OK.

Time for something stupid...

I have a holiday due in a few weeks, from the 16th to the 29th of June. No work for two glorious weeks.

This makes me happy.

The idea is that I get to travel around the UK visiting places that I've never seen. But how do I avoid just going to places that are hiding in the recesses of my mind?

I get you folks to write my itinerary.

I've set up a wiki (an website that anyone can edit), and I'll leave it up to you folks to edit in some interesting places to go and/or people to meet.

So please, go to this website, and write down some interesting places for me to go. I believe that this is the first time someone has done something like this.

Consider it an open-source, public domain, user-generated holiday.

Or an experiment in being really silly.

After the last post Cookie left a comment asking if I still wanted to leave my job...

We were sent on blue lights and sirens to a young woman who had 'collapsed'. We arrived and found her writhing around on the floor. She wasn't too happy to talk to us, instead she kept pretending to be unconscious.

It transpired that she was having period pain.

My crewmate (who is female) asked her if she had taken any painkillers for it, after some grunting, groaning and flailing around she was told that, no, the patient hadn't taken any painkillers.

"Do you have painkillers?", asked my crewmate.

"Yes", said the patient and named a rather good painkiller.

"Why haven't you taken them then?"

The patient then pretended to be unconscious.

We asked a couple of times, at no point did she answer. Instead she kept 'passing out' in a way that wouldn't win her any Oscars.

So we popped her in the carry-chair (because otherwise she would be throwing herself about) and popped her to the hospital.

She was given two Paracetamol tablets and sat out in the waiting room.

By London Ambulance Service numbers, 8 out of 10 of our jobs are like this, not needing an ambulance or hospital treatment. I think I get more than my fair share. I find myself going to people younger than me, often healthier than me and yet having to carry them downstairs because their 'flu' makes them unable to walk.

I'm glad I don't have 'proper' jobs all the time, I also like it when my patient can walk on and off my ambulance at both ends of the journey. What does happen is that these 'inappropriate' calls* eventually grind you down, the endless parade of people who don't need any of the skills I have except the ability for me to write down what they say and drive them to hospital.

I knew it would be like this before I joined the job.

It's not the main reason why I want to change jobs, not by a long chalk, I'd say it's around reason #17. But the jobs that make me want to stay, the serious jobs where I can make a difference, are few and far between.

*Of course there are, according to people on much higher payscales than me, no 'inappropriate callers', only 'inappropriate responses'. Which is why we spend so much money on dealing with people who don't need hospital treatment but can't be bothered to see their GP or local walk in centre. At times it seems to be our main focus as an ambulance service.

Squeeze

I'm covered in the urine from the five year old child.

Squeeze

We get the call as a child having a fit.

Squeeze

There is a solo responder there, he's giving oxygen to the child while it lies on the floor.

Squeeze

I look at the child's eyes, he's still fitting, his body isn't moving but his eyes are darting around in an unnatural fashion.

Squeeze

His chest isn't moving in the the way it needs to in order to breathe.

Squeeze

I pick him up, covering myself in the urine and race downstairs.

Squeeze

I kick the door release button to the block of flats, my crewmate jokes about me being able to get my leg up that high.

Squeeze

I lay the child on the stretcher in the ambulance. My crewmate hands me the ambu-bag.

Squeeze

Fitting the mask over the child's mouth I start squeezing the bag, I'm now breathing for the child.

Squeeze

My crewmate jumps into the cab of the ambulance, she weaves through the traffic towards the hospital.

Squeeze

I sit calmly, I explain to the child's mother what I am doing.

Squeeze

I keep checking the child. Good pulses and an oxygen saturation level of 100%. It means the child is getting the oxygen it needs.

Squeeze

We reach the hospital. I scoop up the child and jog into the Resuscitation room. The nurses and doctors take over.

Squeeze

Someone else is squeezing the bag now. I stay and watch a while, the child stops fitting.

Squeeze

We head back to the ambulance station, I need a shower and a change of uniform. I have to shower with cold water as it appears the heater is broken.

I sit on the station sofa, I can still feel the ambu-bag in my hand. I sit and look at the TV, my mind is empty.

I should have a new title added after my name. 'Professional waker-upper'.

Two calls in the space of one shift to people who are sleeping in a public place.

