In my experience there are three types of suicide calls that we go to.

By far the largest group are those that don't really intend to die. They normally present as having had an argument with either a family member or their boy/girl/transgender-friend. They then either take a handful of tablets or make some minor cuts to their wrist. I don't believe that they wish to die for, as soon as they perform this act of self harm, they call for an ambulance. More often than not they don't call for an ambulance themselves but instead phone round their family and friends and let them know what they have done. These friends then call us and rush around to the patient's house in order to give their support

When we arrive they sometimes put up a pretence of not wanting to go to hospital, but will come without a fight as it were. Surrounded by the people who care for them they sit chatting in the back of the ambulance.

Often paracetamol (acetaminophen) is the drug of choice and occasionally someone will take too much of it thinking that it is a 'safe' drug to overdose on - a mistaken belief that has killed more than one person, especially when mixed with alcohol.

A much rarer suicide call is the person who has succeeded in killing themselves, seldom this is due to a drug overdose. We will get sent to someone who has hung themselves, or someone who lives alone and has taken a mixture of every drug that they can find. Often these people will have a collection of anti-depressents that they take all at once.

These patients will normally have a long history of mental illness and they go somewhere private and kill themselves - it is only when someone hasn't seen them for a few days that we are called.

While I've never been to one myself, there are people who kill themselves in public places, often fathers who kill themselves to be found by their children - something that I've never understood.

Then there is the final group, those who truly wish to kill themselves but have been 'unlucky' enough to be discovered. These are the tough cases as they don't want to be saved. We find ourselves trying to get them to go to hospital, but they refuse and, as the law stands, I can't frogmarch them into my ambulance. So the police are often involved in persuading them, and on more than one occasion I've had to rely on the Mental Health Act in order to have them removed to hospital against their will.

Sometimes they do come quietly, and this can be heartbreaking to see - one memorable job of this type was a teenager with a long history of mental health problems. They were taking a whole bunch of tranquillisers and anti-depressants, their arms were just a mass of scar tissue from repeated self harm and they were incredibly unkempt. But the worst thing about this call was the utter hopelessness that radiated from them, they spoke with no emotion and answered any question put to them curtly. In my opinion it was unlikely that this teenager was ever going to become 'normal', or be able to live any life without constant supervision. They were accompanied by their adolescent mental health worker and she was very caring, which is sadly a rarity.

Which is a long way around of wondering which of these three camps this particular gentleman came from?

I love my crewmate.

Not romantically mind you, that would be very wrong, but in a brotherly way.

You see, she's had a few days off work and I've had to work with other people. Now, these other people are fine people to be working with, but as I've never worked with them before we don't have the 'telepathy' that my regular crewmate and I share.

Let's imagine that we have a patient who is actually sick (I know, I know it hardly ever happens, but please bear with me) a simple glance from either one of us can let the other know what we are thinking with the patient being none the wiser.

It's nice not to notice that the nice ambulance people who are trying to treat you also think that you might end up shuffling off the mortal coil somewhat sooner than later.

The back of an ambulance is fairly cramped and so you work out fairly quickly how to work with the other person without bumping into them while still sharing out the jobs that need to be done. With a strange crewmate you find yourselves doing awkward shuffling dances in the back of the ambulance as one of you goes to put away the carry chair while the other tries to check a blood pressure.

With mixed sex crews there is also the potential of sexual harassment, thankfully my crewmate has managed to keep her womanly desires under control and away from groping my bum.

The current joke is that I'm looking for a divorce - like a married couple we finish each other's sentences, we whistle at the same tunes on the radio, we think alike and, like a married couple, I've stopped flirting with her.

Why, it's only a matter of time before I feel comfortable farting in the cab.

And of course, when we can, on nightshifts* we get to sleep together - me farting and drooling on one sofa while she snores and scratches herself on the other, slightly smaller, sofa.

Of course she does try to get me in trouble, like the time we were going to a little girl who'd apparently swallowed a magnet.

"You get bonus points if you can work a pun in there while you are talking to the mother", she suggested.

"Like what?", I asked.

