UNEXPECTED

ALL OK.

2007-10-08T00:15:00.000Z

All is well in my world really. New bird and having fun.

The truth is that there is an underlying feeling of relief. As hard as that sounds I no longer have to think about how I will care for my sister after my parents are gone. Don't get me wrong - I loved her, but as sad as things are it will make my life easier.

|Is that heartless, probably. Is it honest, totally.

Other than that I seem to of run out of things to moan about. I'd just be repeating myself. The truth is that at the moment I find little true worth in what I do for a living. I love my job when I do what I am trained to do; the reality is that I drive a taxi - for half the cash and I really can't be fucked with it all.

Cheers to you all. Live long and prosper!! :-)

BACK TO NORMAL?

2007-07-24T14:16:00.000Z

Well work have been great I, actually, was offered more time off than I requested and realistically I needed it. It has been a very strange and stressful couple of weeks. I don't think I've stood still until today.

Normally in such circumstances we skulk away and leave the police to do what they do. Now I know what a fantastic job that is done by these men and women. Thank you all.

Dealing with the estate is a nightmare all of its own. The Government are mercenary bastards when it comes to this, even clothing needs to be valued for Inheritance Tax purposes. The last thing you need to worry about at times like this are how much a few pairs of old shoes are worth.

Still this is the way of the world. Managed to get away for a few days. Fishing, which is the best thing for the sole, and a wee break with the old's. Today is the first day I've had to myself for two and a half weeks, which sounds and is good. The problem though is that I've cried more today than in the last 14.

Back to work tomorrow though and I hope the return to routine brings me back on track. I've been pretty good about everything so far. I know that you never get over the loss of a loved one - you just get use to living with it.

So, back to normal? There is a new "norm" to become accustomed to. Feels very strange suddenly being an only child. I miss my big sister.

P.S. Thanks to everyone for the support. It is not unnoticed nor unappreciated.

GOODBYE MORAG.

2007-07-08T05:46:00.000Z

For twenty two of her forty one years she had lived under the specter of being mentally ill. A hellish twilight region known as bipolar disease, a place that few know and fewer fully understand. Every day was a struggle. A dark world where every direction held uncertainty and fear. Every shadow was a ghost to dread and every noise was the start of an assault.

She struggled on showing a strength that not many people have. A determination to fight the un-winnable fight. Desperate to be liked by everyone and loved by those close to her. She was the inherent mixture of fun, happy and miserable. She could be a real pain in the ass at times and mean as hell to those who cared most for her, she could also make you laugh. She was ill. That was known and she was loved. She knew that, deep down she knew but could only see a cold, lonley future. Sometimes being loved just is not enough.

Over the past couple of years the, irrational, worry of what the future held began to drag her down. Fear of little things like how she would do the shopping to the big things like how would she pay the bills. An inherent fear of loneliness, a fear of living within the realm of the mentally ill with no one to hug her and no one to make her smile. A fear of things the future may hold.

There had been some previous pseudo suicide attempts. Scratching with knives and threats. Nothing to leave a mark on her just cries for help and a strength that she could not find within herself. She was a lovely, considerate, kind girl who did not deserve this. She was an innocent. She deserved better; the best.

Her parents came home yesterday to find her hanged from the banisters. Her dad did all he could, knowing CPR, and the Ambulance crew turned up to take over. Realistically there was noting that could be done but the effort made really did make all the difference. I cant stress this enough. I know it was a token gesture, but it mattered that it was made.

Sometimes you become hardened, not unconscious of, or immune to, the suffering of the relatives. Just, "it's a job", it's what we do. You clear the scene and control send through the next call - off you go. Another day at the coal face.

No matter how hardened you become, how long in the tooth, how much of an old hand you may feel - when it's your sister it hurts like fuck.

Goodbye, Morag. I love you and I'm going to miss you. I hope you have found peace. Sorry I was not there when the storm broke.

WHO ARE YOU.. WHO, WHO, OO, OO?

2007-06-22T22:27:00.000Z

Someone once said I looked like Bruce Willis ( I'd heard this before when thinner) but I don't know if I ever saw this. I think I look like a young Saun Connery, but realistically I think I could get away with pretending to be Dara O'Brian.

You decide. There's a photo of each of us.

HO HUMM.

2007-06-22T20:02:00.000Z

No interesting work stuff to report. Am pissed off with midwifes who think that it's fun to call 999 for a 32/40 pregnancy because their on a half day. Then again I am a grumpy old man these days. I'm sure the fact that she blatantly lied to the hospital to justify this makes her feel good. The whole crash team was waiting on us when we trundled up with this healthy 19 YO. No bleeding, no pravia, no hypertension, no tachycardia. I think she gave us the wrong girl, not that she bothered to provide a handover or a letter. Should be struck off.

Good news is that I've organised my physical for the OZ application. Not for a couple of weeks and the closest centre is a 4 hour drive away. Still, gives me time to cut out the fags and practice carrying things up and down stairs. Hope I can manage it!! The stopping smoking bit is not that bad.

WILLINGLY GIVEN .... ?

2007-06-17T08:25:00.000Z

My Granny called it the "sight", some call it the "gift", some call it precognition. I call it bloody predictable. The price was paid and I must say it was particularly painful.

Some people I have learnt to hate over the years and last night kicked off by three of these folk in a row. None of these people had anything wrong with them and being well known to us everyone involved knew this, especially them. All were pissed and would walk out of the hospital before we had finished booking them in, as usual. All wanted a wee trip up the road for whatever reason that springs into their rotten, Ferrel heads. Eight minutes (8) was the longest any were prepared to wait before getting a taxi home. Ho Hum. Who am I to suggest that these things should be charged for abusing the service? Give them a lift I always will.

A few more drunks and a couple of quite sad psychiatric jobs. A change of blood soaked uniform and here I am at home.

Predictable? It never fails.

THE EYE OF SUSPICION.

2007-06-16T06:48:00.000Z

It was a Friday night shift. The rain came down in sheets and the wind blew hard. Rivers had burst their banks. Generally it was pretty shitty.

The most worrying thing for all members of the A&E system was that it was scarily quiet. This is not good. You cant relax, something is wrong. Now if I was not at work I'd be staying in and watching Friday Night With Jonathon Ross but our normal customer considers inclement weather no hindrance to getting pissed, having a fight and throwing up on me. They may decide to ware a long sleeved t-shirt but that's about it.

Nights like this make you uneasy because you know you'll pay the price at some point. Nurses and Ambo's pace about, bighting finger nails, waiting on the next job and it just did not arrive. You expect the call to an 8 car RTC, buss crash, fire at an old folks home. Something! It's written in the stars, Carma, kismet - call it what you like but we all know that by the end of shift on Sunday morning we'll of given our pound of flesh.

Knowing this I now have to try and get to sleep but , you know, I'm scared of what will come.

2012

2007-06-12T16:42:00.000Z

I was catching up on the world of Blogs and red a comment on Frank Chalks site that got me googling. The comment was absolutely right and it made me laugh.

Now I must say that I approve of the message and would encourage all over the age of consent to indulge in this new Olympic event. Get training and perfect your technique. I'm available to train any women looking to participate, even in an armature capacity.

A man on the left and a woman on the right. Can you see it yet?

THE FOURTH DAY.

2007-06-11T22:22:00.000Z

Four day shifts over the weekend and what has it held? Well, a little bit of everything. I can be a bit of a pain in the ass at times to people that know me and have been grumpy over the last few weeks anyway. I wasn't looking forward to this long weekend of being at the mill but this is what I did.

We got a job to a 56 YOM (Year Old Male) with chest pain and unable to use his legs. On arrival he was in the bog, walking just fine and had no chest pain. It turned out he was a frequent flier and insisted on being taken to his appointment at the dermatologist which was in two hours time. I told him to fuck off. Now this is not service policy but really! What do I care about this creature, selfish git.

Drunk at a pub. Well I get drunk at pubs, I ,generally, am able to walk at 1400 hours and have never called anyone a C*** for trying to see if they are ok. Let this pass but when told to F*** off was glad to see him get lifted for breach. Pissed wanker!

26 YOM methadone user who was found lethargic by mum. Had not taken methadone for 3 days but there was none left in the bottle. Hmmm? OK he was stoned out his tits and mum was worried and he needed monitoring in-case he went flat but he was playing on it. "Legs don't work" yeh, right. Grow up.

22 YOM assault. This happened 4 weeks ago. Had a sore knee. This knee was in plaster but he cut this off because it was itching. Didn't want to go to hospital because he was out his head on a cocktail of heroin and booze so there we go. His uncle did ask my partner ( a female) for a wank as he liked the latex gloves. What can I say? Really, what? He deserves to be shot. Tosser.

65 YOF having am MI (heart attack). ECG, pin in the arm, aspirin (this is the most important thing if someone is having an MI. If mum or dad gets bad chest pain drop in a 300mg aspirin ASAP). Not thrombolisable so batter into A&E.

A number off lovely old folk with ongoing heart problems who didn't want to be a bother but should of been earlier. Call us! We are there for you, not your pissed grandson.

The grumpiest man in the world. A guy who drank 10 litres of cider a day for 20 years suddenly decided to give up without GP advice. He also decided to come off the Valium at the same time. We arrived after a 20 minute trip just as he stopped seizing. Did not look like a seizure patient (ambos will know what I mean) more TIA or even cardiac. Basically he looked very ill. Anyway, after everything we could do in five minutes (which was just about everything - when in a hurry it don't take long) he was telling us to get to "F" which was, according to his wife, his good old normal self. Signed the form and told us that we were wasting our time as he was "fucking OK." Hopefully his wife will get him to his GP if he's not in hospital by now. The seizure lasted about 10 - 15 minutes, a very, very, very long time. Still we can't kidnap people so I hope he knows best.

34 YOF taken an overdose. Eyes role and looks of disbelief pass between the ambulance crew. This may sound unsympathetic but the reality is that very few OD's actually ever take the pills they say. Anyway, I felt for this woman after a wee chat. I think it was post natal stuff but she had also lost her dad and grand-dad within the last 5 months. Not a good spot. In reality she was a bit of a pain in the ass but I hope it all works out and that shes OK.

The first job today was to a miscarriage. Normally these are to threatened or inevitable miscarriages. This is where it may prove to be or is going to be a miscarriage. Today it was to a miscarriage. 21 YOF who was being treated for a urine infection. Went to the toilet at 0730 and lost her child. From my perspective I hate these jobs. I don't know what to say, or even if there is anything you can say. I hate having to pick a 19 week old foetus out a toilet and try not to vomit and cry at the same time. I hate the angst, stress, confusion and melancholy that this brings on me. Most of all I hate the fact that I cant do anything to make things better, I cant help. I cant do anything but feel sad and know that what I feel is nothing compared to the loss of the mother. I took five minutes in private to shed a tear, I guess she will be crying for much longer. I only wish that I could let her know that my silence was because I do care. I can't begin to comprehend the loss.

The next job was to a 19 YOM with a 2 week history of having a sore shoulder. I wanted to break his fucking arm!!!!

SPARE TIME.

2007-06-06T23:33:00.000Z

Board again really. I've been on a week off, following a week of night shift. As mentioned somewhere previously, it always take a few days to get over the jet-lag. Anyway I've not done much, the plan was to head off for a couple of days but that went tits up so was left here looking for mischief.

Found no mischief at all. Quite disappointing. Had a funeral to go to on Tues and helping a friend move house on Thurs. Out for a meal with an old friend tonight so I guess that I should feel like the weeks been full. It's not.

Been banging my head off the walls for the last few days and smoking for Europe.

The big news is that I've sent off my application for a job in OZ. Wish me luck - though it's running away from this life I may even find someone "special" over there. I like the Antipodes and seem to function better over there. I hope it all goes to plan as, in reality, I've had it with the NHS and this PC led country.

THAT SMELL!

2007-06-02T01:05:00.001Z

I was talking with my partner the other day about death.

Now this may seem a strange thing to those that don't deal with it but the reality is that it's like discussing the weather after a while to those that do. It's not that you stop feeling nor that you stop caring. It's certainly not that you don't feel the loss of those around you. If I get to that point I leave and become a traffic warden.

I remember everything about my first arrest. The name, face, location even what was in the shopping trolley. I remember the thump, the shocks, the conversation I had with a dead man, willing him back to life. Unusually we got a return of spontaneous pulse giving his family time to say good bye. I will never forget this, any of it; ever.

After a while though it changes. I hope I never forget that someone has died nor that those that survive are hurting and that I will always empathise with their pain. I no longer know how many people I have been to that have died though. How they died and where they died does not stay in my memory. It may be dozens or even hundreds, I really don't know. I still feel uncomfortable having to break this news and hope that this is a sign that I retain a basic human decency despite what I do for a living.

How has this changed me? Well, I see the mortality in everyone I know and meet. I assess the likely-hood of a heart attack or stroke, the chances of cancer - how they are likely to go. This is all done on a sub-conscious level but it is there and I'm aware of it. I expect my father to have a huge stroke, my mother to succumb to cancer and my sister to meet an untimely death at her own hands. Me, it's COPD and cancer. I don't expect any surprises.

Does this make me more passionate about things, overly keen to meet life head on and more susceptible to fits of anger about what I find unjust? Dammed right it does.

The outcome of this.... we all, as Ambos, carry the feint smell of death around with us. People know, normal people know, what we do. I think that while they all are amazed that we do what we do the very fact that they "couldn't do our job" says more than they think. We deal with the dirty, the sick, the maimed and the dead. It's a fantastic job when we do what we are trained to do but it leaves a mark and it's not always comfortable.