One person fell asleep in a magistrate's court, waiting for his friend to be finished in one of the courts. His friend must have been so excited not to receive a custodial sentence that he left his friend behind.

Smelling slightly of alcohol he'd bedded himself down and fell asleep. We were called by one of the security officers, no-one seemed too happy to shake him awake.

One application of slight pain from the nice ambulance man and the patient woke up, thanked me n his own language and walked off home.

The second patient was asleep on a bus, he'd had a bit more to drink and needed a bit more... ahem... stimulation to wake up.

No thanks from this patient, but at least he didn't make good his threat to punch me. And we didn't need to call the police on him either. A good result all round really.

It's strange that some people seem to think that you need an ambulance in order to wake someone up. I've even been called to nursing homes when one of their patients has been asleep at 3am in the morning.

In fact the whole shift was like that, fourteen jobs in twelve hours with only five of them travelling to hospital.

Ho-hum. Easy money I suppose.

This blog has been many things over the years, it's been a place to rant, a place to explain what us ambulance people do, a place to celebrate what we do well, a place to defend the service from inaccurate news reports and a place to criticise some of the planning that occurs.

The benefits of this blog are many and varied, I've met people I never would have otherwise, done things that I'd never have imagined and made some very good friends. Doors have been opened to me.

I enjoy writing this blog. I like having a place where I can write and people listen to me - I know that sounds egotistical but I'm not alone in liking an audience. Sometimes it's hard to motivate myself when I'm coming off a twelve hour shift, but other times I can't sleep because of something I need to write.

Why am I telling you this?

I've been sitting on an application form for the position of Press Officer for the LAS for the past week or two. The reasons for even having this form are many and varied and will be a subject for a future blogpost. I'm not qualified for the post, even though I think I would bring a breath of fresh air into the role. The chances of me even getting an interview are tiny, if not non-existant.

But it was only this morning that I realised that I can't go for the post.

It's all to do with credibility.

Would you trust me, dear blog reader, if you knew I was now part of a PR machine? Would I still be able to rail against some of the inadequacies of the NHS, the Government or the LAS if I were further on the 'inside'? Would such a job role completely neuter this blog?

I think that it would, so the application form (no shift work, less heavy lifting, more money, just as much fun) has gone into the bin.

It's a damn shame, but this blog has come to mean so much to me over the years that doing something like this would make me feel like I've 'sold out'.

It would have been nice to have a kettle always within reach though…

Ambulance Nut works for the Trust mentioned in the last post and has a few important things to say, things not reported by the news story that I linked to.

It's important to see how media reports differ from reality.

(Thanks go to Ambulance Nut for drawing my attention to this).

For those that are interested, I was invited onto the Radio 5 Live show to talk about this very sad story. The BBC are lovely so I had a cab to a studio in London, while the presenter sat up in Manchester. Stephen Nolan the presenter obviously plays the devils advocate while I play the voice of reason.

As is normal with talk radio there are some… interesting viewpoints, although I'm quite sad that no-one surpassed the first caller in comparing me to the Nazis.

You can listen to it again here, my segment starts 1:08:50 into the stream. I don't think it will be up for too much longer.

I am grateful to the ambulance and police workers who phoned in to support me - It just goes to show that I'm not mad, or at least I share my madness with other people.

I had my first letter of thanks yesterday, the first one I have ever had.

It was a lovely simple job, one of those jobs that you tend to do a lot of. The call was to an elderly woman who had maybe collapsed. The problem that faced us was that she had collapsed behind her front door and no-one was able to gain entry.

We never really know what to expect from this sort of job, sometimes the person is fine, they've just fallen over. Sometimes the person is seriously ill and this is the reason behind the collapse. Occasionally the person will have died in the night.

The, also elderly, sister had gone to our patient's house and was unable to raise her. She'd then gone to the police station and they had contacted us.

We arrived to find the police already there, they were waiting for the officers who had the battering ram as there was no other way to get into the flat. An officer had just brought the sister of our patient with him back to the house.

So the door splintered inwards and the police officers entered the flat. We follow them in and listen to see who finds her first.

Thankfully she is alive and lying on the bedroom floor. She's a stick of a thing and well into her late eighties.

We quickly check her over to make sure that she doesn't have any injuries, then pick her up and lay her in bed.

What then follows is little more than a more extensive examination of her and a bit of the old 'chat'.

