GP pay £110,000 after a 10% rise
Average family doctor pay in the UK rose by 10% to £110,000 in 12 months, according to latest figures.

Is that why nurses and other people working in healthcare, like me, have had a pay-cut (a.k.a. 'below inflation rise')?

I don't begrudge GPs getting paid this (even if they don't have to work shifts like the rest of us). But it will add a bit of bad feeling within the NHS - especially when you see the poor quality of some of the GPs in London.

As I've mentioned before, the government is trying to get ambulance services to take on the role of 'out-of-hours' GP work, I bet we won't be getting paid similar money though.

I just wish that we could have some sort of bargaining power in order to stop the government from crapping all over us.

And in unrelated news - 'Staff shortages and unsafe wards are all the nurses fault, not the government'.

Ever thought of giving up in disgust?

The house was spotless. I'd just managed to climb through the broken window without rupturing myself in order to reach the lady who'd fell over and was unable to get herself up.

Every scrap of furniture was as least forty years old. The wallpaper was ancient, but immaculate. The kitchen had it's original fittings, and even the drinking glasses looked to be years old.

You could open it as an attraction, a 'history house' to show how people used to live in those post-war years.

The two concessions to modernity were a small television and a telephone.

After checking that she hadn't been injured in the fall we sat our patient in a chair - the first thing she did after ten hours on the floor was to reach for a cigarette.

I let her know that we'd wait for her to finish it before driving her off to hospital.

The police, who'd accompanied us to the call in order to help us gain entry, were asking a few questions of the patient. They have their own paperwork to fill in. They were obviously concerned for the lady, they kept asking about carers and community alarms. They asked me if the hospital would help arrange such things.

The police would stand guard over the house until the council sent someone to board up the window that we had broken to gain access. They asked the lady if she had any money in the house.

She named a large figure.

"Better keep that with you", suggested the police officer. I suspect that he didn't want to get the blame if it went missing. I can't fault his logic.

So, along with the patient, we took this sum of money to the hospital. As usual it was packed with patients and seemed a bit low on staff.

I handed over the patient's history and then explained about the money.

It's always amusing to see the nurse in charge's face sink, and then listen to them swear at you.

I remember when I was a nurse that one of the worse things that can happen in the day to day running of the department is for a patient to bring in more than £20. We can kill as many patients as we like, but if money goes missing then nursing careers become a little less...secure.

So we checked and double checked the money before booking it into the safe, three of us counting it out in the psychiatric room, making sure that none of us would run off with it.

Paperwork signed, it was time to look after the patient.

To be concluded...

(One hour of sleep last night - many hours of staring at the ceiling. Now it feels like my right eye is trying to grind itself out of the socket).

If my crewmate were a bit crueller you'd now be looking at a picture of me half hanging out of a window.

It was one of our usual calls, a 'Nan down!', otherwise known as a 'collapse behind locked doors'. Some elderly person has a fall, normally during the night, and is unable to get themselves up. Sometimes they are found by carers, sometimes they hit their community alarm. In this case it had taken her ten hours to manage to crawl to the telephone.

We arrived at the same time as the police. Our patient had already told Control that we would have to break the door down. The police have a ram they can use to smash down a door, so they are tasked to these calls as soon as we know it might be needed.

Looking through the letterbox I could see our patient sitting on the floor in the hallway. She didn't seem hurt at all, and after having a shouted discussion with her, she let if be known that breaking in would be the only way to reach her.

The door was secured with two locks, two bolts and a chain. It wasn't going to be opened with my size twelve boot. The police suggested getting the ram from their station but I had a better idea. Smash the glass window in the door and climb through. It would be a lot less damage and would be easier and cheaper to repair.

Out came 'Vera', my favoured pair of trauma shears and I made short work of the glass. As the window was around five foot off the floor I used our carry-chair as a stool to climb up to it. Then I put my hi-vis jacket down as protection against any small bits of of glass left in the frame and heaved by bulk through the hole.

This worked well and I got all my body through.

Apart from my right leg, which dangled half in and half out. I was stuck.

