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View Article  My Job Description

I don't know who wrote this on the NHS Careers website, but I think they got their information from "The Ladybird book of ambulance drivers".

Under the supervision of a paramedic, they carry out essential emergency care, such as controlling severe bleeding, treating wounds and fractures, and looking after patients with possible spinal injuries. They use electric shock therapy to resuscitate patients with heart failure and are trained to give a range of drugs.

Two things - we don't need the 'supervision of paramedics', there are a lot of double technician crews out there. The 'supervision' that we get from having someone not medically trained on the other end of the radio justifies why the government pays us so little. As a FRU solo responder I didn't even have another technician 'supervising' me.

Secondly - if I start using 'Electric shock therapy' on patients with heart failure I suspect that I'd end up in prison. 'Electric shock therapy' is not defibrillation (the closest thing would be the ECT using in treating mental health problems). Neither is 'heart failure' a cardiac arrest - they are two entirely different things.

If you can't even get the job description right, then what else are you getting wrong? Would it have been so difficult to get someone who actually knows the job to write something? Or would that be too honest to recruit people?

"70% of the people you go to will not require an ambulance. Many people who are younger and fitter than yourself will want to be carried down stairs. You will be dealing with members of the public - many of whom will be drunk. The government will expect you to reach jobs in under eight minutes, despite the driving conditions. You may be required to deal with dead animals. Expect to have someone take a swing at you once in a while".

It is a very English description though, as the weather is mentioned twice...

It's up to you to decide whether I posted this job description as a humourous aside, or as a point that there are a lot of people in the NHS/government who haven't a clue what we do...

(Tip of the hat to the person who posted this on the BWTS forum).

View Article  The Jobs We Do...

We arrived at the location at the same time as the FRU, one of those warrens of estate flats that cover our patch. It was gone nine in the evening and there were patches of rain. The job started well as I fell arse over tit up an unlit flight of stairs while carrying some of our kit.

Our patient was given as a sixty year old having an asthma attack. After peering at door numbers in the dark and climbing three flights of stairs we finally managed to find the flat. Our FRU was peering at his watch, he was off work in ten minutes so was hoping that we wouldn't need his help.

A bedraggled woman opened the door, she was in her late fifties and was crying.

"She's dead", she said to us, "She's dead".

I pushed past her, not knowing what to expect.

The body was lying on the floor, half in the living room, half in the hallway. Flies crawled over it, and there was the smell of death in the flat.

"I came home from shopping, and she was just lying there", the woman sobbed.

I wondered if I should check for a pulse on the corpse. But where is the pulse on a dead dog?

The deceased was a rather overweight collie dog. I walked over to it - while my expertise is in dead people, it was pretty obvious that the animal had been dead for some time. It looked like doggy CPR would not be needed. It would also take an hour to shave the dog enough to be able to stick our defibrillator pads to it's chest. So we decided to step outside our guidelines and declare the patient dead without the customary heart-trace.

My crewmate looked after the human patient as I waved the relived FRU goodnight, looks like at least one of us would be getting off work on time for a change.

I looked around the flat - it was a bit cluttered and a bit grimy but not too bad. Unfortunately there has been an explosion in the fly population in East London recently - and I think that most of them came from this flat. One bit of flypaper had been hung and it was solid with the bodies of flies. The rest buzzed around us - landing where the dog had evacuated it's bowels and then in our hair.

Lovely.

Our patient was incredibly upset that her dog had died and I have complete sympathy for this. It's awful to lose a loved pet - and as this woman lived alone it was probably her only company. She'd become so upset she'd started to have trouble breathing. My crewmate had already done a good job of calming the woman down, but every time she saw the body she'd start crying again.

It also became obvious that the woman had some sort of mental illness, she had some strange beliefs that didn't affect her ability to look after herself and was a bit 'off' (which is obviously a highly professional medical term for 'somewhat eccentric').

The woman also refused to come to hospital.

But what could we do? All the council services that would remove the dog would be home having their supper.

Once more it was down to the ambulance service to step outside our normal job of giving people a taxi ride to hospital.

Leaving my crewmate with the woman I made my way back down to the ambulance and radioed Control, after giving her the story there was silence on the other end of the radio. Once she had stopped laughing she asked if she could phone me privately. A few moments later my phone rang and I was greeting by Control giggling down the line at me.

