Summons from Above

Hmmm….

I have been summoned by the AGM (Area General Manager) for chat. I wonder what it’s all about?

Previous experience of being summoned would suggest there has been a complaint. Yet, surely one of his minions would have dealt with me already were that the case?

Instead, I sit here at Felixstowe enjoying my break. Not a care in the world.

Very strange. I am to seek him out whenever I am next in Ipswich apparently.

Two possibilities spring to mind. Either he is going to deal personally with a rather nasty complaint, perhaps too sensitive for a duty operations manager, or he is acting on behalf of someone else.

Intriguing yes?

I wonder if my threat to make war on a particular department has rattled someones cage? Someone high up I would imagine.

Interesting.

Watch this space.

M

Burnout

I am in need of a break.

Fortunately for me that is exactly what’s on the cards. Some well calculated and strategic booking of annual leave has ensured I am off from the 11th of Jan till the 11th of Feb. That’s a whole bloody month! I fucking well need it though.

How so? I hear you ask. Why I would have thought being a paramedic, whipping around on blue lights and saving lives would be a fantastic job surely?

Well it is and it isn’t. There are times when I enjoy the job. I get to a really sick patient double quick, sort them out and come away feeling as though I have made a real difference. The problem is that that kind of patient is a ‘once in a blue moon’ kind of patient. If you consider my working week as a group of four twelve hour shifts, that’s days and nights then I will try and outline briefly what I do with that time. Let’s say I start work on the Monday morning at maybe 7am. This is a record of a genuine day. Okay here goes…

7am – Phone rings. Please proceed to McDonald’s in Utopia for standby.

Make our way down. Sit there for 30 minutes staring at people. The maximum time you can be allocated to a standby position is 45 minutes in our area. Sitting on your arse in a car park for this length of time is truly mind numbing. Its not conducive to a happy working environment and can get a little tense. Especially if you don’t get on well with your crew mate.

7.30 – Red call (that’s an emergency to you and me) to a woman fallen from bed. Arrive to find an elderly woman on her bedroom floor. No injury. Assisted back into bed. Left scene.

8.30 – Urgent call (that’s a timed pickup. Usually between 2 and 4 hours) to an elderly male struggling to walk. Arrive to find a man with a urinary tract infection. A local GP has booked him into hospital and we are to be his taxi. Roger that, you call we haul.

11am – Red call to man with a knee injury. Arrive to find a 34 year old man who has injured his leg while out running two days ago. He has now decided that he requires an ambulance to take him to hospital because his friend is first aid trained and advised him to get an x-ray. Neither have a car and threaten to complain if we do not take them. Fuck it, get on then you wanker. Watch through gritted teeth as man hobbles out to ambulance negotiating a flight of stairs on the way.

12.30 – Return to base. Stood down for break. Munch on cold sandwich.

1300 – Sent to local Asda on standby.

1445 – Call up and ask to be moved on as have achieved Lv10 Mind Numbness and Lv8 Bladder of Fullness. Drive back towards base and receive red call en route.

1450 – Red to a woman short of breath. Woman is 80 and has a chronic lung condition whereby they are slowly failing over time. She is a lifelong smoker and is happily puffing on a fag as we walk in the door. She is assessed as having a probable chest infection. Attempt to pass to her own GP for management at home. GP feels pt is likely suffering something else but does not know what. Advise we take the patient to hospital. Arrive at A&E to a poor reception. Why didn’t I refer the patient to their own GP? Do I think it is appropriate to bring this minor chest infection to a busy A&E department? Grit teeth and smile.

1700 – Return to base.

1702 – Red call to a man collapsed in the street. Arrive to find a man drunk on the floor. Police are also on scene. Fierce debate between myself and police officer ensues. Police officer states patient is drunk and it is therefore a medical problem. I state patient is not a patient. He is a drunk in a public place and therefore he is committing a crime. In the end they refuse outright. They know we can’t leave a man laying in the road. Even if we could it would a matter of mere minutes before some do-gooder called again. The police won’t show a second time though.

