It's getting harder for me to blog because I'm trying to not lose my sanity.

You see, this blog has been a place for me to tell stories but it has also been a place for me to get angry – to shout about crappy social care, uncaring and criminal nursing homes, the misuse of our service and, indeed, the mistakes that I think the government and our own management have made.

But of late I've come to realise that getting angry about things doesn't matter, not really.

I can shout all I like, rant and rave, fill in paperwork and publicise things on this blog – and the net result of all that energy, strain and anger is precisely nil.

So I've been working on not getting angry anymore about things that I cannot change.

No blankets on my ambulance – not my fault.

No essential medical kit on my ambulance – I'll muddle along without, but it's not my fault.

Being sent on 'active area cover' 800 yards from the station – So what if it's almost certainly against the policy I'll meekly go there like a lamb.

Someone dials 999 because they've had a blocked nose for three hours? – Fine, come on to my ambulance and I'll drive you to A&E where you can wait for hours.

I'll try not to listen to the desperate calls for ambulances to go to a fitting child.

You dialled 999 because you want 'treatment' for the headache you've had for the past hour – sure, I'll point out that it says 'Emergency' on the side of the ambulance and not 'GP', 'Pharmacy', or 'Most things get better left alone'. Then I'll take you to hospital and you can sit in a noisy, brightly lit waiting room for three hours and fifty minutes.

When the drunk with the cut to his head turns violent, or walks off, I'm not going to struggle with them to get them into my ambulance.

Basically I'm worn – nothing I do has any wider effect than the comfort that I can give to the patient in front of me and their relatives. If I keep worrying and getting angry I'm going to lose my head.


So, I shall continue to treat my patients to the best of my ability with the equipment that I have to hand and the training that I have been given – and to stop worrying about the big picture.

The only downside to this is that, without the passionate hatred of where things are going so obviously wrong, I'm finding it hard to be motivated to write blog posts.

After all it's a bit tricky to write something interesting about a young man calling an ambulance because he vomited once.

And so this is my 'excuse' as it were as to why my blogging has been light of late.


I'm also somewhat fed up about double standards.

A paramedic who lied about his failure to try to revive a collapsed heart attack victim on a 999 call was jailed for a year today.

That's lied about something – still very wrong, but really? A year in jail?

Especially when you look at this,

A Rotherhithe woman received a suspended sentence after attacking a paramedic and police officer who tried to assist her. Kate Ibrahim, 30, of Tawny Way, pleaded guilty, having changed her plea since a previous appearance, to two counts of assault.

Or even this little charmer – who, if I met in the course of my work I'd have to call sir

A joyrider has walked free from court after killing a police dog and injuring two officers in a road smash while three times over the drink-drive limit. As his 12-month prison sentence was suspended at Newcastle Crown Court, Sean Lawson, 20, shouted ‘Get in!’

I don't know – I just feel like buggering off to a remote island somewhere and letting people get on with it.


My comment on the paramedic jailed for lying, because a lot of people have asked is simple – if he'd said that he couldn't start resuscitation because of the size of the patient and the cramped environment he'd probably have been fine. I don't really see the point of lying about it, at the end of the day the police and the coroner would have understood (and this is why I suspect he's been jailed for lying rather than for manslaughter or similar.

Still, he's got a year to think about it.

25 thoughts on “Worn”

  1. i feel so sorry, tom. it's such a shit situation you're in i don't even know what to say. it is obvious through your more recent posts you've become a lot more fed-up, frustrated and cynical – and earlier than this years S.A.D. can account for, too.i doubt you're the only one, either.

    if you're at the point of throwing up your hands and shouting “I GIVE UP” when you care as much as you obviously do, it would be such a shame – but it might ultimately save you.

    i secretly live in hope that we do fuck everything up beyond (our) repair, and the rest of the earth can get on with being relatively nice to itself.

  2. PLEASE PLEASE PLEASE DON'T GIVE UP! I love your blog, sitting down after my shift at a not-so-bad-care-home and reading your very funny blogs.So please, I beg of you, keep writing!

  3. Oh I'm going to keep writing, I'm just explaining why I haven't been writing *as much*.Maybe as the days get longer I'll get my energy back…

  4. It's time for you to read Tao Te Ching. (Try to find a recent English translation.)The title should probably be, “How to live with stupidity without getting sucked in yourself”.

  5. There is a tipping point, I think, where we stop. We stop caring, we stop fighting, we accept that it is all shit. Next comes the point where trying to do a good job begins to fail.The question is what then? There is something about the job that is great and I don't want to give up but I am finding it harder and harder to recognise it.I have found you blogs help. Not what you are saying, we are all saying the same thing (with less eloquence) but the replies you get.We work predominantly with the bottom layer of our society and that effects our view of the world. We have a management structure that only seams to care about government targets and nothing about patient care.The support from the non-medical people shows that we are not alone. Most people are shocked at what we actually do shift in shift out. They value what we do even when we loose sight of what it is to be valued.Your blog help me to do another shift. If it helps me then it is helping others to do the same.So you see, your passion is doing something positive.