Two young lads who were watching from the street started laughing. My crewmate forgot to get some mobile phone snaps and I wondered how far apart my legs could go.

Thankfully I managed to free myself while retaining the ability to have children.

I'm a real child sometimes - I love the chance to climb through a window, or over a wall, or hop over a gate.

Luckily our patient wasn't hurt too badly - she had a bump on the head and pain in her knees, so we would be taking her to hospital for further assessment.

To be continued...

I saw this at the BBC news site this weekend.

Many people use the clocks going back to gain an extra hour in bed - but a sleep expert says the change can actually leave people tired.
Even such small changes, said Dr Neil Stanley, can disrupt sleep routines and cause semisomnia - low grade exhaustion caused by inadequate rest.

...and laughed like a drain.

You see, I work rotating shifts which plays sheer bloody havoc with your body clock, leading to an increased risk of getting such illnesses as diabetes, heart disease, bowel cancer, depression and (while not a disease) divorced.

Let me tell you about my sleep pattern over the past few days.

Tuesday night - Four hours sleep.
Wednesday night - Four hours sleep.
Thursday night - Twenty one hours sleep.
Friday night - Forty minutes sleep.
Saturday night - Eleven hours sleep.
Sunday night - Eight hours sleep.

I think someone somewhere said that regular sleep is good for you? This sleep pattern is me on 'day' shifts, when it gets to fitting into night shifts it gets even worse. Then I end up staying awake something like thirty-eight hours.

If I didn't do these rotating shifts then my £400 a week take-home pay would be cut by around 25%.

I love the government.

---

Yesterday was quite a pleasant shift, plenty of things to write about, but I'll start off with the only bad job of the day.

Called by a 'good Samaritan' (on which more later) to a 'male collapsed in the street', we turned up to find a drunk male snoring away in the rain.

We can't leave them there, because we'll only get called back to them and the police won't take him, so we loaded him up onto the ambulance and went.

Let my paperwork speak for itself.

'Patient found asleep in the street, smells heavily of alcohol. Pupils large and sluggish, nystagmus. No obvious physical injury. On waking refused to allow me to take observations. Told me to "Fuck off", which is apparently the only English he speaks. Unable to get details of patient. Acting aggressive.
On arrival at hospital patient attempted to hit me, told me to "fuck off" again and left the ambulance and walked off.'

Sadly, not an unusual job.

Here is an idea - if we pick up a patient drunk from the street, we should take the to hospital (unless someone decides to operate a 'drunk tank'), there they receive their treatment, then the police are informed and the patient is hit with a penalty charge of £100. The proceeds of which then go to the NHS.

Of course what would be better would be to have private companies running 'drunk tanks' where the 'patients' are looked after until they sober up - and then are charged for the privilege.

We pulled up outside the front door of the house and I had the unmistakable feeling of having been here before. I searched my memory, but as the best description of said memory is 'Swiss Cheese', I couldn't remember why I'd been here before.

We'd been called because an eighteen month old child had been having a fit. Normally these are caused by a high temperature, sometimes by epilepsy. The older sister who opened the door seemed uninterested, so we assumed that the fit had finished.

We were led upstairs to the bedroom where the child was lying on the bed, the mother standing over her. The mother didn't seem too distressed, so my crewmate asked what had happened while I examined the child.

Apparently the child suffered from epilepsy and usually had one seizure a month, she was on various medications for this but they didn't seem to work as well as hoped.

My examination of the child showed her to be breathing, and a bit 'knocked out', which is usual. But there was something alerting my 'something's not quite right' sense. To be honest I was sure if the child was still having a seizure.

Some seizures involve the classic flailing around of the limbs, others are much more subtle sometimes showing up only as flickering eyes.

There was something not quite right about this child, her eyes didn't focus on me, she was holding her body in a strange manner and she wasn't trying to pull off the oxygen mask I'd put over her face.

We asked the mother and she told us that the child was normally like this after a seizure.

So we bundled her up and took her to hospital, my crewmate keeping a close eye on the patient while I drove.

As we got to the hospital and I opened the door to the ambulance my crewmate was standing there with a big grin on her face.

