One out, one in. The prequel

One out….

You never forget the first patient you lose. Mine was a frail elderly person who lived close to my ambulance station at the time. The job came in as a cardiac arrest, and that’s exactly what it was. We got there very quickly, the patient’s heart had stopped, and it was my job to try to save them. I began CPR, the first few chest compressions broke some ribs. The dull crack is audible across the room. My partner was setting up the O2 bag and mask, they looked over at me and nodded encouragingly. That was a sound I would hear many times during my career. Some adrenaline injections (for the patient!), and 20 minutes of CPR without any signs of self sustained heart activity dictated we stopped and declared the patient’s life ‘extinct’. But this was my first. Surely there was more we could do, something we had missed? My partner handed me the paperwork and I filled it out, just like I had been taught during my training.

Later, I reflected on the broken ribs with my partner. “It’s perfectly normal” they said. That’s exactly what it became to me. It was an indication that we were pressing down hard enough to make the patient’s heart pump blood properly. “Broken ribs will repair, stopped hearts need help” – I remember my instructors telling us as raw recruits. They didn’t explain the heart-sinking feeling we would experience each time it happened. It was a blunt reminder that this was a real person you were dealing with.

I lost count of the deceased patients I saw, each one making me harder inside. I had to be to cope. You have to treat them as ‘jobs’ not people. You didn’t know most of them before, so you couldn’t be upset. We joked among ourselves about ‘killing’ patients each time deaths occurred during shifts, not because we were twisted or enjoyed it, but because it was a way of coping with it.

If the patient was ‘gone’ before we arrived then distancing yourself was easier. If you knew them, usually as a regular, it was a bit tougher. The really hard ones were the ones you were talking to when you arrived. The ones who went into some form of arrest in front of you.

One patient who arrested on me lived in a nursing home. The staff were quick to point out the patient had a DNAR (Do Not Attempt Resuscitation – a legal document that prevents medical intervention in such situations). We asked to see the document as, without it, we must continue life support. The document arrived and we watched as the patient slowly faded away. As we had accepted the duty of care for that patient, we couldn’t leave until there were no more signs of life. Watching a life slip away in front of you is a strange experience. It’s difficult to explain the emotions involved, but none are good.

Then the hard walls go up again and control gives you a meal break. It’s a bizarre thing, but even now there’s not much will put me off food.

Coping mechanisms keep you going…..until something comes along that weakens them.

Recently I’ve heard of some charities that offer physical and practical support for crew members. Charities, not ambulance services themselves, not the NHS, although it looks like most only operate in England and Wales. I have heard, however, that one ambulance service (possibly more) has recently implemented a more practical support service for its staff. It will be interesting to see how it works.

One such charity, PTSD999, has recently employed the services of a rock legend to help record a version of the late David Bowie’s song Heroes. Please look them up on iTunes or Amazon. The band is called Burn Out (enough said). Just 99p gets you an amazing song and helps them provide such an important service. The charity offers support to all types of emergency workers, please support these guys and other charities like them. We hope the song does well. Their tagline is “help save the lives of those that save yours”.

So yes, deaths affect us but, most importantly, don’t forget that each time one life fades away a new one is created somewhere. We could be heroes, but that’s not why we do it….

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