You Give Love a Bad Name.

I’ve read a lot of news stories and posts on the socials about ambulance waiting times, and people who may or may not have died as a result of ambulance delays (the fact they don’t get investigated makes me sceptical).

We all know news companies and media companies love scandal and sensationalism, but why have a go at ambulance crews?

I regularly get messages from a friend and former colleague about the waiting times at their local A&E department. 3 hours, 4 hours… An ambulance crew doesn’t just dump patients at the door and trot off to the next job. They must wait for a nurse or doctor and give a detailed handover before they can leave. I know of one major hospital where the A&E department that was rebuilt and doubled in size a few years ago, and is still manned by the same number of staff as the old department.

Nor do ambulance crews hang around once a job has been allocated to them. Whe someone calls 999 (or 112) and requests an emergency ambulance the call taker will ask questions and follow an algorithm on their screen. The result will add the job to a list according to the level of priority the system decides. Ambulance crews have no involvement in this process.

There are, and always have been faults in the above system, and paranoia on the part of the call takers can often make smaller jobs into bigger ones.

Then there are the time wasters, the ones who know all the key words to use to get up the list, when they don’t actually need to go to hospital at all. And the ones who call for an ambulance because the waiting time for an appointment at their local surgery is too long (yes, that happens…a lot!).

These things all add on to the time before the job is even allocated to an ambulance. I could list many other types of time wasters.

Maybe, instead of the Scottish government talking of using the army to drive ambulances (so they can add to the waiting times standing in the queues in A&E departments too?) they and the other politicians could look at the overall problems and maybe find a sensible solution to the whole problem.

In the meantime, don’t take it out on ambulance crews. This problem is far from new, it’s been an issue for many years now. Those ambulance crews (and call takers, dispatchers, A&E staff…) are doing their best with what they have.

Those ambulance crews are the same ones you made rainbows for, the same ones you stood on your doorstep and clapped for this time last year!!!

Cruel to be Kind?

Kindness costs nothing.

Being based in a small rural hospital, we were part of the community. That meant patients expected a certain standard of care. We did our best to oblige but it wasn’t always easy. Some tried to take advantage, the majority appreciated it

An example : in the city, if an elderly person fails out of bed the crew take them to hospital, at best they return them to bed, check them over and drive away. In the country, we’d check them over and return them to their bed if they were uninjured. We’d make the patient a cup of tea and call a friend to see if they could come around to sit with the patient for a while.

The powers that be didn’t like this because jobs took longer and the figures on their computer looked bad, but we still did it.

When I first began with the ambulance service I was an Ambulance Care Assistant, a non-emergency transport driver. Even then we had memos saying we were taking too long when dropping patients back home after hospital stays. That’s because we took the time to settle them and make sure they were comfortable. We put the “care” in Care Assistant into practice. Kindness is free, if ambulance crews can’t show that, who can??

I recently called my broadband service provider to upgrade my service. The person who took the call was friendly, caring and kind. They listened and made me feel like I mattered, something that doesn’t happen often with large companies. If that kind of care can happen elsewhere, why were we being told we were wrong to make patients feel valued?

Many years ago I worked for a large mobile phone retailer. The company was based on a number of principles (I may have mentioned this before), the most meaningful one, the one that has stayed with me, being: Treat Everyone the Way You Expect to be Treated Yourself.

There’s nothing cruel about kindness. Now, more than ever, show some everyday and who knows what might come back to you.

It’s happy (mostly) hour again

Being part of an ambulance crew at a rural station frequently meant long journeys into the main hospital in the city. This often meant spending time in the back of the ambulance with a patient. If it was an emergency you were usually busy, and the patient was most likely unconscious. For a general admissions, the patient was conscious and it was our job to offer reassurance when necessary.

It was like being a barman inost situations – the patient would open up and talk about anything and everything. There was an unexplainable trust, like they knew they could tell you anything. Obviously there was the whole patient confidentiality that meant what was said in the back of the Ambulance went no further, but it was more than that.

I worked in a bar one summer, and I learned things about people because I was somebody they could comfortably share their problems with. Being in the back of an ambulance with a patient was the same.

Sometimes the patient was terminally ill. It was a privilege to be a listening ear to them. To help them by allowing them to get things out of their system to someone who was disconnected from their situation, but could still show sympathy.

Elderly people would talk of the changes the had seen, the difficult times during and after WWII. Some spoke of their experiences of war. Not as innocent victims at home, but as active soldiers involved first hand in the fight. I’ve spoke before of the heroes, not looking for glory.

But being in the back of an ambulance can also be a challenge. There are the aggressive patients – more than once I….”asked” a patient to leave the vehicle. There are some things that won’t be tolerated and, generally, if the patient is able to threaten the ambulance crew then they most likely don’t need their help.

I had many humbling experiences, I have many special memories of patients. It is very like being a barman, but a million times better!

Who’s going to drive you home tonight?

Older people. We know they great, we know they come in many flavours – sweet, grumpy, old-fashioned…

With Christmas soon to be upon us again, along with the long nights and cold weather, it’s a time when ambulance crews are often called to elderly people suffering from hypothermia, or dehydration. Sometimes infections set in, chest, urine, kidney. All required a visit to hospital. Other times it was something simple that could be treated with medication at home. When I was in the service, the mentality of most of the city crews seemed to be that everyone went into hospital, that’s ok in a city where there is a good transport system, and non-emergency vehicles, dedicated to returning patients home, readily on hand.Because I worked in a large rural area, it was different. There was quite a long journey into the nearest main city hospital so, whenever possible, we and the decent GPs in the area would try to treat the patient in their own home. This was often the best policy as many had no relatives in the area and, as a result, no way to get home after treatment in the city.

