big warm hug, and said she’d hoped to see them today and asked if they were travelling with us.
They weren’t, but while we waited, they enjoyed a chat and caught up on each other’s news.
Paperwork completed, Dan and Adrian met their next passengers including an elderly lady who was heading to a nursing home – her new home – for the first time.
She was clearly upset and anxious about this arrangement.
Adrian said these types of trips were often more challenging for PTOs and in this lady’s case, the team decided to take this lady separately straight away, so her anxiety wasn’t prolonged with any more waiting.
“These trips can be really difficult for patients, particularly if they’re confused or upset,” he said.
“We do assess each situation like this pretty carefully and, working the OpCen, alter our plans to match our patients’ needs and well-being, and it can be tricky as often we’ll have no verbal clues about how they might be feeling.
“We’re careful to create the right environment for them – usually a calm environment – we’ll never lie to them about where we’re going, but we’re also careful to not be explicit about taking them to a nursing home as we don’t want to distress them any further.”
In this case, the team had also spoken with their patients’ daughter in the Transit Lounge, and she would meet us at the nursing home to help her Mum settle in.
The crew took this lady to a nursing home close by, so it was a shorter, more subdued trip, but they ensured she was comfortable and took her to her room with warm words of assurance before heading to our next Transit Lounge.
The day progressed with the crew’s pick-ups shuttling between the Royal Brisbane and Women’s Hospital’s (RBWH) Transit Lounge and on to the Princess Alexandra Hospital’s.
One passenger we picked up after his treatment at a clinic was to be dropped home in the next suburb.
He could have been anywhere between 50 and 70 years old and spoke no English, but the team said he always smiled a lot, and would draw while he waited, often showing them his works afterwards, which were exceptional.
An elderly Indian lady we returned to the sanctuary of her nursing home room in Spring Hill insisted on giving us each a small bag of lollies she’d made especially for these occasions and a parting hug in thanks for the crew’s care.
Adrian, who had taken over behind the wheel with this stop, said this was a common response from their older more regular passengers who just wanted to show their appreciation for the crews’ care.
At another transit lounge, I watched Adrian and Dan look after our next passenger, a lady who’d wet herself while waiting for us.
Without any fuss, Adrian and Dan unobtrusively and with genuine respect and kindness, cleaned her and her chair up, ensuring she retained her dignity in front of the crowded room of people waiting for their own rides home.
If you hadn’t been closely following their interactions with her, you would never have known it had happened.
The patients these teams transported were not only the elderly – they’re of all ages, from all walks of life and abilities, many carrying with them complex health issues and co-morbidities.
Both crew members said they have observed their regular patients, many with co-morbidities which have snowballed over time.
Dan paused to greet a patient in passing at RBWH and said he hadn’t seen them for a little while but was glad to know they were still around… but this patient was looking really unwell.
I’d noticed while either Adrian and Dan were in the back with the patients, they had constantly been monitoring the air temperature and patients’ comfort during our travels.
“We have closed circuit cameras and alarms in the van to help us keep an eye on our patients, to help us make sure they’re safe and comfortable, and breathing well especially if there are any concerns,” Dan said.
The team said occupational violence was rare, but some patients, like those with dementia or cognitive impairments, could get easily confused and heightened.
It’s afternoon now and we’re crawling along the Bruce Highway headed north to Caboolture trying to meet a patient drop-off deadline.
Adrian is in his early 50s and moved into PTS as a graduate in late November last year after a highly successful 25-year career in the winemaking industry both in Australia and overseas.
Awarded 2001 Young Winemaker of the Year, Adrian said this award opened doors to further his career specialising in Shiraz and travelling around the world, eventually climbing the corporate ladder.
“I chose to pursue winemaking when I finished school as it was clear there was an oversupply of people entering nursing which was what I had also been interested in pursuing,” Adrian said.
“I never lost that interest in health, so when I started waking up in the morning with the realisation I wasn’t enjoying what I was doing anymore, I decided to seize the moment and make the change.
“I didn’t have children, so I had no excuse not to give it a try – I just had to get over myself – park my ego and find the courage to go back to uni. I’m so glad I did.”
Adrian had spent six months working in the Northern Rivers area in the New South Wales Ambulance’s graduate program before taking on a GPIP PTS pathway at QAS to fast-track his career towards an ACPII role.
“When I first got in, I thought this might be a little bit dull, it’ll be lacking the lights and sirens and all the excitement of a fast drive and the emergency aspect, and on reflection I can understand why people would think this,” Adrian said.
Adrian said he’s learned more than he ever thought he could about being a paramedic while working in PTS over the last seven months.
“From a non-technical perspective, I’ve learned about the way patients interact with the health system, to the extent of how fragile a big chunk of our community actually is, and it’s a consequence of the fact we’re living longer with more co-morbidities which is increasing our health system’s workload.
“We are all really only one significant event away from things becoming very challenging, and this experience has certainly made a lot more empathetic.”
“From a practical perspective, the PTS pathway gives you time to breathe, to hone your communications skills with patients and hospital staff, build relationships with staff - both hospital and QAS colleagues.
“You learn your way around a station and the vehicles, become familiar with using all our communications, stretchers and equipment, find your way around the hospitals too, all without the additional pressure of an emergency, so when you do step into higher acuity roles, you can concentrate more on your patient with the confidence you’ve got the basics under control.”
Dan partnered with Adrian four months ago as his mentor, introducing him to the role and the pair have also managed to perfect their stable of daggy one-liners and karaoke skills to bring a smile to their passengers’ faces.
“When you pick up a patient you want to leave them in better condition than when you found them and sometimes that might take music, or humour, or just being calm and quiet and you have to gauge that with each person,” Adrian said.
“We do spend a lot of our time laughing and usually at ourselves which makes life lighter for us too.
“Sometimes we will have palliative patients heading home for the last time to spend time with their family and pass away, so we will try to make their trip a little more pleasant and special for them.
“Overall, we aim to bring a little joy to all of our patients, perhaps crack a terrible joke or two which they quite enjoy, and they will often tell us it’s their best social outing of the week.
These sentiments were echoed when the van came alive with banter and laughs on our way to our second last stop for the day returning a younger person and their carer home where their much-loved pooch was waiting for them.
But what is it these two crew members love most about their PTS roles?
Dan said outside their day-to-day work which he loves, he was also passionate about mentoring graduates in the PTS pathway.
“It’s a privilege to be able to mentor people in this industry and give them a positive start and it’s important to me even if things don’t go perfectly every day – as we all make mistakes and it’s often how we learn,” Dan said.
Adrian also echoed the importance of mentors and their role in helping graduates build strong foundations for their futures.
“At the end of the day, every patient has their own unique story and why they’re here,” Adrian said.
“They don’t need an opinion, but they often need an advocate, and for a very short time, Dan and I have that privilege to be that person for them, to make sure we understand as much about them as we can to ensure the best transfer of care for them.
“You always learn something from every single patient, there’s always something you learn along the way every day and invariably, you’ll learn something about yourself at the same time – it’s a beautiful exchange.”
SEQ PTS’s Director Drew Peters said the PTS was a vital cog not only in QAS’s, but also within the broader health system’s wheels.
“We connect many vulnerable people, often through multiple transports a week to their essential appointments, on a regular basis.
“Additionally, the teams also assist the hospitals and health system with discharges freeing up much-needed beds”.
“This is achieved by our very dedicated team of Patient Transport Officers, EMDs and Supervisors who, day in and day out, advocate for our patients, collaborate with the health system and, most importantly, care for our patients.
“I’m really proud of what our teams consistently achieve for our community, and I agree with our description – we are the quiet achievers of QAS.”
