If you came here from here – I have no idea about the news about chemical masks, but I do know that we are all going to be given radiation detectors.  I mentioned it here along with a suggested new name of ‘London Ambulance and Canary Service’.

Also the news story says ‘Paramedics’, as an EMT am I therefore expendable?

(Yes, yes, I know that ‘Paramedic’ is media shorthand for anyone who works on an ambulance).

Mentalnurse tells us about the big headline in community psychiatric services.  I’d say that this post sums up the whole of the NHS…

First off Care coordinators have to look for services that say they will do the work that’s shown on a care plan, then you have to beg for the money to pay for the services, and then you have to monitor the services so that they do what they say they are doing. This last bit is really frustrating, because often they are not, but there are no other services available, so its a bit like being a toothless tiger - and if you want to know what that’s like, just imagine trying to suck an antelope to death.

 

Once upon a time, in the far depths of internet time, back when the Lynx browser was pretty much the standard, I signed up to be a ‘Humanist Priest of the Universal Church’ or some such.  Don’t ask me why, I think it was set up so that Americans could get tax-breaks.  Not much use for myself who (a) wasn’t American, nor (b) as a student wasn’t paying taxes at the time.  I printed off the certificate. laughed about it and forgot about it.

If only I’d known that I’d end up working on an ambulance I may well have paid extra (that is paid anything) to get the Advanced certificate.  Let me tell you why…

Every so often we get sent to ‘person behaving strangely’, sometimes this is an adult and sometimes it is a child.  When we reach the patient we are told, with a straight face nonetheless, that the patient is possessed by ancestors/spirits/demons*

*Delete as applicable.

Despite being (currently) an evangelical atheist, I have to take this sort of thing seriously, there is however a problem – our training guidelines pull us in two directions.

Direction one – We should respect the culture and traditions of our patients.

Direction two – We should never collude, or reinforce the delusions, of someone who is psychotic.

(Psychosis is defined as ‘irrational beliefs not shared by the patient’s traditions or culture)

You can see the problem that we have.

I have been to a thirteen year old boy who has been possessed by spirits and, when the police arrived, ran off like Linford Christie.  Of course they reckoned without the police van coming around the far end of the street.

I’ve been to a teenage girl who has been ‘protected’ from demons by some wall hangings, but that they may have found a way through and this is what is making her sick.

I’ve been to mothers who are channelling spirits in order to drive out the evil ancestors plaguing her daughter (who, unsurprisingly perhaps, has mental health issues).

I’ve been to evangelical Christian cults who have been trying to drive evil spirits out of their elderly relative by throwing salt at them.

I’ve been to countless people who have believed that they were possessed, and have had near superhuman strength to prove it.  I’ve seen them ‘levitate’ off beds despite their father sitting on top of them.  I’ve seen them running down the street naked, covered in their own excrement all in order to fulfil some direction from God.

So where do I stand?  Do I respect the culture and agree that ‘yes, it might be demons’, or do I not reinforce their delusions by reminding them that a urine infection can cause similar symptoms?  More importantly, where does madness end and religion begin?

I had my first famous person in the back of my ambulance the other day.

Jesus Christ.

We were called to a 'Male, 51, Schizophrenic, acting violently'.

So we waited for the police to turn up, for we are not stupid.

The door was opened by a woman, she said something to the police and they pulled out their asp truncheons and loosened the straps on their CS sprays. They made their way upstairs and left the woman downstairs with us. I started to have a little chat with the woman and thought to myself, "She's a bit strange...".

The police came down the stairs, one of them took me aside and, indicating the woman, told me that *she* was the patient and was on leave from the local mental health unit. We took her outside where she explain that, yes, she was on leave from the unit but her father had suddenly developed schizophrenia.

I asked her if it might be her mania flaring up, and if she would like to return to the unit. She agreed that this would be a good idea, so the police asked her for her name.

"Jesus", the policewoman and I looked at each other, "Christ", she continued.

"OK", said the police officer, "but do you have another name, perhaps one your parents gave you?".

The patient gave us her 'birth name' and, fetching her *huge* bag of anti-psychotic medication from under the sink she hopped into the ambulance.

We drove her straight to the mental health unit that she was on leave from. We went into a side room to talk to the mental health nurse.

"What's the story now then?", she asked.

I told her.

The nurse tutted, "She's not really mad, she's just playing up".

I looked at the huge bag of medicines the patient took, "But", I said, "why is she taking all these anti-psychotics?"

"Well", the nurse replied, "she is a bit mad, but she doesn't need to be in the unit".

I wasn't in the mood to argue, after all it's not my place to question the long term care of the mentally ill.

We started to leave the unit.

"Have fun with Jesus Christ", I fired over my shoulder.

Ah, the pure pleasure of being in the middle of a domestic dispute, oh how I love the shouting, the swearing and the pulling of hair.

We were called to a patient with a long term illness, his daughter arrived at the same time as the ambulance and was crying before the front door was opened. Our FRU driver was already there talking to the patient and his partner (a surprisingly young looking woman).

Barely had we set foot in the flat than the arguing started, it appeared that the daughter had some 'issues' with the patient's partner, so they started shouting at each other over the (rather ill) patient.