ACUTE, SUDDEN ONSET.

2007-06-01T17:24:00.000Z

999 call to 38 YOM, depressed, feeling unwell.

On arrival the man was slumped in a chair, pale, glazed eyes. Said he was afraid that there were strange things going on and that the henna he had pit in his hair may of had some strange effect. All through this his eyes were distant.

He wanted to go to hospital and who am I to refuse. Even after trying to explain the effects of smoking hash he wanted hospital treatment.

In my day it was called a whitie and cured with coffee.

So there you have it. Acute sudden onset of sadness. The handover was fun at the hospital.

WORK, WORK, WORK.

2007-05-29T15:15:00.000Z

Well, work has actually been pretty slow - for the last few months. Cant really think of much to write about. I'm on night shift at the moment and have actually been pretty quiet after about midnight.

If anything exciting or unusual happens I'll let you know.

THE STORY

2007-05-22T19:07:00.000Z

It should be OK to tell a tale as I suspect those involved wont read this now.

Some of you wished me well so here is the story.

I hooked up with my childhood sweetheart a wee while ago. I was very happy and got carried away with things.

She came out of a pretty destructive relationship a short while ago and I guess she thought she was ready for something new. She wasn't, certainly not what I threw at her after 20 years of carrying a torch for her. I also have more than my share of baggage to lug around and this manifested itself as a flood of love and affection. It is exactly the sort of stuff that scares me off so why did I expect her to do anything other than run? I don't know.

I felt pretty stupid at blowing it and sad that two people who really do get on so well couldn't work things out.

Anyway I'm nothing if not resilient and feel pretty normal again. I hope that she'll still be my pall but if not I learnt some pretty good lessons about where I am emotionally. Too much time on my own living in a ditch in the country. Not healthy. Even though I love it here it's maybe time for a change. Maybe I need to engage with polite urban company again.

I really do need to get a life.

PS. if you do read this, A. You'll always be cool with me <3

SOMETIMES II

2007-05-19T19:09:00.000Z

Sometimes life just sucks; and it's all your own fault!

A PLACE FOR EVERYTHING.

2007-05-16T13:18:00.000Z

One of life's great mysteries to me is the shopping trolley.

As a child my father always said "a place for everything and everything in its place". He was right. When things are tidied up and put away in an orderly fashion they are not only easier to find but take up less room.

Why then is it that on completing my circuit of Tescos and having packed the groceries, randomly thrown into a trolley, into plastic bags and then place these bags into the cart do they tale up more room? These bags should fit neatly into the trolley making you thing "that's not to bad, really" rather than "what the f*** did I buy to take up that much space"?

My theory is that the supermarket chains have developed some strange marketing device that imperceptibly shrinks the trolley as you pass the checkout. While shopping it's bigger so you think "not bought much, have I" after it's all to late and you've paid it shrinks so the thought is "boy, that's a lot of stuff".

The volume contained in a shopping trolley is therefor inversely proportional to the amount of goods purchased.

Still confuses me.

THINK ON IT!

2007-05-14T22:15:00.000Z

I could go on and on about how i feel about this subject and how my perception has change since I joined the ambulance service. A complete U turn.

Nothing I could say however would touch THIS.

Enough from me.

SOMETIMES

2007-05-14T21:38:00.000Z

Sometimes life is good. I'm pretty happy at the moment :-)

I like this.

FINGERS CROSSED.

2007-05-13T19:21:00.000Z

There is a young girl, 16, that I've taken on the two hour trip to the nearest transplant unit a couple of times now. She has cystic fibrosis and is awaiting a lung transplant. It's not happened yet but despite this she smiles and is full of hope and life. Her sister died from this a year or two ago. I can't begin to imagine how this effects her and her parents.

She smiles and talks, constantly, some may say too much but I like this and I cant help but admire her strength and optimism. She was back to the unit yesterday, all smiles and chat. I hope that the Donner is suitable and that all goes well for her.

While things don't ever seem to phase this amazing kid, they phases me though, it breaks my heart every time she's turned around and sent home. I hope that I never see or hear of this girl again. This would mean that all is well. Good luck Lass, fingers crossed.

SOMEONES WATCHING!

2007-05-11T21:00:00.000Z

Actually someones listening. This is quite important and if your in the ambulance service, or possibly the police as its the same system, beware the new radio system that is being deployed. This is the national radio system being rolled out for the emergency services and is already in use in some areas, notably the police force where I work.

I heard a rumour and got my union convener to check up on it. The rumour is correct. The new radio system has a facility whereby "authorised" members of the control staff can listen in on your conversations. I don't mean just the stuff that you may transmit to your colleague while on a job, I mean the private stuff you talk about in the cab - and you cant tell when this is being done. Get this --- even if you turn the personal unit off they can still listen in.

As a result both UNISON and the T&G here are pulling out of the consultation and advising staff to refuse to carry the new radios unless this feature is removed prior to roll-out. Typical ambulance service stuff this not just staff privacy but patient confidentiality being ignored.

I'd advise anyone who reads this to chase it up in your area. If its anything like the service here when you think you've hung up and start talking about how crap a particular controller is you'll get disciplined and possibly sacked, regardless of any assurances that are given.

Don't sign for the radio or carry it, if you do don't talk or ask the patient any questions. They have rights that are being breached. I'd also emphasise that your union reps should chase this one up as mine has. She's on the committee responsible for the roll out and heard this from me. She was socked that it was not being openly discussed and that rumour proved to be true.

Just something for you all to think about.

HAVING NOTHING TO DO CAN PROVE FRUITFULL.

2007-05-08T15:14:00.000Z

I was board beyond belief. I'd done the shopping and was even thinking about cleaning the bathroom when a random trawl through the web brought up this picture. I had to post it. Laugh, I weed in my trousers a little.

IT'S ALLIVE!

2007-05-07T13:46:00.000Z

Hi there people. I am alive but I have been very lazy over the past few weeks. Actually I've been having quite good fun going on holiday and fiddling around with the Land Rover. Bit of a money pit though.

Workwise, there's not much been going on for ages that inspired me to post. There was a period of about 4 weeks where there was only one person ill enough to warrant canulating. Most were in better health than me.

Things seem to be changing though so I promise that there will be something that pisses me off enough to overcome the inertia that has set in.

Thanks to everyone who has kicked my ass. I needed the push.

MOVIE UPDATE.

2007-03-15T23:11:00.000Z

I usually hate foreign films. Just watched "Pans Labyrinth". It is really quite beautiful. Recommended.

Also watched "Tenacious D". My type of thing. Fantastic.

MAKE ME CRY.

2007-03-15T18:42:00.000Z

A new clutch. Almost £600 with delivery and VAT.

Not what I was wanting for my old Defender. My eyes still sting as does my wallet.

HMMMM!

2007-03-12T22:54:00.000Z

Some may call me mad. Some may call me weird but I do. I fancy Sarah Jessica Parker. No accounting for taste.

A STRESSFUL DAY!

2007-03-11T20:07:00.000Z

I've been single crewed the last two days. I've actually quite liked it. There are only a few jobs that you can do and they tend to be high priority jobs where you go as a first response.

Yesterday I only did five jobs. Three people went to hospital, two were little girls who were not well but not seriously ill. I like small people, they make me smile and restore my faith in the inherent good of people. Small jokes and a bit of fuss and wonders can be done. One of the girls, a 4YO, had tonsillitis and a temp. of 41.1C. She still nattered all the way in, except when she slept on her mums lap, and had a smile on her face. Very high temperature though, for anyone never mind for a wee tot. She did say she'd help get me organised though, so I don't think she was too sick.

Today was an endless stream of NHS referrals for chest pain. Well 6 jobs. That's all I did, six jobs. A very manageable workload. Everyone of these people was having a panic attack. Anxiety had taken over their day. Not a nice thing. Two wanted to go to the hospital and I was quite happy to oblige.

So, a stress-full day. But not for me. I may be starting to become less grumpy - but I doubt it.

WEEKEND.

2007-03-08T21:06:00.000Z

Well the weekend is my week-start. Four days from Friday and to tell you the truth I can't be arsed. Spent all day today working on the Defender trying to get the door locks working. Figured it out after dark so no chance of finishing it off. Will have to wait until Tuesday.

Hope something interesting happens at work. Bit board of playing taxi to people who are in better health than most. Will have to wait and see.

WORK, REST AND PLAY.

2007-03-06T12:13:00.000Z

Well it's been a while. I thought I'd leave the previous post up for a while in an effort to direct as many people as possible to the petition thing. Guess my bit is done by now.

WORK.
Work has been a bit strange. Very dull. Nothing of interest yet again. I was reminded though of a couple of instances where I hate people. You see, one of the things that gets my goat is interfering relatives. Relatives that stand exactly where you need to place the chair or try and wrap the blanket tighter around their husband while your carrying him down the stairs. These type of things just piss me off and I find it hard not to tell them this. I find a couple of deep breaths and a follow up policy of ignoring everything they say helps me out. I always feel sorry for the patients in this situation. Makes me glad that I'm not married.

Get out the way. Let us do our job and no, we wont wait 10 minutes while you change your trousers and do your hair. Idiot!!!

REST
Lots of rest. Too much. Things to do but not doing them. Too distracted by ... play!!

PLAY
Well, play is fun. Everyone should be playing more. I'm still struggling through Zelda, in fact I've had to look at a walk-through in order to try and escape the mines. Need more arrows and a touch more coordination and patience. Still, I will prevail.

Also I've been a bit naughty and bought myself an old ex MOD landrover that needs some work done on it. I know nothing about cars so this is a bit of a challenge and may take the rest of my life to complete. The aim is to get it into mint condition then trash it on a friends farm driving through mud and over rocks. Unfortunately this all costs money and I spent it all on the thing. My gut feeling is that it will end up a pile of rusting parts but at the moment I'm spending lots of time sanding things and replacing bits. Feel like a real man - good honest manual labour.

Other than that life plods on. There are a couple of changes in my life being planed and I will let you know when things progress. Other than that if you see a couple of Ambos next to a bed or struggling down the stairs -- get out the way. Ta.

SIGN AND PASS ON, PLEASE.

2007-02-23T22:09:00.000Z

Well I'm OK now.Took Thursday off as a sicky and slept until 3PM. Think I needed it. No more unpleasantness for the time being.

Found this though ***here*** and would urge everyone to sign. This is something particularly close to my heart and, I guess, all Ambos across the world, although it only relates to those of us dealing with the British unwashed. About time something was done.

Got to say that the Government hear obviously don't believe in democracy, as evidenced by their stance on the travel tax thing, but you never know.

Pass it on to everyone you know, even if you don't sigh it yourself. Again ***here*** it is!

ANOTHER DAY.

2007-02-21T22:32:00.000Z

I felt crap today. Think I've managed to pick up a D&V bug from someone. Actually I'm surprised this does not happen more often in the service. Anyway it left me with a sore tummy and a thumping head. I hated everyone I came across including their pets.

Strangely, though, one call was to a GP who wanted our assessment on someone who he thought might be having a MI. He wasn't and the GP was fantastic. Will take me longer to get over the shock of this than the bug I've got.

Hope tomorrow comes with less nausia or it'll be a sick day and I always get bored of these about mid-day. Still Zelda calls from the corner of the room. Will have to wait and see.

THE EARLY BIRD.

2007-02-19T15:02:00.000Z

Back to work tomorrow for the first of three day-shifts. Quite looking forward to it. Hopefully something will happen to inspire a new post of interest to me at least.

I should of been going to thy gym bit I've actually spent most of this last week trying to escape the Goron mines. taken me for ever but now I just have the big boss to kill. Rock on Zelda I Loooove my Wii.

(NFR) = NOT my FUC***G RESPONSIBILITY

2007-02-15T02:53:00.000Z

This post is actually about NFR/DNR (Not For Resuscitation/Do Not Resuscitate). I will call these NFR as I’m old fashioned in this regard and this is what I understand.

I will start, however, by stating that Valentines Day is over. I am glad about this, as I don’t like it. I am also pretty pissed but, surprisingly, not too depressed.

I, once upon a time, spent it with a wonderful, beautiful woman whom I loved very much. The bitch did not like me as much though so she must be mad. Obviously. Broke my heart and I’ve only just forgiven her. Well I forgave her a couple of years ago actually and hope that all is well in her life. Feel sorry for the man she’s with though, nutter.

Tomorrow is my birthday. Just another day but the day that I get older. Older, older I hate that. Why cant I be 18 forever. Still feel 18. My body feels about 80 but I’m still the stud I was 20+ years ago, in my mind. Would love to be able to try and prove it.

This story is an example of something that has become more common over the last year or so. I can’t say that I remember these things happening before, but the situation described has occurred a few times over the last 8-9 months.

I was on a dayshift and, unusually, was in early. I don’t generally do mornings very well but this day I must have been hyper. A 999 call came in 20 minutes before the start of my shift so I volunteered to let one of the night shift crew get home on time and cover their space. The call was to a nursing home about three minutes from the station and I figured it would not be anything too serious. We don’t usually get spurious calls to this place. If there is anything near a good nursing home this may be it. Probably because it’s run by nuns, but still-------.

As we entered we asked what was going on and got the reply, if you can believe it, “we think she’s dieing but just want your opinion!”

What sort of thing is this to say to anybody?

