Category Archives: Blogging

Some Summing Up

A quick listing of things that might not warrant a full blogpost, but have been clogging up my 'I really must post about this' file.

Adrian Sudbury is dying, in his final weeks of life he is petitioning the government to improve education about bone marrow donation, as there are still a lot of myths about the process – if you live in the UK please do sign his petition. It's a bit of common sense legislation that works in other countries.

'Jeremy Clarkson has been criticised for claiming he drove at 186mph on a public road, by a father whose son died when a speeding car crashed into his vehicle…

…When asked about driving the supercar, Clarkson, who lives in Chipping Norton, said: “I got a great speeding ticket. I think it was 186 in the Limehouse Link.

I love Top Gear and I have no problem with the presenters doing daft things on the telly, but 186 m.p.h. through the Limehouse link tunnel is utterly moronic. If this is true (and let's face it, he was probably willy-waving) then I'd suggest that this was 'dangerous driving' and perhaps worthy of a driving ban. The Limehouse link tunnel is in my patch and I remember, before the speed cameras were fitted, having fatal R.T.A's there seemingly every other week.

Boing Boing recently had a post on a 'Right to Die' card. I hope that Salford council have liaised with the emergency services because if someone waved a bit of card at me while I was about to start doing CPR on a recently dead person it wouldn't mean a thing to me. Our rules for not starting resuscitation on a patient are strict for a reason – to prevent mistakes that could quite literally cause someone to lose their life.

Saying that, there may well be a point in my life when I have DNR (Do Not Resuscitate) tattooed on my chest.

In a related story here is a tale of a movement to recognise that sometimes it's best not to be over aggressive with the treatment of disease. We can't all live forever, but for some people it seems like a goal to aim for regardless of the consequences of the treatment.

I'm not too sure how it would translate in the NHS – dealing with decisions in a privatised health service raises some very different questions than in the socialised medicine of the UK. How much does treatment cost factor into things? Would a poor person choose to die rather than saddle their relatives with debt for instance?

But ultimately, if you are hoping for a dignified death keep your fingers crossed because it so seldom happens, it's definitely not the 'important life journey' that certain groups would have you believe.

'Incidents of violence and aggression against drivers of one-person rapid response ambulance vehicles are not recorded separately by the Scottish Ambulance Service'

Shame, because that's exactly the sort of information we should have before moving ahead with the 'Front end model', that has a lot more ambulance staff on solo responder cars – and therefore probably at increased risk of being seriously hurt. One day a solo responder will be killed and I can predict that the service involved will say, “lessons have been learned”.

By the way, I adore They Work For You watchlists…

A good idea to use 'Telehealth' to keep an eye on our ageing population. One of the trial areas is on my patch. Unfortunately the report itself is written in a really childish fashion. I suppose that it's alright to insult the elderly, here's hoping they do the same to those rascally Jews next…

Peter Canning writes about something that all us folks in the emergency services occasionally worry about. Recently one of our FRU drivers was involved in a crash (thankfully no-one was seriously hurt) and only the other month some… person drove into the back of our ambulance while we were on lights and sirens. Under pressure to hit the ORCON targets some people are going to drive too fast to get to a job (which is probably just someone with an ingrowing toenail anyway). Thankfully our managers are too smart to tell us to drive faster as I think they know exactly what answer they would get…

Here is another fear that us ambulance types have – being falsely accused of sexual misconduct. You will notice that his ambulance service took the brave step of supporting him by firing him even after he was found not guilty in a court of law. Unfortunately it wouldn't surprise me if the UK services didn't take a similar tack. I hope that Mr. Howes has some good luck with his arbitration.

I know that this is something that I'm very scared off – it only takes one drunk, drugged or mentally unstable patient making an accusation to have you suddenly out of a job.

It's one of the many reasons why I like having a female crewmate.

Some nice news now. Inspector Gadget will have a book out soon. His is a top blog and I wish him all the best with it. He is on my list of 'fellow bloggers who I'd like to buy a pint, but are likely to want to remain anonymous'.

On Thursday I'll be entering all the information from my 'holiday wiki' into Google Earth and making some decisions on where I'm going and what I'll be doing, feel free to edit it until then. Afterwards I'll have to make a decision what to do with it, the smart money is on me tidying it up and leaving it as a permanent resource.

I think that's everything – lots of these came from people sending me links, something I'm always happy to receive so do keep sending them to me at the usual address.

Chemical Cosh

My memory is poor, but I'm sure that, when I was a nurse, the NMC had it as a condition of being the sort of nurse who gives drugs to people that the aforementioned nurse understand what a drug does and what it's side effects are.

It's 3am in the morning and I'm miles out of my area on the FRU*. I have been sent, as a blue light response, to a nursing home where one of their 'clients' is sleeping.

Yep – sleeping.

I get there and the patient is in the reception area of the home sitting in a wheelchair. He is… asleep.

The 'nurses' at the home tell me that normally he is very active at night and often comes to see the night nurses and sits chatting with them. He's ninety-eight years old and mildly demented.

I bite my tongue and do all the checks that I can to make sure that there isn't anything obviously medical going on. All his observations are fine and he responds somewhat when I try to wake him. I'm sure that if I provided enough pain stimulus I could fully wake him up, but it would just seem cruel.

I look at the patient's drug chart. Two days ago he was prescribed a rather strong sleeping pill.

I ponder, for about 2 milliseconds, if this might be the cause for his sleeping. At 3am in the morning.

I suggest this to the nurse.

She shrugs.

The staff don't say anything, but I get the distinct impression that they have been getting tired of this patient being awake while they are at work. If all your patients are sleeping then the night shift has little to do. If this patient has been awake, then they actually have to talk to him. In a lot of the nursing homes that I've been to the nursing staff don't like talking to the patients.

In a fair few nursing homes that I've been to the staff and the patients rarely share a language, and so everyone just 'gives up'. As a digression, the good nursing homes that I've been to have been those where the staff and patients do talk to each other, and the care of the patients is considered to be more of a 'partnership'.

The nurses, who I suspect have got exactly what they asked for, aren't happy. They've already rung the elderly relative of our patient (at 3am!) to let her know that he is heading into hospital.

The ambulance crew arrive and I have a real problem explaining to them why we have been called.

“The nurses wanted this patient to sleep at night. They have given him a sleeping pill, and now he's asleep”, doesn't really seem reasonable for a trip to the hospital.

But the 'customer' is always right – and so the patient is driven off to the hospital.

I talk to the crew a few days later and they tell me that the receiving nurse at the hospital was as befuddled as the rest of us.

I don't know, jobs like this make me despair at the general intelligence of people, not less the intelligence of the sorts of people who look after the elderly.

Oh well, at least one of us had a bit of a kip that night.

*I really need to tell you about FREDA one day – perhaps a joint post with Nee Naw.

I'd like to apologise, blogging has been a bit slow of late. Mostly this is due to working on the sequel to 'Blood, Sweat and Tea' – I'm needing to put some concentrated effort into it. this is not easy with twelve hour shifts accompanied by the utter lack of energy I have at this time of the year.

Medgadget are running their annual Medical Blog Awards – you should go over there and have a look at the nominees, there are some really good ones there. Also there is no other motive for suggesting you visit the link. No. None at all…