The child still looked neurologically unwell, but the next words out of my crewmate's mouth removed all doubt as to why this was so.

"The mother has just told me that the child is blind, has cerebral palsy, developmental delays and is unable to communicate".

It was only after our assessment, our treatment, and halfway to hospital that the mother remembered to tell my crewmate this rather pertinent bit of information.

While the child looked rather ill to us, it was apparent that she had made a full recovery to her normal state of being.

Funny how people can forget to tell us about these apparently small bits of information.

I'm currently doing strange things to my Macbook at the moment (by breaking half a dozen warranties I'm getting to upgrade my hard disk. Hopefully). Consequentially I'm writing this on my Ubuntu laptop.

---

Our patient, lets call her 'Gladys', is ninety-nine years old.

She lives in her own flat, but has a carer come first thing in the morning to make sure that she is alright.

She's blind in one eye, deaf in one ear and normally potters around her house. She should use a walking frame, but often walks around without it.

She's been laying on her floor all night.

She has a community alarm. This is a pendant that is worn around the neck. If the person needs help they press the big red button on it and a call is put through to a care centre - they will then call us.

Her community alarm is on a table.

She'd managed to pull a tablecloth off the table to use as a blanket. Sleeping on the floor she waited until her morning carer arrived.

Community carers aren't allowed to pick people up off the floor - that is a job for the ambulance service, with our backs of steel we are often called to do some heavy lifting.

But we like these jobs, if the patient hasn't hurt themselves we can leave them at home - the patient is always happy to see us and it makes us feel that we have done something useful.

So we check Gladys over, she hasn't hurt herself, she isn't too cold and she wants to stay at home.

We pick her up, tidy up the things that she pulled on the floor when she grabbed the tablecloth. We make her a cup of tea and chat a bit about her family. I tell her off for not wearing her alarm, and remind her that we are more than happy to come around her place should she get into trouble.

I let her know that I'd rather pick her off the floor than yet another drunk.

I'm betting that she won't wear the alarm, there are a lot of people who don't even though it costs £100 a year.

I've known elderly patients who have fallen over at night, then not pressed the button until gone 8am. They 'didn't want to bother us'.

It's a generation that is getting smaller and not being replaced, this self-sufficiency and the desire not to be a burden on others. The feeling that spending the night on the floor isn't an 'emergency'.

I'll miss them when they are all gone.

While I sleep - a round up of some stories that have been sitting in my brainpan. Some of these were sent to me by readers, do keep up he good work. Please excuse any random kneejerkage - I'm drunk on lack of sleep.

The Healthcare Commission judged LAS as 'good' for both its use of resources and its services - a better rating than any other service in England.

First off, well done to the LAS for being the 'Best in the Country' - this really deserves a blogpost of it's own, but I thought I'd mention it here in case I forgot.

---

A union has taken legal advice after ambulance managers posted details of the salaries of call centre staff on the internet.
Ray Salmon, of Unison, said the details posted on the internet included staff members' length of service, their grade, how much they earned, their date of birth, personnel number and what redundancy payment they would receive.

But then WMAS do something a little bit naughty - if you read the article the irony is rather rich, as other staff have been disciplined for releasing information in the public interest. (Begin Snark Mode) Also of some surprise is the sight of a Unison rep for the ambulance service doing something (End Snark Mode).

---

A woman who won the title Nurse of the Year from a magazine is to leave the NHS because she is fed up with cuts and reforms.

"what I see as a waste of resources is when I'm sitting in a big meeting, and as a clinician I am the cheapest person there at £35,000 a year, and decisions are still being put off to another meeting."

She's a better person than me, if I were paid £35,000 to sit in meetings I'd probably put up with it. I can't blame her, banging your head against a brick wall wears a bit thin after a while.

---

Individuals can no longer be held responsible for obesity so government must act to stop Britain "sleepwalking" into a crisis, a report has concluded.