Her daughter was on the way and all they wanted from us was to say, “Yip, she’s on the way out”. The home manager had previously discussed the option of an NFR. This is where a person is known to be at deaths door and a decision is made that any attempt at resuscitation is not in their best interest. CPR is not to be undertaken.

We entered the room and did the basics. The woman was obviously near the end of her life. Sometimes you see people and know that the worst thing you could do is try and move them. The very action of trying to move them and take them to hospital will result in their death. A “nurse” turned up with the documentation that they have and points to a signature under a heading at the bottom of a sheet relating to a NFR.

Now, this means nothing to us, as ambulance personnel. As it stands, where I work, the only legally relevant documentation relating to an NFR is: -

A signed letter from the patients GP.
An audio recording from the patients GP
A preforma signed by the patients GP.

In reality if we don’t have a letter from the patients own Doctor there is no NFR in existence.

The nursing home manager knew this. In my opinion the very fact that they had the discussion and had not formalised it is negligent. They know the legal requirements as well as I do. If they have not been negligent at the very best they have misrepresented the facts to the relatives. I can only hope that they get sued at some point in order that they stop knowingly misleading the relatives of people nearing the end of their life. The distress that this causes became all too evident to me as time went on.

If we moved the woman she would die. You get to recognise these things. This does not invalidate our legal responsibility regarding duty of care. We had to do everything in our power to ensure the survival of this woman.

Blood pressures, BM’s, Oxygen sats, ECG, GCS were all taken as was temperature. The picture was not good. Knowing the circumstances we did all we could to kill time untill the daughter turned up.

The relatives were all under the impression that their mum had been placed in this home for palliative care, with the NFR in place as discussed with the “nursing home” manager. To be looked after until she died. On hearing that we had no option but to remove her mum to hospital the daughter became, understandably, distraught.

While we were, at this point, taking no actual moves towards moving the woman the daughter actively started preventing us from doing so.

I understood her actions completely. Her mother had been placed in a home to die. This had been discussed and her understanding was that everything was in place: she had made her peace with this. To have a 6’3” stranger trying to explaine that yes, we know your mother is going to die and that this is almost certain to happen if we move her but that no, the nursing home lied to you about the NFR and we have no option but to move her and effectively kill her, is not a nice thing.

All the while the daughter is crying. I feel like crap. I know that I don’t want to do what we have to do. That if I follow the rule of law I will be subjecting an old woman to unwanted assault and her family to unnecessary stress/distress.

I ask everyone to leave the room for a minute and my partner and I have a quiet word. She’s way ahead of me. Experience is everything and she’s been around a lot longer than me. Obviously there is no point in calling her GP at 7am (they’ll still be in bed) so call the out of hours service.

While we can hear the daughter crying outside the door we try and explain the situation to a Doctor who has never even heard the woman’s name before. Fortunately he’s a good one. He takes the decision to permit us to withdraw. I have no idea how ethical this is but it was the right decision. It could have been so much different.

We apologise to the daughter and she seems to appreciate the actions we took. Despite this her eyes are still red. All she wanted was her mum to pass away in peace. While we did what we could, we stole some of this. We were an unwanted presence at a time of sorrow and distress.

The home should either not of called us or ensured that they fulfilled their legal obligation to formalise the NFR.

Three times in the last nine months this has occurred. I never expected to be put in this situation. If it happens again I’ll inform the police. Nursing homes have responsibilities that they should not neglect. Nor should they place the responsibility for their negligence at our feet. Their job is to care!

Fuck, I hate nursing homes; and this was one of the better ones.

NOT AGAIN.

2007-02-11T22:02:00.000Z

I seem to of run out of steam.

I have had so many holidays to use up that I'll of only been at work for 7 days in five weeks by the time I go back a week on Friday. Also when I have been there there has not been anything particularly noteworthy to comment on. Maybe I'm just a bit jaded at the moment and the perpetual Autumn is getting me down. SAD is it not.

There are a couple of pending posts I need to catch up on so may spend valentines day doing that rather that getting pissed and depressed but I cant guarantee that.

Normal service will resume - sometime soon.

IT'S CHRISTMAS

2007-02-08T12:32:00.000Z

I always associate snow-men with x-mas. Not so much snow as the things people make with it.

It's here and I like it but don't think it will be around for long. Wish it was more like the 70's when I was a kid and snow came every year and you could go sledging.

Is it bad to hope that Global Warming leads to arctic winters in Britain? If it is I'm a bad man!

SHAME.

2007-02-07T14:25:00.000Z

I’ve been off work for the last few days, not back until Friday. Loving it. It’s snowing at the moment, which is nice. I like winter to look like winter and find the 8 months of autumn we now get depressing.

Work-wise it’s all been pretty normal stuff. I ranted about alcoholic **here** but met a man the other day who falls outside the general profile.

This guy is in his late 20’s and has been an alcoholic for a number of years. I’ve seen him before, lots, but not for a while and had forgotten all about him. Not seen him for about ten months.

The circumstances of the call were not unusual; alcoholic feeling suicidal. It’s the man that is unusual. He is not one of these types that look to justify their addiction or lay the blame for it at someone else’s door. He knows he’s had all the (limited) help available and that he has not followed through on this.

In short he knows he’s an alcy’ because he drinks too much and that that’s his choice. What gets me is that with all this, he does not feel sorry for himself; he hates himself. You can see the shame he feels in his eyes and body movements. He avoids eye contact whenever possible and wrings his hands. He knows he has a problem and has accepted responsibility for this though so that’s a start I guess.

In an unusual moment of compassion I feel sorry for this bloke. I hope things work out for him.

I NEEDED A Wii Wii

2007-02-06T11:04:00.000Z

My life has taken a big turn. I have something of an addictive personality so try to avoid "bad" things.

I gave in though and bought a Nintendo Wii. I may never see daylight again. I have not had a console since the PS1.

White, pasty man.

IT'S NOT EVEN EASTER.

2007-02-01T09:51:00.000Z

I would not believe it if it had not happened to me.

At training school I was most definitely told, “you can have a pulse and not be breathing but you can not be breathing and not have a pulse”. Set in stone. One of life’s certainties or maybe one of deaths.

Anyway on Tuesday night this was proved to be wrong. I have to say I didn’t believe it when it was going on so it took a minute to get my head together. It went like this.

Call to a difficulty in breathing. We turn up and my mate goes in to see the patient and I get the chair out the back of the bus in readiness to load up. Things are done and it seems like the man has no other complaints – no pain in the chest etc. although he is a bit clammy. We decide to do a heart tracing in the bus rather than loiter in the mans house.

In the back and we say “ok, if you get yourself on to the trolley.” The man looks at my colleague and his head slumps. Oh shit! We heave him onto the trolley and I check for a carotid pulse. Present but slow, resps at about 20 a minute, GCS E=2 V=3 M=4 so he’s not quite in a coma, but trying hard.

The defib’ pads are placed on his torso and after a second it shows VF (where the heart is having a wibble and not contracting properly). Fuck, “shock him,” the machine screams out. I say, “but he’s berating” and he is. Still berating at 20 a minute and moving his arms. We look at each other and see the doubt. What do we do? Another pulse check – no pulse. Thump the mans chest to no effect.

Decision made, shock. 200 joules thump through the man and he says “for fucks sake”, he’s still in VF. I say “for fucks sake”. My mate says “for fucks sake” and starts CPR as I try to intubate. The man has tristmis (clenching his teeth) and grabs my partners arm. He’s still in VF and becoming more agitated as the oxygen leaves his brain.

Back to basics, manage the airway as best we can and give him lots of O2. Another shock brings him back to NSR (the heart rhythm we all hope we have). Still no tube and still clenching his teeth.

All of this must of taken under 2 minutes. I jump in the driving seat and batter along the 5 minutes of road to A&E. They know were coming and are sitting there having a nice chat when we arrive. He’s been shocked again on the journey in so arrives in NSR with a GCS of E=3 V=3 M=4.

Beeeeeep. Off he goes again. The doctor shocks him and the man says, “ Fuck off, Jesus Christ”. We all look at each other again. He’s back in VF and fighting off the doctors and nurses. Bam! Another shock and he’s in NSR.

14 more shocks were delivered, along with drugs to calm the man down, and allow intubation, as were the other things for someone in cardiac arrest. Throughout all of this the man was breathing, talking and fighting people off who were trying to do CPR.

I have never seen this before. I have never even heard of this before. As far as I knew this was not possible except in Shaun of the Dead. The mans heart is not beating and he’s telling us to F off and complaining about the pain.

Apparently if you get in there quick enough there is enough oxygen in the blood to keep the brain working for a while, even when the heart has stopped. Very unusual and something I doubt I’ll ever see again.

It was a BIG learn for me. Sometimes you think you’ve seen it all but you are always learning in this job. You will never know it all and never see it all.

The man was eventually stabilised and is now in CCU. He’s a save. The first real save I’ve ever had. Sometimes you get a pulse back but that’s not a save. A save is when you run into them buying their grand kids a birthday present 2 months later.

I still can’t really believe what went on. If anybody reads thin and can shed some light on this or has had a similar experience I would love to hear about it. Crazy, totally mad.

FIRST DAY

2007-01-30T07:48:00.000Z

Well, the first night back at work is over. I'm glad about that as I always think that I'll of forgotten everything I once knew, good to get one under the belt.

I was working with one of the two regular partners I have and was "in the back" looking after the patients. Nothing to out of the ordinary although I suspect that the last patient was having a NSTEMI. Basically this is a hear attack without the ECG/EKG changes that are normally present. It was a good cardiac story with the pain coming on at rest, nausea, clammy, previous MI. Basically he looked like he was having a heart attack and the history fitted in with this, although there was no "solid" evidence to support this conclusion.

We did everything we could and battered him in to the Doc's. Hopefully he'll be OK. He laughed at the right places when I was talking to him so he must be a good lad.

Back pain, D&I x 2, maternataxi, couple of NHSD calls that were left at home and a couple of calls we got redirected from. That was it, not bad.

One of the calls we were redirected from though was to a 30 year old man who had broken his leg playing football. Our dispatch system, AMPDS, classifies this as a green call meaning that we can be sent to something more serious while en-route. Poor bloke had been on the ground for 20 mins. when we got sent somewhere else. Where did we go --- to a drunk at a bus stop.

I should just accept this as the way things are; but I cant. It's wrong on so many levels. Frustration sets in and I know I'm back on the bus. Love it.

AN ABSOLUTE MUST.

2007-01-29T03:16:00.000Z

This must be followed through.

This HERE.

Don't think there's anything better, but there's nothing worse.

I HAVE FIREFOX!

2007-01-29T02:43:00.000Z

0320320, JOHN, EVA whatever you want to call yourself; I have firefox 2 and, for your info. everything else I currently need.

If you want me to visit your blog/site, interest me. If you cant do that just fuck off, I'm not going to just because you have some free software that everybody already uses.

Your sadder than me. Fuckwits!

HI HO HI HO.

2007-01-28T23:02:00.000Z

Well, the holidays are over. 11 days away from work and I've achieved nothing with it. Sat around and done hee haw. I really do need to get a life. Not even done the shopping never mind the housework.

Looking forward to going back to the mill. Hopefully something will occur to stimulate my mind. Only four nights though as tonight is a holiday too. Still find it strange to enjoy my work.

I'M SURE THAT WAS MINE, RAY!

2007-01-27T19:10:00.000Z

I’ve been watching Ray Mears Wild Food on TV. The program where he tries to figure out what food our stone aged ancestors ate. I like his programs.

The guy can do just about everything from making fire from a couple of twigs and a mushroom to canoeing through rapids. He can catch wild things with his hands and climb up mountains. He truly knows how to survive in the wild and would be the person I’d want on my island should I get stuck on one with nothing more than a broken watch.

What keeps me watching these programs though is the suspicion that this all knowing, action-man must spend lots of time watching telly and eating pies.

HERE I AM.

2007-01-27T16:19:00.000Z

I've been doing quite a lot of lurking on Caramelo and Nicenuse's sites the last couple of days. This has taken up all my time and I must say I'm surprised at the vitriol that has been expressed. I guess that not everyone likes blogs but that some of these people read them anyway. Also personality clashes on the web can be just as destructive and childish as in real life.

Strangely, Nicenurse seems to of ended up being the battleground for issues that had nothing to do with him and, Caramelo is the only one to walk away from his site with any dignity.

Anyway, I hope Caramelo will keep blogging under one name or the other and that Nicenurse has his site back. You can see the slagging matches HERE and HERE respectively.

On a lighter note watch THIS. You may of seen it before, I first saw it about 7 years ago. I still cry.

GET ME ON A GOOD DAY.

2007-01-24T02:52:00.000Z

Now here’s the thing, if your drunk, or out of your tits on drugs, be nice to me.

I’m a pretty decent person, really, and do my job because I care about people. Honestly that’s the reason, pretty wanky, but the truth. I like people and I like helping them and, heck, think I’m pretty good at it when their ill, sick or injured.

If your just a piss-head or out your tits on “E” I’ll still be nice to you, even though I know you don’t need my help. If you start the verbal or get punchy I’ll become a lot less caring.

I’ve only been assaulted a couple of times, this year, and neither were very serious. I got a good thwack on the chin from a drunk I was helping from under a bus (no injuries, he placed himself there) and became a bit dizzy as a result, but that’s it.

