Not only do we have young lads being stabbed in broad daylight (as blogged about earlier), but we are now having police targeted in drive-by shootings with automatic weapons. It's gotten so bad that the government is thinking about making the wearing of body armour compulsory outside the few places in London where this is already the case. This thought is also helped by the fact that the police officer shot was saved from more serious injury by her body armour.
The L.A.S has given us all body armour - which I have worn perhaps three times "in anger" but have worn on a couple of nightshifts just because it makes a nice body warmer. I can see our management making us wear our armour all the time, in one of those knee-jerk reactions that we all know and love from working for the N.H.S. It'd be a shame not only because they are heavy, uncomfortable and restrict your movement; but also because by trying to squeeze into it, I can see how much weight I've put on in the last few months.

So it snowed in London for the first time in a year.

Try having your car towed at 2am with no windscreen wipers with snow covering your only view of the car doing the towing. Then (because the battery doesn't work) realising you have no heater - so the inside keeps steaming up. The only light you can see is the indicators of your mum who is towing you in her 1 litre Ford. And the rope keeps breaking so you have to keep tying two frayed ends of rope together, in the snow, in the dark. Lovely...

So yes - it bloody did snow, no it didn't lay on the ground and yes I was bleedin' freezing.

And I'm working tomorrow, where I shall no doubt be spending the better part of the day picking grannies off the floor after they try skating down to the shops to get their cat-food and box of hankies.

One year, when working in A+E we had 23 "Colles" fractures; which are broken wrists suffered most often by grannies falling over with their hands outstretched. It was like a Russian factory getting all those broken bones set properly.

Roll on Spring...

I've learnt than when I am nearly out of debt, or am about to have the right amount of sleep, or even think I'm gonna have something nice to eat for a change the universe decides to visit one of it's "Random Acts Of Reality".

I was driving my brother to PC World to return a game that wasn't working for him when my car started to develop a "tapping" noise. About this time I start to get a bit of a hypochondriac and think I can smell something burning...

Me: "I must be imagining it; I've spent all day burning the brake pads on my ambo".
Brother: "Can you hear something wrong with your car?"
Me: "Damn-it!"

So we stop at PC World, and while he goes to exchange the game I look at the engine. I'm not mechanically minded but I can do things like check the oil level - which is a bit low, so I top it up and the noise goes away. Excellent, problem solved.

My brother then comes back and we continue on our merry way toward a friends house. Then the noise starts up again - only this time after every 10 or so "taps" there is a "Crunch!". WE both look at each other and he starts suggesting that it's because I go too fast over speed-bumps.

Then there is a **CRUNCH*** and the engine stops dead. And my heart sinks, just a little...

So I'm stuck on the side of a road on the coldest night of the season with my brother trying to cheer me up by being what can only be described as "perky" (and being "perky" does not suit him at all). I know he is only trying to help but my mind is full of worries like "How much will it cost?", "How am I gonna get it home?", "Am I gonna need a new car?" and "Why does this bastard Universe hate me so much?"

I'm big on self-pity you can see.

Our friends came to pick us up, and my mum has agreed to tow me back to my home tonight. Then I can use my day off to search around for a mechanic who will probably look at me like a vet and suggest that my beloved car be "put out of it's misery". But my brother (who is worth loads of money as he is a "super-teacher") has said he'd help me get it fixed...And I writing this here so he doesn't forget that promise...

But now I get to walk to work...and it's bleeding cold.

This PvP Comic explains how I feel at the moment. I like to dip into the FPS online world now and again; normally with Planetside. But I keep find myself being beaten by 17 year olds called L33t-5p34k3r or somesuch.
I'm feeling very, very old at the moment - I thought it might be lack of sleep, but I think I'm just sl.o..w...i...n....g......d.....o....w.......n.

Warren Ellis' webpage/blog Diepunyhumans has a lovely example of the two ends of camera technology. In one posting you have the Mars Express pictures with a camera that cost millions, and a picture from a millions of miles away; in another posting you have phonecam pictures that cost a tiny amount of money; and come in from all over the globe.
It puts me in mind of something, but I can't think what...I'm reading some Alvin Toffler right now, so that might explain it; thinking about technology and its impact on culture.

Sorry folks, bit of a rant here...but I last slept 22 hours ago...

We got a call to a patient who was "Depressed - not moving", normally it's some teenager having a strop, but this time it was a little different. Basically the patient suffers from depression, was discharged from the local psychiatric unit three weeks ago and has recently had her dose of anti-depressants reduced. Yesterday she was crying all night, and tonight she was just sitting staring into space, refusing to make eye contact and not talking at all.
One of the things that we as an ambulance crew cannot do is physically remove someone to hospital if they don't want to go - that would be kidnapping and is frowned up by the law. This young girl wasn't going anywhere despite my best attempts to persuade her - she just wasn't communicating.
The solution would be simple - call the Community Psychiatric Nursing Team to come and assess her, and if needed arrange her compulsory removal to the psychiatric unit ( called a "Section" under the Mental Health Act). The problem? It was 11pm...
First off I phoned the psychiatric unit that she had received treatment under, after talking to two idiots who had trouble understanding plain English, I finally managed to get the number of the CPN team. Now the LAS is quite smart; when we want to arrange an outside agency we go through our control and all the telephone conversations are recorded...so if someone says they are going to attend they damn well better. I got onto Control, passed the details to them and waited for them to get back to us.

