Friday 27 July 2012

Sick Note

"Four weeks off sick....for medics"

This was the headline that The Sun decided to go with today. Simple and to the point! Us 'medics' have  four weeks off sick each year (on average). How dare we?!
"AMBULANCE staff averaged more than FOUR WEEKS’ sick leave each last year, shock statistics revealed yesterday. 
The figure of 22.6 days is FIVE TIMES the norm for UK workers.
In all 405,000 days were lost among 17,922 qualified staff, NHS Information Centre data shows. 
East Midlands Ambulance Service had the highest sickness rate of all with 6.73 per cent of working hours lost. 
NHS sources said many paramedics took time off for stress after being forced to deal with traumatic incidents.
Jonathan Fox of the ambulance workers’ union said they faced soaring call-outs and a pay freeze. He added: “It’s a culture of take, take with very little understanding.”
Overall, NHS staff were ill for 15.56million days — an average of 15 days each. That far exceeds the 4.5 days national average.
Hospital doctors took the fewest sickies — an average of 4.2 days. 
The Health Department wants to cut sick days by a third by March to save £555million a year."
by Emily Ashton, Journalist

Dear Emily Ashton

What an insightful, well researched,  utterly pointless article! Would it not be an idea to ask WHY?! WHY is our sick leave five times the national average? WHY are we going off with stress? These SHOCKING statistics about the NASTY NHS workers must mean we are a bunch of lazy money grabbers surely? Why else publish the article? I wonder what kind of hours you, the writer of this scholary article, work? I wonder what you see on a day-to-day basis? I wonder what physical exertion your body is put through? I wonder how many night shifts you do? I wonder how many times you have been punched, kicked, spat at, beaten, sworn at, vomited over and pissed on? I wonder how many dead babies you have held in the last 12 months?

Guess what Emily Ashton; in the past 12 months I have had almost 11 weeks off work! Write about that. Write about how naughty I am. Write about how I am a scourge on the NHS budget. Write about what a SHOCKING amount of time off this really is! I must add though, when you do, can you also write about the guy who beat me and four 999 colleagues over the head with a fence post? Make sure you highlight how many bones were broken. In fact, while you are on that subject, why not write about every single member of the NHS who has had time off after being physically assaulted by the drunken taxpayer. They do pay our wages after all eh?!

Once you have finished writing about the broken bones and abuse, why not write a little paragraph about shift work?

Why not tell everyone about the 12 hour shifts we do? Why not discuss the changing from early shifts to night shifts, every single week? Why not talk about 70-80 hour weeks we do? Why not talk about doing all of those shifts without a break or a hot meal? Then if you could highlight that we do all of those hours around SICK PEOPLE! Yes, people sometimes call ambulances because they are ill. They have infections, contagious diseases; they cough, vomit, and they spit. Why not talk about the NHS workers who have been off sick after being exposed to HIV blood? Wouldn't that stress you out?

Talking of stress, why not write a list of what we all see on a day to day basis? Would this not affect you?:

  • Seeing a dead 7 year old in a bath
  • Delivering a full term dead baby
  • Delivering a 21 week old foetus
  • Trying to resuscitate an 18 year old who'd fallen 4 storeys
  • Seeing a family of 4 dead in a car
  • Seeing our elderly neglected
  • Losing count of the number of dead bodies you've seen
  • Seeing bones sticking out of limbs
  • Watching a teenager bleed to dead after being stabbed.
  • Finding a desperate soul hanging in front of you.
Would any of this keep you awake at night? Would it stress you out? Maybe not, maybe you're thick skinned. 

I thought I had you there! How about after a 70 hour week, with little sleep, holding a dead baby and being assaulted at least once, you would also then be expected to carry a 30 stone patient down the stairs, oh and wait, there are some stairs to go up too?! Now carry all 10 patients for that one shift, whilst tired, having not eaten, having not had a break? Had enough yet? No? Good because luckily you only have half a day off and then you are back on, for an early shift, after a run of five 12 hour nights.

I think only 4 weeks off is a bloody miracle. Sure, there are a few who take the piss and abuse the system, but there are people in every walk of life that do that. I bet there are even people going around calling themselves journalists.....write about that scandal. Perhaps instead of berating us for the SHOCKING amount of sick leave, you should look at why and write an article about THAT instead. Maybe the Department of Health should look at your findings on that, before trying to cut sick leave by a third. Oh, one more thing, we do all of the above for less than £10 an hour. Living the dream.

Lots of love, from your biggest fan

Ella x

Monday 16 July 2012

A Quick Fix

"67 year old female, Asthma attack"

I like asthma attacks. It is one of the few jobs where our actions can cure someone in front of our eyes. I've been to people who are a few minutes away from death and after a few drugs, a hope and a prayer, they are sat up talking to you. Most of the jobs we do we never see the results, or hear the outcome, and that can be really frustrating, so it is refreshing to see the fruits of our labour.

We got the job in the middle of the night and after a short run we arrived on scene at the same time as the FRU. We piled into the tiny lift and went to the 8th floor. As we entered the flat I could hear the wheeze! Never a good sign! Our patient was sitting on the edge of the bed really struggling for breath so we gave her a nebuliser straight away. She was a lovely lady, apologising for wasting our times in between gasped breaths! It always amazes me how the elderly feel they don't deserve an ambulance when they are in fact the most deserving. The nebuliser worked well and she was soon talking in full sentences. Job well done! We gave her a full MOT and suggested a trip to hospital would be wise but she refused. Our concern was that her symptoms would return and she'd need to call us back:

"Did you use your inhaler when this all started?"

"I tried but it didn't work. It's new but doesn't give any spray"

She had one of the new types of pump, no canister to squeeze down in the traditional way, just a mouthpiece to breathe through. When you inhale it delivers the required dose of spray. Simple! I asked to have a look at it. She opened her drawer and passed me the brand new looking inhaler. I opened it up to see if the canister was full. It was. I manually squeezed it to see if it was working. It was.