I’m pretty easy to understand in my belief about self-preservation. I give you 30 seconds. If I walk into your house and you start gobbing off at me, I’ll try and explain/appease but there is only so much I can do. If you really think that because your mate has been drinking for 48 hours and has been sick you can call me a C++t your wrong. If you’re angry that we were not there in 5 minutes you’re wrong. Very wrong, I walk out the door and you can walk the 500m to A&E yourself.

If you really want to hit me make sure you do a good job. At 6’2” and 18 stone (28% body fat) I may be old and slow but you only get one free hit. I am use to getting the odd thump. I’m not sure what “reasonable force” is but remember …. I’m not drunk; and I only want to hit you once.

Usually the police are there do deal with you, thankfully. Just a thought for you though. Think about it if you ever can. I know it’s not happened yet – probably because the police are there to deal with you.

Tossers!

IN THE NEWS.

2007-01-23T21:58:00.000Z

My thoughts on this article will be a post in the next couple of days (when I'm over the hangover tomorrow will bring). As will the fact that there seems to be a problem with sending RRU's out with Technicians rather than Paramedics.

Bless the press.

At least this is not to sensationalist.

GOING MAD!!

2007-01-23T15:40:00.000Z

It’s cold, dark and I’m bored. The only thing good is that it’s snowing. I like the snow and we don’t get enough of it these days.

I’ve got another week of holidays to go before I return to work. I was going to go skiing or take off to the sun for a week but my telly broke. I now have a nice shiny new TV and digibox but nothing to do with my time; other than watch ABC 1.

Bored, bored, bored, bored, bored.

In an attempt to pass the time I’ve been thinking about people I hate. Nicenurse had a good post about the people who think it’s ok to open the back of the bus when there’s a patient onboard. This means I cant really post on these halfwitted, scrotums.

I hate Chavs and have said enough on this for the moment. The same with alcoholics who phone for fun.

I’m just bored. Think I need to get drunk. Maybe I’ll get to build a snowman tomorrow. Must go buy a carrot. That will pass some time.

YOUTUBE CLASSICS.

2007-01-22T21:01:00.000Z

This just made me laugh. Tears in my eyes.

Up with the old girl.

Worth a look.

AM I HUMAN AFTER ALL?

2007-01-21T19:46:00.000Z

I’ve been off for a couple of days and, in fact, won’t be back at work for another week or so. Using up holidays before I loose them.

The last job I was at before this break was a house fire with one fatality. An elderly smoker who fell asleep and set fire to himself. Not a nice thing. What got me thinking were the actions of the 20-year-old neighbour who ran into the house to try and rescue this old man. A highly commendable and brave thing to do and an action that almost restores my hopes that society is not totally screwed. There are those who would say it was stupid to do this. This is what I have been contemplating over the last day or two:-

Is it stupid and would I do it?

Is it stupid? Well, I’ve got to say yes. He placed himself at risk and while he was unharmed, other than breathing in some smoke, he could of died. It is undoubtedly a brave, courageous thing to do but not the most sensible.

Would I do it? I haven’t decided on this yet. I would like to think that I’d find a nearby phone-box to change in and save the day but I don’t know if I would. Inherently I’m a bit of a coward or at the very least don’t like the idea of getting hurt. There are people I would try everything for; my family, my friends and their kids and, possibly, my neighbours (although I’m not sure about the last.) I’d do everything I could for this select few. If your not known to me I think I might let you fry. Sorry about this but unless I know you’r worth saving I’m not sure I’d risk my life.

Would I expect them to do the same for me? No. I’d be pretty pissed off to think that someone I know placed themselves in danger on my behalf. They all have families to think of and this is the job of the fire brigade. Someone who does not know me from Adam should think about their families too.

Would I run into a burning house? I really don’t think so. All this means is that if I ever find myself in this situation I probably will and be pretty pissed off if someone doesn’t for me.

It’s all theoretical and hopefully will never happen, but I’m still thinking about it. I hope my decision wouldn’t depend on weather or not I thought you were worth saving. Hopefully I’m not that jaded with the world. I think this is what is causing me to stop and think more than the idea of the fire itself. While working I have to place crew safety first. Would I do the same at play? Hmmm???

DO YOU OWN A CAR?

2007-01-19T19:47:00.000Z

There are many things wrong with the Government. Hopefully they will listen to us.

The government's proposal to introduce road pricing will mean you having to purchase a tracking device for your car and paying a monthly bill to use it.

The tracking device will cost about £200 and in a recent study by the BBC, the lowest monthly bill was £28 for a rural florist and £194 for a delivery driver.

A non working Mum who used the car to take the kids to school paid £86 in one month.

On top of this massive increase in tax, you will be tracked. Somebody will know where you are at all times. They will also know how fast you have been going, so even if you accidentally creep over a speed limit you can expect a NIP with your monthly bill.

If you care about our freedoms and stopping the constant bashing of the car driver, please sign the petition on No 10's new website

http://petitions.pm.gov.uk/traveltax/

Please pass this on to anyone who owns a car/motorcycle. It affects ua all

AN ACT OF THEFT.

2007-01-17T22:12:00.000Z

For those of you that don't read "Random Acts of Reality" you must watch THIS.

Sorry for the blatent theft.

IT WAS BROUGHT.

2007-01-17T20:10:00.000Z

Well, today was good by my standards.

The second job was to a 64 YOF with a cold who all but ran to the bus and had her daughter follow in the car. Hated GP referrals by 08:30 hours. Will never understand the lack of thought that Doctors put into things like these. Blood pressure up and the day begins.

Just before lunch a call came through to an 82 YOM with chest pain. On arrival he looked fine but using the skills of a sleuth, that would make Bergerac proud, discovered a barn door MI. These skills involved doing a 12 lead ECG and asking him some standard questions. Now until December this would have been thrombolised; but now we take kids like this to the “cath lab” for an angioplasty (balloon in the artery to expand the vessel). First time taking someone here so this equates as a good job. Pain relief, heparin and transport. Job done and I hope he’s going to be ok although they decided that an angioplasty wasn’t appropriate.

Second last job was to a 55 YOM with an almost un-natural medical history for someone his age. You could tell that he had been a big, strong, intelligent and, I guess, handsome man. Now he has osteoporosis, Parkinson’s, infective soars in his legs, cellulitys – for a start. It was a long list. I guess that he wouldn’t want my pity, and well, I wont give it. I do however feel for this man ravaged by such indiscriminating and debilitating diseases at such a young age. There are so many people we come across that are just a waste of skin. If I believed in god, which I don’t, I’d think, “You bastard!”

BRING IT ON!!

2007-01-16T20:10:00.000Z

Today I was desperate to get something interesting to deal with. Tuesday dayshift always seems to be a struggle, it’s quite a quick turn around from the weekend nights and the old body clock seems to always kick me in the nuts on the Tuesday.

Nothing. Nothing at all of any interest. To make things worse everyone needed an ambulance and was very nice to deal with. Couldn’t even get angry at the system or hate a patient, even for a wee while.

Hopefully tomorrow someone will piss me of and I can enjoy the day. Bit board today.

UNCONCIOUS, UNKNOWN PROBLEM.

2007-01-15T05:01:00.000Z

What can we do? In the last four year I have been to one person who was genuinely unconscious; he was a technician who worked at a neighbouring station and was seriously ill.

Now, if you have a GCS of 8 or below you are in a coma; I accept this as being unconscious/unwell. In fact if your GCS is, seriously, below 12 you get quite a lot of my attention and a very quick trip to hospital. Just because you’re too pissed to walk doesn’t interest me. Pretending to of taken an overdose does not either.

Why do you think I’ll find this interesting? Why do your friends? Because you have spent 10 hours drinking vodka and red bull I wont find you any more interesting than I would otherwise. The six co-codamol you’ve taken over the last 8 hours don’t really interest me either!

I get that the general public don’t understand that to be unconscious your, well, unconscious. Not responding to anything. Really out of it; I mean really out of it.

Why can’t you take your pissed friend home? Why can’t you behave like a friend and look after your mates? Why do you think I’ll care when you don’t?

Bunch of wankers. If my mates acted like most of the “you” out there I wouldn’t talk to them any more!

WHAT STRANGER THING??

2007-01-14T14:23:00.000Z

The first job was to a 3 YOM who had pulled a pot of hot oil onto himself. He was very lucky. About 3% burns to his arm and similar to his face. All looked pretty superficial and he’s going to be ok but I must say that jobs like this get my bowels moving. Always worry about kids in situations where things could deteriorate.

I also got to see my first dislocated patella reduced. Seen many arms and ankles etc but never a knee. The pissed 14 year old had fallen and oops, knee cap round the side of the leg. It was actually really simple. You straighten the leg and it just slides into place. Very interesting to see and something I learnt, always good.

Couple of assaults, a spurious OD and an old dear that woke her daughter up coughing. There was at least one other job but, honestly, I can’t remember what it was; oh there was a 73 YOF with the flu. That’s about it though.

Another Saturday night over and more lives saved. Job done. Not even any prats to contend with although I have a feeling that one of the assaults probably got what was coming but, who am I to judge.

SCARED.

2007-01-13T16:44:00.000Z

Friday night is always busy. Lots of drunks to contend with. Assaults, falls and the usual amount of sick Grannies. I quite like them really as you tend to know what your up against.

Not last night though. It was strangely quiet. The weather was wilde and, I guess, people had spent their cash over Christmas but I don’t trust nights like that. They unsettle me.

Tonight we’ll pay.

HUMOUR

2007-01-11T23:43:00.000Z

A man walks into his son’s room and says, “ I don’t mean to embarrass you but if you don’t stop masturbating you’ll go blind.”

The son says, “Dad; I’m over here.”

IT SHOULDN'T HAPPEN TO A ..................

2007-01-11T19:41:00.000Z

NeeNaw has posted about a couple of incidents at control where the callers were obviously formed from the excess scrotal skin of an elderly, kilt-wearing highlander.

For a while now I have been saving up a couple of stories; this sounds like the time.

We all find it amazing that people, with no debilitating illness, are prepared to wait for 2 hours on an ambulance. Usually when they do the mother, son, husband etc. will jump in their car and follow you to the hospital. Now, this pisses me off because even if they have not got the common sense to realise that an ambulance is not a fun ride, and that we have serious things to do, their GP should.

Last shift, on Monday, we got a call from a GP to a 49 YOM with chest pain. We were, literally, as far away as it is possible to get without leaving the region. Never the less we got there, after some F’ing and Blinding at other road users, within 17 minutes. It was a frightening drive really although it felt like fun at the time.

Knock, Knock – no reply. Shout through the letterbox – not a sound. No one visible through the windows. This is the point that we either kick the door in or call the Police to do it for us. After hearing all the fuss a neighbour appeared asking if we were looking for Mr Y. Yip, knocked on his door and am about to start kicking; that would be Mr Y were looking for. Oh, says she, he left with his wife about 20 minutes ago. Fuck, fuck, fucker, tit, cock!!

Good on him for doing this, although really in this situation an ambulance was required and he’d have been better waiting for us. But couldn’t he of let someone know, even the GP who was calling as he got into the family saloon. This irked me as much as the follow up people.

Should have kicked the door in anyway.

__________________________________________________________

A woman was with her mum for 2 hours waiting for transportation to Hospital A. She had been booked in here by her GP as she has ongoing problems and is receiving treatment here. Getting a bit fed up with this she called Hospital A, allegedly, who, allegedly, informed her just to call 999.

Now this was all crap as the hospital staff don’t do this (although see next post). Up we turn to a 999 and get the story. Fall 2 weeks ago and a sore back. Lovely old dear but her daughter obviously did not realise that ambulance crews come with a fully working “load of bollocks o’meter”.

Yes, yes they told you to call 999, Hmmm, strange that because we can’t take you to Hospital A. No honestly; it just does not accept emergency calls any more (this is true – just to clarify); we will need to go to Hospital B on the other side of the globe. Ah, yes its very busy but the original transport request has been cancelled so you’d go back to the bottom of the list and the weight will be about 4 hours.

Off we go. Sorry about that dinner you’re going to miss tonight. Ah, you heard the nurse say that there’s a six-hour wait. What a fucking shame.

______________________________________________________________

Wooo Weeee Wooo “ fucking idiot, out the way”!! Weeeeee Weeeeee “ pull over, cock!” Woooo Woooo Woooo. Were there. Bag and O2 up the steps, where is he? Watching TV. What’s the problem? And I quote, “ he’s been of colour for the last three months, the doctor took some bloods yesterday and booked him in to the hospital.”

I must have missed something. “So, what’s changed that led you to call 999?”

“Nothing, the person on the phone said they could arrange transport through the bed bureau but it would be faster to call an emergency ambulance.” The reply came.

I looked at her like she was beneath contempt. She noticed and had the decency to blush. Most don’t.

I tried to find out more details about the source of the suggestion, as I have never come across this before. Also it sounded like the bollocks of all bollocks. She wasn’t able to provide much more info and she seemed to be genuine enough. I reported it to the Duty Officer who was equally baffled and followed it up.

It transpired that the GP had to get home for his salad so left it to a secretary to organise transportation. This was her solution, an NHS employee with no medical training what so ever, saying that according to the doctors notes she thought the situation was life threatening. It was her that advised that it would be quicker to call an emergency ambulance. Stupid, stupid, cow. I hope she looses her job. I really do.

If it was her job at all, and not the GP’s, she should have done what she was told.

EDUCATION.

2007-01-11T00:07:00.000Z

Just a thought.

Wouldn’t it be cool if school kids got to read some of the Blogs from people in the Emergency Services. We all know that politicians should, and some do but pay no attention. School kids would get the knowledge of what we do and hopefully learn not to call when little toe is stubbed.