I'd just like to say that in eight years of medical experience I have never had a simple referral to a psychiatric service, they always seem to try shirking any form of work - by "forgetting" you or by being just plain obstructive. Maybe I'm just lucky and get the idiots every time.

Needless to say we waited...and waited...and waited...from 22:20 until 23:00 we waited; then at 23:02 Control got back to us. Apparently the CPN team all goes home at 23:00 and hadn't answered the phone until 23:00 on the dot. So they refused to visit the patient - the moral so far is if you are going to have a psychiatric breakdown in Newham - don't do it after 22:00.
So we switched to plan "B" which is to arrange the out-of-hours Social Worker to come and visit as they double as Psychiatric liaison. Again we went through Control and waited...and waited...and waited...Finally we heard back that the social worker would ring the family and would like to talk to me. (Outside agencies try this trick, as they know the patients phone isn't being recorded, and so can say whatever they want with any disagreement being my work against theirs) The social worker explained that she was very busy and so would prefer not to come to see the patient and have I tried the out-of-hours GP?
Back to Control I went and got them to try and contact the out-of-hours GP (A GP for those not in the UK is the patients "Family Doctor") Can you guess what we then did? We waited...and waited...and waited... Finally Control got back to us and informed us that the out-of-hours GP hadn't arrived for work yet and that when they did, they would have to see two other patients first.
All through this time the patients family were very understanding and were happy when I explained that the GP would call at some point in the night. All I could do was advise them to remove anything that the patient could use to hurt herself, and keep an eye on her - calling us back if they felt the need.

Total amount of time an Ambulance was tied up trying to get outside agencies to DO THEIR DAMN JOB - Two Hours and Nineteen Minutes. And not the worlds most satisfactory outcome.

As I mentioned to our Control - sometimes you feel very lonely out there on the mean streets of Newham.

More runs of twelve hour night shifts, which at this time of year is really tiring. The human body needs to see some daylight, and the short days of winter are not conducive to this. Last night I was asked to work out of Tottenham which, for those of you who don't know the geography of London, is about 20 miles away from where I normally work. No worries I thought, a change is as good as a rest - and rest I did, we had 3 calls all night, only one of which was serious.
The "proper" work was a Farsi speaking gentleman who was having a heart attack - it's important to try and keep the patient calm in those situations, and the language barrier is a big hurdle to jump. But despite not working with this particular crewmate before the job went as smooth as silk - it's always nice when that happens.
I also got to go to two of the hospitals that I used to work at in my nursing days, all my old friends had to say was that I looked "fatter", which I can only put down to my happiness at my current career and the diet of chips/kebab/burgers that this job seems to force on you. (I'm 6"1' and around 12 1/2 stone - not exactly a lard-arse).
So I'm working tonight (typing this from work at the moment) and then I have four days off until I need to start working from 7am. More unfortunately I'm busy over the whole of my break - so sleep will be a treasured thing. My best bet is to try and grab a few moments of sleep between jobs.

ZZZzzz...

Much fun and games last night, working out of Poplar. Not only did some German bloke graffiti on the back of one of the ambulances - but he also called the crew from a payphone and ran off, repeating it twice.
There are a lot of strange people out there...
MacMedic gives a rundown of what his shifts are like, so I thought I'd do the same, in honour of our brothers in foreign climes.

All these people called an ambulance by dialling "999".

(a) Fractured Wrist - Young lad at the Boat show.
(b) "Frequent Flyer" who has just been released from prison...We thought we'd got rid of him for good.
(c) 15 year old with a runny nose.
(d) Very minor R.T.A.
(e) Domestic Assault, with no actual injury, but police already on scene.
(f) "Facial Injury" which turned out to mean "Some bloke kicked my door".
(g) Assault with a cut hand, actually a decent injury with tendon involvement (which means surgery and physiotherapy).
(h) Varicose Vein that had burst, plenty of blood everywhere.
(i) 29 year old with chest pain, hyperventilating with very upset relatives.
(j) Overdose in a house filled with young men with short hair and tight t-shirts (ifyouknowwhatImean).
(k) R.T.A with a traffic light pole coming off the worse in a two car collision.
(l) 8 month pregnant "lady" who had fallen earlier that day.
and...
(m) A fitting 9 year old, only one of the parents spoke English, and so decided to stay at home and send the father who doesn't speak English with us, because "The hospital has interpreters..."

Now, out of these thirteen jobs, only five actually went to hospital...a prize if you can tell me (via the comments) which five went to hospital