Rest in peace.

I’m feeling controversial….again.

Working 12 hour shifts requires energy. Some dispatchers seem to think ambulance crews have unlimited supplies of energy.

When I first began we had the option to choose “uninterruptable” meal breaks. That meant that the dispatcher could only assign us a job once the meal break was over. Almost every time, within seconds of the break finishing we would be given a job. Crews set stopwatches at the start of breaks and proved this.

Many of the old school crews initially chose to remain interruptable, any other way showed a complete lack of dedication in their eyes. Most changed to be uninterruptable after being pushed hard and realising they were changing nothing but their own health.

A prime example of this was an older crew member I worked with when I first moved to the rural station. They worked late, took extra shifts (“not because of the money, but because the community needed us!”) and basically ran their body into the ground. They became a hazard on shift because their body was no longer coping. Finally they retired and, after a handshake from some senior officer who’d never worked with them or particularly knew much about them, they never heard from the service again. They have their NHS pension, but two knee replacements later, no one has shown them any form of gratitude whatsoever for their decades of service, dedication and long term severe body wear and tear.

We enjoyed our breaks, we enjoyed the peace, a short period of time to switch off from the day’s jobs, sometimes to talk about the bad ones.

Then one day it happened – somewhere in a remote village, a trainee crew member was accused of letting a patient die while they were on a meal break. There was public outcry! The newspapers reported “Patient dies while ambulance paramedic drinks tea!” and other dramatisations. Details still appear to be sketchy regarding the whole incident, and the crew member was later found completely innocent, but the outcome was the removal of uninterruptable meal breaks nationally. Rumour has it that the patient actually died of hypothermia, not something that becomes fatal in the relatively short time it takes to drink a cup of tea, but no ambulance service officer ever stepped up to verify this, or defend the crew member in any other way.

For months, ambulance crews were being run for hours without breaks. Stories began circulating of crews testing their own blood sugar levels, finding them lower than acceptable levels then signing off unwell. The most I was was run was over 8 hours without a break. Finally the unions stepped in…

The union in my area was pointless. The reps knew the rules and they knew how to argue, but they were too close to management. “Yes” men, so nothing changed quickly. Eventually, nationally as far as I’m aware, rules were put in place whereby time windows were created within which crews must be given breaks, now known adamantly as “rest periods” by dispatchers. The only problem was that they could be given said rest period anywhere, and there were strict rules about being able to carry food, and consume it, in ambulances. Also, in winter especially, crews wanted access to microwave ovens to heat their soup etc.

Finally, after a number of incidents across the country, it was decided that crews would be returned to their home stations “wherever possible” for their rest periods. These rest periods could still be interrupted for a high priority job, but they had to return you as soon as possible for the remainder of the break.

For months, the distain was audible in the dispatchers’ voices over the radio as they returned you to your home station. For months they gleefully called, just as the microwave pinged, to send us to Cat A (the highest category) jobs. They also became experts in emotional blackmail, knowing that we would never turn down certain jobs. We got used to cold food, just as we had with cold coffee.

Things eventually settled, and dispatchers realised crews were actually happier after food…or rest. The public never knew any of this. Heaven forbid a patient found out the crew that was sent to them was tired and very hungry, possibly with reduced functionality, possibly with baseline observations unhealthier than their own.

There are many things the public don’t know about the Ambulance Services in the UK…….