Something needs to be done about the level of unnecessary calls; and I hate to suggest that teachers need something else to worry about but a little project or something would do it. I’m sure that there must be something in schools; I don’t have kids, relating to the evils of alcohol, knife carrying, drugs etc. It could be fitted in with this.

SWAB TEAM 6

2007-01-10T23:47:00.000Z

Further to my application to SWAB I thought I'd submit an example of my "Parkland and Rural Areas Covert Transportation Vehicle"

Not wanting to sound too keen but hay, if you got it ......

ABOUT TIME.

2007-01-10T20:02:00.000Z

This has been doing the rounds a bit today. I'm glad it's been brought to my attention and signed up straight away.

http://petitions.pm.gov.uk/USE-999-PROPERLY/

If you have not by now, please do.

THE BING.

2007-01-10T19:18:00.000Z

It was over a year ago, the summer of 2005. A good hot day where everyone seemed to have a smile on their face. I know I did and my crewmate who is normally grumpier than me laughed on at least two occasions. All was well.

We were on station having a cuppa when the bat phone rang. Motorbike accident at random shale Bing in the general area of Smallruralvillage. Off we went trying to get more precise directions and were advised that we would be met at the end of Road to Nowhere road. As we got to the allotted spot there were a couple of youngsters on Trail bikes that waved and headed off along a track. This was not good; it felt like it was going to be a proper job and seeing these blokes tearing off at speed sent a shiver down my spine. I reached into my bag and got out the stethoscope and tough cuts. Progress was slow over the mud track and it seemed to take forever to get to where the track ended.

Out we hopped and grabbed the response kit, bag, O2, defib and even a blanket. Everything that the manual says you should take and that we don’t to most jobs. Dodging around the police car I wondered where the coppers were and started a half-walk/jog thing over the half mile to where the patients were. I heard another ambulance arrive and thought, “Thank fuck”.

I get a brief history from a kid on a motorbike. Head on collision, probably each doing 40 mph.

Turning a corner I saw two people on the ground with a policeman doing CPR on one. This is where I headed and relieved the copper of this responsibility. Could he hear me? No. Were there resps or pulse? No. Good man that copper, doing the right thing. Checking his c-spine told me it was broken, very broken. Think of immobilising it and then think – better to get the oxygen in and blood moving. I started to continue CPR and one of the Paramedics on the second ambulance tubed the guy and got IV access. He was in charge here so I went to the second patient.

This person was 18 and conscious, GCS 15. Where are you sore? Ok, left leg and arm and your ribs. Head to toe examination to find any other injuries then expose and examine – look, feel, listen. No evidence of c-spine. Yip, pretty sure the arm and leg are bust and think there’s reduced air entry in the right lung. My partner confirms this. He’s already on oxygen and I can’t give Entonox for the pain, as there is a suspect pneumothorax. IV access and Metoclopromide then Morphine. He’s comfortable.

The helicopter is on the way; this should take 15-20 minutes. I see CPR still being done in the distance and new oxygen cylinders and bags of fluid are being brought up from the bus. It really is not looking good for this young man, 20.

I take a BP and get my patient wired up to the defib to see if I can spot anything sinister. Nope all well. His stomach is normal with no swelling or rigidity and his BP is normal. Limbs are splinted. I explain that despite the fact he has no pain in the neck or down his back were going to have to immobilise him, given the mechanism of injury. He’s ok with this; I’ve already cut off most of his body armour, boots etc. so I didn’t think he’d mind. Collar on and some friends are instructed how to assist with a log role as my mate has taken hold of the head and can’t let go. We have time to explain this as someone retrieves the spinal board from the ambulance; they also come back with the Area Officer, a good man.

On to the board and where the fuck is the helicopter? It’s been called primarily for the person who has arrested as a result of the trauma but we are all getting to the point that we know it is, ultimately, going to be futile. We’ve been there half an hour now and it’s getting time to “call” it. He’s been flat line since arrival and probably for the 15 minutes from the accident to our arrival. My colleagues are still pumping his chest with a determination and resolve that says “your 20 and we wont give up, not yet” but a decision must be made. The area officer steps up to the mark as the helicopter arrives.

It kicks up a storm of black, fine dust that blinds us and sticks to our sweating faces. The medics on the ‘copter take a handover and load the 18 year old into the back. Most of the spectators have dispersed at this point with the help of the 7 or 8 policemen who have turned up unknown to me in my focused state. The young man I have been dealing with for the last 30 – 40 minutes has gone. He’ll be OK. Sore but OK. Between us my crewmate and myself covered everything we could think off. Nothing evidently life threatening but x-rays and a doctor will confirm this. I’ll never see him again.

As the dust settles there are half a dozen coppers, with one of them owning braid on the peek of his hat, and 5 ambulance men, one with 3 pips on his shoulder, standing in silence. No one wants to look at the corpse of the 20 year old as if it screams out “why did you stop? Why! Why could you not do more?!”.

Slowly people start to move, gathering equipment, talking in hushed voices. Everybody feels it. Whatever “it” is about this job “it’s” got to us. The other crew are passed their finish time so we say we’ll remove the body to the police morgue. He’s covered up and placed on the orthopaedic stretcher and carried to the ambulance. I catch a look at my face in the wing mirror and that of my partner.

Maybe it’s the dust that covers us but the lines on our faces look deeper – we look like we have just become a little bit older, we’ve left something of ourselves on this remote, barren landscape. But not as much as some.

I leave work and go for a drink, go home and cry. Call my colleague and cry some more. I turn up at work the next day, not because I want to, but because I need to be with someone who understands.

I don’t know why, but I took this one home. I can no longer remember their names but I will always know their faces and I will always recognise the haunted look on my partners face as we closed the doors on the back of the bus.

THE WONDER OF IT ALL.

2007-01-10T17:15:00.000Z

Sometimes I wonder, just wonder why the country is full of Chav's.

Adverts, on the radio and TV, state that one in five people have difficulty in reading, writing and sums. In my day it was reading, writing and arithmetic, to say nothing about maths.

I dislike these people, not those that have a genuine problem with learning, but Chav’s. I know that there may have been unfortunate family circumstances and that they are not responsible for their own actions or behaviour. God help that they should take ownership of their attitudes or attempt to turn up at school for more than 2 days a week.

Why when they have six or seven siblings are they so maladjusted to general society? Why, having lived with the deprivation that having parents that have never worked creates, do they breed at 15? Why is Burberry so popular? Why don’t they realise that everything will be provided for them by the state and that having a job is bad for their image.

Sometimes I wonder, just wonder.

THE DARK SIDE OF IT.

2007-01-10T16:07:00.000Z

I seem to remember reading somewhere, in the distant past, that research has found that there is no relationship between the moon being full and an increase in admissions to A&E.

I guess that this must be true as a whole bunch of people with BSc's and knowledge of statistics have proven this. So, accepting the fact of this I must say it is, to my mind, total crap. There is a change that takes place over the full moon.

Now, there could be a number of reasons that statistics dont show this.

They may not pick up the fact that on any friday night the ambulance service is at capacity. If the most jobs that can be done by a crew in a shift is 14, then an increase just means people dont get an ambulance before they decide to go home. People go home with a cut eye rather than get themselves to hospital by taxi so no increase in admissions.

The type of incident is different. On any given night there may be X amount of assault. These are usually drink induced in a pub and involve a couple of scroats that would be better off being used as practice targets for knife throwers. When the full moon shines it wonder on the earth there may still be only X amount of assaults but these seem to be more random. Innocent blokes walking home to the wife after a couple of drinks with his best mate. Kerpow.... he's on his back while some scum he's never seen before has hit him over the back of the head with a bit of 4*2.

I tend to be silly enough to believe research but I know from experience that the full moon thing is not just an urban rumour. The moon exerts quite considerable powers on the earth and people have even worshiped it. It makes my back hurt and I tend to wake up naked in a field with a funny iron like taste in my mouth, I think my nose must bleed too as my face is covered in blood. Strange.

Anyone I have brought this subject up with in the emergency services, and those I know in education, say the same thing. Beware the full moon. The next one is on the 19th and I'm on a rest day. How cool is that.

ASSISTANCE REQUIRED.

2007-01-09T22:26:00.000Z

Yip, I’ve seen someone.

Angrier than usual with the underclass yesterday. Was hurtling through Northtown on lights and sirens to a suspected MI when we got flagged down by a bloke about 20. This was at 1730 hours.

Radiod conrol who allocated a job number and would of had to find another crew for the 64 year old having a heart attack. “my mates collapsed” sais young man 1.

“What happened?” says I.

“He’s pretty pissed, we’ve been drinking since 11am” says young man 1.

Red mist crept into my field of vision, a target forming between the too close together eyes.

Combined with last nights whisky my thoughts were extreme. Please accept my apologies.

MOVIES.

2007-01-09T03:40:00.000Z

Now, I was not going to blog tonight because it's my Friday night. I've just done 48 hours and although it's a Monday this is my Friday. I own this time. I can do what I want.

Monday night TV is pants so at this point in the shift pattern I get a couple of DVD's and settle down with a drink. Tonight my drink selection was one of the rather pleasant malts that I got gifted over the festive period and the DVD's are as described below. I have had much fun and wish to impart this to the general public. The post is about the films.

First I watched "NACHO LIBRE". This is the sort of film I like. Switch of the brain and leave it ticking over in neutral (my normal state). Laughed a lot and thoroughly enjoyable nonsense. Jack Black makes me laugh.

Secondly, "TONY JAA, WARRIOR KING". Boy this was good. Everything I love. Enough contrived sentiment to bring a tear to my eye and kick ass moves that had me on my feet. I'm too old, fat and slow to ever think of kicking ass but when you see a movie like this I want to move to Thailand and become a lethal weapon. I truly believe that I could do it at the moment. Tomorrow I'll have a hangover and feel 90. Enjoy it while I can. If you have even heard of the movie "Blood Sport" this is your thing. (the same with "Born Free")

Lastly, and if you have red this far your in for a treat, was "BEERFEST". If you have ever been young and had a good time with good friends this is the movie for you. It's a bit from the male perspective but women are just as guilty and know the score, probably better than we do. If I wasn't grinning like a fool I was laughing out loud. I know these people and am, in fact, one of them. It may be sad to admit but this is one of the best films I've seen in ages. Watch it. That's all I can really say. If you don't like it then your more mature and responsible than me, and god bless your little cotton socks for that.

TODAY.

2007-01-07T19:44:00.000Z

I've been trying to fight of a cold for the last 5 days. It has inspired me to try and stop smoking again. I think, however,that the double whammy of man flu and nicotine withdrawal could explain yesterdays paranoia and inability to join up any two thoughts.

Today was a good day though. Only once did I have to refrain from hitting someone. Calling an ambulance for a sore throat you were at the doctors with on Friday is stupid. Stupid people breed. Breed lots. More than the average bear.

I'm shivering, have a runny nose, headache and everything hurts. Just one punch would of made me feel so much better. If it was in the right spot it might of stopped him breeding. Even the thought brings a glow to my otherwise pallid, snot-covered visage.

Of to my scratcher early tonight. My eyeballs hurt.

TODAY IT WAS NOT MY FAULT

2007-01-06T19:46:00.000Z

Not sure if today was a good one or a bad one at the office.Of the nine jobs 3 of them actually required an emergency response, which is ,sadly, a pretty good percentage.

Sometimes you turn up and have a great day. For no particular reason you enjoy the company of the patients and have good crack with your work partner. The illnesses are never out of the norm but seem more interesting. You get to a good trauma and everything just slots into place. The patient gets assessed, packaged, delivered and you leave hospital feeling like you did a good job.

Not one of those days. It could of been if it was not for the second last job of the shift. Sometimes you turn up at a good trauma and feel like a clown.

We were at the hospital dreaming of food and a hot coffee when we got a call to a rugby ground for a "traumatic injury, dangerous body area". Not having any more information and not knowing if this means that the patient has very sharp fingers which need to be kept clear of we hit the road. Now, I played a bit of representative rugby as a school kid so kind of like these jobs as I feel at home it the mud and the chances are I'll know the coach, or nowadays the parents of the team member.

Turning up at the ground I said to my colleague that we probably shouldn't go on to the grass as we could get stuck. I would stress at this point that I was NOT driving. Not this time. The patient was surrounded by waving friends all looking frantic and I had to close my eyes as we mounted the kerb. Four metres later there was the all to familiar feel of an Ambulance becoming sucked towards the centre of the earth. Oops but hay, at least I was not driving.

The referee ran up and gave us an idea of the injury which was spinal and potentially dangerous. We unloaded the spinal board, head hugger's, straps, blankets, oxygen, response kit, radio, mobile phone. Everything we could think of and headed off the 300m to the patient.

Someone had placed him in the recovery position which may not of been the best thing for the suspected injury. You should really leave them alone if possible, in my book, if the airway is clear. Anyway, it's usually the best thing to do so I'll let them off - no hand slapping's.

The story was that he had been tackled, landed on his head and his body had gone over the top forcing his head further forward than his creator intended. His creator was a generous man, at 5'10" and I guess 19 stone there was a lot of him. A good old fashioned prop from the 1970-80's before they all became professional athletes. Consequently there was not much of a neck to be in danger but this could be very serious so you always suspect the worse and treat accordingly.

