Category Archives: News

Meal-Breaks

For the first time *ever*, ambulance crews are going to have rest breaks.

For too long we have been working 12 hours a day without a break.  Sure, we may be able to sneak a cup of tea at hospital, but if you take longer than half an hour to unload patient, handover to nurse, clean and restock the ambulance and finish your paperwork so that the patient can’t sue you, then we often get asked if we could ‘green up’ for another call.  Trust me when I say that it can easily take longer than half an hour to do all the above.

We rarely get to see our station, too many people call us and we simply don’t have enough ambulances to deal with all the drunks, cut fingers and coughs and colds that we get sent to.

European legislation means that we should all get a short ‘rest break’.  If you work for 12 hours, is it really too much to ask for a half hour break at some point?

Apparently it is too much to ask for ‘The Sun’.

Some journalist, who can no doubt have plenty of cups of tea during her day, decides to attack our service for (a) following the law, and (b) treating it’s staff like human beings who need feeding and watering.

It can be hard work on an ambulance, while a lot of our work is fairly simple, there are days when, not only are you run ragged, but you also have a string of tricky jobs.  Why shouldn’t we be like everyone else and get a break.  The police have meal-breaks, nurses have meal-breaks, doctors have meal-breaks and the fire service have meal-breaks (if I were being uncharitable I say that the fire service have occasional breaks in their meals for work).

So why should we be any different?

We make enough sacrifices for this job – shift work knocks years off your life, wrecks your health and social life.  We go into dangerous situations on a daily basis, get beaten up and sit in enclosed spaces with infectious patients.  We also don’t get paid enough considering how the government keeps expecting us to hold together the tatters of the NHS.  Until we got breaks we would also be eating unhealthily, wolfing down fast food between jobs, so physical fitness is a concern for us – gym memberships are a waste of money when you work half the time they are open.

So ‘The Sun’, rag that it is, wants us to work like robots.  Instead they should ask why, despite meeting targets,despite an annual increase in calls, despite being told we should cover the shortfall in GPs and A&Es the government has taken money away from us.  Ask why we can’t have more ambulances?  Ask why we have to go to people who have stubbed their toe, got a wart on their foot or have ‘man-flu’?  Ask why, after dark, it’s us and the A&E departments against the world as all the psychiatric teams, social workers and care home staff vanish along with the sun.

Maybe that would be proper journalism.

I’m already hearing about crews getting abused due to this article, one person reports being shouted at while having a sandwich, while another received abuse from a patient with a cut finger (needing only a plaster) – all because they think we should be running around ‘saving lives’.  It only needs someone to abuse me on this subject and they would get a lecture on how you shouldn't believe everything that you read in your chip wrapper.

In reality meal-breaks won’t make much difference in responding to emergency calls, it just means that the ‘stubbed toe brigade’ will have to wait half an hour for their free taxi to hospital, while true emergency calls will be covered as well as they are at present.  Being able to have a protected break may also mean crews will  be refreshed, meaning that they will ‘green up’ that bit faster, improving our response to those genuine calls.

Catchup

I’m feeling really disconnected – I shouldn’t do, I have a metric ton of computers in my flat, even a few old laptops…

But without my Macbook which I’d set up ‘just right’, along with all my emaail settings and the like I feel like I’m missing an arm.  I think that it’s because my desktop needs me to sacrifice a small animal before it’ll start up…

What I would like to know though is why it takes ‘7–10 days’ to fix a problem which I could fix in forty minutes if I had the parts.

This is why blogging has been slight of late, and why I’ve been pretty much unable to answer any emails.

 


But…

There is superb news, both from my publisher.  Firstly my publisher Clare Christian won ‘Best Young Publisher’ and secondly I’ve sold the rights to my book to various people – which is fun.

Clare writes about the award here (where you can see my gap-toothed smile); and about the rights stuff here.

 

Getting Lost

Ambulance 'loses way' to hospital

Ambulance drivers are to get additional training after a vehicle got lost as it was taking a woman to hospital, who later died.In a statement East Midlands Ambulance Service (EMAS) said: “During the journey… the ambulance satellite navigation system failed and the driver, who usually operates in the Skegness area, took a wrong turn.

“This was realised and the crew member in the rear of the vehicle, who was familiar with the area, was able to direct the driver back on cours
e.

I rely on the Sat-nav system on my ambulance – not so much if I'm working in my area, but if I'm elsewhere in London then I'm like a fish out of water.

Strange hospitals are the worst as I keep circling the area trying to find the A&E department.

If I do a transfer to a hospital outside of East London, there is then a big chance that I'll get another job in the area. I don't have 'the knowledge' so end up following the sat-nav or relying on one of our mapbooks.

