Interview: Tim de Jonge, Medical Manager for the Netherlands at Bristow
Tim de Jonge, winchman, technical crew instructor and paramedic, talks to Jon Adams about his varied international career and the knowledge, experience and training required for his work
You have a been working in the healthcare sector for over 20 years, what attracted you to the profession?
My parents always pushed me into the direction of helping others, to be open to assist other people and listen out for other people’s needs. I started on the beach when I was 13–14 years old, helping out the local lifeguards, becoming a junior lifeguard. I then progressed into a full lifeguard. That’s where the caring for others really started, and at 46 years old, I still volunteer on the beach; it’s something I still really love doing.
When I was 18 years old, I joined the Navy for eight years and, during that time, I got the opportunity to be a winchman / rescue swimmer, where not only life-saving skills but also the combination of first aid and advanced third aid was given to the casualties that we received. The official healthcare processes started to get more interesting and after a flying career over five years, I joined the ambulance services as an emergency medical technician (EMT) to learn and develop myself more into healthcare services.
How did you get interested in search and rescue and heli-ops, and what do you love about it?
I love the not knowing where you are going to be 15 minutes from now, the unexpected, and needing to adapt – having 20 plans in your head ready to go but only needing to follow up on one or two once you arrive. Helping others with the need to improvise and utilize all your skills and knowledge is something that that really attracts me.
I also like being active and working on the line; that’s what gives me the satisfaction of the job. It’s really great to do and every day you’ll be challenged. No mission is the same, nothing is routine, so although you regularly train for it, every mission has its little hiccoughs or challenges that you need to overcome. The role I like the most is being a winchman, just being the person on the wire doing the medical interventions, having the responsibility but being able to adapt to the situation from one minute to the next.
As well as being a winchman and paramedic, you are also an instructor. How does your active hands-on experience translate into being an educator who teaches other people? Do you have any tips for teaching and engaging with your students?
Teaching in an airborne environment is always a trial because you have so many things that you need to think and care about. Luckily, most of the people that we teach are either emergency services personnel that already work with us, or specialist groups of people that have a devotion for care; this helps because they are all really enthusiastic about the job. They take safety as a very high priority, which makes it always easier to work with and to train them. One of the things I always try to do is to level myself to the students, I try to understand what the student needs. For one student it can be crew resource management or communication that they struggle with, for another student could be a key skillset. You need to adapt, find out where the specific needs are for the students and how to actually get them to the next level.
Working across mountain, coastal and maritime environments each has their own requirements and challenges, do you prepare differently for each situation? And what stays the same regardless?
You need to dress for the situation, and you need to dress to survive. Carry the right kit for the job. You don’t want to end up in your immersion suits on a hot day in the middle of the mountains.
If you take the example of being in April in a high rocky mountain or you go out into the Atlantic, you’ll need to dress to survive by wearing your warm clothing on that emergency. However, if you subsequently go onto flat land, it’ll be much hotter so you’ll have to balance your need to change your outfits quite quickly. Always look at the weather and consider the environment you’ll be working in. Check your gear, check your lights, and make sure you always have a spare kit with you so you don’t end up somewhere completely wet and unable to carry out an activity.
I like being active and working on the line; that’s what gives me the satisfaction of the job
Do the aircraft you operate from also need special equipment for each topography?
All the search and rescue aircraft we operate in the Netherlands have the same equipment, such as forward-looking infrared, dual hoists and terrain warning systems. So, it doesn’t matter if you’re flying an aircraft in the north or south, or any coastal or maritime environment, the specifications of the aircraft will be the same. Across all our Government Services operations, Bristow maximizes the safety of crews by giving them the right tools for the job; for instance, avalanche bleepers for winter operations in the mountains or an airdropped, deployable life raft for offshore situations.
Do you have any particular methods for retaining information, because you are trained on a lot of different gear, in a lot of different environments, across a lot of different emergency situations? What is your process for remembering everything?
