Leaving My Job

I think I’m going to be leaving my job soon.

I went to a six month old baby, possible meningitis.  The baby had the right sort of rash (although it was only on the back of the knee, and nowhere else.  I checked).  It had a temperature, but was one of the happiest, most alert children I’ve ever had the pleasure of meeting.  It just didn’t seem as if it had meningitis, and trust me, I’ve seen a fair bit of children and adults with meningitis to have a pretty good idea.

Then, like my previous post, I was left waiting for an ambulance.

I think it was around 45 minutes.

There was no way I was going to be able to transport the patient in my car.  It’s just not equipped to carry such a small child.

So the family ended up phoning a friend to take them to the hospital.  The ambulance turned up just as they were getting into their friend’s car.

All I had going through my head was “No Ambulance For Baby Dying Of Killer Bug!”.

Later that night I went to a woman who was having an extremely painful miscarriage.  There is nothing I can do for that, the patient needs to be in hospital.  Thankfully the ambulance wasn’t too far behind me, but if I had been waiting on scene, then it would have been a very awkward and distressing wait (again, because of the pain, it would have been impossible to transport her in my car).

More and more I’m looking at my watch as an ambulance fails to arrive.  It’s only a matter of time before I have someone die in front of me while waiting for an ambulance.

So, I’m seriously considering leaving the FRU/RRU and going back to work on an ambulance.  That way I can pick up sick people, and take them to where they need to be.  A hospital.

So after the holiday season, I think I’ll be sending a memo up to the office asking to return to my ambulance role.

The reason why there is a shortage of ambulances?  Partly the season and the increased number of calls, partly because while the population of our area has increased the number of ambulances haven’t, and partly because of a lack of manning.  Oh and that we have to go to crap jobs.

22 thoughts on “Leaving My Job”

  1. whatever you do, we know it's not a decision you'd take lightly. Ambulance or FRU, best of luck.I desperately hope your bosses, and your bosses bosses, read this, and get some idea of what an infernal mess the ambulance service is in. God, but I would love to make a couple of them, with their nice big leather-upholstered company cars that executives have to have, sit in a room with a woman who is losing her baby and bleeding and crying and begging for help and pain relief, and let them be the ones to say “sorry, we don't pay enough to retain enough qualified ambulance staff in London, so there isn't an ambulance available right now…”

  2. You have to wonder whether FRUs are really a good idea at all.An ambulance service manager, with (in my very rough estimation) the same amount of money could provide one fully equipped ambulance (with a staff of two) or one single-staffed FRU car.

    So in theory, by providing FRUs, there are twice as many vehicles available to respond to calls.

    But…since an FRU can't transport anyone…unless the FRU gets there in time to decide that the patient doesn't need to go to hospital and stand down the ambulance, in fact three staff (and two vehicles) are needed to respond to a single call. One of these staff could be tied up on scene for a very long time doing very little apart from waiting for the ambulance to arrive.

    How is that time (or money life) saving? If for every two FRUs there was instead one ambulance, there would be less staff time spent waiting, and the ambulace crew could transport the patient right away.

    Of course there would be less vehicles in total to respond to calls, but wouldn't the average amount of staff time taken per call be reduced (therefore increasing throughput)?

    I understand that really what's needed is a lot more ambulances, less FRUs and other schemes which are really only geared towards government targets, and educating the public about when and when not to call an ambulance. A bit of basic first aid training for the masses wouldn't go amiss either…

  3. Your needed at both jobs.They are short people on the ambulances.

    No matter were you go there is still going to be times they have to wait for ambulances.

    Let me tell you, if I had to wait for an ambulance I would be ever so grateful if you were at my side caring for me and waiting with me.

    To me, that would be a hard call.

    I vote for you at my side, caring and waiting!

  4. Thought this might come in handy soon!Sweet cure for a hangover

    FORGET prairie oysters and paracetamol – the best treatment for a hangover is toast and honey, say experts.

    According to the Royal Society of Chemistry, a breakfast of honey or golden syrup spread on toast is the most effective remedy for pounding heads and heaving stomachs.