"I don't know, something like 'I'm really attracted to your daughter'"

"Oh, so 'pun' is a new word meaning 'paedophile' and you want me getting arrested for telling a mother that I'm attracted to her three year old?"

She did manage to stop laughing by the time we reached the job.

So there you have it, part of the reason why I don't change ambulance station or go for my Paramedic qualification is that I just like working with her too much. A good crewmate makes all the difference to this job, and I'm glad I get to work with her.

*And by 'nightshift' I really mean any shift where we are left alone for longer than ten minutes - gotta grab those naps when you can.

It's been a long two or so weeks - lots of shifts with some nasty changes (getting up at 12am for some shifts then less than 48 hours later having to get up at 5am, changing shifts 'backwards' is awful). Add in hardly doing a 'decent' job for a month or two and coping with the management led changes that are causing morale to plummet and it's easy to see why I'm incredibly grateful to be off work for a few days.

Before starting Friday, Saturday, Sunday night-shifts.

Rather than bore you with lots of posts about how bad it is getting I thought I'd keep my moans all short and put them together in one post.

As an example of the sorts of calls that I've been running on blue lights to, with a FRU already in attendance, include a blocked nose and someone with an earache. These then get categorised as 'Cat A' rapid responses - surely this is proof that the computer system which triages these calls is not fit for purpose. Giving everything a high priority is not triage, it's arse-covering.

I'm going to start testing people's eyes soon as part of my assessment - stand them on their doorstep and ask them if they can read the writing on the side of the ambulance, you know, the bit that says 'Emergency Ambulance'...

The blocked nose and earache calls weren't even the normal 'demographic', young wimpish men, they were calls from people who should know better.

Due to 'Call connect' jobs are being sent down to us half-formed. Nothing but an address with no indication of what is wrong with a patient. I refuse to drive on blue lights to these jobs until they give us more information - I'm not going to turn up somewhere without any idea how dangerous it is. Imagine being sent to someone who has been stabbed by a mad family member, knocking on the door and being greeted by someone with a bloodstained knife.

This dangerous practice is due, once more, to the governmental target needing to be met rather than any actual clinical need.

If this job was based on clinical need I'd not be blue-lighting it to blocked noses, yet trundling down the road to elderly patients who have been on the floor all night with a broken hip.

Active Area Cover (AAC) continues to be a farce, as if a computer can predict where the next call comes from when there is a population density as high as in London. Only the other day I returned to station after being out all shift, behind me was another ambulance. We hadn't even opened the front door to the station when the phone started ringing to tell us both we had to turn around and start driving around.

I was told to go to a point 0.7 miles away from the station.

To say that I was fuming that I wouldn't even be able to get a cup of tea would be putting it mildly. So instead I found myself sitting in a cramped cab in the rain only to have to drive back past my station on the very next call.

What irritates me even more is knowing that the people who order us out to roam around are sitting in a nice comfortable office drinking tea and eating biscuits while clapping themselves on the back for a 'job well done'. And they get paid more than me.

Our stock of equipment has been of it's usual high quality, in the last two weeks I have been out on an ambulance with...

• No scoop stretcher
• No drug pack
• No reagent sticks for measuring blood sugars
• No blood pressure cuff
• No working ECG leads

And

• No oxygen masks

Good job I hardly ever go to anyone who is actually 'sick'.

When I first joined this job, staff morale wasn't too bad, it has now plummeted. This can be the best job in the world, but the changes that are brought in for no reason other than to make some governmental minister happy are destroying the job. To them a successful job is getting two resources to the earache within eight minutes, while ignoring the hypothermic broken hip patient. to them a success is 'doing something', even though there is no evidence that it makes things work any better - after all no-one was ever re-elected by doing nothing to a service even though it works well - you have to 'stamp your mark' don't you know.

It also doesn't matter if you get to a job and can't give the patient oxygen, as that doesn't impact the all important eight minute target.

Expect to see more of this sort of thing and be under no illusions, as far as the government is concerned this is a 'successful' job, because the FRU got there in under eight minutes - it's one of the many reasons why I came off the FRU.

Most of the time hoax calls are rather simple things. Often someone, mostly a child, will call the ambulance service from a phone box. We dutifully whizz around there with our blue lights and sirens in an effort to meet the government target save a life, only to find that there is no-one there.

