You may have seen this before, but I read it for the first time last night, and my ribs are still hurting because I was laughing so much.  As I’m not working for the next couple of days you are going to have to put up with whatever I can think of.  If you behave yourself I may do some live posting on my Friday nightshift.

Enjoy…

HOW TO GIVE A CAT A PILL

1. Pick up cat and cradle it in the crook of your left arm as if holding a baby. Position right forefinger and thumb on either side of cat's mouth and gently apply pressure to cheeks while holding pill in right hand. As cat opens mouth pop pill into mouth. Allow cat to close mouth and swallow.

2. Retrieve pill from floor and cat from behind sofa. Cradle cat in left arm and repeat process.

3. Retrieve cat from bedroom, and throw soggy pill away.

4. Take new pill from foil wrap, cradle cat in left arm holding rear paws tightly with left hand. Force jaws open and push pill to back of mouth with right fore-finger. Hold mouth shut for a count of ten.

5. Retrieve pill from goldfish bowl and cat from top of wardrobe. Call spouse in from garden.

6. Kneel on floor with cat wedged firmly between knees, hold front and rear paws. Ignore low growls emitted by cat. Get spouse to hold head firmly with one hand while forcing wooden ruler into mouth. Drop pill down ruler and rub cat's throat vigorously.

7. Retrieve cat from curtain rail, get another pill from foil wrap. Make note to buy new ruler and repair curtains. Carefully sweep shattered figurines and vases from hearth and set to one side for gluing later.

8. Wrap cat in large towel and get spouse to lie on cat with head just visible from below armpit. Put pill in end of drinking straw, force mouth open with pencil and blow down the straw.

9. Check label to make sure pill not harmful to humans, drink glass of water to take taste away. Apply band-aid to spouse's forearm and remove blood from carpet with cold water and soap.

10. Retrieve cat from neighbor's shed. Get another pill. Place cat in cupboard and close door onto neck to leave head showing. Force mouth open with dessert spoon. Flick pill down throat with elastic band.

11. Fetch screwdriver from garage and put cupboard door back on hinges. Apply cold compress to cheek and check records for date of last tetanus jab. Throw Tee-shirt away and fetch new one from bedroom.

12. Ring fire brigade to retrieve cat from tree across road. Apologize to neighbor who crashed into fence while swerving to avoid cat. Take last pill from foil wrap.

13. Tie cat's front paws to rear paws with garden twine and bind tightly to leg of dining table, find heavy duty pruning gloves from shed. Push pill into mouth followed by large piece of fillet steak. Hold head vertically and pour two pints of water down throat to wash pill down.

14. Get spouse to drive you to the emergency room, sit quietly while doctor stitches fingers and forearm and remove pill remnants from right eye. Call furniture shop on way home to order new table.

15. Arrange for RSPCA to collect cat and ring local pet shop to see if they have any hamsters.

HOW TO GIVE A DOG A PILL

1. Wrap it in bacon.

While we deal with a lot of crap jobs on a day to day basis, but when we are really needed I think we do a bloody good job.

One of the people injured in the London bombings is getting married this weekend.

The thing that gets me is this quote.

“As well as losing both feet in the bombing, Ms Hicks lost 75 per cent of her blood and her heart stopped twice on the way to the hospital.”

That means that an ambulance crew successfully resuscitated her twice, long enough to get her to hospital and that because of that unnamed crew, she is now alive and getting married.  It’s stories like that which makes me happy to do the work that I do, that sometimes we can make a difference.

(Via: Going Underground)

Did you know that the Meteorological Office offers ‘health forecasts’?  We got a memo from them (via our office) about a predicted increase in paediatric respiratory infections.

No kidding!  For two days all I attended were patients with chest infections.

Then on Friday all but two of my thirteen calls were faints, or epileptic fits.  I’m left wondering if it is something in the weather that caused that little spike.

Oh, I also attended three schools on Friday (one epileptic and two fainters), while normally I wouldn’t see that many schools in on month.

A strange day.

I’ve checked with my sources, and the story is true.

At Poplar ambulance station there is no room to park.  The station itself is tiny, barely bigger than a portacabin.  There is a big metal fence and electric gate around it.  There is minimal parking.

