The thing about wearing a uniform – it really changes your behaviour.

I’m guessing that a lot of you are aware of the Milgram experiment, where members of the public more willingly follow instructions if the instruction giver is wearing a uniform or other symbol of authority (follow the link for a more complete explanation - if you’ve never heard of this experiment, it and the Stamford experiment, make scary reading).

So when I am wearing my uniform I am more confident and can ‘order’ people around.  The police, firefighters and members of the public tend to do what I tell them if there is someone sick around.  Obviously I only use these powers for the force of good, but without my uniform I am a much more shy person.

I noticed this when I went to the Open Rights Group meeting.  When I arrived I knew one person there, and once I’d stopped talking to her I became an instant wall-flower.  It’s something that I need to change and change pretty quickly.

But there is a flip-side to wearing an ambulance uniform, you also become more passive.

If I were in the street and some drunk tried to hit me – I’d punch them on the nose.  If I were verbally abused – I’d soon be ‘in their face’ shouting and ranting along with the best of them.

Yes, I know one paragraph ago I said I was a wall-flower – but this is in a social situation, when my temper is raised it is a terrible thing to behold.

But with the uniform I’ll gently restrain the drunk trying to hit me and I’ll ignore any verbal abuse that is thrown at me.  Unfortunately the anger that I feel is then turned inward, which I am guessing is not a healthy thing to do.

I wonder if it is the uniform, or the risk of having a complaint put in about me that turns me into such a wimp.  It might just be that I spend so much time trying to keep patients calm, that I’m feeling very mellow when people abuse me.

Tomorrow I’ll explain why I started thinking about the way I take abuse without defending myself...

Some patients with chronic lung disease need oxygen, and rather than keep them in hospital, these patients often have cylinders of oxygen delivered to them at their home.

Until recently it was the pharmacist who supplied these cylinders, but the government in it’s infinite wisdom has decided to privatise the supply of oxygen.  This means more paperwork, which NHS Blog Doc has already covered.

And now a patient has died, possibly due to a delay getting her oxygen delivered.  It drives me crazy that I spend my time in my ambulance going to 23 year old men with coughs, yet apparently no ambulance was called for this woman.

It all comes down to the government wishing to run the health service like a business.

I know that some people believe that the free market will constantly provide superior service to anything run by the government.  Unfortunately healthcare isn’t a ‘market’ and this market view of the NHS  leads towards some very silly initiatives.  It’s why ‘failing’ hospitals get less money than ‘successful’ hospitals, who would want to throw money into a failing business?

Why are hospitals so dirty?  Because of the free market contracting of cleaners to the cheapest supplier – regardless of the quality of the cleaning.

It’s also why, despite increasing numbers of patients, increasing calls, very few new staff and all the other reasons why we may not meet our government ORCON target this year, we’ll get less money to be spent on improving our service.

But what do I know – I’m a van driver not an economist.

For the past five nights the majority of my patients have been sick with one or more of the following…

• High temperature.
• Runny nose.
• Vomiting.
• Night sweats.
• Lethargy.
• Cough.
• ‘Generally unwell’.

So there must be at least one highly infectious disease epidemic in the area, while you or I might want to curl up in bed with some Lemsip and paracetamol, it would seem that a large number of Newham would rather sit in an A&E waiting room.

Madness.

Which leads me to the point of this post.  Us ambulance crews spend a lot of time around these infectious patients, patients who have often never been taught the good manners of putting their hand over their mouth when they cough.

So is it any wonder that I’ve got painful eyes, a streaming nose, a constant mild headache and a feeling that I’m suffering from a mild hangover.

But.

Us ambulance crews mustn’t have more than three periods of sick in an eighteen month period.

So I’m having to drag my potentially infectious body into work – where maybe I can infect some more people…

So in conclusion.

Send me nurses – pretty female nurses with plenty of drugs.*

 

 

*With apologies to another writer/blogger who also asks for nurses and never seems happy when I mention my previous career.

Gordonjcp sent this link to me via email.

The auction is of a nice new car…after an encounter with a local ambulance and firefighter crew.

Thus the message is…don’t move people who have been in car crashes.

(Besides the worry about getting your car chopped up, it’s not good if they do have a neck or back injury –  I’m guessing the patient involved in this didn’t have a neck or back injury, but ambulances crews need to err on the side of caution).

 

With the first draft of the book given to the publisher, it’s time to get this blog back on the regular track.

Canary Wharf has a skating rink at the moment and my crewmate and I were sent there to attend to a ‘fall, head injury’.

“Excellent”, we thought, “a nice simple job – nothing complicated”.

We were met by a worried looking ice rink worker who wobbled across the pavement on his skates to meet us.

“We wouldn’t normally bother you guys, but we think it might be serious”.

Grabbing my bags I was led to a woman sitting in the changing area with two youngsters, both of which were looking a little concerned.

“Hello there.  I’m the ambulance, what seems to be the problem”, I normally start with a version of this as a conversational opening gambit.

The patient replied, “Well, I had a bit of a fall….”, she paused, “I…”, she paused again, “Head…hit…migraine…”.

She seemed to be having trouble finding the right words to use.  I quickly examined her, and was happy that she hadn’t hurt her neck and the small lump on the back of her head didn’t look serious either.  So why was she acting so strangely?