This is a tragedy, but despite this it is a bit of a non-story in my opinion, someone from outside of the area took a wrong turn, it was corrected and they found the hospital. That the father of the patient reached the hospital 15 minutes earlier isn't unusual – I'm often beaten to hospital by relatives 'following' in the car, partly because we do various things before we leave the scene and partly because I don't drive like a loon with a patient in the back. Ambulances have different handling to cars and so we'll often drive slower.

If someone could tell me how 'better trained' can be implemented in order to make sure that when driving in an unusual area with a failed navigation system the driver never takes a wrong turn I'm sure every service in the country would be grateful.

And yes, I've taken a wrong turn or two myself and had to rely on the experience and knowledge of my partner to help me out, and I've done the same for people who have worked with me. It's why a good ambulance crew is a team.

And not being able to find a place can be one of the worse things that happens to you – as this example from the archives shows.

I got a job, '14 month child, floppy and lifeless'.

The address was given as 'Flat 1, Rose house, Starling road'.

I sped up and down the road. I spotted some of the names of the flats in tiny writing, on little blue plaques many of them pointing away from the road. My pulse started to rise. It had taken me four minutes to reach the area, but how much longer would it take me to locate the potentially very sick child?

I found 'Lilac House', 'Lily House' and 'Tulip House', but I couldn't find 'Rose House'.

Now I was starting to panic.

Flagging Addresses

Notes On Assaults 1 Notes On Assaults 2 Notes On Assaults 3

(You can click through to Flickr to see the notes that I've added to my notes)



Just some notes that I made before going on Radio 5 Live to talk about this story.

Donal MacIntyre devoted part of his radio programme to it (and you can download and listen to it here, I don't know how long it will last).

So I got on the radio and said a few words (here for a few days – the section starts 1:03 in and again I suspect it only lasts a few days and won't let nasty foreign types listen to it).

But I didn't get a chance to say as much as I wanted to. But I have an audience here – so here goes…

Sadly we don't tend to flag addresses for people who are just verbally abusive to us, as I said in the radio segment, I'm working next Friday, Saturday and Sunday nights and I fully expect to be sworn at on every one of those shifts. If I were to fill in forms for that sort of abuse I'd never get any work done. Instead we fill in the forms for those people who have either physically abused us, or have acted in such a way that there is a high chance of them physically abusing people in the future.

We fill out the form, explaining why we are flagging it as a dangerous address and then fax it off to Control (using the hospital fax machine, our station doesn't have anything so high tech as a fax machine…)

So the dangerous addresses are flagged by people who have actually been there. And trust me, if someone dies as a result of a delay by us waiting for the police, the person initially flagging the address will get some serious questions asked.

The flagged address system is a warning system, it informs and compliments our 'at scene' risk assessment. Sometimes we ignore it, sometimes we wait for the police. It all depends on the situation. If someone is reported as not breathing then we'll probably go in, if they are calling because someone in the house is drunk then we are more likely to wait for the police. An example of when it was right to enter the address is this one, while in this example it was right for me to wait outside for police assistance.

It's that sort of risk assessment that we make all the time, often without consciously thinking about it.

The address is reviewed every six months, taken off the register if there have been no further reports, at least that is how it was explained to me.

So why are people violent towards us? Obviously drink and drugs play a huge part, mostly drink. But I think that there is a more subtle thing in action here.

When I wear my uniform people do as I say, they don't see me as a slightly overweight bloke – they see me as a figure of authority, that I know what I'm doing and that it is in that person's best interests to do as I suggest. Conversely, the uniform dehumanises me – it makes me a 'thing' rather than a person and it's much easier to hit someone if you think about them as just being a 'uniform' rather than a living, thinking, feeling human being.

A lot of arguments are started because of the raised expectations of people to be looked after by the state, they don't want to wait for their treatment and they want an instant cure – this is why I would suggest that actual violence against staff is higher in A&E departments, although they do have security guards posted there now.

The dangers for ambulance staff have only increased – there are more solo responders now, and they go into situations where the police would turn up mob-handed. While solo's aren't supposed to be sent to assault cases on their own, I know that I attended a fair share of such things – often waiting ages for a proper ambulance to arrive. I remember one stabbing I was sent on and it took forty minutes for the ambulance to arrive. I'm just glad that the assailant didn't return to finish off the job he'd started.

The other huge danger is Call Connect.

Due to “call connect”, the government's new way of measuring the “success” of ambulance trusts, we are finding ourselves going into houses without any idea of the possible dangers. Once we are out of the ambulance, there is no way for control to contact the crew.

The new 'Airwave' radios have been delayed, so there is still no way for Control to contact us once we are out of the ambulance. We are often sent calls that just give the address.