So the ambulances park out on the street – if they didn’t then every emergency call would be delayed by minutes as the crews wait for the gate to open and then maneuver the ambulances out.  This would be very bad for the patients (and more importantly, extremely bad for our ORCON times).

There is nowhere else to park.

So…a couple of days ago the ambulances all got parking tickets.

Apparently there is a man who lives in one of the nearby tower blocks who keeps complaining because his daughter nearly had an accident pulling out of the turning.

So a nice man from the council (or a parking warden) came around and put tickets on the ambulances.  In his defence he did try to not ticket them by telling the crews to drive around the block…

The ambulance crews find this all very amusing.

(We are, by our driving exemptions allowed to park where we like as long as it’s not ‘dangerous’, we are guessing that this man has complained so much the council has been spurred into action).

40 stone patient.

On the floor.

-----

3 hours on scene.

Tears, swearing, pain and blood.

Up to 9 staff on scene at once.

-----

I am F******g knackered. Maybe a more detailed post tomorrow, maybe not.

Gah...

I was miles out of my area, but this was not a worry, as the sun was shining, the scenery was pretty (well...prettier than Newham, not that that is hard to do) and there was some nice music on the radio.

Then the call came down my terminal. 'male ?suspended in car'. I consider it a personal strength that I was thinking 'excellent! I can use my big trauma shears to break a window'. I soon reached the car and was dismayed to find the passenger door open, and two bystanders watching the man intently.

"He's breathing", they said.

I tried to hide the disappointment that I wouldn't be smashing any windows.

Checking the patient, who was slumped over the passenger seat drooling like a baby I immediately thought that it would be one of three things. He was either having a diabetic crisis, had just had a stroke, or was just incredibly drunk.

A quick test of his blood sugar showed that he wasn't diabetic, a neurological assessment showed that he probably hadn't had a stroke (he was also younger than me, so a stroke would have been rather surprising). This left the last option. He was drunk.

Once more I found myself cursing my own particular disability - that I can't smell alcohol. Thankfully the ambulance crew turned up and let me know that he did indeed stink of booze.

The crew loaded him onto the ambulance, which was tricky as he could hardly walk, while I turned off the engine to his car,amazed that he had driven as far as he had without crashing into something. He was also lucky he'd stopped when he did, as less than 100 meters away was a main road with a speed limit of 50mph...

We called the police, who duly arrested him. Meanwhile he kept saying that all he wanted to do was die...

...I would think that his desire to die would only increase as his hangover hits him in the police cell. I got the impression that the reason he was drunk was because he had had an argument with his family.

Somehow I don't think that getting arrested for drink driving (oh, and his tax disc was out of date as well) will do him any good with his family.

See, I keep telling people that getting pissed solves nothing. But do they listen to me? Do they buggery...

I had to do a police statement, before going back to work, returning just in time to get called to a Bed and Breakfast where an alcoholic was having a panic attack.

I have a hilarious story to tell you later, but before I write about it I need to check my sources...

It was as if my prayers had been answered, a GP who today managed to balance the poor skills of yesterdays doctor.

I was sent to a 74 year old male with difficulty in breathing and chest pain. My computer display told me that the GP was going to remain with the patient.

I got there and was met by an apologetic GP who thought that the patient just had a chest infection, but while she was talking to him, the patient developed a possibly heart related pain. She had tried treating him herself, but thought that the best thing was for him to have some further tests in hospital.

My assessment and treatment of the patient went without a hitch, and I agreed that although I also thought the pain was as a consequence of his chest infection, it would be best for the patient to be assessed in the local A&E department.

As was the case yesterday the ambulance was 40+ minutes in arriving, so I had a bit of a chat with the GP (who was rather pretty...) and the patient (not so pretty). As there was nothing else the doctor could do with this patient, I let her leave the house to see her other patients.

A nice job, made easier by another health care professional.

Just how it should be.

GP (Family doctors) are supposed to be intelligent right?

So here is a question for you all, answers on the back of a £10 note...

And elderly patient enters your surgery. She is asthmatic and is having real trouble in breathing. Do you?