I'm getting rather brassed off at the growing lack of personal responsibility. "It's not my fault that I'm a heroin addict", "It's not my fault that I'm an alcoholic", "It's not my fault that I kept eating after I stopped being able to see my feet". Apparently the government are force-feeding people like pâté de foie gras geese. Maybe people would like rationing brought back?

---

Heroin and cocaine addicts on the government's treatment programme are being given drugs as a reward for clean urine samples, the BBC has learned.

The National Treatment Agency (NTA), which runs the £500m-a-year scheme, admits the practice is "unethical".

Here we go again. I think that there are better treatment options than hooking someone on Methadone instead of Heroin. This seems an awful, awful practice - the pressure of bribery coupled with the pleasure of being able to get high again, just on a government mandated supply. Is it any wonder that people remain on Methadone for years and years? I'm with Theodore Dalrymple and Mao Zedong on this one.

---

Nearly 13,000 nurses across Finland are threatening to resign next month in a pay row, trade union officials say.

I don't think that much will come of this, I'd suspect that the union would blink first. Would that we had an ambulance union with that much power in the UK to balance the 'reforms' that the government is forcing on the NHS. Instead we have a union whose idea of representing us is to roll over and agree to everything - including an agreement that new members of staff are allowed to be treated like crap. Of course if we did strike the government would just privatise us all.

---

Bloggers are now finding themselves prey to censorship from repressive governments as much as journalists in traditional media, a report says.

At least I'm unlikely to find myself imprisoned because of my blogging. There is always someone worse off than yourself.

---

The BBC's online services will be made available free of charge at thousands of wi-fi hotspots around the UK.

The corporation has agreed a deal with wi-fi firm The Cloud, which operates 7,500 hotspots around the country.

I love the BBC, but this is just wrong. Signing up with a private company in order to provide content that I've already paid for with my TV license just isn't cricket. This is also I suspect a way in which the BBC is trying to get around the regulators ruling that people who don't run Windows should be allowed access to iPlayer functionality. Unfortunately, in the same breath they contradict themselves.

From September 7th.

"The BBC Trust has committed to making sure the BBC would meet calls for non-Windows versions of the iPlayer "as soon as possible" said the government statement."

Then October 15th.

Ashley Highfield... "We need to get the streaming service up and look at the ratio of consumption between the services and then we need to look long and hard at whether we build a download service for Mac and Linux. It comes down to cost per person and reach at the end of the day". He added: "We are not ruling it out. But we are not committing to it at this stage."

'Committed' to 'not committed' in the space of five weeks - I guess that the media world is fast paced indeed.

And yesterday, another turn around.

Are the people at the BBC (who still have jobs) feeling dizzy yet?

Essentially it all comes down to DRM - if the BBC were brave enough to offer content without DRM then platform agnosticism would be a trivial problem. But unfortunately someone somewhere has decreed that all content should expire after 30 days. Just like my old VHS recordings from 20 years ago. Because we all know how home taping has killed the entertainment industry.

The people that I know at the BBC are forward thinking, brilliant people. Unfortunately it seems that their management are holding them back. Give these sorts of people some power and you'd easily have your efficiency improvements. I have real sympathy for those on the shopfloor who are going to lose their jobs.

You know - sometimes I should just blog by Twitter posts. Then you too can watch as a man slowly loses his mind over the duration of a single nightshift dealing almost exclusively with drunks, druggies and fools.

One more nightshift to go before a bit of rest.

(Tweets, like blogposts read from the bottom up - Leeisserow asked my why the police don't take the 'drunk and incapable any more).

Now I'm going to sleep, try not to miss me too much.

It's 3 a.m. in the lonely hours of the morning and I'm nervous.

We are in the bedroom of a six year old boy. His mother found him having trouble in breathing half an hour ago.

His airways are so tight that every breath that he takes turns his chest inside out. He is trying to breathe so hard that I'm waiting for his breastbone to snap under the strain.

From across the room I can hear the air whistling through a tiny airway. He has the classic posture of the asthmatic trying to force air into their lungs - he's sitting upright, hands on knees.

He can't cry - he hasn't the breath for it.

I want him in the ambulance. No, I want him in hospital.