"You do know that there is nothing to squeeze now don' t you?!"

"Yes, I read the instructions and did what it said"

"Can you show me what you were trying, we'll see if we can get it working"

"OK, i'll give it a go"

She put the inhaler in her mouth and took a deep breath in. Nothing!


"You're holding it upside down, try it the other way up"

"AM I!!"

I said, while chuckling away!

She turned it around, exhaled slightly and took a deep breathe in. The all telling sound of the spray was audible to all. Her face lit up with excitement!

"Well I never! You mean it wasn't working because I was holding it upside down? I'm so sorry for wasting your time. That's how I have always held it. The other style works that way."

I assured her that it wasn't a waste of our time and it was an absolute pleasure to help. It is worrying though, how ill someone can get from not knowing how to use their medication. The doctor or pharmacist should really ensure it is being used properly. I see similar cases far too often when patients who speak little english simply don't take their medication because they don't understand when they are supposed to. Luckily today, we were there in a timely fashion and were able to solve the mystery of the upside down inhaler!

Sunday 15 July 2012

24 - Part 3


The following takes place between 2am and 7am (ish)


"6 month old male, crying, difficulty in breathing"

The fatigue had well and truly kicked in. Unfortunately we had agreed to swap over half way through the shift so at my most tired, I was now behind the wheel of a 3.5 tonne ambulance. Awkward! Within 3 seconds of greening up for the next job, we got the next job! Off we went; the roads now were pretty empty, which although makes the drive easier,  means there are less distractions to keep you awake. I opened the window, turned the volume up and sat bolt upright whilst I drove. My eyes were fixed on the road ahead, but I could feel my rate of blinking increasing. Focusing became harder and my eyes were feeling so heavy. Pleased to still be in one piece, but with no memory of the journey, we pulled up outside a rather lavish property. 

Inside was our patient, crying. No difficulty in breathing, just crying. He had been crying for an hour apparently. He also had a cold. He had had calpol. He was just crying. It wasn't a teary crying, just a grouchy wimper. It was more the noise that I make when I'm awake and don't want to be or I'm hungry. Now I was driving, I didn't really have to talk to people, which was a good thing as I was suffering from 'grumpy driver syndrome'!
'Grumpy Driver Syndrome: A condition that effects the driver of an ambulance. Symptoms include increased irritability, decrease in levels of patience and overwhelming feelings that no patient deserves an ambulance. In severe cases the driver is best to be left well alone and avoid eye contact'
All that was going though my head was IT'S A BABY. IT CRIES. DEAL WITH IT AND DON'T CALL 999. Rules are rules though and all under 2's go to hospital. The dad followed us to hospital in the CAR! The car by the way, was a Porsche Cayenne. Why that is important, I don't know, it just added to my annoyance. The drive to hospital was no better than the journey to the job. My eyes were getting heavier and heavier, this was the most tired I had ever been. Not  a nice feeling.


"68 year old male, chest pain"

Having dropped the 'cryer' and the doting parents to A & E we sat there sipping the watered down Maxwell House hospital coffee. It wasn't pleasant but I needed caffeine to snap me out of the 3am lull. I even took some ProPlus in the hope I'd get some energy. Nope. Not a chance. In the 7 minutes spare we had, I dozed off, woken only by the screeching of the MDT sending us off on yet another magical mystery tour. My eyes were bloodshot and the thought of having to drive 3.4 miles filled me with dread. Yet again, we made it! I think the concentration I was having to use to stay awake was making me more tired, but I had no choice. At least we were greeted by the sight of an FRU as we pulled into the road. We headed in, I was a good 4 or 5 steps behind as I didn't have the energy to lift my weary feet off the floor. 

What I didn't need was that smell of urine again. It hit me as I walked through the door and I gagged. The patient was in the kitchen chatting away to the FRU. He was basically a lonely old man and just wanted someone to talk to. He was complaining of a 6 month history of intermittent chest pain but 3am seemed like the pefect time to call us. If it was 2pm and I was attending I would have been full of the joys of spring. I love talking to old people and listening to their stories but now, at 03:31, all I could think about was a) how tired I was and b) how the hell I was going to wake up enough to drive to hospital. We were on scene for ages, the guy kept changing his mind about whether or not to go and once it was decided he was going, there was the task of collecting everything he wanted to take with him. I sat in the front, starring through the windscreen watching the first rays of light fill the air, waiting to be told that my crew mate was ready to go.


"Ready when you are!"

Off we went. This 2 mile drive would bother me for hours and days to come. It made me evaluate what exactly I was doing. Was all this worth it? Was this the job for me? As I drove I could feel my eyes shutting. I was fighting it so hard. I started hallucinating; seeing buses and lorries that were not there, seeing things that would make me brake but when I re-focused they were nowhere to be seen. It terrified me, but what could I do? Call control and say, 'sorry I'm too tired for this'. Would this count as going off sick? Would I be reprimanded for it? Probably. If I had a crash it would be my fault. Yes! I am the driver, it is my responsibility. It doesn't matter if I have been awake for almost 22 hours. It doesn't matter that I have been working 9 and a half hours without a break. That's the job. Isn't it? Maybe if the advert had read:
'Work up to 80 hours a week on a night heavy, debilitating shift pattern with no rest breaks & late finishes which causes you physical and mental ill heath, crippling insomnia and fatigue beyond your wildest dreams for less money than a bin man. On successful completion of your training you will be rewarded with a divorce and have no relationships with anyone outside of work and no social life. You'll ferry people around while getting verbally abused, kicked, punched and spat at. Not allowed to go off sick.'
I would have thought twice about it. Please please please remind me why I love my job?!

We got to hospital and I headed straight for the toilet, I splashed cold water on my face and then drank 2 more cups of coffee. By the time I emerged back outside it was light again. I could feel the glaze over my eyes. One more job. One more job. One more job. The finish line was in sight!


