Tuesday 12 June 2012

The Collapse

Yesterday I read a blog by Inspector Gadget titled 'The Collapse of the ambulance service'. As I read it, I nodded along and to be fair I couldn't argue with a lot of what was said. It sang very true. However, as it was written by a policeman, it very much looked at the issues from the police view point. And why wouldn't it!? Like everything though, there are multiple sides to an argument and different perspectives to be had. If you asked ten different bloggers to blog about the same subject you'd have ten completely different blogs at the end, all with their own personal slant and identity. I could have easily written a post called 'The Collapse of the police service' but instead I will just say my thoughts on the issues highlighted from the ambulance point of view.

I can't disagree with anything that was said. I have experienced police waiting for ages and ages for an ambulance, often with patients that do need us. Working in a city, the distances travelled are smaller than that in 'Ruralshire', but it is all relative. We may not cover three counties, but the higher call volume has the same effect on resources. At busy times, rather than travelling 2 miles we are travelling 7, and at the times of day when we are needed the most there always appears to be less units available. The government's cuts ARE killing the ambulance service, not necessarily from cutting numbers of front line staff directly, but by limiting the opportunity to employ new staff and a huge void is being left by the dozens and dozens of staff leaving each month. As a consequence, the shortfall results in a reliance on private ambulance services and volunteer community responders to help fill the gap. At busy times it does feel like we are on the verge of collapse. Calls being held for hours, general broadcasts asking for crews to help with waiting jobs, messages asking for staff to work on, offers of overtime every day of the week; it's never ending. Yet the work we are doing still seems the same; time wasters, drunks, sniffs and colds and *cough cough* police jobs.

Yes, whilst the police are frustrated with being called to 'perceived risks' because a patient at an address once had a knife 3 years ago, or an occupant once looked at a crew funny, we also have our frustrations. I can see their point, a lot of the flagged addresses need reviewing, but at the end of the day we are not equipped to deal with the risks that may or may not be there. We have no training in dealing with situations which turn sour, unless you count a half day course in conflict resolution. We also have no means of personal protection; no CS spray, asp, Taser etc, and no legal means of restraint. We also don't have the back up in sheer resources the police seem to have. It's a running joke that when we request police for an assault the 'no units available' on the previous job turns into 4 cars and a meat wagon for the most innocuous of jobs. But who am I to say what resources should and shouldn't be allocated? I'm always grateful, but is there now an expectation that ambulance crews should put themselves more at risk to save police resources?! I know the Daily Mail think we should! A crew was recently maligned because a patient died whilst they were waiting for police. If I get a message saying 'patient is violent' I will not go in without police. If the police take an hour to arrive, so be it.

We do call the police routinely for a number of jobs like domestic violence and assaults, but shouldn't that be the case?! They sound like jobs that police should be doing. It is crime after all! How about all the ambulances the police call for chest pains in custody, cuts and bruises post arrest and a variety of other calls where someone with a 'first aid at work' certificate could deal with it? Do these require an ambulance from an already stretched service? Yes, because no one wants the blame when the shit hits the fan. That's why the police rely on us and why we rely on them. If we get attacked because the police didn't show up the finger will be pointed and if someone dies because we don't show, the same finger is pointed. There have been times where I have waited hours for a police response. 'No units to send' is the answer we get, and it is the same answer we give them when all our ambulance crews are queued up at the hospital because there are no beds to offload our patients on to. Starting to see the chain? Hospital full, ambulances tied up waiting to offload, police tied up on jobs waiting for ambulances, ambulances stuck on jobs waiting for the police who are waiting for an ambulance, basically everyone is stuck and no one will budge, because we won't do the other one's job and can't! 

