Hey, just because I’m leaving the FRU doesn’t mean that there is a lack of people willing to take my place.  All they have to do is listen to our management as they insist we spend more time sitting in the car (which is bad for my back) and that we faster to jobs (which is bad for my safety), and maybe spend time on standby on night shifts (which unions successfully stopped double crewed ambulances from doing, because it’s just not safe).

At the end of the day, sick people need to be in hospital, not in their own home, or on the side of the road with me standing over them watching as they get sicker and sicker.  Sure, I can give some lifesaving treatment, but this is only for a few specific illnesses.

What we need on the road are not more FRUs, which exist mainly to get our ORCON times up, what we need is less people calling ambulances more ambulances on the road.  We need more ambulances than we have at the moment, as total numbers of ambulances have hardly increased in the past ten years, while our workload has soared.

This really needs to be a subject of a long post all of it’s own.

As an example – consider Christmas Eve night.  After 1am, there were no ambulances from the busiest complex in London.  Other complexes had to cover Newham, Poplar and West Ham.

There was one FRU.

At the end of the day I believe that I will be providing better help, to more people, working on an ambulance rather than a FRU.

15 thoughts on “Clarification”

  1. Hi Tom,When you first announced you were off to become an FRU, I wondered how long you'd last. Job satisfaction and safety must be very different in what you're doing now and what you're going back to. You're obviously deeply committed to your job and the patients that need you. There has to be a lesson to be learnt by those upstairs from you and others like you in whom additional training and resources must have been invested.

    Best wishes for 2006.

  2. Hi, and the compliments of the season to you.I read your blog regularly because I find it exceptionally interesting and informative.

    As a journalist I have had some dealings with ambulance crews and management over the years.

    In a previous existence I worked for Auntie Beeb in Scotland and did a documentary during a period of industrial strife within the Scottish Ambulance Service – SAS (unfortunate acronym). As part of the documentary I stayed with a crew for the duration of a Saturday nightshift in Glasgow and boy, was it an eye opener. The crew were brilliant. As they shovelled up drunks with (imagined) heart failure (indigestion) and tended victims of Saturday Glasgow's favourite sport (serious assault by knife or bottle), I stuck by them, recording every moment. On that one shift they attended fourteen calls and lost one life. And they were more cut up about the life they'd lost than the rest of the crap they'd had to put up with for the duration. To say they earned my unconditional respect and admiration is an understatement.

    At the time the SAS was being run by John Wilby, a fly-by-night cretin from South Africa. He wanted everything done his way, including shift patterns that would have diverted care from the areas where it was required. Thankfully, public opinion and the unions (and hopefully my little part) persuaded him that his plan was a non-starter and common sense prevailed.

    I don't know where Wilby is now and I hope that the crew I spent the night with are both well.

    The point is – and I'm sorry this comment is so long – that the managers, as in every other industry, are simply glorified accountants and do not have a clue what happens 'on the street'. At the same time it isn't always possible to make a good medic a decent manager, but the least the bosses could do is make sure that they spend some time not just speaking to crews, but staying with them for a shift or three and find out what actually goes on at the sharp end. Perhaps then they might have some idea of what happens when they make ill-considered decisions.

    I applaud your decision to go back on an ambulance. Your talents appear to have been wasted in your present role and I wish you all the best for the coming year (and beyond).

    Again, apologies for the length of this comment, but I hope it makes some sense to those who care about our emergency services.


  3. It's amazing what they (management/government) think about manning. Glad to hear that you aren't actually thinking about quiting, just changing your effectual role. Hope it gives you the relief you want. Lower anx, less back ache etc. Oh, and a warm cuppa or at least the ability to make one more often.j

  4. This disease is everywhere. I'm in the university world, about as far from the life-and-death pressures of ambulances as you can get, and it's the same thing. More work, and more of that spent on stupid or useless stuff instead of what you're supposed to be doing, less pay, worse working conditions, legions of unhappy workers that management just can't seem to understand. (They had that nice Staff Appriciation Day for everyone, didn't they?)Have they all been reading the same management guru books? Or is it something to do with all having the same economic pressures? Or is it just the result of endemic human stupidity?