Once the pair of us had calmed down a bit we decided to contact the RSPCA and see what they could advise. After a bit of to-ing and fro-ing I ended up speaking to one of their inspectors. For some reason they are only really interested in animals that still have a pulse, but he did tell me that the Harmsworth hospital would take the dog in to be cremated if our patient agreed.

I checked with Control that it would be alright for us to do this, they agreed that it was in the patient's best interests and none of us wanted to leave her all night with an incontinent dead dog in her living room. We spoke to the patient and, after saying her final goodbyes, agreed to let us take the dog.

I've been in the job longer than my crewmate, so I made sure that I was at the head end, while she got the leaky end that was covered in maggots. She's worked with animals before so didn't mind.

Honest.

We wrapped the corpse in a sheet and started lugging the dead weight down the stairs.

Now, I know it's awful to lose a pet, I've known people devastated by the loss of a dog and can fully sympathise. But there was something inherently funny about two ambulance folks carrying a dead dog out to an ambulance at the dead of night. So I'll admit that there were a fair few giggles. All the time we were hoping that no-one would look out of their window to wonder what we were doing...

Finally we made it to the ambulance and loaded up. Just then a police carrier crept up to us and asked if we needed any help with anything (for we were on that kind of estate). We told them the story - I think they enjoyed the entertainment...

We then found ourselves driving across London with a dead dog on the back of our ambulance. My crewmate spotted me checking the corpse in the rear-view mirror - there then may have been some suggestion that I thought it was a zombie dog and that it was waiting to attack...

We reached the Harmsworth hospital and signed over the dog to the very helpful nurse. I'm not sure what the people in the waiting room made of two ambulance people carrying a dead dog past them in a sheet, all four legs stiffly pointed in the air.

Then it was a case of mopping out the back of the ambulance (where the dog had... leaked) and getting on with finding some less hirsute patients.

Now - some people might think of this as a waste of an ambulance, but we did what we had to do in order to help the woman, to stop her having stress-related breathing difficulties. We also filled in one of our 'vulnerable adult' forms to refer her to the social services in order to help with her fly infestation and maybe have someone formally assess her mental health. Sorting out someone's health by removing a dead dog is a new treatment - perhaps I could get a grant to research it?

View Article  Housekeeping And Thanks

First off, a big thank you from myself and Merys - thanks in part to your donations she will be able to continue to train to be a doctor. You are all absolute stars - thank you.

The other big news is that I LIVE!

I'm left with a slightly stuffy nose and some pain in my left knee, but other than that the 'man-flu' has left the building and I am able to leave the nest of my flat. This is good as I've almost run out of lemon tea.

Actually, trying to classify this illness is a bit of a problem. When I do my 'return to work' interview they will ask me what was wrong with me. Now, the medical professional in me knows that it wasn't the 'flu, but likewise it was more than a cold. Also the symptoms were what most people would refer to as the 'flu. So do I 'lie' and say I had the 'flu, or is it just a bad cold?

All my fault for being so honest.

In response to some of the comments on the previous blogposts (sorry, I didn't have enough energy to turn on the computer), the LAS sickness policy is something like 'three or more periods of sickness in an eighteen month period, or any one period of sick lasting more than a week' leads to an unwritten informal warning. This is straight off the top of my head so I may be mistaken, and this will be my fourth period of sickness in this period (I think).

I'll let you know more after my interview. I'm not hugely stressed by it, as I tell my station officers, "I'm only sick if I'm sick". Besides, shift work flattens your immune system.

All going well, I'll have a working phone by 18:02 today...

View Article  To Be Disciplined

Looks like I will be in line to be disciplined. I dragged my body into work and while sitting in the back of the ambulance taking my first patient* to hospital had to struggle not to vomit on him.

Which would have been an unusual turnaround, normally people vomit on me.

So I'm off sick at home molly-coddlying myself with lemon drinks and drugs.

*Yes, I was sicker than him.

View Article  Bleurgh

No blog post today because I am currently doing an impression of Nick Frost.

Unfortunately I can't take time off work because otherwise I run the risk of being disciplined (it being too close to my time off work for heart palpitations).