A) Start treating the asthma attack, giving the correct amount of drug, then when she doesn't improve, call for an ambulance, keeping the patient on oxygen. You then take her vital signs, and observe her closely until the ambulance arrives. You even manage to phone the hospital to refer her to the correct speciality.

Or...

B) You give her the paediatric dose of the medicine (The dose you give to under-twelves). When she doesn't get any better, you call an ambulance and sit her (without oxygen) out in the waiting room where here wheezing can entertain the toddlers playing there. You write a letter to the hospital, but as you haven't written any vital signs on it, you can't have even taken her pulse in then first place.

Warning, if you answer (B), you then might have to put up with a slighty miffed FRU person explaining that you might have just been a bit silly...

There are a scarily large number of GP's who just cannot deal with anyone who might be seriously ill.

Still that's what the L.A.S. are for, and also why we still rush on blue lights and sirens to patients who are being looked after at their GP's.

I have in my possession an ambulance benevolant fund* diary, which is something I'll never use, as I have shiny technical tools for planning my life.

So, I think I'll be giving it away to one lucky reader.

The competition is as follows...

Tell me, via comments or email, an amusing tale of seasonal injury or illness.

Stories may be real or fictional, my decision will be final. Closing date will be next Monday, 12 noon GMT. The winner will receive one (1) diary (worth approx £1) delivered via the cheapest post I can find anywhere in the world. Entry is non-binding, no purchase necessary, etc, etc, etc...

Just a bit of fun.

This is also the first post from my new mobile/pocket pc, so if the formatting is weird, I'll have to change it later.

*The benevolant fund is something we all pay £2 or so into, and it funds good things for sick ambulance people. Well worth the money, and you hope you never need to us it.

WARNING!: Introspective wankery ahead!

It’s that time of year when the chemicals in my head start to go a bit wrong, for I am a sufferer of Seasonal Affective Disorder.  Summed up in a nutshell, when the nights get longer I get mopey.

More mopey than normal before anyone who knows me makes a joke…

I’m only letting you know this because I may become slow(er) in answering emails, posts may ramble a bit and I may seem a bit distracted until…oh…let’s say April.  I let you know because it shows that I have some form of Insight into my own personal brand of mental illness (which I’m sure will please the currently holidaying Mental Nurse – excellent read, reminds me of my short stint as a student nurse in the local rehab unit).

I first noticed this years symptoms a couple of days ago.  I’ve just upgraded my phone to an SPV M5000 which is a lovely new bit of kit that replaces both my phone and my old Pocket PC.  Wonderful, you might think, for I do so love my new technology toys.  But unfortunately, I find myself upset over my old Pocket PC that will now be left on the shelf – unloved, and unwanted, despite many years faithful service*.

You tend to realise that there is something a bit wrong with you when you want to cry over a bit of machinery.

S.A.D. tends to affect me in a couple of ways.  Firstly my sleep is, to put it bluntly, buggered.  Last night I slept about 2 hours, the night before around 16 hours, before that I have no idea, but I seemed to wake up every half hour.  This is seriously not good when you are a shift worker, especially one who is expected to drive ‘progressively’.

Besides altered sleep patterns, I also find myself lacking energy, both physical and mental.  This is why I have emails from a week ago waiting to be answered, and why I can’t seem to be bothered to start any quests in World of Warcraft.  (Yes… I realise that this is a screwed up way of measuring my own mental health).  It might also explain why my blogposting has been a bit spotty over the past few days.

It also means that I get some mood swings, mainly towards the negative end of the scale.  This I can deal with – I just wander off and have a sulk.

I’ll also find myself eating more, or less than normal, so my body weight/shape tends to wander all over the place.  This, I can deal with, as I don’t really care if I start looking a little chubby.  I am more anti-social during this time though, I’m not particularly interested in going out and seeing people, and the effort of getting ‘ready’ to go out often seems too much for me to handle.

It might also explain why I ‘blabbed’ my IRC password to everyone last night, by mistyping the command in the wrong box on screen.  At least, that’s my excuse and I’m sticking to it.