Maybe this is why police and ambulance have that 'special relationship' I have discussed before. There is a mutual respect for the jobs we are doing; we are sharing the same frustrations and the same difficulties, day in, day out, with no end in sight. Inspector Gadget calls it 'The Collapse of the ambulance service', I say it's 'The Collapse of the emergency services'. Well, the 2 that count anyway. While police are fighting crime and bitching about the ambulance control room, and while we are saving lives and bitching about police control room, the fire brigade are pumping iron, practicing "getting onto the truck the quickest" & having well paid second jobs. When they do wake from their slumber, they go on mass (25 fireman) to rescue a seagull from a pond. Yes, that happened, read this! Nothing will ever change; under the current government purse strings will only be pulled tighter, and no matter what government is in charge the police and ambulance service will both continue to cover their own arses whilst being run ragged! To quote Mother Teresa:
"We the willing, led by the unknowing, are doing the impossible for the ungrateful. We have done so much, with so little, for so long, we are now qualified to do anything, with nothing."
A sentiment that rings true for all of us. On a serious note though, if you can get shares in ‘Bluelight services’, then do so now. If I earned decent money, I would!

17 comments:

  1. Just a thought regarding call volume: I get frustrated the most by the home care services in this country. The 2 classics are "no lift policy" which, when asked for, they cannot produce or the business hours-only warden system that abdicates its duty of care to the ambulance service after-hours yet pays no fee to us for doing their job of looking after their residents. Please be clear: this is not aimed at the elderly we see, but the profit making "care" sector and their negligent families.

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    1. Very very true! I'm currently writing a blog about that!

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  2. It is quite frightening how the emergency services are now at the brink of collapse from just sheer expectations measured against cut, cuts and more cuts. I have a looming sense of dread about what event/s may be upcoming that will mean it all explodes (implodes?) around them and us.
    Awww I'm still however quite sad there wasn't a hunky hot fireman pic on this Ella, letting the side down... *takes cover*

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  3. How long till we see a joint Fire-EMS system?

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    1. I hope we don't, it isn't needed, to much expense merging the 2 for little saving. In quiet areas of the country it might work but not the cities!

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  4. Not wholly related but thought you'd like to read this link http://www.bbc.co.uk/news/uk-england-18243232 £5000 PER DAY! What could your service do with that?! Total FAIL!

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    1. I saw that article! It just beggars belief!

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  5. Surely by waiting an hour or more for Police to attend your call is crazy? I appreciate that they are busy & may not always have a unit to attend, but to sit around the corner from the address, doing nothing, isn't helping the shortage of ambulance issues.

    I give it 15 mins, call EOC and request if there are no immediate units to send, then cancel me off that call & reassign another ambulance once the police have a unit to send.

    Just a thought.

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    1. We don't make the decisions! I always ask for ETAs at regular intervals and many a time have suggested re-sending an ambulance once police arrive but once you are assigned as on scene on the job they won't take you off it. The most frustrating thing is a lot of these jobs have been requested by the police in the first instance! They shouldn't call us until they know we are needed. Likewise, it works the other way around but like Inspector Gadget said, once we are one scene police use us as a call triage and visa versa!

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  6. We (my crisis team) once did a visit to a person who was not psychotic but extremely violent, who had thrown a punch at one of the two nurses who were visiting and ripped a windscreen wiper off the car as the two nurses made their escape. They phoned me in the office to report the incident, but because the spouse was still in the home address we had to phone the police. The police told us that the situation was "too dangerous" for them to send a riot van or indeed any officers to, and demanded that the nurses "resumed their duty of care" and returned to the address. When the spouse phoned them they sent out 4 officers straight away.
    In another incident I've seen a person held down, handcuffed and dragged into a van (to the point of sustaining a fracture) by about 6 officers because they had told oneof us to "fuck off". Massive variants in response...

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    1. Like everything, be it hospital nurse, crisis team, ambulance or people, treatment will always vary on WHO you get. It's a shame but it will never change. There are good eggs and bad eggs in every profession.

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    2. Very true that...

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  7. We just have to hope that somewhere in the midst of this apparent collapse, someone has the bright idea to stop sending us to the timewasters that are the cause of it in the first place!

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