We talk to her and her sister while checking her blood pressure and the like about such diverse subjects as dead husbands and playing 'knock down ginger', about how out patient hates doctor yet how kind her GP is.

It's nothing unusual, it's nothing that we don't do for all our patients in order to put them at ease.

We arrange the GP to come and visit her and leave.

But somehow a card of thanks makes it's way to us, the sister walked up to the hospital and asked the ambulance crews parked outside to make sure that we got it. So I return to work, look in my letter tray and find the card.

It's a simple little thing, it just says 'thank you', but it means a lot to me.

His wife lets us in, it's one of those houses that are so clean I feel bad about traipsing my boots all over the carpet. Our patient is a man in his eighties sitting in a chair. He's spotlessly clean, wearing a shirt and a tie, hair brushed back.

He looks like a ghost, the blood has drained out of his face. As I enter he looks up at me and smiles.

We had been called from pretty much around the corner, the wife has already thanked us for getting there so quickly. She's called us because, as she describes it her husband had a fit.

He's normally fairly healthy, a bit of a cardiac history but no epilepsy or diabetes, nothing that would suggest a seizure.

I bend down to his eye level and start talking to him, my hand snakes out and automatically takes his wrist. I feel for a pulse.

Bom………Bom………Bom………

His heart is beating around 25 times a minute. It should be sixty or more. It's no wonder he looks so ill.

I give my crewmate the look. The look that says, "Uh-oh, something's wrong here, we need to speed it up a gear".

I tell her, "Let's get the gentleman in the back of the ambulance eh?"

She understands and jogs out for the carry chair, we don't normally move faster than a stroll. Given the type of call it was given as we've brought loads of equipment into the house with us, we can't always carry the chair in as well.

"I feel sick", says the man and his face drains of even more colour, something I didn't think was possible.

He vomits, his eyes roll back in his head. Warm brown liquid flows over his tie, down his shirt and onto his lap.

I look at this and scrabble to find that pulse again. I'm just about to grab his ankles, pull him off the chair and start CPR when he opens his eyes.

"I feel a little better now", he says.

His wife tries to help me remove his tie, but I'm the one with the gloves on so I tidy him and wipe him down a little while I wait for my crewmate to return. It's only been seconds but it felt much longer than that.

After being sick his pulse had come up a bit but it soon starts to drop again. We bundle him into the chair and rush him out to the ambulance.

We are only three minutes from the hospital and normally we wouldn't 'stay and play', but there are medicines that we can give to speed up his heart, fluids we can give to bring up his blood pressure and an ECG to do to see if the cause for this sudden slow pulse is due to a heart attack.

If it's a heart attack we'll be bypassing the hospital three minutes away for the angioplasty centre, which depending on the traffic, is at least twelve minutes away.

The ECG show a complete heart block not a heart attack, something I'm extremely grateful for.

I often joke with patients that they should only worry if I look worried. In this case I'm trying to keep the worry off my face.

"Let's get a line in him and give him some atropine", I say to my crewmate - then make a mental note to apologise to her later, she's the paramedic she knows her job. It's just that when things start to get serious I can get a little… directive. I think it's because I tend to think aloud and because I used to be a nurse - a rather bossy nurse sometimes.

Despite the medicines his pulse remains the same but at least his blood pressure is coming up with the fluids and with him being laid down.

We blue-light him into the hospital. Three minutes later he is on the hospital bed being looked after by two nurses and a doctor.

His wife is in the relatives room, the resus room is full and another call is coming in (another patient with much the same problem as ours), so the staff can't take the time to talk to her.

I fall back into my nursing mode. I sit with her and hold her hand, she thanks me again and I apologise that the hospital staff haven't spoken with her yet. I explain that they are very busy and she tells me not to worry. I explain to her what the doctors are doing and that the likely outcome is good now her husband is in hospital.

Meanwhile in the ambulance the timer is ticking up, someone in Control is watching this and will be wondering why we are spending so much time at the hospital. I don't even give it a thought.

I pop my head back into the resus room, the doctors are happy that our patient is stable - he's looking a lot better although his pulse is still a little low. I let the wife know. She thanks us again.

We clean the ambulance and get ready for our next call.

A little later one of my colleagues takes our patient to another hospital to have a pacemaker fitted, I hope it's all going to go to plan and that there is a happy outcome.