So there I am, sitting on my computer at silly-o-clock in the morning.

Then I feel a shaking.

It's all part of my plan for being awake for my morning shifts. I come in from work at around 3pm, go to bed and wake up around 11pm. Then I stay awake until I head off to work at 6am. Lather, Rinse, Repeat.

Which means that I'm stretched out on the futon, typing away on a blogpost when I start vibrating. I consider twittering a joke about being in an earthquake but then just put it down to my body doing strange things. I reckon it's just that my laptop was sitting on my femoral pulse or some such.

But no - it's an earthquake.

My very first earthquake and I think it's my heart beating.

Makes a change, normally I'd sleep through such things.

Out patient is in her late eighties, she's demented, she's frail, she's bedbound and she has a pressure sore.

She's in one of the nursing homes that we are familiar with - one of the big-chain 'don't care homes'.

The reason for us being called is that time-honoured reason of "Not eating or drinking". Unlike some previous visits the reason why she isn't eating isn't because the staff are trying to feed a corpse.

We have been as gentle with her as possible, trying to make her comfortable and warm on our trolley. When we wheel it out to the ambulance every bump in the floor makes her wince. It also makes me wince.

The home has sent the normal type of escort 'carer' with her, the "I don't know her, I've only worked here for two days, my English isn't so good" sort of carer.

One day I'm going to leave my job and inspect nursing homes - I will be feared for my ability to make these 'nurses' cry as I point out their many flaws adn get them to do their job properly.

I drive as carefully as I can, but there are too many idiots in my area that insist on walking out in front of my vehicle forcing me to hit the brakes.

One day someone will do this when I'm nearing the end of a tiring thirteen hour shift, I won't see them and they will regret their attitude of 'ambulances always stop'...

We reach the hospital, it's busy and one of the lead nurses take the hand-over from my crewmate. This is where we meet the difference between good nursing and excellent nursing.

Hospital trollies aren't the softest things to lay on, especially when you are so frail you can't change your own position. So the nurse decides to put her on a normal hospital bed, but there is none in the department. She phones one of the wards and arranges to borrow the bed from them.

But there are no porters to go and fetch the bed - my crewmate and I volunteer to go and get it.

By the time we return to the department the patient's daughter has arrived - we explain what we are doing and she thanks us.

We settle the patient into the side-room, she's wrapped up warm again and the bed has a special mattress to help prevent any more pressure sores. Her daughter and the escort watch over her.

I take the escort aside, "Now is your chance to do some one-on-one nursing. Ask the nurses here for a mouth care kit, make sure she is turned every two hours. Sit with her. Look after her".

I'm impressed with the lead nurse - she has reduced the time they have to deal with the patient before she 'breaches' the government's four hour target. But in doing this she has actually cared for the patient.

Shame there isn't a target for that.