“I get migraines”, she told me, “I…lose…um…er…um…words, and I…eyes…eyes…go blind”.

This is a pretty rare presentation of migraines, but not unheard of.

We got her into the back of the ambulance and all my examinations there were normal.  She was complaining of ‘losing her words’ (expressive dysphasia) and of going blind in her right eye.  She didn’t seem too upset by this and had already taken her normal migraine medication, although I’m not sure on how Paracetamol and Metoclopramide would help with these symptoms as I’m not an expert on migraine treatment although I know that Triptans can sometimes be used.

Her symptoms started to get worse, she couldn’t find any of the words that she wanted to use, and so I needed to get a more thorough history from the two youngsters.  They were her nephews and she had been treating them to a trip down to London.  Although young, they were both very mature and helpful and after some prompting from the patient (“Laptop…look…laptop”) we found a patient information card in her purse.  The card let us know that all the symptoms that she was experiencing were indeed part of the presentation of her migraine.

It was a short trip to the hospital, during which she started to make a slight recovery and we left her in the capable hands of the A&E nurses.  Unfortunately for the patient, the hospital was extremely busy, so I’m guessing that she had to wait a little while for any treatment.

The three of them had come from Surrey, so they didn’t know the area well, although we were able to give them directions home from the hospital, we had chosen this hospital over another slightly closer one so that it would be easier for them to get home after any treatment.

A day out into London turning into a trip to the hospital – it happens more often than you would think.

We help the people of Newham.

One of these people has seen fit to ‘tag’ one of our ambulances with grafitti.

This means that the ambulance will be taken off the road so that it can be cleaned.

This will cost money.

It will also remove an ambulance from the road.

This means an ambulance might get delayed coming to a call.

I hope it is a call to the ‘tagger’, and I hope that they are in a great deal of pain.

Tosser.

Another fine post from Bill Stickers today, as he writes about saving the life of a driver.

See how far you get through the post before you can guess a diagnosis, Bill’s writing is so clear I guessed what it was once he described the patient.

As I mention in a comment on this post, it’s a good thing that he came along when he did, as without him acting ‘outside of protocols’ the driver would now be dead.  It’s good to see someone making an effort for the sake of another human being.

Congratulations Bill!

I’ve finished the first draft of ‘Da Book’ and have sent it off to the publishers who will no doubt return it with lots of red marking all over it and a huge letter from the lawyers asking for a thousand and one changes.

I’m still not satisfied with it though – especially the introduction.

Oh well…

I’m also a fair bit nervous, will my publishers like it?  Will they laughingly throw it in the bin?  Will I look like a complete idiot with ideas above my station?  Who knows – the die has been cast.

My hands are now soaking in a bucket of ice and dreading the thought of a second/third/fourth draft.

Time for a little relaxation before I head off to work.

Intueri has this weeks Grand Rounds – the round up of medical blog posts.

First off...

...Bah Humbug.

(It's not just for Christmas).

I've just finished with a job that makes me question this whole 'love' idea.

I'm sent to an alcoholic who has just had an epileptic fit and I arrive to find his fiancè looking very worried.

She tells me, "I've known him for ten months and I've only seen him fit once, so I'm afraid I got scared and called for an ambulance".

I reassure her that this isn't a problem, and that she has done the right thing.

I look after the patient, it's an easy job and I spend some time waiting for the ambulance to arrive (I was 'single', so I was asked to work on the RRU, the alternative was to work out of Waterloo station).

I look around the room they are staying in. It's not what you would call 'homely', it's the typical house of a young alcoholic (he's the same age as me). Cans of cheap cider are laying around the place, there is no furniture apart for a settee and a T.V, empty cigarette packets litter the floor and the pictures haven't been mounted on the walls.

There is an axe leaning against the fireplace.

His fiancè is young and not obviously unattractive, she doesn't seem particularly stupid and she doesn't look like a fellow alcoholic. So I'm confused as to why she would want to marry an alcoholic? I'm afraid it just befuddles me as to how you can 'love' someone who loves their next drink more than you.

In any partnership you will come second to an open bottle of cider.

I just don't understand.



Maybe I'm just emotionally stunted?

Someone (who I can’t mention on pain of death) pointed out an Amazon page to me…

Where Da Book is listed

Which means that I better finish writing it…

It’s definitely a weird feeling to see it up on a website I buy most of my books from.  I’m currently polishing the ‘final’ first draft before sending it off to the publishers so they can edit it into something approaching English.  I’m having a bit of a crisis of confidence at the moment.  Reading through my old posts I’m constantly worried that my writing skills are not good enough to be published.

One thing that leaps out when you look at a collected bunch of posts is how I seem to spend a lot of time trying to get a cup of tea, or worrying about sleep.

At one point we seriously considered subtitling the book “One man’s quest for a cup of tea”.

It’ll be finished before the end of the week, so I’ll see what my publishers have to say.  Until then I’m afraid I’m going to be neglecting this blog and email.  Maybe I’ll post something from work via my mobile phone, but unless I come across a job that I simply must write about, the next post might take until Wednesday to write.

So I shall leave you to ponder an important life lesson about ‘ass-hair’.