In this latest call we were sent around to a house where it was said that a young woman had phoned for an ambulance themselves and, after giving a medical history of some detail, said that she was finding it so hard to breathe that she was unable to open the door.

We arrived to find the house in question looking un-lived in - there are subtle clues that even the densest ambulance man can point to as being a sign of no-one living there. In this case it was over a week load of junk mail in the house foyer.

We knocked on the door and there was no answer. Now, if there is someone laid out on the floor then I'm happy to attempt to kick in a door - however in this case, with signs of neglect and a slightly strange call, I decided that I'd get the police (something that we are supposed to do for all forced entries anyway).

The police arrived quickly and set about gaining access, the neighbours had come out to see what the fuss was about and they told us that the owner of the house had recently died. But we couldn't leave the scene without being sure.

The police managed to get the two front doors open as as soon as we entered it was obvious that the house was indeed empty.

On the way out, while passing the gate I felt a tug, heard a 'Pop!' and felt a tearing sensation - my (not very well made) uniform came apart at the seams. Thankfully it was only one of the leg pockets, but it was still annoying.

After a bit of a laugh with the police officers, and naturally my crewmate, we returned to the ambulance and informed Control that the call was a hoax. I then said that I would need to go to the hospital for 'essential repairs due to a wardrobe malfunction'.

You see, there is a bit of a tradition in the NHS - in that you aren't a proper NHS worker until your uniform, or a bit of kit that you use, has been mended using medical supplies.

Being slightly clumsy I passed that milestone in my career quite some time ago. There is a reason why on some of our ambulances bits of equipment are secured with medical tape...

So we headed back to the hospital where I asked the lovely nurses if I could have a loop of suturing material, and then sat outside in the ambulance sewing up my pocket. I used to suture people up, but it's a fair bit trickier to do the same to a pair of trousers that you are wearing without the aid of the forceps that you need to easily handle the needle.

So - a hoax call not only wasted ambulance time, but also the time of the police and ended up with me off the road while I fixed my kit. At least when the police broke into the house they did so without causing any damage so could secure the house again after we left.

Here is hoping that should the hoaxer ever need an ambulance we are all off dealing with slightly more deserving people.

The thing about twelve hour shifts, especially when you do a lot of them, is that they have a nasty habit of turning into thirteen hour shifts. Or like last night a thirteen and a half hour shift.

Sadly the job that pulled three crews into an unwanted hour and half of overtime was a genuine job. And a sad one at that.

Now, after sleep, I have an hour and a half to get ready and eat before heading back to do it all again.

And that is why this is a very short blogpost.

Stairs. I hate them.

We were called to an older lady who'd fallen backwards downstairs, he'd then managed to crawl up her narrow and twisty staircase to bed. It was there she started to feel more pain than was expected and she asked her carer to call for an ambulance.

As an ambulance person one of the first things that you pay attention to once you realise that a patient is upstairs is the state of the staircase. Will it be easy to move a patient down? Will you be able to safely avoid any loose bits of carpet? Is there furniture (or, more commonly in my area, a pile of shoes) at the bottom that is a trip hazard? Then you meet the patient and start mentally totting up their weight and how likely they are to grab out at the bannisters, thus causing the whole lot of you to fall down the stairs and end up in a very litigious heap at the bottom.

Thankfully this patient wasn't heavy, but after examining her I couldn't rule out a broken neck. That and there was some real concern about a broken leg.

I wish she'd stayed put, crawling upstairs was perhaps the worst thing that she could have done.

Thankfully, despite the pain, our patient was in good spirits - so when I told her that we'd be taking full precautions in moving her she understood.

So, with a potentially broken neck, we would have to secure her to a stretcher, then find some way to manoeuvre her down the extremely narrow, steep and twisty stairs. At least the carpet was tacked down securely.

This would need a second crew, in this case many hands would indeed make light work. I made the call while my crewmate gave her some analgesia. Control were a little less impressed, we'd been extremely busy the whole shift and the chances of getting another ambulance any time soon were pretty slim.