"45 year old female, kidney pain"

Luckily the address given was only half a mile away. Even I could do that drive without too much hassle. We pulled onto the estate and hunted for the block. Unsurprisingly it was the only block without the block name on it and we only found it by matters of deduction. Inside was our patient, lying on the sofa, 6 or 7 family members flocking around her. She didn't speak any english. 

"What's the problem?"

"She has bad pain in her kidneys" her son replied. 

"How long for?"

"3 days"

"Has she seen the GP?"


"Has she taken any pain killers?"


The questioning continued like this for a few minutes. I did her OB's while my crew mate played the translation game. Basically, in summation, she had been ill for a few days, not done anything about it and now her first port of call was an ambulance. We would play taxi and take her to hospital where she would be given antibiotics and sent back home. And that is exactly what we did. 


Having arrived at hospital and handed over the patient we now had 27 minutes to wait until we could go back to station. As we hadn't been given a break, we basically take it at the end of our shift and leave 'early'. I cleaned up the back of the ambulance, got all the bags ready at the back door and then waited until 06:30 and drove back.


Having battled through the rush hour traffic we made it back on station. I was slightly more awake but not much. My crew mate drove back for me as I didn't feel safe to do so. I signed the drugs back in, put my stuff back in my locker and signed out at 07:15. 45 minutes late off.


Clamber into bed. Another day, another dollar; done.

OK, so that was a random day as it happened. I still had 4 more night shifts to come. As a member of the public, how happy would you be knowing that I could have been driving your loved one at 4am? I wouldn't be happy but what would you suggest? I am not alone, every single night there are crews fighting fatigue and exhaustion and they do so under the guise of 'it's the job'. The fatigue aside, this shift highlighted so many problems this country has. It showed the uphill battle the NHS is facing and the consequences the cuts are having. We go from patient to patient all night, forget and move onto the next. We move from one problem to the other having just passed it on to someone else. If I hadn't written down every job I had done, by the time I had woken up the following morning I would have forgotten most of the people I had met and most of the problems I came across. Even writing this now, I can't recall any of their names, not even the mother of the dead baby I held at 19:00. I bet that as you are reading this now, you had forgotten about that too.

Saturday 14 July 2012

24 - Part 2


The following takes place between 10pm and 2am


"76 year old male, fall, lying on floor, confused"

The yawning had begun. Not a good sign so early on! After a couple of cancellations we were dispatched to this job, another night, another fall. The sheer amount of jobs likes this highlights the ever increasing difficulty with caring for the elderly and what a social problem providing the necessary care is becoming. We pulled up outside and our patient's wife was waiting at the door. The usual unnecessary apologies for wasting our time were offered, as were the usual assurances that there was nothing to be sorry for. The smell of urine was so so strong. The house was filthy; our patient was filthy. The smell of a UTI is extremely distinctive, the smell of a UTI with the heating on is enough to make you gag. The smell of a UTI with the heating on and infected leg ulcers is where we were at! It's the kind of smell that gets in your throat and makes your eyes water. It is so difficult to ignore it but I don't like to show  how physically sick I feel. 

Our patient had slipped off his chair onto the floor. His ulcers were dressed in thick dressings and he was unable to sit up, let alone stand. There were no injuries so we helped him up to standing, then back into his chair. Unsurprisingly, he refused hospital but due do his confusion, inability to cope and numerous infections we entered into the grey area of capacity. After a frank conversation with him and his wife I deemed him not to have capacity to refuse but was taking him to hospital against his will the best option? Probably not. The pathways available to us look at what is the least restrictive option and it is a battle between what you want to happen, what the patient wants to happen and what is best for the patient. In this instance a referral to the GP and a home visit was the best we could do. He had a hospital appointment the following day for which transport was arranged so I was happy to pass him into the care of the GP. Yes, it's partly an arse covering exercise but when patients don't heed our advice we have to. 

It is very sad to see our elderly generation living in these conditions. They owned their own home, so as such were not entitled to free care. Despite both paying taxes for 50 years they were left to pay for their own care. Because of this they didn't have any. No carers, no cleaners, nothing. I'd love David Cameron to have been with us on this shift. See how he would deal with a dead baby, a mental health patient with no treatment and a pensioner living in squalor. Would he still think the NHS cuts are a good thing? We are left sat in the truck at 11pm filling out a vulnerable adult form for social services eternally frustrated at seeing our ageing population chucked on the scrap head.


"40 year old female, chest pain"

The second I pressed the button we got another job. The call was 45 minutes old which for a chest pain means the service is being run ragged already. When we entered the house of the last job it was still light. Now it was pitch black outside; the glare of headlights, break lights and street lights was going to be the view for the next 6 hours or so. The job was 9 miles away which at this time of night is about a 15 minute drive. Driving on blue lights has its dangers; you are often going faster than the speed limit, on the wrong side of the road, through red lights  and doing lots of overtaking. You also have to factor in the erratic behaviour of other motorists. A long drive can be quite stressful and there is nothing more frustrating to arrive on scene after a long drive through traffic to find it's been a complete waste of time. Eventually we pulled up outside the address. The smell of burning brakes was lush (that's the petrol head talking)! I grabbed the bags and headed up to the front door. Knock knock. Nothing. Knock knock. Nothing. Knock knock. A light comes on. A guy opens the door:

"You're late"

"Sorry, it's very busy tonight, we only just got the job"

"It's not good enough, she has gone to hospital in a taxi"

"OK, did you tell the ambulance service you no longer needed an ambulance?"

"Nope, it's not my job"

"Well we have just driven a long way to get here, we could have been going to someone else who needs us"

"That's not my fucking problem, you should have come when we called"

With that he slammed the door in my face. Joy! Another happy customer. I detest the ignorance and attitudes of people like that. They think their little problems are more important than anyone else's'Gone before arrival' on the paperwork and off to the next one.