  6. Life's not fair and the justice system is not about justice. Good people sometimes die young. Useless scroats who contribute nothing to society sometimes live to a ripe old age to become a pain in the arse to succesive generations of people who, despite knowing all of the above, hold on grimly to the concept that life is, deep down, fair and that doing right by the people around you is the way to lead your life.I got kicked by a patient recently. The police were still on scene and he was served with an 80 fine. That was most likely less money than he had spent in the pub that night. Had l for any reason, whatever the provocation, kicked him back, I would have lost my job, a future career and possibliy my home. Justice?

    And then you get to bring in a wonderful 93 year old lady with a fractured wrist (Oh no dear, it's not a colles fracture. I did that to the other wrist and this is not the same) and somehow that makes it worthwhile.

    Keep up the blog mate….remember the quote from C.S.Lewis..we read to know we are not alone.

  7. i too reached the point you are at after 10 years as a medic and 6 years prior to as an EMT. I worked nights, was burnt-out beyond belief, stopped caring just did the job, but that too took energy to maintain. I finally realized that it wasn't the job per se, it is the management at the private ambulance company where I work, the low-life people who contribute nothing to society yet gleefully bleed it dry every chance they get, the emergency calls to the 'suicidal ideations,' 'sprained ankle,' 'flu-like symptoms,' etc etc that were burning me out. I decided that I would rather be on the 9-5 working day as a doctor than as a medic, so I applied to medical school. I am now part-time as a medic and sleeping normal hours, living a normal life and was amazed to learn that my hatred and anger and being burnt out have disappeared. When I only work one 12 hour shift a week I actually enjoy it, the whole day, from the pointless transfers between facilities, the non-emergency calls and most everything else. I don't work nights anymore and I choose who my partner is when I do take a shift; it's reminded me that once upon a time, long ago, I used to love this job. I hope you manage to find something that provides the chance to take a much-needed step away from the brink you are at now. Good luck. I love your writing; your blog helps this medic make it through also. Take care

  8. It's not the critic who counts, not the man who points out how the strong man stumbled, or when the doer of deeds could have done better. The credit belongs to the man who is actually in the arena; whose face is marred by dust and sweat and blood; who strives valiantly; who errs and comes short again and again; who knows the great enthusiasms, the great devotions and spends himself in a worth cause; who at the best, knows in the end the triumph of high achievement; and who at the worst if he fails, at least fails while daring greatly, so that his place shall never be with those cold and timid souls who know neither victory or defeat. Theodore RooseveltTom, you are that man. Stay strong, stay safe.

  9. Tom,On the blog – Lots of people read your blog, many of them, like me, are in a position to act on some of your frustrations (only in a limited way of course but there you go). So you see it does serve a purpose, I'd love to see more suggested fixes and solutions but then thats just cos it saves me trying to think of them. Its always valuable to be reminded of the impact of life at the coal face (oddly enough working the occasional shift on the road doesn't help in gaining a feel for what it like to know that tomorrow you'll be doing it all over again).

    On the “lies” – well having re-read the link you posted it suggested that the patient collapsed with the crew present. Now I'm sorry but the idea of the patient being too big to work on, or the room being too cluttered is just complete rubbish. A decision was made to let the man die and no protocols or guidlines anywhere would condone such action. To suggest that simply “owning up” would have been acceptable does a great disservice to your obvious professionalism.

    Still rant over, happy to hear a suggestion that would place a blanket on every patient that needs one 🙂


  10. The year in gaol was for perverting the course of justice which generally results in custodial sentences. It wasn't because he was a paramedic.I've felt similar levels of anger but for far more trivial reasons and ending up changing jobs because of it. I think you need to develop a level of detachment, similar to that which NHS staff tend to develop to deal with patient suffering and death. It is not easy to do and can also result in losing some of your passion and commitment which are what make you so effective. Good Luck.

  11. Isn't there a bit in our protocols about physically being unable to do resus as a reason for ETO11?Besides that, my point is that he wasn't jailed for failure of 'Duty of Care', or manslaughter, but instead for lying. If he had been jailed for a more serious reason I'd have no problem – but he was jailed for lying.

    I had a similar sort of arrest under a stairwell – extended resus in a cramped place – ended up with a back spasm that had be being disciplined for being sick the next day.

    In the old days of 5:1 compression you could do CPR for hours – now with 30:2 you are supposed to change every two minutes. Imagine doing that in the straddle position on an obese patient.

