I'm having an unscheduled break from work today, basically I've had to phone in sick. Those pumpkin seeds I ate really disagreed with me, and I spent the whole night, and most of today, running from bed to toilet and back again.

But I've already bored you with my whineyness, so I'll spare you further details except to tell you that it reminds me of being on P.E.P.

So, if you find yourself offered some pumpkin seeds...I'd refuse.

Lets say you go into your normal day shift work on Wednesday, when you enter the office it's Wednesday, when you leave the office it's Wednesday. Not so with us, when we work a nightshift, after five hours of writing Wednesday the 5th of September, you have to change the date on your paperwork to Thursday the 6th. When you talk to patients at 3am, and they tell you that they have been ill since yesterday you have to work out whether they mean four hours ago, or 28 hours ago.
Then, when you get home, your clock is saying 9am, but your body-clock is screaming 11pm, time to go to bed. Friends wonder why you are half falling asleep at midday, and wide awake at 4am. Time-zones start to blur as you talk to people across the globe, you and your friend in American might both be having dinner, but only they are eating it in daylight. Cory Doctorow's "Eastern Standard Tribe" understands this.
You become confused about what day/time it is, days and weekends come and go, hours spin past and you have no idea when you are. If you are sleeping during the day, then you aren't watching television, so news stories that shake the world can pass you by, or you can be the first to learn the latest news if it occurs during the night (or during the day in America). BBC 24 is an absolute godsend to night workers, it can keep you orientated during the night, if you have time to watch the TV.
This explains the slightly dazed look and mild disassociation that night workers tend to have, and also explains why, for us, it is perfectly acceptable to have a 'night-time' can of beer before going to bed at 9am. (A lot of postmen delivering parcels have given me a dirty look because of that on more than one occasion).

Thanks for all the hugs (((()))) I really appreciate them, I just hope I didn't come across as whiny.... My pleasures have increased multi-fold as the pumpkin seeds that I ate in an attempt to keep fit have resulted in, what can only politely described as, 'gastrointestinal'. I have little hope of getting some good sleep now... I'm also saving up some nice, and some not so nice stories, for after this little themed section.

Due to my increased need for sleep, I have less time to do social 'things', so email/blog reading/blog posting/telephoning friends/IRC/meeting mates tend to go completely out the window. I'm either too busy feeding/washing myself, or I just can't work up the enthusiasm to reply to 20+ emails. Yes...this is an excuse for my sometimes tardy replies to people
The only people you find yourself meeting are drunks (early in the night), wimps (a little bit later) and pregnant women (in the morning). You also have twelve hours to talk to your crewmate, imagine being around one person for that length of time...you get to know everything about them, and heaven help you if you don't get on with them...
The other people you meet during your nightshifts are the police and the nurses working in the A&E department. If you walk around London, you will often see ambulance and police crews waving to each other - this is because we often get called to the same assault/suicide attempts, and we soon get chatting about how crap our respective jobs are. The nurses in the A&E departments are all married, very busy, and hate ambulance crews because they bring in work. Sometimes, if there is a quiet night you can have a chat with them, and to be honest we are friendly to each other, but it's the same faces night after night - and they tend to be more stressed than us.
After working a set of four twelve hour shifts, the last thing you are thinking about is dating/sex/relationships, and this is why single ambulance staff often have trouble forming relationships. 'Normal people' tend not to understand just how tired you are after working all night, nor that when you get home, all you are thinking about is getting into bed and sleeping the day away.

Tonight I feel particularly aggravated - I've had 2 hours sleep in the past 24, I dealt with whiners all night, I got off late because a child with eczema was 'scratching', and then I cycle three quarters of the way home (3 miles) at a sprint only to realise that I haven't got my door key - thinking they have fell out of my pocket I sprint back 3 miles to the alley I think they must have fell out in, only to find them sitting on a hook at work. One cup of tea later and a very slow ride back home to realise that I'm not going to sleep anytime soon, and my computer's mouse isn't working. Also at work there was some bad news (which I will talk about later, but doesn't involve me directly) and earlier today I was watching an RSPCA advert and found myself crying at it...(something I do when I get tired). I think these 14 nights/lates are gonna kill me, I need a hug and there is no-one to hug me)

Blimey I sound like a teenager!

The patients you get on a night shift are of a generally different calibre. Until the pubs and clubs shut you can find yourself dealing with a near constant flow of drunks and assaults. Alcohol makes people violent, or suicidal; so after the pubs have closed we tend to have a run of people who have had an argument with their boy/girlfriend and have taken an overdose/slashed their wrists.
While the pubs are open you get the drunks asleep in the street, drunks who have fallen over in the street, drunks who have been fighting, and drunks who have punched a window/door and have broken their hand. We see a lot of drunks...

The number of seriously medically ill people tends to drop, mainly because most of them are in bed asleep, rather than collapsing with heart attacks. You do get your occasional medical problem, but not as many as on a day shift.

