*BEEP!*

We are spending too long at hospital.

*BEEP!*

In order to have ambulances that can reach calls in under eight minutes, we need to have ambulances 'Green up' (be available for another call) at hospital faster than they do at the moment.

*BEEP!*

There is a policy in place that if we spend longer than twenty minutes at hospital we are supposed to book in with Control and explain that there is a delay. Unfortunately It's nearly impossible to get your patient booked in at the hospital in under twenty minutes. So we don't do it - we only book a delay if we spend longer than forty minutes at hospital.

Otherwise we'll make our controllers go mental with our calling up after every job.

*BEEP!*

You see, you have to get the patient off the back of the ambulance - this sometimes involves hunting around for the increasingly rare 'Hospitalis Wheelchairus', the common hospital wheelchair. Then you wheel them into the department where you need to wait for a nurse to take a handover of the patient off of you.

*BEEP!*

It's in the interest of the hospital to delay this handover for as long as possible, so as to make it easier to make their four hour breach target. Sometimes there are three ambulance crews in front of you waiting to handover their patients.

*BEEP!*

Sometimes the hospital just has a culture of not taking ambulance handovers until they have been waiting for twenty minutes in any case.

*BEEP!*

Then you have to get the patient onto the trolley (or more likely wheel them out to the waiting room while trying to explain exactly why the nurse doesn't believe that they are going to die).

*BEEP!*

Then one of us heads to the reception area to book in the patient, while the other returns the trolley/wheelchair and makes the ambulance ready for the next patient. It is rare that the ambulance trolley gets a clean - it takes too long to dry.

We do try and wash our hands between patients though.

*BEEP!*

The crew in the reception then books the patient into the hospital - sometimes there is a queue of walking wounded waiting to book in - sometimes they are more ill than the patient you have just brought in, so you let them book in first.

*BEEP!*

Then you head back to the ambulance where you fill in your documentation in a way that will cover your arse should the patient suddenly drop dead and you find yourself up before the Coroner's Court. There are boxes to tick and findings to write. Times to be entered and obs to be recorded.

*BEEP!*

Then you hit the 'Ready for another call' button and get sent somewhere else for some fool with a poorly elbow.

*BEEP!*

This takes as a minimum around thirty minutes - note that I haven't included going to the toilet, grabbing a cup of tea or eating a bag of crisps. With an uncomplicated walking patient, with no delays on handover and a reception that is poised ready to take your handover this takes a minimum of around eighteen minutes.

I know, I've timed it.

*BEEP!*

In an effort to 'speed us up', and to remind us that we should be making Control's life more difficult by booking a delay after every job, some bright spark has installed a new programme on our vehicle based computer terminals.

*BEEP!*

After two minutes at hospital a big friendly black screen appears on the terminal. Then a big friendly timer appears that says...

If you are, god forbid, at hospital for longer than twenty minutes it goes

Also after you have been at hospital for more than twenty minutes it starts going...

*BEEP!*

Every minute it goes...

*BEEP!*

While you are trying to do your paperwork, in the manner that is expected of you.

*BEEP!*

It's like Chinese water torture.

*BEEP!*

Oh, and the number starts flashing in a friendly red and white manner.

All in an effort to get you to make available those few minutes quicker.

Now, I understand that there are ambulance crews out there who take way too long at hospital. These cause more work for those of us who get on with the job. But surely if you are concerned about those people (and management know who they are because everything we do is logged) then you pull them into the office and have a quiet word with them.

What you don't do, at least if you want a happy workforce, is to force them to endure psychological torture. Or to punish everyone for the crimes of the few (although it seems that this is the tactic that Nazis in war films use...)

It's all in a bid for increasing the calls we get to in eight minutes (and I've moaned enough about how it is clinically unimportant for such a target).

There is a rumour that in the new year we will be banned from booking our patients in at reception. The nursing staff will have to do this (because, you know, they have so much free time). This surprises me as I can remember when it was tried about six years ago and was a horrible failure as paperwork kept going missing and patients were left for hours without seeing anyone.

I'll still be booking my patients in because of a little thing called 'duty of care'.

But, you know, eight minutes is all that matters.

Anyway, 'nerd determinism' has won out and there is a simple way to stop the *BLEEP!* from sounding that isn't in the slightest bit damaging to the equipment on the ambulance.

I'll continue to have two mouthfuls of coke between jobs, and will make available as soon as I can (if only because I find it really dull to sit at hospital). My patients come first, not the eight minute target.

(It's a shame, for once, that only Mozilla browsers still support the *blink* tag...)