An example,

I'm sent a call to a house I'm just driving up to – no further information is given. If I'd got out of the vehicle then I would have been met by a house full of drunks, one of whom had been cutting herself open with a kitchen knife and was arguing with the other occupants. Thankfully I don't give a damn about the government's ORCON target so I waited until more information came down – then waited for the police. If I hadn't done that there was a good chance that I wouldn't be here today writing this post.

To be honest, I would be very surprised if an ambulance person isn't killed in service before the end of next year.

Edited to add that I found the Unison's comments in the original BBC story particularly unhelpful, seeming to care more for the people who hit us than the members of their own union, then realising that there was a fence that they had to go and sit on.

A Taste Of The Olympics?

I've come to the realisation that I use Twitter as a place to stick ideas for further blogposts, sort of a public memo-space. Which is a bit daft as I have a word-processor on my phone/PDA, but there is something about the immediacy of publishing that appeals to me.

Yesterday was the London Marathon, temperatures were high and all my patients were over the age of 60. They weren't running the Marathon of course.

Instead the St John Ambulance people were staffing it – I've got to admit a bit of jealousy that they get to do all the fun stuff like concerts and sports events, while I get to wrestle with drunks. And before you ask, no, I won't be joining them, there is still bad feeling between a lot of folk in the London Ambulance Service and St John ambulance. Most of it tied to the dispute of the late eighties.

Also, way would I do my day job and not get paid for it. I have a mercenary soul.

Going back to the Marathon, it's sad news that one of the runners has died, but given the weather it's not entirely unsurprising. He must have been running on pure willpower and my condolences go out to his family and friends.

I wonder how we are going to cope with the Olympics, loads more people and I doubt there will be any new A&E departments, in fact the government is trying to close down two local A&E departments. Given that Newham hospital has had to double up it's cubicles to see the 'normal' stream of patients, I dread to think what will happen when we have a couple of hundred thousand visitors to the area.

Returning to St John Ambulance, the current belief is that they will be in the 'security zone' of the Olympic park – they will then take patients to the outer cordon where we will take them to hospital. Now not wanting to give anyone any ideas, but I would have thought that it would be easier for terrorists to infiltrate St John ambulance than the LAS – that and we aren't recruiting people anymore. I'm sure we'll have plenty of our management involved though.


Today was going to be my 'writing and answering emails' day, the plan was to sneak around my mum's place and work on my laptop while she tops me up with cups of tea. Instead she has been on day 20 of her campaign of 'cleaning out the loft'. Loads of old computers, computer magazines, toys, books and cameras have had me looking up beauties like this, this and this on the internet. Because of this I have been prevaricating like an expert.

But I promise – all my emails will be answered by midnight tomorrow, (so if you haven't got a reply and expect one then it's probably gone astray).

Still, I have got my revenge on my mum with this picture. She nearly died with laughter after I told her what it was really a picture of… Is it any wonder I'm an atheist?

At midnight tonight I will have completed my year and a day abstention of alcohol; successfully at that! I shall be celebrating with a can of John Smiths and the company of some friends of mine.

Also for some reason I signed up for Facebook, I don't know why – perhaps my next step will be a MySpace Livejournal page… (I have a Myspace account that I forgot about)

UPDATE: Mum's just shown me a butter knife that she found in the loft (and is using at the moment) that was blown out of their house when a WWII bomb dropped on their street – she later found it buried in the garden while digging as a child. You couldn't pay for this sort of history.

Flight

Later today I fly out to Seattle for a couple of days.

I get the first train from Barking (at 5:27, and given that I slept through 3 alarms yesterday, I won’t be sleeping tonight) to Victoria where I get the Gatwick Express to the airport.  At 09:30 I fly out to Houston, landing 10 hours later at 13:30 local time.  One hour later I catch a connecting flight to Seattle lasting four and a half hours, landing at Seattle airport at 17:08 local time.

All this depends on the plane not crashing into the Atlantic (not that I’m a nervous flyer, but I suspect that there will be some calming alcohol therapy beforehand).

I leave Seattle on the 5th of May at 11:40 local time, landing back at Gatwick on the 6th of May at 9:55.

I get to miss the election, which is a happy side effect of this trip.  So who knows what the state of the country will be when I return…

During the trip I shall be in the tender care of Jeannie Cool from IRC, and I’ll be meeting up with some different folks, and at least one ex-pat.

I shall have my mobile phone with me (0790 325 7650), and will hopefully be checking my email every so often (even if I have to become Starbucks best customer), so if you are in Seattle and are at a loose end, feel free to get in contact with me, so I can buy you a drink.

I asked for places to go  and things to do – and I’ll be trying to fit in as many of them as I can.

So for the next few days you will have to put up with me talking about museums, galleries, theatres and (more likely) the floor of many, many Seattle bars.

This, of course, is assuming those wacky Americans let me into the country in the first place.