"38 year old male, unknown problem" 

With no other information to go on we headed back to the area we had just come from 9 miles away. It's controls game of ambulance dot to dot. I'd love to see what our shifts journey looks like on a map. It's probably the outline of a middle finger! Half way to the address we got an update:
'38 year old male, uncertain of what is going on and feels very angry and violent, history of schizophrenia, calm now but could kick off at any time, NHSD believes patient needs to be in a safe environment, wait for police before entering premises'
Interesting! We were no clearer about what exactly is wrong and what exactly we are supposed to do. It is the middle of the night, as far as mental health services are concerned it's A & E or nothing. This should be fun. We parked up at the top of the road and waited for police. After 20 minutes we got a message from the police. 
'No units to send'
So we waited, and waited, and waited some more.

'Unit assigned, ETA 15 minutes, please ensure your unit is on scene as we are very busy' 
Eventually the police arrived and en mass we knocked on the door. The patient's mother let us in and pointed us in the direction of the living room. Our patient was sat on the sofa, calm as anything.

"What's the problem today?"

"I don't want to go to work"

"What do you mean?"

"They say that I have to go to Jobcentre Plus tomorrow to get a job"

"And why don't you want to do that?"

"Because I shouldn't have to work? I've been on benefits for 20 years and now they say I'm well enough to work so won't give me my benefits what I'm entitled to. They can't just make me work like that"

"What have you called an ambulance for? What do you expect us to do?"

"Tell them I can't work"

"We can't do that. That is between you, your GP and the Jobcentre"

At this point the wound up copper took over. She lectured him about the inappropriate use of emergency services, told him not to call again and told him that we were not all here to help him get out of working. If only we could get away with lecturing people like that. We all bundled out again, exchanged call signs and they left us doing paperwork. 

I hate people who abuse the benefits system. Benefits are there for people who physically CAN'T work or who have fallen on bad times. They are NOT there to live a life on without making the slightest effort or earning an honest living. It is people like this who have put the country in the mess it is in. This guy had mental health problems, there is no doubt about that, but has had treatment for that and deemed able to work. He is no longer medicated, he no longer attends any therapy and is not physically incapable of work. He doesn't want to work. THAT is the crux of the matter, and why doesn't he? Because he has never had to work before. He's lived his entire life on the taxpayer's money. Newsflash sunshine, I don't WANT to work. I do because I HAVE to, to pay bills, support my child and do what I want to do. GET A JOB!!

click to continue......

Friday 13 July 2012


What is a typical day? What is a typical night? I suppose there is no 'typical' but I thought rather than write about one job, or list the jobs I did in a day, or even talk about how I was feeling at a particular time of day, or what my feelings were on a particular issue, I would attempt to blog a day of my life. Write the entire day from eyes open to eyes shut with everything in the middle. I chose the first night shift of a run of 4.

The following takes place between the hours of 7am and 10pm


Precisely 3 hours and 54 minutes after getting into bed, I'm awake again. I glare at my clock with utter disgust. Why am I awake so early before my night shift starts?! It's the same every time, I'm now going to be awake for at least 24 hours and that is not a happy thought. The day drifts by, most of it spent procrastinating and promising myself I will do tomorrow what I couldn't be bothered to do today. It's the same promise I make to myself everyday, yet I am forever lacking the motivation to do the simplest of tasks! Before I know it the impending night shift is looming and I have to start getting ready.


Shower, iron uniform, eat dinner and pack the leftovers away to eat in the middle of the night. This pre-night routine is all too familiar and I know that the middle of the night will come and I will not want to eat the leftovers. At 18:15 I get dressed and leave the house for the short drive to work.


I pull into the car park, switch off the engine and sit there, in my car for about 30 seconds. Do I really have to go and do this?! I enter the garage, I check my pigeon-hole, I sign in, I get my bags out of my locker and throw them on an ambulance. Time for the first coffee! No sign of a crew mate so I take my 'too hot to drink coffee' onto the ambulance and start checking it over. I check the response bags, cupboards, gases, make the bed, refold the blankets and start the paperwork. Still no sign of crew mate! I check the headlights, break lights, blue lights and tyres, then I sign my drugs out.


Crew mate arrives, I have never met them before, but I am unimpressed they have arrived so 'late'. OK, they were not late but it is poor ambulance etiquette. Everyone comes in early so as to get the vehicle ready for the imminent job the second your shift starts. Sure enough...


"38 year old female, 18/40 pregnant, abdo pain, bleeding PV"

This could go one of two ways, it could be just a bit of abdo pain and a trip to hospital or it could be horrific and a trip to hospital. Being the first job of the shift, most of the journey was consumed with me filling in various forms and getting the PRF started for the job we were on. We had a real struggle finding the address; it was a new build on a new road so the sat nav nor the map book was showing where it was. We called control and asked for them to get more location information. Eventually a teenager came running out of a side road up ahead waving frantically. He waved and beckoned until we had parked. He then came running over and told us to hurry as 'it's an emergency'. Emergency or not, we do not like being told to hurry up, though given the presenting complaint and his age, I let him off and followed behind.

We were ushered through to the bedroom where our patient was lying alone on the bed. She looked understandably worried and there was an ominous amount of blood on the sheets. She was 17+5 weeks pregnant and had suffered a sudden onset of abdominal pain which was coming and going. 17 weeks is sadly not considered a 'viable' pregnancy (there is that word again) so consequently this involves a trip to A & E for her, not maternity. Her OBs were fine and she wanted to walk, so after grabbing her bag we started moving to the ambulance. She stopped suddenly, bracing herself on the wall: 

"The pain is back, I feel like I need to push"

My crew mate ran off for the maternity pack while I ushered her into the bathroom. She sat on the edge of the bath, crying:

"I need to push"

She slid to the floor and pushed. Through groans of pain and floods of tears, and whilst holding my hand, she delivered.