His spine was tender from about c3 to t4/5 (middle of the neck to the shoulder blades) with some tingling in his left hand. Ahh, warning signs, I wanted to get a collar on, immobilise the man and get him out of the cold and on the way to hospital.

My colleague was at the bus arranging for a second crew to come and transport the patient so I tried to radio her on the mobile handset. It's broken - again; it was "repaired" 2 weeks ago.

Middle of a field with a stuck Ambulance, again, with an audience watching as I start to swear and grumble under my breath. Without our bits and bobs were first aiders like any other. So, as I was unable to do anything on my own I stood there for a minute trying to calm down and explain to the guy what a complete tool I was feeling.

Luckily at this point a couple of his mates ran up; one was a water fairy the other a life guard. Both with training in the use of a spinal board. Could I be saved? Yes!!! We were also joined by a consultant urologist who lived across the park. Magic, the doctor took control of the head/neck and on we put a stiff collar. This went terribly and I knew it would. I think I'm OK at my job and hopefully I'm at least that good. Getting even our shortest collar on to someone whose shoulders start around his ears is never easy. I hope the doctor know this because I felt like I had only thumbs with which to attempt this maneuver.

With the assistance of the buy standers we managed a log role onto the spinal board, got blankets back over him and then I discovered I'd forgotten the straps. Bugger!! Really I'm not this incompetent but with my mate still in the wind I was once again having to send a runner to the bus for equipment. Once on a board there is only about half an hour before they have to come off, bed sores develop and our A&E wont accept them. The clock was ticking.

At this point the other ambulance turned up we strapped the patient to the board and the long slog started. The patient had been on the ground for about 40 mins. by now and I wanted to get him warm and away a.s.a.p. Normally I bring the trolley out the bus which makes placing someone who is immobilised on it really quite easy. Not today though and with the helpers not knowing the footsteps required to dance in an ambulance we all but dropped the poor guy.

Anyway, away he went leaving us to get a tow out of the swamp by a very kind man with his Land Cruiser.

What did I learn:-
1. Do not drive on the grass.
2. Double check that I take everything I may require when walking any distance from the van.
3. My mobile phone is better than the service radio system (everyone knows this really, I've just never been caught out before).
4.If I do something stupid keep my head. Because there's a consultant something there that should not bother me, it normally dose not.
5. If it's my patient at the time work my way. Everybody dose the same thing but develops their own way of doing it, so - get the trolley out the back.
6. Even relatively straightforward jobs can leave you looking, and feeling, like a bit of a Gumby.

There will be more I learn from this as I ponder it through the night. I love my job and in particular incidents similar to this. I normally leave thinking that I've done a good job and feeling proud of what I do and how I do it. Not today though.

Bad day at the office.

BACK TO WORK.

2007-01-05T19:46:00.000Z

Well the first day back at work is over. It went something like this:-

Job 1. Epistaxis (bleeding nose).
Job 2. Code Purple (person who has been dead for some time).
Job 3. Code Purple (getting a bad feeling about today at this point).
Job 4. CVA (stroke).
Job 5. Patient with tracheotomy with breathing difficulties (more to come).
Job 6. 2yo with a cut to the head after a fall (nasty cut, poor wee sole)

So not too busy and not as bad as I thought. job five made me angry as I usually am when I find out that people are better off than me by living on the dole/state. Apparently she's disabled because of the tracheotomy so has a brand new Nissan x-trail. It's just all so fuc*** up. bring back the poor houses.

BACK TO THE REAL WORLD

2007-01-04T18:14:00.000Z

Been watching the news now I'm back in the world of TV, and....

Well there are going to be shortages in the NHS over the next few years. I am aghast, how could this not be seen. Amazed that cuts and the politicians lies mean that Doctors are moving abroad and that there is a shortage of Nurses. How could things get to the stage where it is one of the lead articles on the national news? Surely someone knew, somewhere!!

Also, a 9yo girl in America has been neutered and subject to medication to stop her getting older. I have no problem with animal testing, stem cell research etc. etc. but this made me feel sick. Her parents think that because she has the mind of a 3 month old baby that this is OK. Hope they burn in Hell, or whichever particular pit of despair they believe in.

Where's that ferry timetable; I need a holiday.

GUESS WHAT I GOT UP TO...

2007-01-04T16:01:00.000Z

Well, I'm back from a fantastic week on Islay. I must say that it a beautiful place and that I'll be back; largely because my mate has a holiday home there but also because I liked it so much.

Much alcohol was consumed, food eaten and a general feeling of good will spread through the land as is the theme of the season. The weather was awful however. I don't think the wind got below 50mph at any point with gusts over new years eve in excess of 100mph. It was exciting though having to batten down the hatches. It rained most of the time too with squalls being driven of the Atlantic by these gale force winds. I love it really, cooreying down in front of an open fire with the weather doing its best to let you know who's boss.

For the first time in my life, though, I went land yachting (hence the pic.) and I loved it. I've done a bit of sailing in my time but it's really quite easy and don't think this helped much. I'm quite a big lad and it takes quite a breeze to get me going so conditions were perfect.

It's a bit like setting up a wind surfer on wheels except for the fixed mast. 10 minutes and your off. I loved the exhilarating of tearing along the beach at 30-40mph with my bum only inches from the sand. Of course I got soaked to the skin but, hay, what the hell...... I'm going to buy one.Love it, love it, love it. The last sport I tried that took me like this was surfing, not that I do that much anymore so why not. I only live 8 miles from a beach.

Hope the holidays, if you got any, were as good as mine and that '07 is fab..

NOT AGAIN!

2006-12-28T08:13:00.000Z

Last night I was driving, we take alternate shifts at this, if that's what you could call it. We were at a job in the middle of a park for a kid with a sore back.

I managed to reverse into the fence around the play area resulting in minor damage. As a result of this, however, I was feeling particularly stupid so headed away from the offending post - into mud.

We waited two and a half hours for the rescue truck who took a further hour, and 3 broken tow ropes, to get us out. So a quiet night work wise as a result. Luckily I'm off over the new year week and the copious alcohol consumption should clear my head. No doubt I'll return to a disciplinary hearing and a retraining course which, in all honesty, may not be a bad thing.

I'm off to a whisky soaked Scottish island tomorrow for a few days but will let you know how bad I was feeling on the 1st when I get back. Happy new year to one and all.

NURSING HOME; WHAT NURSING, WHAT HOME?

2006-12-27T08:56:00.000Z

Was trying to think of a good work related thing from last night, and there was a couple but I kept thinking about the call to a nursing home. Now there is no accuracy in either part of this title. There was no discernible nursing and it certainly was not home to anyone there.

I find it really sad when I enter one of these places and see two or three elderly people crammed into what would be called a double bedroom. These people worked, saved and had their dignity only to have it rot away when they are least able to do anything about it.

Tonight's job was to an 85 year old man who was apparently "powerfully" cyanosed. Not knowing this particular medical term we got there pretty quick and rang the bell. A couple of minutes later a care assistant type person answered the door and pointed us down the corridor. Getting to the end of this corridor we discovered that we were alone so headed back to find someone who could show us a powerfully cyanosed man.

Up the lift, along the corridor and into the room. There was this frail, skeletal man with blue lips struggling for breath lying on the bed, in his curtained off quarter of the room.The "nurse" started to tell me some history but, and hopefully she thought I was impolite, I ignored her; sat the man up, which is basic stuff for people who are short of breath, and got on the O2.

Keeping an eye on the patient and knowing my mate was busy with sats readings, BP's etc I got the story. Mr Powerful had been a resident for some months, he had breathing problems but they were not sure what and were unclear about any other medical conditions. He had been discharged from hospital earlier today, as he had been in with a chest infection, with steroids and antibiotics.

Now, I didn't even know his name at this point but would bet all of my mates monthly salary that the man had emphysema and dementia. You could hear the gurgling in his lungs and sitting him up should be the first thing anyone does, even a nurse in home. I would of also thought that a little bit of knowledge of what the medical history of a resident is would go a long way to helping formulate any care plan.

What really disappointed me though was the fact that they had not given this poor man any of the domiciliary oxygen that had so thoughtfully been provided for his benefit. A huge black and white bottle of the good stuff was sitting next to a powerfully cyanosed, emphysemic with a chest infection and the nursing staff in a nursing home did nothing but provide us with a print out of his next of kin and GP's address.

We took him back to hospital as much to keep him out of harms way as anything else. Hopefully they will keep him in until he's well enough to survive the neglect that his family probably pay £400 a week for and know nothing about.

It sickens me and makes me angry. This is negligent: but it happens at every home I go to.

NICE THINGS.

2006-12-27T08:45:00.000Z

There are nice things that happen. One thing I think is nice is a good scratch.

A new nice thing is getting comments on this blog. I'm fully aware that most of what I blether on about is largely for my own benefit. A cathartic rambling of disjointed, half thoughts. It has also meant that I have found new blogs to wile away the hours, I need to update my list.

Thanks everyone. I appreciate it.

WHAT??? I MEAN WHAT!!!!

2006-12-27T08:34:00.000Z

I was driving home after last nights shift and heard on the radio that the government is to plough millions in to Britain's most antisocial areas. These areas are to be called "RESPECT AREAS".

You will never teach these Burbery clad scrotum's respect. You can't even teach them English. Still, nice to see yet another well thought out project from the government. Just as well we have all those policemen on the streets or that could of been where the money went. Thank God that long term solutions to a problem don't win votes or who knows where we would be.

I CAN ADMIT WHEN I'M WRONG.

2006-12-26T07:55:00.000Z

Well, I was wrong! Christmas eve was quieter than I anticipated without the run on drink related issues that I was expecting. Last night was also unexpectedly free of family boxing. Not that we were not kept going just that we were not chasing our tails as much as I expected. Quite good nights for us with most jobs being "proper" jobs where an ambulance was required for whatever reason.

The biggest thing I was wrong about though was our last job on Christmas eave. The call came through as "21 year old male fallen in stairwell". Now, I'm a cynic by nature and experience so heading en-route there was a pretty high expectation that we'd be attending someone full of Christmas spirit who had fallen asleep in a stairwell.

Well; as we walked up I did a quick assessment of the scene and thought to myself "bugger, that's got to hurt"! It did. There was this young chap sitting on the bottom stair clutching his thigh. The complete leg was rotated through about 100 deg. and there was another knee up by the top of the femur (long thick leg bone between knee and hip).

In situations like this really anything we do is going to hurt. I gave him some morphine, actually quite a lot of morphine, and we immobilise as best we could the injured leg, this hurt. We then had to get him on to the stretcher. As mentioned he was sitting on some stairs and this is never an easy maneuver. Getting him on to the scoop from this position really hurt. It involved quite a lot of sudden movements as he made the sitting on a stair in pain to lying on a stretcher in even more pain transition.

Once on the trolley we further immobilised the leg trying to make him as comfortable as we could. There was good distal (below the fracture) sensation and piedal pulse. The fluids were up and running and his blood pressure was stable at about 115/70. The swelling was massive, you can bleed up to about half your body's blood into the thigh when there is a nasty break of this bone.

Really that's about all we could do other than get him to A&E as smoothly as possible.

Talking to him through all of this it transpired that he had a prosthetic knee following bone cancer. He'd got the all clear 3 months ago. Despite the pain and us having to lug him around, making everything worse, he didn't even swear. Brave, brave man to my mind.

I apologised to him for the things we had to do and the pain we inflicted. I think he understood but I still feel bad. Sometimes no matter what - you just have to get on with it, even when you know it's going to hurt and sometimes make things a little worse.

I know that this man is waiting on the consultant to make a decision. A big decision. The replacement knee was quite extensive and where the break has occurred means there is not a lot of bone left for them to do anything with. He may loose his leg. He's 21, f***k I hope not.

SEASON OF GOOD WILL

2006-12-24T17:42:00.000Z

Well, here we go. I'm just back from a couple of days away -- ah relaxation -- and am back for a string of five twelve hour night shifts. Don't mind this really but hope that people behave better than I expect them to. Including my self.

Anyway, happy Christmas to everyone and I will let you know about any interesting Christmas frolic's that I happen across. Enjoy!!

A LITTLE KNOWLEDGE....

2006-12-20T22:02:00.000Z

It's a sad admission but I can't remember if this job was from today or yesterday. Everything just becomes a blur after a while, merging into the mulch that is my brain.

A call came through as an "alcoholic feeling unwell", now this has all the hallmarks of a job that is a load of pish and, well, I'll let you decide...

The patient had been known to be an alcoholic for the past 18 years. 7 weeks ago he had what sounded like a severe gastric bleed, although his wife said it was ruptured osophogeal Varese's. These Varese's can burst like a balloon and spurt like a fountain. I've never been to anyone, and that's only 2 people, who has survived this. Usually there is more blood on the walls than in them; although caught in time they can be banded. It may of been osophogeal varisees - I don't know, I'm no doctor.

Following this admission to hospital he stopped drinking and was discharged 3 weeks ago. He was given medication including Diazapam, which is to help manage the withdrawal. The other medication was for his (mild) dementia.

Three days ago he came up to his sons for Christmas. Here his son was concerned that his dad was a bit drowsy and not as coherent as he expected, so he phoned his sister. His sister is a policewoman and as explained by him "she knows all about this sort of stuff". (now i have the greatest respect for the police so don't think that this is a jab at anyone/any organisation). I have no doubt that she has encountered Diazapam in OD's or with our Jakie friends and this exposure enabled her to form the opinion that the Diazapam should be stopped immediately.