The process is repetition, having to repeat the checks that you do, but Bristow ensures we remain properly trained and experienced. We are line checked every year to ensure that we can demonstrate that we have the knowledge. We need to do certain currency flights every 60 or 90 days and we train for medical emergencies every 30 or 45 days. So you are always training. If you’re operating more in the maritime environment than a mountainous environment, your skillset will adapt slightly more to the maritime environment. When you do go back to the mountains, you need to be really strict with yourself to be able to regain and update your knowledge, when necessary. But again Bristow ensures we’ve got the resources to do this with yearly CLE courses, special winter survival courses, swift-water rescue courses and wind turbine assessments; all those courses are repeated for our daily work.
We all also have a really strict attitude for working with certain items, that makes it easier to do your checks. As aircrew, you’re always doing the same checks of your equipment, always the same startup procedures. And, of course, if you need to adapt, then you are able to do it easily because your experience gives you the ability to alter for the best outcome.
Do you have a designated set of equipment prepared for loading onto the aircraft depending on the type of call out or do you just take everything with you?
The medical equipment is always onboard the aircraft since you never know which type of medical emergency you’ll be facing, but we also have a ‘ready rack’ where we store certain items for specialist missions. So you can also say, 'Okay, we’re now going into a mountainous area, so we don’t need our deployable life raft.' You can leave the raft at the base, but it will be set on the ready rack in case you need to go out to sea. On most of the ready racks we have a salvage pump, so if you have a vessel that’s taking on water, you’re able to deliver the salvage pump by hoist to the vessel. Hopefully not only saving lives but also saving the vessel and actually preventing an environmental disaster. It’s not always only about rescuing people, it’s also sometimes about the broader spectrum that Bristow does.
Do you find the different aircraft suit different situations better than others, and in what ways?
Most recently, I've worked on four types of aircraft: the Westland Lynx, the Sikorsky S-61, the Sikorsky S-92 and the AugustaWestland AW189. The most recent are with the AW189 and the S-92. The S-92 is a stable, robust aircraft. It’s really great in the mountains because of its stability and can carry large groups with a lot of kit. The AW189 allows for great situational awareness for the rear crew, if you’re working on a casualty, you only have to glance up and you know exactly where you are because there are large windows and direct access to the cockpit.
Check your gear, check your lights, and make sure you always have a spare kit on you
What is the most challenging aspect of being a winchman/paramedic/instructor?
What I found the most challenging was becoming a Bachelor in Nursing. I started my Bachelor’s studies when I was 26–27 years old; I was also just starting a young family but I got encouraged by some of my senior nurses and EMTs that they thought I had the capacity to excel myself. Going through that with a full-time job and starting family was tremendous challenge, juggling all the responsibilities and trying to learn so much, but now I have a Bachelor’s degree and it’s something I’m proud of.
What is the most important lesson you think our readers could learn?
I think the most important lesson is to never accept ‘no’ or accept that your skills are fading. The moment you start accepting that things are fading or that you’re lacking knowledge, then you’re not going to push yourself to the next limit. So, challenge yourself. It’s important and one of the things I would always try to push for my students; I try to challenge them and always try to push them to the next level so they’re on the highest level that they can be at their age and experience.
Always try to push to the next level
What is on the horizon for you or your work with Bristow?
I’ve actually just been working on a brand-new position. I’m now the Medical Manager for the Netherlands contract. I am already a Netherlands registered nurse and UK registered paramedic, but the next thing I’m going to obtain is the Netherlands ambulance nurse registration. So, I need to go back to school and do some courses and training to be on the same level as the ambulance services or an ambulance nurse; it’ll be a combination of hands-on and academic learning. The good thing is that it’s like a crossover because the skillset of a Dutch ambulance nurse and a UK paramedic are roughly be the same. The healthcare system in the Netherlands is set up with a core of nursing, then you go on to specialize in certain areas before you advance to becoming an ambulance nurse, whereas in the UK, you need to have a basic training as an EMT and then progress into a paramedic, a critical care paramedic or even a Bachelor of Biomedicine. So I’ll be adapting to procedures from different countries, but also learning some background that I might have.
May 2023
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Jon Adams
Jon is the Senior Editor of AirMed&Rescue. He was previously Editor for Clinical Medicine and Future Healthcare Journal at the Royal College of Physicians before coming to AirMed&Rescue in November 2022. His favorite helicopter is the Army Air Corps Lynx that he saw his father fly while growing up on Army bases.