I placed the foetus in one of our vomit bowls and wrapped the bowl in an incontinence pad. How horrible does that sound? It was all we have. I couldn't leave a 6 inch foetus on the floor, it just seemed like the right thing to do. We got the trolley bed inside the house and got the Mum onto it. She answered my questions with nodding and shaking her head. She was consumed with grief. I didn't know what to say. We drove to hospital; myself on one chair, her on the bed and the small bowl on the chair next to me. We arrived at A & E, transferred her over and I wandered off to book her in. My crew mate cleaned the bed, made the bed and made the coffees. 

It is these jobs I struggle with; it is one of the sights I struggle to get out of my head, and the rush of negative emotions are hard to deal with. Working with someone you have never met before makes it harder to talk though these jobs, instead it just sits with you for the rest of the shift. Sadly, I can't dwell; time to press the button for the next job. My 15 minutes are up.


"34 year old male, thinks he is about to have a fit"

We get quite a lot of these jobs. Epileptic patients often know when they are going to have a seizure and call us first. More often than not there is no seizure and we just take them to hospital; occasionally there is a seizure. Today, there was no epilepsy! We pulled up outside the address to the welcome sight of the FRU! Inside the building the medic on scene came and met us in the corridor.

"This is just plain weird. He's crying at the moment but doesn't know why. He says he thinks he has epilepsy and diabetes but has never had a seizure or seen a GP about it. He also says he had a heart attack three weeks ago but has no medication. There are clearly some mental health problems but he says he has amnesia. It's all a bit odd to be honest"

We entered the flat, the smell of alcohol hit us. Our patient was lying on the bed, kind of crying but not. He was very hard to engage with and just reeled of symptom after symptom. He had a headache, nausea, back pain, chest pain, abdo pain, leg pain and shortness of breath. In fact, he had everything we asked him about from urinary symptoms to photophobia. His pain was 10/10 yet when we suggested coming to the ambulance he just got up and walked with no obvious discomfort or reduced mobility. Once on the ambulance there was no change; he declined any pain relief and didn't want an ECG. It transpired he had already had an ambulance earlier in the day. He had been taken to hospital and had self-discharged from the waiting room after an hour of waiting. I don't know what he expected would be different this time around, but all we could do was convey and hope he stayed.

At the hospital a handover was given to the nurse who yet again, sent him to the waiting room. I booked him in and returned to the cab. Within 5 minutes, he emerged from the main entrance of the hospital and wandered off up the road. Another worthwhile use of an ambulance. It's so frustrating to see. There is nothing you can do or say. I know the hospital are busy, but surely a guy who has already absconded and who is clearly suffering mental health problems should be seen before being chucked back to the waiting room. I have no doubt he'll be back in another ambulance very soon. Anyway, no time to worry about the inevitable drain on resources. More lives to save......

Thursday 12 July 2012

Cold and Clinical

"86 year old male, cardiac arrest, CPR in progress"

There it is again. That itch of excitement. The sense of urgency that has been dissipated through every time-waster I have seen, yet bursts back to life when the words 'cardiac arrest' appear on the screen. The term cardiac arrest for all intent and purposes means dead. The heart isn't beating in any discernible rhythm; breathing has stopped and the brain is being starved of oxygen. Without intervention that is how it will stay. With intervention, that is probably how it will stay, but there is hope, hence us! We sped out of the garage and started the daily battle with rush hour traffic. Only 3 miles to go but on a bumper-to-bumper dual-carriageway that takes some negotiating. We pulled into the road and at the end was another ambulance. That would make things easier! We parked up, grabbed suction, some spare oxygen and a few other bits that the second crew traditionally bring in and headed over to the house.

In the hallway there were a number of people, most of whom were in tears. The emotion at a resus when the family are present is something I often find hard to deal with. The patient's wife was standing in the doorway to the bedroom, tears running down her cheek; there were a few neighbours there for support and one of their children had arrived. It was a sombre feeling walking past them; I could feel the all too familiar eyes of expectation bearing down on us. I was first through the bedroom door, lying on the bed was the patient, he was lifeless, eyes open and fixed on the ceiling, hands in a half closed position and a pale purple tone to his skin. I looked at the crew who were standing beside him and one of them just shook their head. It was a telling a shake. There would be no resus, this patient would remain dead. 

"You can leave it with us if you like"

We exchanged call signs, picked up our stuff and left. On the way out I exchanged sympathetic smiles with the relatives; the fact we were leaving told them all they needed to know. Our colleagues explained what had happened, why we were not bouncing up and down on their loved one's chest and what would happen next. We got in the cab and filled out our paperwork.
'On arrival crew on scene, pt. laying prone on bed. 0 heart sounds, 0 resp. effort, heavily cyanosed, postmortem staining present, asystole, crew left on scene dealing, see their PRF for full pt. details'
Seems a bit clinical doesn't it? I wrote it and read it back and realised that we had just walked in on a dead person, looked at him, spoken to the crew and left. Seeing a dead person is a huge thing for most people; I suppose we take it for granted. I hope the family didn't think it was insensitive that we just walked in and out. There was nothing for us to do, a recognition of life extinct form would be filled out by the other crew and police would arrive as it was an unexpected death. I think where possible we distance ourselves from all emotion, it's what enables us to go off and carry on our shift. It maybe seemed as cold and clinical but sometimes it has to be. I just sat here thinking about all the cardiac arrests I have done since I started this job. I can only remember one name; most of you will know the job that was from. As for the rest of them, I haven't got a clue. As for this guy I'm writing about, I couldn't begin to tell you. Is that bad?! 

Wednesday 11 July 2012

If you don't mind!

Hello one and all!

Firstly, a massive thank you for the continued support, kind words and lovely comments you all give me. I really can't thank you enough! 

Now, to the point......

I have recently been told by a few people that they have nominated me for a Digital Media awards through Mind charity's upcoming Media Awards. As you know I have a keen interest in mental health so the fact that some people felt my writing was worthy of a nomination was touching.