But we can't go just yet. The single mother has two other children, both under the age of five and they can't be left alone in the house. They need to be woken up and dressed. One needs to be thrown, still sleeping, into a pushchair.

I'm counting the seconds, I'm waiting for the boy to start turning blue.

I'm eyeing the kit in our bag, how much experience has my crewmate had in intubating a closed down airway?

We are already giving him all the drugs that we can. He's so sick that he quietly accepts the noisy nebuliser mask.

I help the mother dress one of her children - socks and shoes slipped onto sleepy feet.

Then it's time to go. Like all parents she worries about out insistence that we leave the child topless as we walk out into the cold air. It's due to his high temperature I tell her. I don't tell her that it's also so we can easily see that he's still breathing.

For once my big fear isn't a complaint from the mother - it's that the child will die in the back of our ambulance.

I pass the blue call over the radio to prealert the hospital, the radio isn't working too well so I have to repeat some of it. I don't think that the radio operator understands one of the medical terms that I use, it's not their fault as it's pretty obscure. The broken radio means that I can't be sure of the read back.

I don't care, as long as they have the paediatric doctor waiting for us there I'll be happy.

We are 1.9 miles from one hospital, 2.4 from another. I go for the further hospital, the drive is straighter and I can use the A13 which at this time of the night is clear. The other hospital has too many speed-humps and side turnings on the route.

I'm listening to what is going on in the back of the ambulance. My crewmate sounds relaxed and over the sound of the engine is the reassuring noise of the child's breathing.

I glance at the speedometer - I'm hitting 80mph, I didn't know that these ambulance reached that kind of speed. I'm thankful that the road is clear and empty, and that there are no hazards.

I spot the patient's young sister looking at my face in the rear-view mirror, her eyes wide open now.

We pull up to the hospital and I take care of our patient's siblings, I bed them down in the relatives room while the doctors and nurses and mother look after their brother.

---

It's only half an hour later that I'm talking with the paediatric nurses - while it looked touch and go for a bit, our patient responded well to the medications that we can't give. His breathing is back to normal.

I love the paediatric A&E nurses at this hospital, they are experts at what they do and despite the cynicism that is endemic in the NHS, they really do care for their patients.

We are chatting and laughing at the memory of our fear. We have fought back against death, and this laughter is our victory cheer.

The family are reunited.

I still have that memory of fear though.

It's getting late in the year, so the nights are drawing in and I find myself driving to work in the dark and making it home again before the sun rises above the rooftops.

At 4 a.m. in the morning I feel like killing myself as my body just wants to shut down. Instead I find myself going to people who have called an ambulance because they have had a nightmare.

There are a few bright spots, an easy home delivery results in a happy baby and family. We save the life of a six year old and think that we've done something good.

But these are overshadowed by the sixty-five year old drunk woman who makes to hit me and tells me to "fuck off" as we pull her out of the freezing puddle. The patient who calls us 'just because' at five in the morning could do with a thump as well.

I'm not eating well, pasta for three days running in order to try and keep my energy levels up through the night, it's not the most interesting food.

The nights are wrecking havoc with my heart palpitations, I'm trying to keep off the caffeine, but I think that the missed beats are my bodies way of telling me that the job is slowly killing me. I'm getting more of them every night.

A station officer tells me that I could always swap to permanent day shifts - I ask myself how I am supposed to survive on a 25% paycut that coming of rotating shifts would mean. From £10 and hour to £7 an hour? For the same work - no thanks.

The job is going down the drain - we are pulled from one directive to another. I hear something that makes me angry - looks like the slow privatisation of the NHS has reached the ambulance service. I wonder how I'm going to write about it, to describe my utter disgust at the idea of 'private' FRU cars.

I waiting to make a mistake that'll cost me my job - will it be my 'attitude' to another wasted call that does for me? Will I be so tired that I miss a treatment or diagnosis? Will I cause a crash in my ambulance? Will it be something that I write on here?

I float around my flat, all enthusiasm drained from me by that 4 a.m black hole.

It's that time of the year again. Maybe I should start thinking about better living through chemistry.