As the night progresses towards 3-4am you get your young men with minor illnesses who, because it is dark outside, get scared and call an ambulance. Perception of the seriousness of illness increases during the night, so we tend to get a lot of calls to people who have had diarrhoea/vomiting/headaches/bellyaches/coughs/colds and sniffles all day. You will also get the small child who has a high temperature - parents panic more once the sun goes down.
The night before last we had to go to a tearful mother who's newborn baby was desperately ill - it's umbilical cord had dropped off, I'm guessing that she was asleep in class when the midwife explained that this is what normally happens...

Then as dawn approaches, there are the 'maternataxis', pregnant women who think that they are going to deliver their baby in the next 20 minutes, and so can't call a taxi. This can be a nice easy job to see you off shift, and as long as they walk (and don't moan too much) I'm normally fairly happy to deal with them.
You live in dread for the last job of the morning though, it is fairly common to have a 'suspended' call as one half of an elderly couple wakes up to find that their partner has died in their sleep. Not normally a good end to a shift.

For a start off night shifts are bad for your health, humans are 'designed' to sleep when it is dark, not to charge around like loons looking for people who have fallen over because "My drink was spiked". Shiftwork can increase the risk of...

Obesity.
Cardiovascular disease.
Mood changes.
Higher risk of motor vehicle accidents and work related accidents.
Cause a 1.5 times increase in breast cancer.
It can increase your chances of colon cancer by 35%
Increased likelihood of family problems, including divorce; in my case the difficulty in maintaining a relationship due to a non-understanding girlfriend.

Why do I do this again?

My skin tends to get very bad when I'm working nights, and it is on nightshifts that I'll catch coughs and colds; the stress of working unnatural hours no doubt knocks my immune system on it's arse. Unless I eat nearly constantly I'll also find myself having a general feeling of nausea throughout the night. When I do get to sleep, I'll find myself sleeping longer hours, which means less time for social contact outside of work - not very good for your mental health I would suspect.

On the positive side - if you need to put on some weight, then the diet of chips and kebab that you find yourself forced to eat (ever tried to find a salad bar that is open at three in the morning?) will soon 'pad you out'.

I've been working night shifts all last week, four normal shifts followed by two on overtime (Saturday and Sunday - what a glutton for punishment I am). Then straight into seven late shifts which run from 4pm until 1am in the morning. It's got me thinking about night shifts. So for the next couple of days I'll be telling you about the horrors, and pleasures of night shifts.

Consider this a theme week, or a theme five days, depending on how much I can get out of the subject...

Last night we were out all night, I think we managed to wave at the ambulance station as we drove past on yet another call. Most of the calls were either drunks (injured hand, asleep in the street, fall and head injury), Maternataxis (including one who was 300 yards from the hospital and was having contractions every 10 minutes), and one overdose who walked on and off the ambulance, but was vomiting a bit.

We were also pulled out of our area to Whipps Cross, and the Royal London which was happening to every ambulance, as I saw a Becontree and Homerton ambulance at Newham. At 4am Control were desperate for ambulances as they were holding seven calls in our area, and there was one ambulance to go around.

I'm working the same shift tonight, starting at 7pm Sunday evening, finishing at 7am Monday morning, going back into work at 4pm later that day. Makes me glad I don't have a long commute.

Just discovered (why did no-one tell me earlier?), a blog from a British policeman. Entertainingly written, similar outlook on life (and scrotes) as myself, and very funny/shocking/depressing.

Only thing is he writes better than I do, so should I be publicising my 'competition'?

This isn't my normal post, I tend not to do the 'Linklog' thing, but The Evening Standard has a number of recent articles about alcohol and how it affects Ambulance staff.

In this article they give a basic run down of the problem, including the statistics that out of 62 calls, 40 were alcohol related. This ties up with my own experiences.

In the second article they describe how an EMT has had to come off the road because of the amount of abuse they have been getting.

And finally this article describes a plan to identify pubs and clubs that let their customers get too drunk. It costs us around £18.6 million pounds to deal with drunks each year, perhaps getting some money back would be a good idea.

Normal non-linky post tomorrow/later today.

Lots of people want to know what happened to the lady in my previous post, so tonight I spoke to the nurse who was looking after her.

The patient continued to be unable to talk, although (perhaps sadly) she could understand everything that was happening to her, and around her. She was also unable to use the entire right side of her body. It seems that the stroke was caused by an infarct (or clot) in her brain, and not the more life-threatening cerebral bleed. She went to one of the better wards in the hospital after spending some time in the resus room, during which her husband constantly stayed by her bedside. The nurses looking after the pair of them felt a lot of sympathy towards them, and I think they all fell a little in love with the husband.
I mention that the nurses looked after the pair of them, because that is what good nurses do, they look after everyone affected by the illness
Sometime later today or tomorrow she will have a CT scan of her brain to determine the extent of any infarct, and then she will start the long road to a hopeful recovery.

I used to work in a medical ward, and we would have a lot of stroke patients. Unfortunately there is no magical medical treatment for a stroke once it has taken place - instead it is a long gruelling slog through physiotherapy, speech therapy and occupational therapy. It can take months to recover some function, and for many they do not recover at all. They remain chair, or bed bound - and are discharged into a nursing/care home until they succumb to an infection that kills them.

Unfortunately, given the type and strength of the stroke this lady has had I would not hold much hope for a recovery. Miracles do sometimes happen, and I suspect that this entire woman's family will be praying for such a miracle.