1830 – Return to base and pray no one else calls us.

So there you have it. Yes there is a fair bit of sitting around and yes I suppose there is a lot of variation. There is also a lot of piss-taking too. People will always deem an emergency to be what they personally deem to be an emergency. For this reason they will not stop calling. Ever.

Its not one thing in particular that causes me to feel particularly stressed. So how would I describe how I feel?

Imagine your empathy, your caring nature if you will as the face of a massive cliff. Occasionally a big wave of stress is going to come along and give your face a bit of a battering. You can handle that though. You can shrug it off because its expected and doesn’t happen very often.

Life as a Paramedic, for me, consists of a near constant low level erosion. That’s is to say that all those minor irritations are ever present and nothing is done to prevent or change that fact. My cliff of empathy has been gradually eroded to the point that am I just as likely to stab my next patient as I am to treat them.

That’s the NHS though. They simply do not believe in tidal defences to protect the staff. They believe in burnout. Its a given. It will happen.
You simply cannot care 100 percent of the time. Not when you can easily compare old Doris and her heart attack with young Pete and his hurty knee. You feel sorry old Doris has had to wait so long for a response but Pete? Pete can fuck off.

Yep, it’s time for a break.

Me.

The Day After Tomorrow.

I work in a large town somewhere in Suffolk. Let’s call it Utopia.

“Early weather reports are suggesting the public, particularly if you live in the East of England should prepare for snow.” – BBC Reporter, two days before.

“We have never been more prepared. We have stock piled ten times the amount of salt and grit we had this time last year. We are ready.” – Spokesman for Suffolk County Council and mirrored by another in Essex.

“The people of the east of England are today waking up to hear weather reports saying there is going to be winds blowing over from Siberia and that this will bring a lot of snow with it. I kind of doubt that, this is England. I mean… We don’t really get snow this time of year do we?!” – A member of the publics reaction to the BBC weathers ‘extremist’ reporting.

“The snow is expected to fall over night. Experts predict a fall of at least six inches.” – Local weather report on the day.

“Yes, we’ve watched the weather reports, yes as I said before we are prepared. As a matter of fact we have seventy drivers extra and they will all be reporting in at 6pm. They will be on standby from then on.” – Spokesman for Suffolk County Council. Three hours prior to the fall.

At roughly 5 pm on Thursday 17th the snow began to fall. It was earlier than expected and it caught us all by surprise. The sheer amount that fell in the first hour was more than any of us thought possible in England. Now before I go any further I don’t want you to think I am trying to make this into some tragic hollywood style story. No, I just want to get down on paper the events how I saw them as a paramedic on duty that day. I’m sure the rest of the world ground on as usual oblivious to awful cock up going on around them but hey, that’s just life isn’t it?

If you had been out had about on that day, christmas shopping or whatever, you too would have thought, ‘Gosh! That’s a fair bit of snow. I thought that wasn’t supposed to come to tonight?’ You wouldn’t be wrong for thinking that either. Hell, thats what we all thought. I mean that’s what we were told wasn’t it? Then as time dragged on and the traffic in front of you started to back up you’d likely start getting a bit concerned. You’re an hour away from home and you’ve moved maybe half a mile in the last hour. Worse still is that the snow has not stopped. If anything its coming down thicker and quicker if that seems possible. You look outside your window and see people trudging through snow thats laying on the pavement. Its at least three inches already. You notice your fuel light is going to come on if you don’t fill up soon so you make a point of pulling into the next garage you slowly approach. Oh dear, the garage has closed its doors and switched its pumps off. You sit in your car paralyzed with dread. Its getting bitterly cold out. The snow is heavier than ever, you’ve got no fuel, little Johnny and Mable are starting to get hungry and cry, your heating is not adequate and… wait, over there! Why, there’s an ambulance sitting next to one of the pumps. One of the paramedics is walking over right now in his hi-vis jacket. You wind the window down.