Without a second crew I was considering calling out the fire brigade. They have a policy now of only assisting us when the patient has life-threatening injures (which is, needless to say, a policy that we should be copying). I'd have to sell it to them, and perhaps demand that we remove the patient via the first floor window on a cherry-picker.

Except that the window doesn't open and so would need to be smashed.

However a second crew did arrive and we proceeded to strap our poor patient to the stretcher, by now she was nearly pain-free and telling bad jokes, something I normally consider a good sign.

Fully strapped down in a way I described to her as 'as close to bondage that she'd ever likely get' we then started getting her down the stairs.

When you strap a patient down in such a manner it should be possible to stand the stretcher on it's head without the patient slipping. In this case we kept her feet down, but we would have to stand the stretcher vertically in order to get her downstairs. With a broken leg, if any pressure was put on her it would be incredibly painful.

Well either our pain relief, our strapping or our patient's pain tolerance held as we got her down the stairs without any yelping.

From there on out it was a simple matter to get her out to our ambulance and from there to hospital.

It would seem that my decision to strap the patient motionless was a good one, the Doctors were having serious suspicions of a broken neck once the initial x-ray films came back, and the leg was indeed broken.

I don't often strap patients down but in this case I was very glad that I didn't just sit them in my carry chair and have at it down the stairs. Sometimes going slow is in the patient's best interest.

A couple of months ago we had a quiet start to the day - three crews all sitting on station waiting for someone to be sick. It was lovely. We sat around, had a cup of tea and chatted. We talked about some of the jobs we'd been on and about a new violent regular patient. We did some informal teaching and generally renewed the sense of teamwork between those crews.

It was unusual, but very, very valuable. It's why I can remember it four or five months later.

But that's not going to happen anymore because, from yesterday, we have the brilliant new idea of 'Active Area Cover'.

Active Area Cover means that we will no longer spend more than thirty minutes on station. Between the hours of 8am and 10pm if we are not out on a job we will be expected to go to an area to either sit in the cab of the ambulance waiting for a call, or roam around in a half mile radius.

Outside those hours we may be sent to different stations, or sent to sit outside a hospital.

We are to remain at these locations for up to an hour before being allowed to return to station. Or if we keep getting sent jobs then we are to be given three chances to go to the cover point before being allowed back to station.

The idea behind this is that it will reduce our activation time by a whole 60 seconds, while also putting us closer to the next job that is about to come in.

But how, I hear you ask, do our management know where the next call is coming from? Well, we have a brand new piece of software that can see into the future. Connected to a crystal ball it uses past trends to tell us where the next person to fall off a ladder will be. I wonder if anyone will be able to connect it up to the lottery numbers...

Now, while there is evidence that the psychic computer can be of some use in rural settings, according to my crewmate who studied the system for her degree, in urban settings it's effectiveness is unproved.

Essentially the population density is such that a computer system like this is almost certainly worthless.

I'm 6'1" tall and lanky with it, I get a bad back from sitting in a cab as much as I do anyway - this new policy can only increase the amount of time that I spend cramped up there. The rare occasions when we get back to station is a chance to use a clean toilet that hasn't been used by infectious patients in the A&E department and maybe even get a cup of tea.

I'm dreading it, or I would if we weren't bouncing from job to job anyway.

And the purpose behind this? Well, obviously it's to meet targets. Getting to a patient one minute quicker won't matter in 99% of the jobs that we do. The psychic computer will be useless, as useless as the automated dispatch we have been using for the last few months.

And before you ask, yes, the unions did agree to this, apparently it was going to be even harsher than this, I can hardly see how.

Once more it will pit those in Control on the phones against road staff, it's not Control's fault they they will be ringing us up on station telling us to go to our standby points with 'the same urgency as an emergency call but without lights and sirens', but they will get the brunt of the bad feeling - not the bright sparks who thought this idea up.

Staff morale will decrease and sickness will increase. Floggings will continue until morale improves.

Patient care won't change, it may even get worse - especially if the computer is wrong. I suspect that our targets will continue to plummet slide.

What is needed is either less patients or more ambulances, and these ways of 'working more efficiently' are all trying to disguise this truth.