    Dr John Emsley, a member of the society and author of the Consumer's Good Chemical Guide, said: “The happiness comes from alcohol; the hangover comes from acetaldehyde.

    “That is the toxic chemical into which alcohol is converted by the body and it causes a throbbing headache, nausea and maybe even vomiting. The hangover disappears as acetaldehyde is slowly converted to less toxic chemicals.”

    Only time cures a hangover, as the acetaldehyde in the body gradually dissipates, he said. But eating toast and honey could speed your recovery by replenishing sodium, potassium and fructose levels. Fluids also help, but a “hair of the dog” only works by relieving alcohol withdrawal symptoms.

    If topping up the body's alcohol levels brings relief, it should ring alarm bells as it suggests you are getting addicted, Dr Emsley added.

    He also suggested a recipe to avoid a hangover in the first place. First, drink a glass of milk, which slows down alcohol absorption, and then stick to gin, or vodka, and tonic. They are relatively “clean” spirits, twice purified by distillation with mere traces of botanical flavours, Dr Emsley said.

    Dark-coloured drinks ought to be avoided as they contain natural chemicals that can have an adverse effect. Drinking non-alcoholic fluids is also important, as alcohol increases water loss. “The dehydration makes a hangover worse, so moderate your drinking with a soft drink now and again, and drink a large glass of water before sleeping,” said Dr Emsley.

  5. Yeah get back on a truck!you have someone to talk to, someone to watch your back, more chance of having a para on scene, easier to kip on a trolly than winding down the seat of the frv, get to ride about as a passenger, dont have to wait for ambulances (after all you are one).

    Oh but then again whats all this about london sending out trucks with one crew on them (effectivly working as a FRV but driving a truck) because of lack of staff – same stuff different vehicle

  6. The lack of ambulances is propably down to one reason. The money goes to the multitude of highly paid adminsitrators in the Health Service. I used to do a lot of contract computer work for governments and they are the same all over the world. They spend far too much on quango admin roles and not enough on the areas that matter most.

  7. Don't do it Tom! Just think about the asthma patient, and where he would have been with out you and your RRU. Besides, just throwing an extra ambulance into the equation wouldnt change it all that much, and the patients that you used to get to in under 8 minutes would still have to wait 45 minutes. Your work is not in vain, just think of how many you have saved that wouldnt have made it until an ambulance got there. Your job is very important.

  8. I can see where you're coming from, Tom. It must be so damn frustrating to have to wait that long with a patient, especially if they really need one. My only query is this – if you go back on the ambo's does it mean there is one extra ambo crew and one less FRU out there? Will you be making as much of a difference to these people's lives if you return to the ambo crew? Whatever you decide, I understand you have to do what's best for you. As much as you're an excellent FRU (from what I've read!) I guess you can only take so much crap, and you can only do so much to help.Good luck, whatever you decide.

  9. Tom as a reader since July (yes, that was the reason) and as someone who lives in your patch (Stratford), please stick to the cars as the chances of me spotting you in a wagon are much slimmer!. I would like to add that although I have been a lurker rather than a commentator, you, Brian (of Brians Brief Encounters) and a handful of others have become required reading every day (or several times a day when at work). Your humour (as dark and as black as I like) coupled with your writing style are good enough that the book deal is going to be very interesting and is something that I am looking forward to. Yes, this may appear to be very sycophantic but please keep up the posts irrespective of where or what you are driving like some of the other comments, I think that you probably prefer being out on your own rather than being part of a crew but I can only comment on what I have read here.Suffice to say having followed all the pay related posts as well as all the maternitaxis I now have a different impression of the work that you do compared to six months ago. Please dont let one job get you down; I spent two years working for both NATO and the UN in Sarajevo in 96/97 and know that occasionally something bad happens which makes you question what you are doing but it is the little things that go right that add up to outweigh the big things that dont.

  10. The thing is, waiting 40+ minutes for an ambulance is just too common now. I recently went to a woman who'd fallen down stairs, and waited an hour and twenty minutes for the ambulance to arrive.Christmas Day – I got a job with 5 minutes of my shift left. I ended up being over an hour late off because I had to wait over 40 minutes for the ambulance to arrive.