‘You need to turn around miss. The fuel station is closed,’ I say.

You look at me gob smacked. Your eyes are brimming with tears and you wince as your children scream.

‘Why?’ you ask as I move to walk away. I shout over my shoulder to busy and caught up in what the hell I and my colleagues are going to do to notice how cold and uninterested the words that come out are.

‘There’s no bloody grit. Chief in there can’t keep the forecourt open if its covered in ice,’ I say gesturing to a man in the forecourt shop sitting behind his till all nice and warm. And with that I’m gone.

I walked away from that car without a seconds thought. The sounds of the screaming children abruptly muffled by the stressed out mum closing her window.

My colleague was actually filling up at the time I had that brief conversation. We’re allowed you see. The petrol stations have to keep a reserve for us and allow us to fill up when we need. Incidentally had I turned up in my own car and flashed my ID I would have been able to fill up too. It’s not just the vehicles. Vehicles are useless without staff to drive them.

We finished filling and left. Anarchy had started early. We did not want to be around to watch the public shouting abuse and gesticulating mob fashion at the poor clerk indoors. It just goes to show how close to a complete break down our society is, when the most minor of things occurs. I say minor because, not 300 miles further north is Scotland. Now I’m pretty sure they won’t be acting the same way these crazed-its-the-end-of-world-nutters are acting. What about the Swiss? I’ll bet they’d be laughing their arses off. England! One little snow storm and they fall to pieces. Its true, we do fall to pieces. Then again, it doesn’t matter how minor the weather is if you’re not prepared for it.

We were most definitely not prepared.

By 8pm, Utopia was at a standstill. Literally. The major junctions and roads were gridlocked and nothing was going anywhere.

Those that tried had pretty good odds on not getting to their destination either by getting stuck which was the most likely option or by coming off the road altogether and crashing.

I lost track of the number of road traffic accidents I heard over the radio. But why? Why was this happening?

We got a red call to a woman with a broken hand up in a nearby town. Ordinarily it would take us maybe fifteen to twenty minutes to get there on blue lights from Utopia. On this occasion it took us an hour and a half. The A14 was down to somewhere in the region of 10 – 20mph for the majority of the journey. To make matters worse… it was just a bloody hand injury for crying out loud! Why the hell someone up in the control centre couldn’t have seen sense and told them to sod off I don’t know. No sooner had I got the patient aboard the husband announced matter of factly that he’d be following in his car. I gave my best sneer and evil eye and slammed the door. I think he could tell we were not impressed.

I heard a cardiac arrest (someones heart has stopped beating – this person is dead without help) go out in the immediate area and a roll over RTA (a car has rolled over, likely trapping the occupants inside) somewhere in Utopia as I rejoined the A14. My fists clenched till my knuckles cracked as I listened to the woman in the back making demands of my colleague and asking why we weren’t going faster. My colleague to his credit, kept his cool and simply grinned back. A bit of drool swung pendulum like from his gritted teeth (this is how to tell if this particular colleague is stressed out – you watch for the drool bungie) as his glared at her. It must have worked as she apparently wouldn’t dare make eye contact again for the rest of the hour long journey back in.

So, between us getting that call and finally dropping the bitch off and hospital our ambulance had been tied up for nearly three and a half hours. On any other day we should have knocked that one out in around one hour. This was happening all over the county. It didn’t take long before we had no ambulances left to send. The police were in a similar pickle, and the fire brigade I am happy to say didn’t know what had hit them. No sleep for them tonight. Gits.

A Thursday night this close to christmas is going to a busy one for everyone involved in any area of public services. The snow really couldn’t have come at a worse time. Most of the major drinking and eating establishments had some form of christmas do on and it was late night shopping.