I have a friend who is training to be a doctor. She is a lovely person who works (at last count) something like three different jobs to support herself in addition to doing voluntary work.

I'm not sure when she gets to sleep.

Anyway, the medical school are threatening to throw her off the course if she can't come up with some money sharpish - so she's taken to begging on her blog.

If you could see yourself able to donate a quid or two I'd consider it a personal favour.

She will make a wonderful doctor, and to be thrown out because of a lack of money seems entirely unfair to me.

View Article  Putting Up with Pot

"Patient smoked weed - now feeling funny".

The thing that I normally ask these sorts of patients (for there are a fair few) is, "Isn't that what it is supposed to do?"

Our patient was used to smoking cannabis, but for some reason this particular strain of 'erb had caused him to become panicked. So he gone out into the street where his friends had poured some cold water over him.

Cold water - I never understand it...

We were told that it was 'commercial cannabis', whatever that means.

It was a good thing that I was driving this night, I would have been seriously tempted to tell the patient that there was a new and potentially fatal additive to cannabis in the area just to see how quick I could get his pulse going - but we were being nice, so my crewmate calmed him down and, by the time we reached the hospital, he was laughing and joking with his friend.

I suspect that he wouldn't wait to be seen by a doctor - instead he'd take himself back to the party that we picked him up from.

Now, unless I'm mistaken (and, y'know I am terribly naive), but isn't it still illegal to smoke cannabis? So why didn't it cross anyone's mind to call the police?

The answer I would guess is that it is a 'victimless' crime (unless you count the person having an angina attack we could have gone to), that the CPS wouldn't be interested, and that the police have many more serious things to be getting on with (like filling in their countless forms). We as the ambulance service also have too much work to be calling the police ever time we witness something illegal.

Of course, if we did start reporting people then we'd be viewed by certain (violent) members of society as little more than stool pigeons and end up getting beaten up a lot more than we do at the moment. At the moment we aren't seen as being part of the forces of law and order, which is why we can often walk unharmed through the worst parts of town and stroll into crack dens.

Current Status : Full of illness, throat like the bottom of a parrot cage and an eye that is leaking *stuff*. And my mobile phone isn't working, I suspect that it knows it will soon be replaced...

View Article  Nan Down (3)

We'll often leave our 'Nan down's' at home, if they haven't injured themselves then it is more risky to take them to hospital than to leave them at home.

This one we would have to remove from her spotless house and take her to hospital. She would be staying, probably for a long time.

Out patient, until the moment she fell, was normally very mobile. She would walk down to the shops to buy her food, she was able to keep her house clean and squared away. There was no need for a stair-lift, nor other mobility aids. Given my knees she was probably more mobile than I am for much of the time.

But suddenly, one evening, her legs had given way on her.

When we picked her up, her fingernails left crescent marks on my arms, she was so frightened of falling. She was barely able to take a step, it was as if she had aged twenty years in a minute.

It wasn't the fear of falling again, that much was certain. Instead something had happened that had completely removed her ability to balance properly.

My assessment didn't show anything neurologically wrong with her, but it would seem most likely that she had suffered a stroke. Something that affected her balance and had struck out of nowhere was unlikely to be an ear or urine infection.

She had no next-of-kin, no carers, no support. She had gone from being able to look after herself to needing hospital treatment in a matter of moments.

Yet she was lucky, if it was a stroke it had left her mind untouched, she was able to communicate, to read, to carefully smoke a cigarette. But her legs were 'gone'.

Hopefully it would resolve itself, with time and work from the physiotherapists I'm hopeful that she would be able to regain the ability to walk.

She might need a bit of help, maybe a bit of support. A community alarm and maybe some handrails. Maybe a stairlift and someone to help with the shopping.

And one day I hope that she'll be able to go back to her home and live like she did before she became a 'Nan down'.

View Article  Snark
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?

View Article  Nan Down (2)

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...

Welcome to Random Acts Of Reality, a Blog based in London, England, written by an E.M.T working for the London Ambulance Service. Also, number one search result for "Womble porn". All names have be changed to protect the guilty. This Blog was previously known as "Why I Hate Humanity" but the antipsychotic medication seems to have kicked in.

All opinions on this website are mine alone, and may not reflect those of the L.A.S or other ambulance crews

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