There are a number of categories in the awards, the one that I am eligible for is the Mark Hanson Digital Media Award.  If you have the time or inclination to nominate me, please please do! All entries must be received by midnight on Friday the 13th July so please hurry!!

To nominate me, click the link below. Write your nomination in the box at the bottom of the page titled 'Digital Media' saying why you think I deserve it and include a link to a post you like. Below is a list of mental health blogs I have done which you can copy and paste into the nomination. 

Mental Health Blogs:

Pass the Donkey
Mental Health in an Ambulance
Snap out of it
No serious, leave it with us
The Irony in Crisis
OCD, Tree & GPs
Mental Health: No ones responsibility
I'm up against many many great writers, authors and journalists so it's unlikely i'll win but it's so nice to be mentioned!

Thanks again, really appreciate every single one of you

Ella xx

Just like a taxi

"47 year old male, fainted"

To most people, a '47 year old male, fainted' would mean exactly that. A 47 year old male who had fainted. A faint, or what we call syncope or a transient loss of consciousness, can have a number of causes. They vary from prolonged standing and hot environments to sudden standing and anxiety. A faint can last from a few seconds to a few minutes. This guy hadn't fainted, that I was sure of before we had even started driving. Next to the address was 'O/S' which means outside. In the text about the faint it said 'lying on grass' and it was 11:30pm. It was also called by the infamous 'passer-by' who shockingly was no longer on scene. In my experience, 47 year old men don't faint at night on grass! The 'fall' onto grass due to excess alcohol! 

Sure enough, sat on the wall with an FRU was our patient, heavily intoxicated. There had been no 'faint' just a stumble into a bush! He was drunk but still able to walk with a little assistance and able to answer the ll questions asked to him. He didn't know where he was so after checking him over we agreed to take him home as long as there was someone else there. He told us he lived with his parents and that they were in. The guy was quite rude and dismissive but I didn't think the hospital would appreciate his presence and I didn't want to be responsible for letting him try and find his own way home drunk. As much as we are NOT a taxi, this seemed the simplest option and would prevent a hospital visit and more ambulances called by the lovely, caring passers-by. 

We headed off for his home address while I was doing the paperwork. Whilst I wrote and asked questions he was starring around the back of the ambulance and started chuckling.

"If you look at it, this is just like a mini-cab that I don't have to pay for isn't it?" *laughs*

I stopped writing, my head remained totally still and my eyes raised up slowly from my clipboard and fixated on his grinning face. In my most sarcastic of voices I replied:

"Yes, we are JUST like a mini-cab" 

He laughed again...

"So is this all you do all night long?"

"Yes, pretty much" *biting tongue*

"Seems like a waste of money, is that what my tax goes on?" *laughs*

"Yes, it is a complete was of time, money and resources" 

The irony of the conversation was, sadly, completely lost on him. I looked back down at my clipboard and asked for the phone number of his next of kin. He chucked his phone onto the bed and told me it was under 'mum'. I pressed the green 'phone' button to turn the screen on and it brought up his list of recently dialled numbers. At the top of the list... 999.

"So you phoned the ambulance?"


"So you did know where you are?"


At that moment, the back door swung open, we had arrived; he got up and staggered out.

"This isn't my road"

"Yes it is"

"No it isn't"

"Yes it is"

"No it's..."

The front door of the house we were parked outside opened. It was his dad. 

"Oh... it is my house"

He staggered off down the garden path, into the front door and straight past his parents, who obviously wanted to know why there was an ambulance outside.

"Your son is drunk, he phoned an ambulance and lied so he could get a lift home, so here we are, bringing him home"

Pleasantries were exchanged, apologies were given and feeling cheated and disgruntled we left. I suppose we could have taken him to hospital, but to what end? Waste their time for a while and cost more money? We could have left him where he was but if we had and he had been hit by a car, who would have been blamed?! What can we do?! How can we get around this?! We didn't know he was the caller, we didn't know that he knew where he was, we didn't know he was playing us until it was too late. We can't charge him. We can't report him to anyone. Seriously, what can we do?! People joke about us being a big yellow taxi but we are! Clearly! Call 999 when you're drunk and you'll get a lift home. It makes me so angry but what can I do or say? Nothing.

Tuesday 10 July 2012

Medics should be seen but not heard

"Bunch of primadonnas acting like spoilt brats"

Doing the job I do, I get the opportunity to work an various different types of events for a number of different companies. Most recently I worked at Wembley for the England international match against Holland. Being a new stadium and one with a huge capacity, as expected it has excellent medical facilities. There is a mini hosiptal which has minors, majors, a resus, x-ray facilities and everything else you would expect from a hospital. There are doctors, nurses, consultants, radiographers, paramedics, EMT's and first aiders enabling it to be a self contained fully functioning hospital. Due to beaurocricy however it is not run by just one company. Wembley Medical staff the hosiptal, but they do not have the contract to take patients to hospital. This is done by another contractor who provides 3 ambulances and staff to man them. On top of this London Ambulance Service have to provide staff incase there is a major incident as neither of the other ones have the resources to cope. The problem is the 3 companies don't work in harmony. The whole operation can't go ahead without LAS presence, Wembley Medical don't welcome LAS and the transport are treated like a sub species by Wembley Medical. It does make for some interesting interactions which I have seen first hand from all sides, having firmly stuck my fingers in all the pies going! On this particular occasion I was working for the company contracted to transport the patients to hospital.

Each company has their own priorities regarding patient care. Up to 90,000 people cram into the stadium and all have the right to treatment free of charge. The NHS does still exist at the moment! There are mobile medical teams, first aid points on every levels and skill mix of staff to deal with everything. Once in the hospital they are treated for their illness or injuries and either discharged or taken to an NHS hospital by one of the ambulances. Unfortunately it appears only certain facilities are available to the paying public. If a precautionary x-ray is needed, rather than have it done on site by the radiographer the public will be sent to join the queues at the local hospital. X-ray is reserved for footballers only. If a patient is ill enough to be in the resus room they can only go in there if all 3 beds are empty. Resus is reserved for players only, they need privacy afterall. If a patient dies, the priority isn't to work on them and save them. Oh no. It's to get them off site as quick as possible because, and I quote:

"It's not good for PR if someone dies at Wembley, imagine the headlines!"