Roll on the next day and dad suddenly starts to shake and becomes unsteady on his feet. He manages to soil himself, but this is not an uncommon thing according to his wife. He also kept falling asleep.

We turned up and helped him to the bus and to A&E, where they prescribed ......... Diazapam.

I thought everyone knew not to suddenly stop a prescribed medication. Knowing of a drug in a particular set of circumstances does not lead to a knowledge of it in all. I know very little about some drugs and nothing about most. There are the ones you come across all the time but then why some patients are prescribed a particular eg. antidepressant than another is well beyond my ken.

A little knowledge is a dangerous thing. The decision to withdraw their fathers medication could of led to seizures/stroke many things. Leave these decisions to those who are supposed to know.

THERE THERE.

2006-12-19T19:59:00.000Z

Not a particularly busy day today. Elderly people only and only urgent cases. Not one of them needed an ambulance and only one of the seven wasn't followed to hospital by a relative in a car. They all walked, only 3 with a helping hand.

Still all very nice people, and it gives us something to do when there are no ill people.

JOB DONE!

2006-12-18T22:20:00.000Z

At the moment it's -4c here in the wopwops. I've bought, wrapped and delivered all the x-mas presents I need to.

Job done!

REQUESTING INFO.

2006-12-18T02:14:00.000Z

Puke, vomit, shit, alcoholics, Ferrel people. I'm use to the smell.

I'm lucky enough to have never been called to a two week old corpse. BUT, Is there a remedy to the smell of some body who has been burnt to death?

It kind of lingers.

EMOTIONALLY

2006-12-17T23:16:00.003Z

I sometimes wonder about how my description of my job comes across. I cant stress enough how much I love my job. I've done many things before finding this including (mostly as a student)
1. Bar man
2. Door man
3. Bank Clark
4. School janitor
5. Ski instructor
6. Furniture manufacturer
7. Locations assistant manager in Film/TV

For most of my working life I was a Chartered Surveyor. A job I think I liked in essence but honestly didn't like the people I worked for. I never had that greed for money or the inherent desire to be a businessman. I left surveying to join the police but due to a home office directive at the time, they did not employ asthmatics. What would I do?

It took a bit of time and a spell building database driven intranets to find my calling. It was a bit of a fluke really. A girl I have known since I was 3 has parents that go to church with my mum. She's a paramedic. I met her for a drink and had a chat. 4 years later I too am a Paramedic.

I love my job and will always be involved with this work. There is no greater reward than helping someone who is in trouble or seriously unwell. We are limited in what we can do, our remit is to get people to hospital, but we can and do make a serious difference to those in need. We save lives or at the least give people a chance that they would not otherwise have. We reassure, console, relax and sometimes make people laugh. Despite the fact we give morphine, fluids, adrenalin, oxygen etc. 80% of what we do is make people feel that they are getting the best care possible, and they do.

There is a bit of political piss with the "technician/Paramedic" thing but I would rather have a good Technician turn up to one of my parents than a burnt out Paramedic.

I once thought I was worldly wise. As a surveyor you go into houses all over the city; good neighbourhoods and bad. I also thought I knew people. I knew people from my background and speculated about the rest. My eyes have been opened. In a country where 1 in 5 people leave school unable to read/write or do "sums" I shouldn't be surprised with what I come across.

As far as I am concerned the welfare state has destroyed this country. We are now into 3 or 4 generations of people who have no intention of working. It is more beneficial to have a few kids and live of the state. This is the education they get from their parents so why bother at school. And, lets face it, their right. I'd be better off having another 2 kids than working and having to pay child support at the same time.

The biggest thing though is that people, the general, undereducated people have no idea about self responsibility these days. We live in a Nanny state so I shouldn't be surprised when they expect an ambulance for something trivial. There are two factors in this:-
1. Age
2. Education

Age. Well, the number of people over 70 that don't call an ambulance when they should is amazing. I spend a lot of time telling them that that's what were here for, if they have chest pain etc. it's my job and I enjoy helping them. The NHS was established for these people but they seem reluctant to bother anyone. I get a great deal of reward from helping and reassuring these people. People under 50 think of us as a taxi. Screw those people who are ill/dieing, we want a lift; no really that's their attitude.

Education. Well I'm biased. I had a good education and so did all my friends. We lived it large in our day but never sought trouble and always looked after our friends. We still do. We always knew we'd work for a living and that there was a point where we would have to be responsible for ourselves. This just don't happen in chavsville.

I love my job. I hate the state of the country. It started with the Tory Thatcher and is going on with the Tory Blair.

God help the emergency services.

Sorry, ran out of steam on this. could of gone on for ever.

BUSY, BUSY.

2006-12-17T18:41:00.005Z

As mentioned I've been on nights Friday and Saturday. I'm still recovering and trying to re-set the clock for day shift on Tuesday. Never easy.

Friday night was mad. I think it was the busiest night of the year so far. normally it's the Friday before Christmas so next week could be worse.

What did we do? Well we did:-
3 chest pains
2 difficulty in breathing
5 assaults
2 D&I
2 urgent cases (where a GP has seen the patient and booked transport)

I was quite impressed with one of the D&I's. I've seen it before, but was breath taken by the achievement of the individual involved. This 19 year old student had got so incredibly drunk that not only had he passed out, GCS 9 (Below 9 is a coma) he had filled his breaks. The stench was terrible. Clouds of shit guff hovering in the air, mustard gas would be less toxic. The volume passed also exceeded anything I have previously encountered, so I obviously managed to get some on my trousers. Luckily for me he diluted this with vomit en route so off I was to get changed.

The second urgent case is still irritating me. 48 year old Mrs Y had to wait 4.25 hours for a lift to the hospital. Her GP suspected a UTI ( Urinary Tract Infection) and in an open letter, which she had red, suggested that she be monitored and on fluids for 4 hours, unusual for a GP to be this specific but there you go. When we turned up she was waiting and walked out to the bus with her husband saying, as expected, I'll follow in the car. FU**ERS. She would of been getting ready to go home if she'd jumped in her husbands car as suggested by the Doctor. People really have no concept about what we do and the limited resources available, even on "quiet" days. Hope her piss burns for weeks.

Saturday was unnaturally quiet. Not to say we were not on the move all the time just not under the same pressure to clear at hospital for the next job.

4 assaults
4 chest pains
2 DIB's

Normal stuff really.

One of the assaults could of potentially been vary serious. A 23 year old male had got into a fight at a club and he Had been "glassed". Why someone would glass this 5'3" Gent was beyond me. He walked like a Paratrooper with the jaw on his shaved head thrust out and was kind enough to ask everybody to fu*c off before he bumped into them. Anyway, the glass shattered cutting deeply into his neck. It had sliced through the skin and partly severed the thick corded muscle that runs down the neck. In hospital they could see the carotid artery through the wound. Another couple of mm and he'd of bled out before we arrived. His cousin was with him. A very pleasant woman who would not stop shouting about the revenge that the family would take on the culprit and refused to do anything asked of her because everybody in the police and ambulance service is " f***ing stupid". Last I herd they had both been nicked for breach while in the hospital. Such a shame, such nice people.

I actually like being this busy. Time rattles in and before you know it your asleep on the station couch after finishing time because your to tired to drive home. They were good nights and the people who needed help got it despite the mayhem.

UTTER, UTTER RUBBISH!

2006-12-15T15:08:00.000Z

My attention was brought to a particular toilet paper article by the most excellent blog "Random Acts".

There is not much more to say other than read the comments. And the article in question, below.

http://www.thesun.co.uk

My twenty cents are that there is a difference between rural crews and town crews in this regard.

I sit somewhere in the middle. We're supposed to be a ruralish crew but spend most of our time in Northtown as there are not enough crews there to cover the workload.

I know that in more rural stations they accepted the derisory offer from the ambulance service of £250 a year to "buy back" the meal break time we no longer get paid for. To make it clear when we are on our break we are not working. We could go home, shopping --- if there was time. A call during these welcome breaks is the same as calling you in to work from home, in effect.

The acceptance of this miserly sum, in ruralshire, was largely because the workload is not at saturation point. Crews are more likely to get time to have a meal during their shift without having to set aside a special "window" for this. Also there is additional social responsibility within smaller communities where you may be the only crew serving the community in which you live.

In larger cities or towns the £250 was stuffed up the services arse. This equates to an offer of approx. £2 an hour for overtime. It is not that crews do not care, of course we do. It would be a pretty thankless job if it was not for the reward of helping people who really need help. Rather the refusal is because 1. The offer was an insult 2. We need a break.

45 minutes away from work in 12 hours is not bad. If lives are lost it is because there are not enough crews around to meet demand under normal circumstances; not because humans need to eat to survive.

Eating aside, the 20 or 25 minutes you get off the clock makes a heck of a difference to your mental state over the 12 hours. Never getting fed was always a main complaint. Now its not. I wouldn't go as far as to say moral was better, just that we cant moan about being starved any more.

As for people being "forced" to finish a break, well - their not at work, not getting paid for it. The problem is more of finding the time to eat/rest rather than being made to. If there is an issue with a shortage of ambulances then there are things that could be done.
1. A reasonable offer to buy back the 45mins a day could be made. Although this would have to be "healthy" for me to consider having experienced the luxury of undisturbed breaks.
2. Additional crews could be put on the road to meet the underlying demand.
3. The "right" to transport by ambulance could be varied. It's never the ones who need/deserve an ambulance that complain. It's the bleeding warts and drunks that take exception to waiting. We should be able to refuse to transport such people where transport by emergency ambulance is not "appropriate or necessary". How many crews would this free up? I guess between 50% and 60%.

WEEKEND

2006-12-15T11:44:00.000Z

On the coalface for Friday and Saturday night. I don't actually mind working these nights as you tend to know what your up against. D&I's and the regular PFO's (pissed fell over). Given the amount of office parties it will be busier than usual but I guess you can only do one job at a time.

We will see.

Chinese Whispers

2006-12-14T18:49:00.000Z

I was reminded of a job I did some time ago. It was a strange thing but, I guess, not that uncommon.

A 999 call came through for a man knocked off his bike by a car. Now, this has the potential to be a "good job" as there may be some good trauma, which means that we get to use our toys and skills. Obviously its better if there is no injury but if there is we can help; do our job.

The lights and sirens were doing their thing as we battered through Northtown towards the scene. On arriving there was no car nor any obvious patient. There was a small group of people near a bin on the side of the road 100m up. We trundled along and asked if they had seen anything. Sure enough they had the "patient" pinned against the large bin and were asking him various things - no idea what. He was obviously agitated and was shouting at these well doers to leave him alone.

I took him to the side and managed to get out from him the information I needed. He was homeless and had been raking in the bins for clothes. He had about 15 bags of clothing on his bike and couldn't balance it as he pushed it along the road. Hence the RTC - man in road off his bike, obviously a hit and run.

Despite my concern that there may be some mental health issues there was nothing wrong with him physically and just wanted to be left alone. The caring members of the public became abusive when they heard we were not taking him to A&E. Words like heartless, bastard and uncaring were banded around. Nothing new but usually it's drunks swearing at me.

(I can imagine the handover - "was pushing his bike along the road and it fell over. He was GCS 15 on arival with no injuries. We've placed him in a collar and on a spinal board as a precaution and he's had 20mg of morphine because, despite the fact he was in no pain, the bystanders thought I was a c**t for not bringing him to A&E resulting in all his worldly goods getting nicked".)

We contacted Control and started away from the scene. Five minutes later another 999 to where we had just been. Same man, same do gooders. This time however the poor man was angry that they would not just piss off and let him live his life. When he saw us again he started shouting even more and thankfully the well meaning passers by got the message and left. Good.

Informed control and headed off..... 999 to man fallen of bike in Same Street.

Back on scene more pesky Samaritans being yelled at by this poor man. The thing was that he was getting a bit pushy at this stage so my colleague contacted control and informed them that the patient was in an aggressive state. We talked to the concerned citizens and to the "patient" and made the peace. The public went on their way and the bag covered bike was trundled off into the dark by a very frustrated homeless person.

He had gone no more than 50 metres when all hell seemed to break loose. Control had informed the police about the aggression and they had sent the armed response unit.

It's good to know that the police are there like that for us, I know that the other emergency services get extra special care from me, but really. I don't know what message was passed on and how it was distorted but the look on this poor mans face was a picture.

I have never seen someone crumble so efficiently in my life. The World landed on his shoulder in the space of 1 second. His shoulder sagged, his eyes lost their shine, his mouth drooped and I'm sure I heard the words "what the f***". I'm sure if I was close enough I would of heard his heart break.

Fortunately the police used the common sense required to do their job and the man was last seen heading to his favourite bench. Don't know what he thought he'd done to deserve this night, but don't think he'll forget it soon. I'll never forget the speed at which someone can suddenly look so completely dejected and set upon.

The thing is that he was set upon. I think it is highly commendable that people take responsibility for their fellow human beings and feel that they are able to call on emergency services when their required. Sometimes though they can do more harm than good. This poor man was looking for a new pair of shoes and ended up surrounded by half a dozen cops in Kevlar and ceramic plate. If people would use their ears and common sense things, sometimes, would be better all round.

Poor bugger.

NO LAUGHING

2006-12-13T22:17:00.000Z

One of the things I like to do is catch a wave whenever I can. Don't get out much these days and may never go again after seeing this. Still trying to get the stains out ... and its only a photo.