What is really stupid, is that my life is currently *excellent*.  My work is great, I’m working with great people on something that is utterly brilliant, and I have few, if any, money worries.  So the huge part of me that is pragmatic is telling me to get over it, and enjoy the good times.  But it just seems that you can’t combat Bad Brain Chemistry.

The only thing that I can do about this lack of Serotonin washing around my brain, is to get myself out and about.  I can’t afford a ‘lightbox’ (£150–£250 for a lightbulb!, and I haven’t got an hour each day to sit in front of it), and anti-depressants would take too long to start working, and that would be after spending the better part of a year to find a dosage that works for me.  So I guess it’s cognitive therapy for me, essentially recognising that I’m mad and thinking my way around it.

Funnily enough one of the few things that provides me with any relief is work.  I’m guessing that it’s the outside life that helps, with the increased amount of sunlight I get from working out on the road.  I was laughing to myself the other day while slaloming through the traffic at the thought that I get paid to do this…  To be honest it’s reason #1 why I left working as a nurse in windowless A&E departments to come out ‘on the road’, the thought that increased daylight might mitigate my symptoms somewhat.

Still, at least I have Spring to look forward to, when I spend six weeks being horny as hell, and then spend my Summer being sickeningly happy and positive about everything…

 

* Fear not!  For my old Pocket PC will find a loving home in the hands of my mum, who will use it to play Solitaire, Mahjongg and Su Doku.

I’ve had some good comments from the Morphine post, it’s very interesting to hear about the different dosages and protocols that various ambulance organisations use.

This post is one that I’ve been thinking about writing for at least a year, but I’ve always been a bit shy of writing it because it touches on possible racism.  Just remember, I hate everyone, not just one type of person.

Sickle Cell disease is a horrible illness, it results in massive pain, and due to the blood cells ‘clumping’ it can cause stroke, blindness, kidney failure, heart attacks and numerous other complications.  The pain these patients feel is unbelievable.

The thing is, most of these patients are black.

Here is the problem that I have.  There are a number of sufferers who are banned from certain emergency departments, there have been legal orders that say a patient should not got to a specific A&E when they get a crisis.  It’s normally because the patient has caused trouble while waiting to be treated, I was an A&E nurse in North London for long enough to realise that some Sickle Cell Disease patients aren’t saints, but…

In my personal experience, Sickle Cell Disease patients are the only patients who get banned from departments.  Drunks can be much more violent, yet they never seem to get banned.  ‘Frequent flyers’, patients who attend every day, use up more time and resources than those with Sickle Cell Disease, yet they never seem to get banned.  I’ve also personally witnessed nurses being hit, yet the patient still receives treatment, and isn’t banned.

Why I understand that Sickle Cell Disease patients can be demanding, they are in a huge amount of pain.  Some of them are indeed opioid addicts, but my thought on the matter is that it isn’t hurting me to give them painkillers, and that the stresses of withdrawal can cause a sickling crisis.  But it does seem that Sickle Cell Patients are being discriminated against.

This affects the ambulance service in the following way – we might pick up a patient 200 yards from the local hospital, he has chest pain, and is in a lot of general all-over pain.  If he is banned from that local hospital, we might have to travel miles to get him to a hospital that will accept him.  If he has a heart attack or stroke on the back of the ambulance, is it our fault for bypassing a nearby hospital?

These patients often have a ‘treatment protocol’ at their hospital – this states the type of pain relief that they get, and who should be contacted to continue their treatment.  These patients are often concerned that if they are not taken to their specialist centre (always miles away…) then the hospital that we do take them to won’t have their treatment protocol.

Also, will we be called more because we are now carrying morphine, and will maybe give it to patients, when their personalised treatment protocol states that they shouldn’t have morphine at all?

 In my opinion, Sickle Cell Disease patients are treated poorly in A&E departments, and I don’t think that it can be just that they are ‘demanding’ for their pain relief, or that they are personally ‘annoying’.  While a lot of these patients can be annoying, I think it’s only because they are treated poorly to start with.

Disclaimer: I used to work in an A&E department with a huge patient population of Sickle Cell Disease patients.

And don’t forget, it’s World Aids Day today.