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!

The show must go on.

Someone recently asked me how I coped with the death and dying when I was in the Ambulance Service. I spoke in a previous post about how the crew depersonalise jobs. It’s something you learn the importance of very quickly. Often a crew will be required to give a police statement regarding a death, if a patient’s death is unexplained (usually the case, until a doctor writes a death certificate or a post mortem is carried out). One of the questions always asked is “Would you recognise the patient again?” to which I always answered “No”. The patient could be lying in the next room, but I had blanked their face from my mind, I had to. Occasionally the patient would be someone we had dealt with a number of times, one with an ongoing illness, someone you had built a rapport with. On those occasions there was sadness, and the family usually appreciated your precence.

On one occasion, I took my old school master in to hospital for a planned stay. I didn’t recognise them initially but, when I did, the respect came back as I remembered this kind person who had helped shape me and my school mates. Little did I know this would be their last journey, but I’m glad I was able to pay some kind of respect before they passed away.

The terminally ill patients were frequently inspiring. They knew the life they has left was short but they spent their time preparing, and preparing the people around them. “Live every day as if it’s your last” one of them said to me. Something I still need to remind myself of constantly. Those were the ones who lived life to the full, who often saw so many positives, even when facing their own end.

“There’s always someone worse off than you”. Words from another terminally ill patient. Words that kept me going often during my time in the service.

Some didn’t know death was coming – cardiac arrests, RTCs… The patients who had passed away before we arrived were the ones that were easy to blank out. The ones who we worked hard to save, only to have the A&E staff make the difficult decision that it was hopeless to continue, those were difficult to blank. While still being able to depersonalise the job, it was still hard to forget the effort we put in. Sometimes there was anger – anger at the patient for dying, anger at the hospital staff for giving up…anger at ourselves for failing to save a life.

I remember my first cardiac arrest. It was also my first real CPR. The horror of breaking ribs lasted seconds as we worked hard to save the patient. We rushed them to hospital but it was all hopeless. I thought I had come to terms with it until we returned to A&E the same day. One of the nurses pointed out the patient’s family being shown to the relatives room. They looked up at us as they walked past, and my heart sank as they tried to smile, grateful smiles for our efforts. Our part in it all would be forgotten quickly, but at that point in time we had done our jobs as best we could.

Sometimes relatives would ask to see us so they could thank us for our efforts. The first time I initially declined because I felt that I was “only doing the job I was being paid to do”, but a nurse politely explained how it was part of the families’ grieving process. Those moments were hard. This was someone elses’ grief, but I was being involved in it.

I saw death in many forms. While the memories of the lost ones will live on in those close to them, most will be forgotten by me over time. But there are those that will stay with me – some for good reasons, inspirational patients, some for bad reasons, the circumstances around their death. But all will have one thing in common – I don’t remember their faces.