MORE LAUGHING

2006-12-13T22:15:00.000Z

I'LL DECIDE

2006-12-13T17:23:00.000Z

Something people should not do, when an ambulance turns up, is to greet us with "they'll need a chair". Sometimes they will but let us assess this. The fact that you have declared the appropriate means of removal makes it more likely that we will get them to walk. Because someone is more comfortable lying in bed does not mean they cant walk. If they can make it to the toilet they can walk. Remember this you divot!

I have a bad back anyway so am not inclined to increase my pain and shorten my working life just to keep you happy. The chances are that you have little idea about whats going on and what our job is, so bugger off and let us get on with it.

Just something that pisses me of.

CATCHING UP

2006-12-13T16:15:00.000Z

Having a couple of days off, and given that Christmas is coming, I went out with one of my mates for a couple of beers on Wednesday night. It was good fun and great to catch up as I'd not seen him for a while, ages actually, and it's been my fault. Much ale was consumed and feeling a bit green around the gills at the moment.

While we were out we also ran in to some of the nursing staff from A&E. I've never met any of these folk socially before. It was good to meet them and get to know them just a little bit better.It's strange how you can see someone almost every day at work and not really know anything about them.

A TRADITIONAL FAMILY X-MAS

2006-12-11T21:30:00.000Z

Dear Sir/Madam,

I am writing on behalf of the people who gave birth to you, raised you and, in most instances, nurtured, loved and worried about you.

As you may be aware Christmas/the winter festival, call it what you may, is only two weeks away. This is generally regarded as a time of good cheer where friends and family get together to celebrate a christian festival or simply to wish each other well. Traditionally there will be a meal for the whole family and the exchange of presents, large or small, and an expression of love and good wishes to those present or, indeed, mankind in general.

It may, therefor, be regarded as an unseasonable gesture to contact the accident & emergency arm of the ambulance service requesting the removal of an elderly parent immediately before or on Christmas day. I understand that they may be incontinent, have very poor mobility or even Alzheimer's but, believe me, the hospital is no place for them to celebrate. They are crowded with ill people who would love to be with their family, if only this was an option. Our staff members are experienced and professional and will generally know within a minute what a heartless shit head you are. Irrespective of the accurate description of the symptoms you found on Google for bird flu the physiological elements will not be present; no matter how much you tell us you think they are.

Additionally, the likelihood of other members of the public becoming genuinely ill over this period are the same as on any other day. There will be as may cardiac arrests, strokes, chest pains etc as at any other time of year. Consequently the crews who are on shift will be quite busy enough without trying to provide respite care for your unwanted parent/relative. May I respectfully request that you enter into the spirit of the season and take some responsibility and show goodwill to those that love you.

Failing this please try and refrain from hitting relatives, that are able bodied enough to attend your shindig, with anything too hard or sharp. Despite the effects of Stella and vodka this may cause harm. Even the application of a fist at speed may be detrimental to the well being of both your brother/father/uncle/wife and yourself.

Should you choose to have your traditional gathering and party games it would be of benefit to remember that there are limits to how much alcohol you can have before driving. Your 3 year old daughter will not understand that you are putting her life at risk, even when you hit the wall and she hears her neck break.

Wishing you the best of the season,

Iain MacBain

I MAY NEED TO APOLOGISE

2006-12-10T22:10:00.000Z

I may need to apologise, at least a little.

It's very easy just to let rip at some anonymous, faceless, cretin when you know not much about what they get up to. I do this lots - to our control, to traffic wardens, to most drivers, to most things that make absolutely no sense in anybodies world.

This is NHS world so, and it's the same in any public service, there is no reason. No rational with dealing with the great unwashed. It's a bit like trying to have a sensible conversation with spinach, you just don't seem to get the answers you expect.

I know this. I know it's not easy and I know the systems in place suck. I give NHS Direct/24 a hard time. They know as well as I do that they take the piss a bit and while I do get frustrated, and hate them at times, I guess that I'm spared the agony of working in a call centre.

I found TALES FROM TRAGEDY TOWER through NHS BLOGDOCTOR. I now understand a little better, sorry. Love the blog; keep it up,( I know that none of you are really cretins).

HMMMMM!

2006-12-10T20:55:00.000Z

I think I probably started smoking because I thought it was cool. And who wouldn't with Audrey babes doing her nicotine thing. Stupidest thing I ever did though. Don't even like it.

I recently stopped for nine weeks. Fantastic!! Then I got a bit drunk two weeks ago. Back to 20 a day.

BATTENS DISEASE

2006-12-10T20:12:00.001Z

Today was not to busy really. Very quiet early on with the afternoon picking up.

One of the calls was to a patient with Battens Disease. I had no idea what this was so looked it up a minute ago. Apparently only about 500 people in the world have this particular genetic disorder. A gene has to be inherited from BOTH parents and then there's a 25% chance of developing the disease.

Basically the body can't absorb certain enzymes/fats leading to various symptoms including seizures, blindness and it destroys the cells in the brain. The patient was having a seizure. This seizure lasted 30 minutes before we arrived, despite medication. Prolonged seizures like this is called status epilepticus.

We gave her some Diazamuls to try and stop the seizure then grabbed her and ran. You don't hang around in this situation. Her airway was secured with a small oropharangeal airway (a small tube to hold the tongue away from the wind pipe) and an oxygen mask was put on. The seizure continued the whole journey in. There was saliva in her mouth so suction was necessary at times during the very fast trip. By the time we arrived at the pre-alerted hospital the seizure had been ongoing for an hour.

The doctors were intubating her when we left and giving other medication to try and stop the fit.

She was only four years old. I hope that she's OK. I'll think about this wee girl for a long time.

HE'S GOT THE LOOK!

2006-12-09T20:11:00.000Z

During Ambulance Technician training you learn lots of stuff in a short period. It messes with your head at the time and you forget most of it. It's not until your on the road that it all starts to fall into place and the signs and symptoms can be related to what you see. Soon you can walk into a room and tell when someone is really sick, even if they don't have all the signs and symptoms that are in the text books. You also learn to spot someone who's swinging the lead pretty quickly.

Long before any of this sinks in however you learn what an alcoholic usually looks and smells like. The smell thing is good because it gives you a warning, on entering a house, what you will probably be dealing with before you find the "patient". Usually it is crap generated by loneliness or a rotting mind, sometimes our friends just like phoning because their drinking buddies find it amusing.

I have to admit that I have little patience with this now. I accept that it is an illness etc. but I long to hear a new story. It always takes the line of "my dad/sister/best friends brother/dog died and I started drinking ... blah, blah, blah. Only so much sympathy to go around and that's generally reserved for the bereaved and/or elderly.

Sometimes they are nice alcoholics, sometimes they spit and swear, sometimes they puke on the floor or hit you. I have not met many of the first type. They all bore me though and, other than the rare occasion when they are ill, A&E is no place for them to be.

The usual routine is that you get the call, turn up, spend half an hour waiting for them to decide if they actually want to go to hospital (sometimes when they hear that we have the audacity not to wait on them and provide a lift home they swear at us and we can leave), get them there, book them in - then watch as they stagger of down the road 5 minutes later. Heading home while you mop the phlegm up of the truck floor. If they're not seen immediately the nurses and doctors can go "do" themselves.

What a waste of time and money.

Despite all this I treat them with the same respect as anyone else I encounter, which is quite a lot, BUT --- I'll be buggered if they get to hear any of my jokes!!

Small victories.

THE SCEPTIC

2006-12-08T22:09:00.000Z

THINK THAT'S SUPPOSED TO BE A THERMOMETER IN THE KIDS MOUTH - ALTHOUGH CERTAIN PARENTS AROUND HERE.......

Why would a GP call an emergency ambulance to a 3 year old, with a chest infection, at five to five? Nothing other than this wrong with the child.

Could it be that his dinner would get cold if he took the time to treat the patient, or did the child need to go to the children's hospital for specialist treatment?

Am I missing something?

THINGS TO COME

2006-12-08T20:11:00.000Z

So,you're waiting on cataract operations - sorry to hear that but guess that explains why you tripped on the step. Thank you for laughing at my joke about causing trouble; I can see that your in pain and that your shoulder is dislocated.

What!! It happened 5 hour ago, I'd be crying like a baby and shouting for my mum. Really it's not bothering us. That's what were here for, it's my job and at 78 you've got every right to phone us.

Hopefully the morphine I give you will help with the pain on the journey in.

Is there anyone we can let know what happened? No, no family and most of the people you know are dead. Don't know what to say to this, but know that an extra bar on the fire would warm the flat up a bit and that there has not been anyone able to look after the flat for a while. It's clean but there are things, I guess, you cant do anymore.

You laugh at my jokes and I like you for it. These are the jokes I tell all the time to try and put people at ease but they are new to you and you seem to like them. Your pulse is slowing down a bit as you relax, but I can still see the pain in your eyes.

Really, its not a problem. You are a pleasure to deal with. Is the morphine working? I can give some more, I don't like seeing you in pain when there's something I can do for it.

Thank you for thanking me and my colleague. Lots of people don't. It actually means a lot.

------------------------------------------------------------------------------------

I hope that you're not as lonely as I have presumed you are. I have no right to do this. I hope that you have good neighbours and that there are friends out there to check up on you or go for a pint with. I liked you and don't know why there is no next of kin to share your life with. It could be for any reason.

I hope that you are happy and that your shoulder is reduced without too much pain and that your cataract operation goes well. Take care.

X-MAS CHEER

2006-12-07T18:52:00.000Z

I've been feeling a bit guilty today. I have done nothing at all apart from play with this new blog thing.

I should of been doing some Christmas shopping. The thing is that I'm a real Christmas humbug. I don't know where this comes from but it's the same with my birthday, which is, lets face it, more important to me. There just other days in the year.

Maybe its because I don't have kids of my own to get overexcited on the 25th and maybe it's because this drives home the reality of being single. It can be very lonely at any time but I guess that at this time of year this is exacerbated. Maybe I just need to get out there and get laid. It would help.

Anyway I've done some online shopping for my friends kids so will need to wrap and deliver these. I have also got stuff for my folks and my sister who kind of like x-mas. In fact there's not much left to do, but I should of done it today. Get it over with.

Fortunately work commitments mean that I'll be on shift for x-mas itself for the 4th year in a row. This is good from a Scrooge perspective, means I don't have to make excuses up for not going to the cousins or wherever. Also a good thing is that for the first time in 4 years I'm off for new year. I intend to spend it with friends getting very drunk indeed and feeling crap for days after.

FOR HOW LONG

2006-12-07T18:46:00.000Z

Just heard on the news that campaigners have managed to keep open the Inverclyde Royal Infirmary (not a PFI). Congratulations.

Being a sceptic I can't but wonder how they'll make you pay. There is always a price.

WORKLOAD - JAKIES, GP's AND NHS REDIRECT

2006-12-07T15:43:00.000Z

The work load of ambulance services is growing and growing. It's got to saturation point in most regions. There are a number of reasons for this.

First there is yet another generation of people who think that we're here to attend their every whim. People who have probably never worked, had homes, tv's, washing machines and taxis provided for them at our expense. People who don't think that they should be responsible for themselves and are brought up to expect everything on a plate. People who think ear ache, bleeding warts, boils etc. warrant an emergency response because, well, that's our job. Why bother to drive your husband/son to hospital with a broken finger when there are special buses that come to your door. It's also fun to call an ambulance when your drunk and/or lonely, we have loads of time to sit around.

Secondly, GP's. Now there are loads of good GP's but I guess that we hear more often from the not so good ones. There is a thing called "continuity of care" that is banded around as a reason for doctors calling an ambulance for otherwise capable people. I will never understand why a GP will let a patient sit at home for a couple of hours waiting on us to turn up when the have someone that could drive them to hospital in 20 minutes. If mobility is not an issue and transport is available they will be seen by a doctor before we even get round to picking them up. Common sense will never prevail. Where is the care in being left with a letter? If this is appropriate an ambulance usually is not.

NHS Direct. The best way to explain this is probably to give a couple of examples of jobs that they send emergency response to.

Turn up at Mr D's home to find him amazed that were there. Totally unexpected and the flashing lights and sirens didn't make him to happy. Talk of the street I'm sure. He had phoned these idiots an hour before because the dressing on his bedsore needed changing. This had been explained to NHS Direct and a district nurse was requested, as normal. 999 to us?? What could we do? He did not need nor want to go to A&E.

Mrs P has chronic back pain which has been playing up for two weeks. She runs out of painkillers and, unable to bare the pain at 0400 hrs calls NHS 24. She explains that it's a pain management issue and that she is a single mum with 2 kids to look after. NHS 24 say that they will have a doctor attend within a couple of hours. She lies in bed trying to avoid crying with the pain. 0630hrs 999 call from NHS 24 to ambulance control, emergency response requested for 36 YOF with lower back pain. We turn up to a women who once again did not want nor expect an ambulance. As she said "what can we do for her"? Nothing; except call back NHS 24 on her behalf and start the thing all over again. This woman was in severe pain but knew what was required to manage it. We responded on lights and sirens for a sore back!!

I can only guess that NHS Direct/24 have about 2 hours to complete a "case", from a call being made to them receiving the appropriate care/outcome. Where they can't do this an emergency response from the Ambos is requested, clearing this from their books and no doubt meeting some government target. While driving fast is fun it is a dangerous thing for all road users, including us. I resent us being used to meet another organisations targets when we struggle to meet our own ORCON times.

TICKLED ME

2006-12-07T15:04:00.000Z

I could just be a bit weird, but these made me laugh.