On more than one occasion, and this still makes me angry, family members would push doctors or ambulance crews to take their elderly relative into hospital over Christmas or New Year so that they weren’t a burden on the family celebrations. My opinion was that the relative was probably better off in hospital surrounded by people who actually cared, and nursing staff often pull out all the stops for patients at Christmas.

Our biggest problem was, even if we could see a way to treat the patient at home, if they or a family member expressly asked us to take them to hospital, we were obliged to do so. Once at the Accident and Emergency Department, the staff would examine the patient, deem them to be fit to return home then discharge them. This did not mean they were thrown out into the car park, but often it meant a long wait, sometimes in the waiting room, sometimes on a hospital trolley in a corridor, until a relative or friend could be found to collect them or a nursing home arranged transport. Neither of these solutions were ideal. Sometimes, if the patient required transport on a stretcher, they had to wait until a non-emergency crew became available. That would be the next morning at the earliest.

I believe things have improved slightly since I left the job. Doctors have more ability to treat the patient at home, but still there are a lot of unnecessary calls made to the ambulance service, patients unnessarily transported to hospital, unneseccarily using resources and bed space that hospitals don’t have to spare. Sometimes its the fault of the relatives or care staff, calling an ambulance when it’s not really required, sometimes it’s just a problem with the system.

Wherever the issue lies, should you or a loved one find yourself stuck in an A&E department for hours waiting to get home, please don’t blame the ambulance crew. Part of their job is to take people to hospital, that’s all they did.

When work follows you home….

I was on day shift the day my father passed away. My partner and I had been out to a couple of jobs but we were on standby in the mess room when I got the call. My partner realised there was something wrong as soon as I hung up. When they found out, they made me go home and contacted control to let them know. I remember driving home, having a shower (not sure why) and changing out of my uniform. The next thing I remember is receiving a call from a family member asking where I was. I was in a small village, some distance from home, on one of my favourite country roads for driving.

I went into hiding for the next three weeks and my friends gave me space. On reflection, possibly neither of those was a particularly good idea. Death was something that happened in other people’s lives. To me they were “jobs”, they had to be. Other people did the grieving, I walked away. Suddenly I was actually one of those other people…and I didn’t know how to be.

On the day I returned to work the second job of the day was to a local nursing home, run by the same company as the one my father had passed away in three weeks previously. The Ambulance screen claimed we were going to someone having a seizure, when we got there it turned out to be an elderly resident in complete cardiac arrest. We began work on the patient, until one of the nursing home staff tried to stop us. It transpired that the patient had a DNACPR order – Do Not Attempt CPR. This document was an ambulance crews’ nightmare, an end of life decision made by the patient or their family and their doctor. It is a legal document that prevents anyone from bringing a patient, usually with a poor quality of life, back from a fatal incident such as cardiac arrest. Unfortunately, until the document is presented, ambulance crews have a duty of care to do the opposite. We asked to see the document and the nurse presented us with a photocopy, not good enough. After 10 minutes of CPR the original document appeared and we stopped. It took around 40 more, long, minutes for all signs of life to completely disappear. 40 long minutes before our involvement was over. As I was doing the paperwork I heard two staff members talking – “That’s the second one this month. There was one in the other home three weeks ago.” my partner looked over at me to check I was ok. I nodded. Back in the Ambulance the screen lit up with the next job….

Some weeks later, it dawned on me that the nursing home my father was in was on the outskirts of my working area and I could have been called to that job

Cancer patients are regular jobs. Usually you gave them analgesia for the pain and took them to the cancer ward. Once dropped off, we’d go to the next job. To sit in a consultant’s office while they explain to you and your spouse that your spouse has cancer is not a situation you expect to be in, nor are you trained for. It is a genuinely surreal experience and it took some time to sink in. “This only happens to other people!!”. These are times when true friends get you both through.

There was no support from my ambulance service, no help offered. Thankfully surgery was successful, but I’m still waiting for any ambulance service manger to ask me how I’m doing, or even show an interest in that situation… or the loss of my father. The support my spouse and myself received was external, from cancer support charities. Without that support it would have been so much worse. The cancer is gone, the psychological effects are still there, but I can’t say enough about how amazing the support of those cancer charities is. If there are heroes out there, that’s where they work.

As always, this post is not about looking for sympathy in any form whatsoever. Ambulance crews face challenges every shift, and I am fully aware I am far from being the only one to face such situations. This post is to highlight yet another reason the Ambulance services across the UK need to step up their staff support, possibly even begin supporting in some areas of the country. We are all only human after all.

This would be funny…

….if it wasn’t happening to me! A phrase that came to mind many times during my career as an ambulance crew member. Like the time we were called to a patient who had been bitten by her very small rodent a few hours earlier, or the guy with the Sunday morning hangover. I’ll make more of both of those in future posts.

There have been many books written about Ambulance life, most extremely good, but not many that I’ve read address the emotional highs and lows a person experiences on a daily basis. It’s taken as an expected part of the job, and Ambulance crews are hardy types but, when you leave the comfort and support of like-minded colleagues behind, suddenly the reality of what you have seen and dealt with becomes very different. It is my hope to7 share these emotions as best as I can in my posts. I have many stories to tell, some funny, some sad, but I will also try to explain the feelings involved too.

Please feel free to comment if you have any questions, or if you disagree with my views. If you can relate to anything I say I’d love to hear from you.