They were shouting at each other so much that the patients concern that he was about to be incontinent of faeces couldn't be addressed in time. Heaven knows we tried to get him to the toilet, but with both women screaming at each other it was perhaps inevitable that he would poo on the carpet.

Enough was enough, so I locked one of the women out of the house so we could actually find out what was wrong with the patient. The problem was pretty simple and not worth the aggravation that we were getting from these warring relatives.

Then there was a fight between the two women with items of clothing getting torn. I managed to calm things down a little by threatening to call the police. We were all getting exasperated by now and just wanted the patient on the back of the ambulance and safely on the way to hospital.

Thankfully the son of the patient arrived and managed to calm his sister down somewhat, we were then able to 'load and go' to the nearest hospital.

I don't know what the argument was about, and to be honest I didn't care. All I wanted was to look after the patient and go on to my next job. In the end neither of the women were any help to the patient (or to us). It's in situations like this that you have to bit your tongue and yet remain forceful enough to stop people beating each other up.

I don't know how the police do it day after day...

I'd want to pepper spray everyone.

Someone left a message on my phone, I think it was a social worker - if it was you then I couldn't understand what you were saying. You can find my email address in the 'Contact Me' link in the top right of this page.

There is often something endearing about the pleasantly confused elderly, at least in the short term. For us at least it makes a difference from the confusion that has little old ladies grabbing your testicles because you are obviously 'a Nazi come to take me to the gas chambers!'

We were called to one of our less regular warden controlled homes, I've been there a couple of times and have normally been impressed with the staff there, not just because I had a cup of tea and a cake once when I helped them out a little outside of what is normally expected of us.

It was two o'clock in the morning as we pulled into the parking area of the home. We'd noticed a little old man in a heavy coat pulling a wheeled basket being flummoxed by the automatic gate.

The warden, looking at the end of her tether came out to meet us. She pointed at the man, "There he is, he's confused and I can't do anything with him".

The patient didn't really want to go to hospital, he wanted to go for a walk. Chatting to him I could tell that he wasn't in a right frame of mind. My crewmate expertly took the warden off to one side and got the information that we needed. I on the other hand worked on the patient.

Luckily he didn't need much persuading, after a bit of a chat I found out that he had a long-running problem with his elbow. I explained that 'as we are here', it would be our pleasure to pop him down the hospital so they could have a look at him. He was a really pleasant bloke, and I enjoyed having a (slightly muddled) chat.

So we had a nice little journey down to the hospital where we discovered the probably source of his confusion.

Someone had cancelled his night-time sleeping pill. It's a well known effect of stopping sleeping pills that (particularly in the elderly) it can cause night-time confusion, agitation and wandering. I believe that an early episode of 'Scrubs' had a running joke to this effect. Still, at least the hospital could make sure that this was the cause for the confusion, not something more serious.

NeeNaw has already written about hoax calls, yesterday I had one that we knew was going to be a hoax but would have to be investigated anyway.

The call came down to our computer terminal as 'Child on phone claiming to be 52 year old male with difficulty in breathing, no answer on ringback, probably hoax, please investigate'.

While this seems pretty cut and dried it's probably for the best that we are sent to investigate, it only takes one misunderstanding and someone to die and the whole service would be dragged over the coals. I can just picture the headline 'Ambulance thought my dying husband was a hoax caller!'.

So we went to the callbox and sure enough there was a gang on perhaps eight young teenagers standing opposite the phonebox. One of them did that annoying thing where run into the middle of the road, stamp their feet then wave at you and shout that they have broken their leg.

We pulled up next to him, "Call an ambulance did you?"

The teenager faked ignorance.

"It's against the law to dial 999 for no reason", I continued.

He just laughed.

So in an uncharacteristic fit of quick-thinking I pulled out my mobile phone and took a picture of him.

He looked shocked and ran off to his friends and muttered something quickly to them.

My crewmate completed the illusion by pretending to talk to Control on our radio.

The gang of kids disappeared.

The good thing is that (a) It's not against the law to take a picture of someone in the street (he has no expectation of privacy), (b) If he's done nothing wrong he's got nothing to worry about and (c) if it was him hoaxing us, then it might give him a sleepless night worrying what we'll do with the 'evidence'. Of course there is nothing that we can do because we can't prove that he was the one to make the hoax call, so the hope of a little worry on his part is the best we can hope for.

I'm sure some Social Worker* would be upset at my actions, but when we are overloaded with calls such idiocy could cost someone their life.

*Talking of Social Workers, a friend of mine went on a call last night where a Social Worker got involved - said Social Worker got out of his car, urinated in the gutter and then bullied an elderly but otherwise healthy patient into going to hospital. Words fail me.

Only a short post today as I'm off filming for the Alan Yentob series 'Imagine'.

I'm racing down the road on lights and sirens, there is a traffic light controlled pedestrian crossing so I have to slow down to avoid running over the people who think that it is a good idea to run across the road in front of me.

Sitting, quite calmly, on the side of the road is a Guide dog for the blind. Amidst all these people running across the crossing, trusting that I'll try to miss them should they fall over in the middle of the road, the dog sits quietly and doesn't make a move.

The dog has more sense than the people of Newham.