Forget about the fact that 'stay and play' is sometimes the best thing to do, we've got an image to protect. That's what's important right?!

When I said there are 3 ambulances, that isn't entirely true either. There are 3 vehicles but only one is for the public. It's the old one. There is a slightly newer one that can be used as a spare ambulance in case the players need 2, but they would rather it wasn't used. Then, there is the brand new ambulance. That is only for the players should they need it. And if they do, these are the instructions we have.
  • Don't talk to them
  • Don't speak unless you are spoken to.
  • Don't ask them questions
  • Don't ask for autographs
  • Don't take photos
  • Do whatever they want, no matter how unreasonable you think it is. They are the priority over anyone else. They get what they want.
Since when did these overpaid, untalented ADHD kids become royalty. Since when do they get to dictate and affect the treatment of the public? We were basically told, 'you are their bitch'. Why are we even there then? I understand the rules about photos and autographs, that wouldn't be professional, but 'don't speak unless you are spoken too'? I'm not a petulant child from the 1950's. I'm here to provide medical care to anyone who needs it regardless of social status or ability to do kick-ups. 

Another example of the needless pampering arose when I was bringing a patient from somewhere in the stadium to the hospital. The lady had a head injury from a fall, albeit a minor one. She wasn't well enough to walk so she was in a chair. As you can imagine Wembley is huge. The hospital is in the underbelly of the stadium. To access it there is an internal road over 1km in length that goes around the entire circumference of the pitch, just outside of public view. We were within 100ft of the hospital and were stopped my security. 

"Sorry, this way is now closed, there may be players by the coaches"

"We are going to the hospital with our patient"

"You'll have to go the other way, we can't have people getting near the players"

Fifteen minutes laters we reached the hospital. I simply do not understand the power these players have. The fact that Wembley Medical seem willing to allow this nonsense goes a long way to explaining. I understand that the players should be left alone by staff, we are not their to verbally abuse John Terry (as much as I'd love to) but if a paramedic and an EMT are wheeling a patient with an obvious, actively bleeding head injury to hospital, how can it be right, or medically responsible to make us walk 1km around the entire stadium just incase we get to near a precious footballer?! Can you imagine the headlines if she, or any other patient, died whilst going the long way round?! Probably not because 'it's not good PR if someone dies at Wembley'

The world has become obsessed with the celebrity culture. These 'role models' that are paid in excess of £100,000 a week (or 5 years wages as I like to call it) to kick a ball around. They are pandered to and yet there are no penalties or changes to their lives for drink driving, racism, violence & sexual assaults. Even on the rare occasion where they go to prison they come straight out back into their highly paid  privileged lifestyle. If the layman commits those crimes the fines and punishments effect them. If I was found guilty of racial abuse the £2500 alone would be a real struggle to pay. I would lose my job and would struggle to find another. If John Terry is found guilty of racism (which I suspect he will be) the fine imposed will be 2 hours 38 minutes wages, he will remain employed on £170,000 a week and will release some kind of sugarcoated statement to appease the masses. No doubt he will still represent our country as a convicted racist. What message does this send out to the youth?! 

The only reason the footballers and celebrities act like they can tread on anyone and do what they want when they want is because our society allows it and panders to it. Until a stand is made nothing will change and we can't really blame anyone but ourselves. I for one will not be working at Wembley again while that Mickey Mouse outfit is running things. 

(Unless of course, I'm offered double pay... slave to the wage and all!)

Monday 9 July 2012


Buggies. Some parents live by them, some detest them. I am the latter. I cannot bloody stand them! The second that the boy could walk more than four steps without falling flat on his face the buggy was put into retirement. Luckily for us he embraced this and like me, he is extremely stubborn. Even on the rare occasions it was offered he would insist on walking. If I was in a rush, he would be carried. Why don't I like them? Well, they take up so much room, they cost so goddamn much and when I wasn't using them they just annoyed me everywhere I went. They cluttered aisles in supermarkets while other mums chatted, they blocked my desired route while in shops and people seemed totally incapable of not driving them into my ankles everywhere I went. Don't even get me started with them on buses and trains or I will explode. From an ambulance perspective loading a mum and her 'ill' child onto an ambulance, complete with the bags, the other kids and a double buggy is a pain in the arse to say the least. OK, OK, they are a necessity but that doesn't mean I have to like them. The reason I am writing this blog though is one of safety and sheer stupidity. I see it every single day at work, I see it every day driving my car and if you haven't seen it you are clearly living in an area which isn't home to muppets!

"RTC Car vs Pedestrian, 2 year old male, injuries unknown"

Those words give a sinking feeling every single time. It is the sinking feeling of fear. A weird fear but a fear all the same. Obviously fear is usually associated with something that makes you jump; a moment of tension in a film or a phobia. It isn't that we don't know what to do, it isn't that we don't feel able to do what we need to do, nor is it the fear of working in front of a crowd; it is the fear of seeing a dead child. A dead child that will make me think of my son. A dead child in front of their mother. That is the fear. Each drive to these jobs is subdued; you are hoping it isn't as given, you are hoping a passer by has got it wrong, you are hoping you are cancelled 'No longer required'. We were not cancelled, instead we struggled to barge our way though the traffic caused by the RTC. As per usual with these type of jobs, it occurred on a pedestrian crossing on a busy high street with a high foot fall. We were first on scene and my heart sank as we ground to a halt. Lying in the middle of the road was a push chair. A contorted push chair. Contorted by the impact with the Land Rover sat at a 45 degree angle on the crossing with its hazard lights flashing. The usual sea of frantic waves greeted us but from where we stopped, all I could see was the pushchair.