    Good luck Tom!

  11. I can understand your frustration. We don't have proper ambulances where I am, and the drivers are not trained paramedics… just drivers. Someone with a probable spinal injury is picked up like a sack of potatoes and dropped onto a (questionabl) stretcher, then driven to a hospital. Even though I have training, I'm basically on my own if something happens around me. Minimal resources and support; different scenarios, but parallel frustration I expect.When I was in the UK over the last couple of years, I cannot describe the feeling of safety at knowing I would was less likely to be dead/crippled if something happened.

    So whatever you decide, I can understand, and sure many others will too. You do the best with what you have, and that's all anyone can ask of you.

  12. I can understand your frustration, but you returning to your ambulance role is not going to make more ambulances available, more quickly! That is not something that is your responsibility and it is totally outwith your control. Yet, if I were ever in the position of the asthmatic lad or the parents of the query meningitis baby, I am sure I would feel immensely reassured by your being there and very grateful for everything that you were able to do.Anyway, best of luck with whatever you decide.

  13. Don't do it…. think of the times that you get there quicker than an ambulance and give the vital life saving treatment needed… Apart from the fact that you keep some of the LOB calls from having an ambulance sent to them wasting more time and ambulances

  14. I live in Guernsey and we rely on the St John's Ambulance Service to provide us with ambulances. You can pay around 80 per year for family insurance to cover the cost of using this service or if you don't have the insurance you pay 150 for an emergency ambulance. We also pay 80.00 to be seen in A&E and the longest I have waited to be seen is 5 minutes (28 to see your GP). This system is not open to abuse by time-wasters. People on low incomes are subsidised. Maybe a system like this would help those who really are in genuine need of an ambulance.

  15. To the commenters telling Tom not to do it:If he leaves, someone else can do FRU. It's not like he's the only one who is qualified to do the job. If Tom steps down, someone else can take his place in FRU, and Tom can work a job that takes a lower personal toll. Frankly, you are telling Tom to keep doing a job that someone else could relieve him from, where (if the funding continues on its current track) he could have several people dying on him every shift because he has run out of options with the equipment he is given. I personally can't believe the audacity of people who tell Tom he should continue working one of the highest stress jobs his department has, assigned to work without a coworker to talk to (people often forget how important this is to your mental health), where he may have one of the highest liability levels that there is. If someone dies, Tom's only consolation will be that he “did the best he could”, while other people didn't give him the tools he needed. While some deaths are unavoidable, knowing that he could have saved someone's life if the higher-ups would staff his department properly is going to be little consolation. Those are the calls that tear at your soul for years afterward, and I don't wish those calls on anyone else. This is something that certain people excel at, but for limited amounts of time. Under current conditions, I don't feel that anyone should work for more than a 6 month rotation. (with frequent checkups from counselors)

    To Tom:

    This is YOUR choice, and not anyone else's. You are the only one who can decide whether you can stand your day if these response times continue to get worse (and, admittedly, if you will miss the extra adrenaline rush of working on the FRU). This is your life. Remember that you are not the entire future of the FRU, and another para can take your place while you rest. You may be able to ask your supervisor if you will be able to go back to FRU after a “break” on the normal crew. If I had designed the FRU program, I think I would definitely have put a time limit of 6 months to a year maximum, then at least that much time out. A similar program is done with a lot of intense drug investigation, hostage negotiation and the like to make sure that the people get more grounded, and still have their core support system in place. While this can lead to slightly higher training costs (more personnel=more classes), it saves us money in the long run, as people don't quit or retire as soon (not to mention it keeps the depression and suicide rate for crew down). Before this program was implemented, we got very few return applicants. Since the implementation, however, people are happily reapplying as soon as their “out time” (as in 6 months in, 8 months out) comes to a close, and we are never short of people waiting for their turn.

    If going back to FRU is an option, I would suggest that you take a break where you can see the differences between the work and see if you're ready to go back to FRU, and if you want to go back, by all means do, but make sure you have the option to transfer back to normal crew if you need to. It sounds like you are in danger of burning out, but that you have caught it early enough that you have a chance of continuing with some help.