    I'm guessing that this is why the coroner didn't push for a tougher charge.

    But at the end of the day it doesn't make us look good – and I know that that is often the bigger concern.

  12. “B – nothing I do has any wider effect than the comfort that I can give to the patient in front of me and their relatives.”Already you are doing better than most of us! Don't expect so much of yourself. Enjoy yourself – you are right, you can't change the world – it's taken you a long time to work that out :). Write a book and don't be ashamed to make some damn money from it this time!!

  13. Tom. Although you may feel that you're not getting anywhere on a policy level. I'm sure I can speak for the thousands of people who read your blog that you've had a huge influence on my perception, not only of the Ambulance life but of the NHS in general.You'd be surprised by how many of your followers agree with you and would happily take a lobbying action, email their MP LAS or whoever.

    I think that blogging in general has empowered the little guy to stick to the man, and yours is a great case in point.

  14. Hey if your looking for a distant island you could alway migrate to Australia,Apparently Australians consider ambulance officers to be the most trusted profession (and have for the last six years running)


    Also Seasonal Affective Disorder is pretty much unknown here, well at least from Sydney and up north (although the summer takes a bit of getting used to).

    No idea what the comparative pay would be though


  15. I just finished your book and I thought it was completely fantastic! I love your humor, and it makes me feel a little hope for humanity that people like you are out there. You care about your job; you care about people. Your devotion is admirable, and your compassion is inspiring. Thank you.I would also like you to know that I promise to always thank my EMT's for helping me and I will encourage everyone else I know to do the same. It can be a miserable, thankless job and I'm glad there's people like you willing to do it.

  16. For the abuse of the service to flourish, it needs the good to stand by and do nothing.I agree with scouseinlondon. You have a mechanism whereupon you can reach out via your site and make your voice heard.

    Please do not despair Tom.

  17. The article says it was accepted that the patient wouldn't have survived even with resuscitation, so the paramedic wasn't responsible for the death. The crime was lying to the police/authorities. The sentence probably reflects that he apparently kept it up throughout the trial, gambling that they'd believe him rather than his coworker. Oops. Likewise, the sentence for the assault was light because the assailant eventually plead guilty. Too light, but there's some sense to it. The drunk driver's sentence, on the other hand…

  18. I have been sitting here since I woke up late this afternoon, post nightshift in eoc last night, feeling the same as you've just described. I'm overwhelmingly fed up with it all. I hope you start to feel better soon, and know you're not the only one who has the massive hump about a lot thats going on at the moment.

  19. Glad you're not packing up, Tom, as I've only just re-found you after a computer crash.Now I have, I've added you to my blogroll.

  20. Hi, TomThis is the first time I've managed to get through the account set up, although they are still telling me the link back through my email was invalid.I just want to say you, and ambulance driver files in the U.S. present the same ugly picture of humanity and administration, both local and regulatory. I didn't know such people existed nor such self serving malfeasance. At my level in California–I'm a teacher, who just lost a fifth of her salary to perhaps 20 years of state pass-the-deficit forwardship, I encounter a similar brand of malfeasance, but no one dies from it. I hope you find health in your deepest self, use whatever means to get there. In wholehearted appreciation, Barbara

  21. Hi tom,I have never commented on this blog before, but I have been reading for about 3 years. I just wanted to let you know, that in those three years you have not only educated and entertained me, but you have also inspired me. I am now (after 10 years of working in the media industry) 6 months into my adult nursing degree, no small part because of you. If the NHS was populated by more like you, there would real prospects for change. I am loving my course but I am also aware of the difficulty's, politics and general incompetence that is endemic within such a sprawling bureaucracy. Those of us that give a shit, can provide better care for our patients due to that simple fact, and I think that is what you need keep in mind. I know it is frustrating but if this blog inspires more like minded people to do something, then it is worth it. I don't read this blog to listen to you rail about the system but to hear about a man who cares for his patients and does something worthy with his day.

    Please don't stop writing.

  22. Dearest Random, reason pleaseas a volenteer ambo retired from the SA service due to disability, I've got to tell you that there are lifestyles a lot less interesting and lives far less just than those you endure.

    What brings us to you as readers is your fabulous interpretation of the wrath of god as it devistates peoples lives. You are as much whitness as savoir, more of a judge than a delivery boy. Keep writing if you will, I care not, just as long as what you have done is preserved for the enlightenment of eternity.

  23. I completely understand the feeling of being worn, and that the things you say or write don't make a difference. But as a fellow EMT, I can tell you that the stories you write are . . . shall I say, 'therapeutic'?. . . to the rest of us. You put into words what the rest of us silly ambulance drivers wish we could say. Don't give up!

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