A little before midnight, the buses decided that they were not going to play anymore. It was just too dangerous on the roads, and they couldn’t move for traffic anyway. Not half an hour after they had pulled out the taxies also decided that they had had enough. Now I am no mathematician but to my reckoning that left a few thousand people stuck with no way home either because all public transport was suspended or because they simply could not get out of Utopia with the roads in the state they were in.

So, what happens now? Well, if your not stuck freezing in your car somewhere, in a ditch upside down, getting hypothermic outside waiting for a taxi that will never arrive then your probably tucked all nice and snug indoors and completely oblivious to nightmare that hasn’t really even started yet.

Its just gone midnight and the snow is still falling. A call comes in for a man collapsed in the street. Initial reports are sparse but we know he’s young and we know he’s not half a mile from the hospital. There are no ambulances available.

A car has span out of control and gone sideways into a tree in the middle of nowhere. He can forget it. There are no ambulances available and even if there was it will be diverted way before it even makes out of Utopia. Gotta hit those times!

People are freezing on the A14 and A12. They abandon their cars and walk.

The calls to people outside and freezing go through the roof.

We have nothing to send.

An ambulance fast response vehicle (erm… it’s snowing?), okay response vehicle is dispatched to the collapsed male in town. It doesn’t make it. It spins off the road instead and gets stuck in the snow.

And on and on.

The male collapsed in the street did eventually get a response. He was twenty eight and he died because his heart had stopped while he walking home from a night out on the town.

A lot of the people who abandoned their cars on the roads were able to find their way to a late night Tesco. It had remained open and was sheltering anyone who needed it. A couple of hotels had also done the same.

Yet what had happened?

The gritters did eventually make it out on to the road but it was too late. The snow was too thick and deep and all the shit they sprayed just sat on top. Apparently they had been taken completely by surprise. Nearly six hours had passed before they were able to mount a response in force, around about the time they had expected the snow in the first place.

So there you have it. A bit sensationalist you may think, but hey I see this shit first hand. I am sure if you yourself work in any of the emergency services you may be able to testify to the utter chaos an unprepared town can find itself subject too. Maybe you have seen worse or maybe you think I am talking out of my arse. Well whatever you may think, if you ever find yourself in a blizzard in England, think carefully before you try and call for help. Do you really need help? Because I guarantee there will be plenty who do.

Reaching boiling point? Step back, relax and enjoy yourself.

There are many occasions during my daily dealings with the people of this delightful town that I feel the anger taking hold.

Sometimes, if I am not careful there is danger that this could spiral out of control and become ‘The Rage’.

I believe this is something many paramedics suffer with from time to time. Okay, daily. A little anger may cause me to throw in some sarcasm, or maybe a little reckless driving as the patient cradles a fractured arm. ‘The Rage’ will cause me to forget the fact that I am there to act in your best interests, to protect your life. This is rarely because I am late off or due a break. It is usually when I am called to deal with some ignorant scrotum with fuck all wrong and I can here the radio screaming with other life threatening emergencies in my area.

A case in point would be a call I attended recently for a man complaining of knee pain. He’d fallen over while playing football just before half time. Yet instead of coming off and resting it he decided to play the second half. He beamed with savage pride as his mate described three cracking goals he witnessed our poor wounded soldier fire into the back of the net whilst dodging between defenders like a ballerina on speed.

I could feel my eyes widening and my pulse quickening but above all an urge to allow my head to snap forward and nut him. I think my clinching fists gave me away as I stood trying to smile and look calm. He flashed me a toothy grin and asked where my chair was.

‘Chair?’ I enquired.

‘Yes, you have to carry him down the stairs. He could fall and break his other leg.’

‘Its that painful is it?’

‘Yeah! I can’t put any fuckin weight on it ya spastic!’

Looking back I can’t quite believe what I did. I bent down and picked up the guys fags, walked over to the window and threw them out. It was a calculated gamble but it worked. I balanced the fact that this guy was in genuine pain against the area of town we were currently in. Why? Because we were bang in the centre of benefit town and I was willing to bet this guy cared more his fags than he did for his own leg.