    I wish you the strength to make the decision that is right for you. And, by all means, make yourself available to those who are applying for FRU and give them honest answers, and what to expect. Best of luck to you!

  16. If your financial disincentives were in place I'd have paid a lot of money last year for my partner to be misdiagnosed by medical people before finally getting the hospitalisation she needed a week later. We saw ambos, A&E nurses, A&E doc, an incompetant and rude GP before finally getting walkin centre nurses to consider that her breathing problems and severe pain weren't just “backpain” or “a panic attack”. They got her seen by their doc who diagnosed liver failure and had her admitted immediately.The rude and incompetant GP told us that he wouldn't see my partner for at least a week after he didn't even ask her any questions or examine her – it took us 4 days to dare go to the walkin centre nevermind anything else. My partner was left in pain for 4 more days that she needed to have been because this GP couldn't be bothered to look past the “timewaster” label that she'd been stuck with.

    If people are misusing the services, a lot of that will be because they are uninformed and scared. This blog has taught me a lot about when and when not to dial those three 9s. I know when I should have used them, and perhaps should not have used them.

    Charging me 28 quid to see a GP would screw me over big time as I have a number of medical conditions which means I sometimes need to see a doc before they get serious or nasty. As a student, I sometimes didn't have money for a prescription nevermind the cost of an appointment. I'm still with the university medical practice and my GP says she gets relatively few time wasters, most of whom are scared either by other people, or by things which they don't understand. Increasing nurse-led services, alternative prescribing options for people on longterm/lifelong medications and keeping people informed about stuff would go a long way. I for one often don't need to see a GP, but can't get the services (prescriptions, or referrals, or sicknotes) sorted by a nurse at present.

    Maybe there could be coordination with taxi companies to prioritise calls from people wanting to go to hospitals, and more encouragement for people to use walkin centres and GP services for serious but not immediate problems. My experience of taxis isn't great, as they can take 20-30 mins to come, if they come at all.

    Before we make a richer/poorer divide we should break down the information divide. The NHS direct website is very good, even if the phone service is mixed. We're never going to solve all of the problems all of the time, but I think we could do a bit more with what we have without making it about money. There will always be drunks/homeless people in the streets, and people getting scared.

  17. Wow what are the chances. Not only is Dickens not dead, but he's reading and passing comment on this blog! I think Tom's bosses are well aware of the state of the service, not least because, like the majority of Ambulance managers they've spent a large portion of their working lives out on the road, in times when decent defibs and stab vests and counselling were unheard of. Truth be told the service was in a better state at the start of 05 than it has been for a very long time (if ever) and the current problems are almost entirely the rusult of a pay system that has been forced upon the NHS by central government. In short, if you want an endless supply of ambulances then vote for it, but remember you'll be paying for it in your taxes.Rant over – Tom have a peacful new year – DSO

  18. You cannot pay too high a price for Peace of Mind. Go where you feel most valued.I can but think that if only all children in schools had a Street Smarts course- where first aid and when to call for an ambulance are taught, as well as how to avoid being mugged and why alcohol toxicity is bad. And anyone applying for a visa has to know this, and pass a test.

    People pay the most for luxuries, and expect bread and medicine to be cheap. Admin creates their own jobs, and decides how much they will pay themselves. The more you actually DO, the less the pay. Great Irony of Life. Ha.

  19. I'm so glad that someone else said what I was thinking.It doesn't matter how 'worthy' the cause; if it kills you to do it, it won't help anyone in the long run. It's why I can't go and work in Africa, it's why I didn't want to be a hospital midwife. As it is, I do a hard but great job in the community, and I don't want to kill myself through sheer emotional breakdown.

    Nobody has to be a martyr. Do what you think best.

    Cxx

  20. Speaking as someone who feels burnt out in their job and works in an area so specialised I feel as if I've painted myself into a corner as regards working in another area – Do what you think is right for you Tom, you may feel in a while you may want to go back to the FRU or maybe not, but at least youve got something to fall back on – Good Luck with the literary career.

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