I grabbed the bags, my crew mate grabbed the collars and a blanket and I tentatively made my way around the car. Lying on the floor was the little boy. He was wearing the same Thomas the tank engine t-shirt that my boy wears. At his head, kneeling on the floor was an off duty policewoman keeping his head still. At his side was his mother, crying and holding his hand. Surrounding them all was a 50 strong crowd, camera phones at the ready. This morbid practice has become customary every time there are blue lights in the vicinity. Could this be the next viral YouTube video, could it be the next malpractice story the Daily Mail would sink their teeth into? I just try to ignore it. I made my way over to the boy. His eyes were open. That was a good start! To cut a long story short, we checked him over from head to toe. Apart from dirty clothes and a small graze on one of his hands he was injury free. Thank god for kids being bouncy. We took the usual precautions but I was happy that he was going to be just fine. Now, what happened?

It didn't take long to establish the facts. The mum had walked up to the pedestrian crossing and pressed the button. Remember 'Stop Look and Listen'? This time she had! She had approached and waited until it was her time to cross at the edge of the pavement. The problem was, she was pushing the buggy and whereas she was on the pavement, the buggy was half in the road. The car, driven by another mum with her child onboard the Chelsea tractor (that's a rant for another day), had not been concentrating and had continued to drive in a straight line and failed to see the buggy in the road. Bang! Land Rover + Maxi Cosi buggy = Contorted mess + flying child. 

What... the hell... was she thinking?! Why do people do it?! It is your child, don't push them into oncoming traffic! Seriously! Like I say, it is not uncommon either! EVERY SINGLE DAY!! Walk down a high street, any high street and look at just how many buggies are edging out into the road! I have taken to stopping and ranting when I see it.  Most sheepishly reverse, some flip me the bird and some tell me to Foxtrot Oscar, but why take the risk?! Every time I see it, my hatred for them increases. Obviously, I am being completely unreasonable in my hatred for an essential item but that's just me! I see things at work that cloud my judgment and make me see red! Have you seen this happen?! Is it just me?! Do you hate buggies too?! Maybe it isn't the buggies, maybe it's the muppet in control of them but it is easier just to blame the buggy and be done with it!

Saturday 7 July 2012

I Shall Wear Purple

"76 year old female, dizzy spells"

There is one thing that never ceases to amaze me in this job and that is the characters that I meet. Sure, there are idiots in the world; there are also time wasters, hypochondriacs, grumpy people, angry people, rude people and ill people, but there are just as many people that make my day. They may not be ill, they may not necessarily need an ambulance, but they are polite, funny and interesting. I had spent the morning with the aforementioned  idiots; every single patient I had seen had been rude, ignorant and a complete drain on resources. I needed a pensioner to cheer me up. I think it's a generation thing. Their generation was formed on respect. They are more often than not happy to see you, grateful for your presence and forever apologising for wasting our time. Over and over again I tell them they are not and it is an absolute pleasure to be with them. 

We arrived at the house, let ourselves in via the key safe and shouted the usual 'hello, ambulance' as we entered. Our patient was sitting in her armchair, the broadest of smiles met us as we approached. To say she had a wacky outfit would be an understatement. She was wearing a green skirt with pink and white polka-dot tights underneath. On top she had a Mickey Mouse t-shirt and a purple suit jacket with shoulder pads. Her glasses were similar to that of Dame Edna Everage and her hair was a pale yellow, styled like GI Jane! I started asking the usual questions to ascertain what was wrong with her but she quickly changed the subject:

"Do you like my outfit?"

"It's certainly a lot more fun than mine!"

"There is no point in being boring is there?!"

"This is very true!"

"My daughter hates it, she is embarrassed to take me out! What a prude"

"I'll take you out then!"

"I'll hold you to that! I was so fed up of my clothes being boring, you see of these fashion sorts on the box, there are no rules saying that just because you are old you can't wear what you want"

"Very true, why the hell not eh?!"

"When my husband died I decided I would never look like a bore again, so I wear what I want when I want."

"Good for you!"

She pointed at the wall opposite and told us to have a read. On the wall, in a frame was a poem by Jenny Joseph. She told us that she read it, loved it and has lived by it ever since. We both stood and starred:

When I Am an Old Woman I Shall Wear Purple

When I am an old woman, I shall wear purple
with a red hat that doesn't go, and doesn't suit me.
And I shall spend my pension on brandy and summer gloves
and satin candles, and say we've no money for butter.
I shall sit down on the pavement when I am tired
and gobble up samples in shops and press alarm bells
and run my stick along the public railings
and make up for the sobriety of my youth.
I shall go out in my slippers in the rain
and pick the flowers in other people's gardens
and learn to spit.

You can wear terrible shirts and grow more fat
and eat three pounds of sausages at a go
or only bread and pickles for a week
and hoard pens and pencils and beer nuts and things in boxes.

But now we must have clothes that keep us dry
and pay our rent and not swear in the street
and set a good example for the children.
We must have friends to dinner and read the papers.
But maybe I ought to practice a little now?
So people who know me are not too shocked and surprised
When suddenly I am old, and start to wear purple.

As I turned back around to her she said:

"I've been practicing, now i'm a master of it! If you don't like me in purple, tough!"

This is why I love my job. You just wouldn't meet people like this stuck in an office. She wasn't that ill, she'd had a couple of dizzy spells and had called NHS direct. She didn't want to go to hospital so we referred her to her GP. Obviously that had to be done over tea and biscuits. She was an incredibly proud woman; proud of her appearance and proud of her home. Her look may not be everyone's cup of tea but it doesn't have to be. This was her time to rebel against the norm and 'step away from the mundane' and she was doing so in style and with a smile. As she said, 'two fingers up to anyone who poo poos me'! Priceless!