He stood bolt up right and hobbled towards the window, screaming abuse and dribbling. I could give a shit. Realising we weren’t ever going to take his ‘hurty knee’ seriously now he sat down and took a pen and paper from the table in front of him. He wanted mine and my colleagues names so that he could write a complaint.

Now complaints are a big deal. They are always investigated and usually stay around to haunt you for sometime. With this in mind I decided to take another calculated gamble. This time I was making the assumption that this chap was not overly intelligent and may cave if threatened himself. I told him he was welcome to have my name and to complain, but that I would be countering with my own.

‘Eh? Whatdouya mean? You can’t report me! I’m the fucking patient innit?!’

His mate looked on nervously. I had my sternest expression on as I launched a barrage of guilt loaded missiles. I told him very simple chimp english that wasting our time was a criminal offence and that if he persisted I would push for prosecution. Okay, so I am bending the law slightly but it worked. I rounded of with heart wrenching tale of how everyday some poor soul dies because our ambulances are tied up with people who should know better.

‘Chill out! I was only messin ya know? Look I can walk to the ambulance yeah?’

‘You can walk to the taxi,’ I replied.

This guy really wound me up. Yet he did cause me to think about how I react to some situations. Since this chap I now try and take several deep breaths before I say something I may regret. An even better tactic which I find works a treat is to simply do nothing but smile. Why? Well, if you can remain calm long enough when let’s say an angry chap is taking his shit out on you. Just think to yourself ‘This guy is clearly angry. He is having a shit day. This pleases me because he is an arse. I am happy he is having a shit day. I am happy!’

See? All I do is to make his shitty time my amusement time. It is working so far. I suppose its because when you get into an argument with someone your both trying to get one over on each other. But hey! If he’s already pissed off and having a shit time then what’s the point of continuing? Haven’t you won already by the sheer fact that he is having a shit day? I think so.

Well, enough mindless mumbling from me. Fuck off and find something else to do with your time.

M

Bath Day

Whenever I visit a retirement home I always come away with food for thought.

Today I was visiting a patient in a local home and whilst waiting for a GP to call me back I do what I normally do and start having a snout about. I love looking at photos for example. I like to see what the old crusty looked like in their youth. There is usually a wedding photo or two. Except today it wasn’t a photo that caught my attention but a poster stuck on the back of the patients bedroom door. It said ‘Beatrice’s bath day is Wednesday’. I asked a member of staff about this and it was exactly as it read. Beatrice has one bath a week. On Wednesday.

Now I am not sure how familiar my dear reader is with residential homes and their clientele, and I don’t by any stretch want to tar them all with one large crusty brush but… Old people stink. Of course not all of them do, but you would be hard pressed to pink a rose out of a line up of ten.

Its by no means their fault. They might want to wash and bathe but many don’t have the strength, coordination or perhaps marbles to be able to. They need help which is unfortunately like everything else in this world, on a budget.

So poor old Beatrice, who in particular has all her marbles, but cannot get about due to a stroke she had four years ago wants a bath. Yet its Sunday and its not her bath day. She has to sit in her own urine (she also has a weak bladder and can’t get to the loo without assistance) soaked pad for hours a day until this evening. After tea, if the stench of twenty other similar residents hasn’t put her off her food she will be assisted up to her room. Her damp pad will be removed, a quick wipe with a flannel, a douse of talc, a new pad and that’s that. All clean apparently.

Is it any wonder these people are much more prone to skin infections, urinary infections, systemic infections and anything else you could reasonably expect from poor basic hygiene?

I wonder if there are other special days? Teeth cleaning day perhaps? Talk to someone day? Or maybe a day out? Okay, I may be stretching reality a bit by suggesting a day out – that only occurs if you have family and that they in turn give a shit.

Some homes are a damn site better than others. They are not all bad. I’ll touch on that another day though. I’m off for a bath now.

M.