  5. I thought the ORCON time applied when an ambulance arrived on scene, not a fast response car or first aider on a bicycle (sorry First Responder).

  6. Ok not being funny , or nasty or trying to start a fight, but i know alot of technicians and paramedics who would be really offended after being caller a “first aider” I know LAS's CRU's (cycle response units) are only manned by qualified medics or techs!!Great blog tho, you should come and hunt me down in EOC and say hi sometime!!

  7. “At the end of the day I believe that I will be providing better help, to more people, working on an ambulance rather than a FRU.” Go with your feelings Tom, it's no good continuing in a FRU if you truly believe you'll make more of a difference in an ambulance.Just out of interest would you be sacked if you spoke to the press about the lack of ambulances and the reason for you choosing to change your job?

  8. By first responder I meant a civilian volunteer who has done about eight hours first aid and AED training and responds in their own car / bike. Lancashire has a number of such volunteers covering rural areas. They can get to their local area quicker than an ambulance from a town 10 miles away. No offence to cycle/car/horse mounted professionals.Nigel

  9. Nope, FRU's count and I'm guessing that community responders do as well.(There is a rumour that one trust includes anyone attending – so that might include the person phoning for the ambulance)

    FRUs are there to hit ORCON, and very little else.

  10. Talking to the press does no good (trust me, I tried when I was a nurse…)Also, “Ambulance manning a bit poor” is hardly 'sexy' news…

    And I might get sacked – we are told not to talk to the press, but instead refer them to our press department.

  11. Aye, some managers are crap, some are good and some are great. Unfortunately, as in the 'real world', crap managers rarely get the sack, and instead get promoted up the ranks.But I think that at the end of the day, the crapness of certain managers is only because the government is putting silly pressures on the ambulance services.

    I mean, when the government decided that GPs didn't have to provide out-of-hours medical cover, did we get any more ambulances/staff to help cover the nights? Did the hospitals get any more night doctors?


    It's ll buggered until someone with a bit of common sense starts putting bamboo splinters up the nails of messers Blair and Brown.

    Yes, I am volunteering

  12. I think you nailed it when you typed less people calling ambulances perosnally, and extended and supported that with your comment to Greg about government pressures above.In Melbourne ambulances get called for stupid things (“I can't sleep”, “The smoke alarm is maing a beeping noise” etc.) . If we could educate people better, get a better class of idiot, or change the policy of a guaranteed response if a request is made, I suspect that would go a long way toward solving the problem. A certain chunk of the problem is societal, rather than it all boiling down to logistics. In that respect I'm not sure that the flood of hospital and pre-hospital based TV dramas have done the ambulance world any favours by raising our profile. Society at large now seems to expect an ambulance withing 60 seconds of calling, staffed by cardiologists and neurosurgeons hyped to eyballs on 'Prozac' and Star Trek technology that can cure everything with the only hint of effort or ambiguity left for the sake of drama. 🙁

    Good luck with whatever you wind up doing.

  13. You're right about people liking the drama of calling an ambulance. I've got a long-term medical condition (yes, I know the regular gang know that) and sometimes fall over, lose consciousness for a few seconds, maybe bang my head or scrape my elbow or whatever on the way down.Within moments I'm going “ow… bugger… my painkillers are in my bag, could you grab me a drink?” but there's a certain type of person who – despite knowing I have this long-term condition and there's buggerall can be done – will already be ignoring that and asking for my phone so they can call an ambulance, and will spend the next half-hour going “I still think we should take you to hospital and get you checked over.”

  14. If management continue to upset and harangue FRU/RRU responders you won't be the only person considering leaving your secondment Tom. These people seem to be unaware that they are biting the hand that feeds them. If they bite too hard I think they might well be suffering poor ORCON times, the one thing they can usually rely on from their FRU/RRU crews. First responders are more than capable of working under their own initiative, that's one of the reasons they seek secondment to the car in the first place. Management would do well not to meddle.

  15. Health Service Managers – dont you just love them…………………….fried.There was one a few years back up here who couldnt understand why there had to be trained nurses covering wards during nightshifts…….'cos after all, the patients were sleeping!

    Always reckon that where management jobs are concerned, the people who would be good at management dont go up for them and the people who do go up for those jobs cant do them.

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