Random Acts Of Reality :: Two Rumours

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Two Rumours

by Reynolds on Thu 12 Nov 2009 12:13 PM GMT | Permanent Link | Cosmos

A short break from the NaNoWriMo posts so that I can tell you about two rumours that I've heard. Note that these are rumours, if I had the time/energy/inclination I'd check them out to see if they are true, instead I'm just relying on the trust I have in the person who told me them.

If anyone knows if these rumours are untrue, feel free to let me know.*

Rumour number one is that a man from the Department of Health visited the ambulance service recently and told people that the moment the government changes (i.e Britain has a collective brain fart and a memory wipe of the last tory government and votes in the Conservatives) the London Ambulance Budget will be cut by £25 million.

This despite hitting our (stupid and clinically irrelevant) targets, despite ever increasing calls and despite the suspected pigocalypse of everyone calling an ambulance when they thing they have swine 'flu.

Additionally, somewhere out there in 'I could find it if I had the energy to Google it-land', is the government plan that a certain percentage of A&E ambulance work should be done by private ambulance firms paid for out of our budget and you can see that we will be going for the cheapest bid, which is never a good sign of quality.

Oh, and I nearly forgot - we have the Olympics coming up soonish.

-----

The second rumour is to do with a bit of our kit changing. This rumour however has been repeated by several people, including officers. The rumour is that because too many are going missing we will be doing away with our electronic blood sugar machines which are quick, accurate and easy to use in any circumstance. Instead we will be going back to the old chemical dipsticks that you have to wait two minutes for the result, and the result is a range of values that you read by comparing the colour of the stick to a chart.

Which doesn't work all that well, I think, considering half the time we are working in 'less than optimal' lighting conditions.

Also the dipsticks are also apparently far cheaper. And much less accurate.

Instead money is being spent on filter masks to protect me** from a milder, less fatal 'flu than is normally present at this time of the year.

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So, less money, less effective equipment and more calls. Probably less training due to the lack of money (training is normally the first thing to be cut). I can see us going back to being men with vans and bandages. Except of course that someone in government wants us to do the GP role on the cheap, but without the training is that really safe?

Expect deaths.

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To be honest I'm getting past caring. The few improvements that we've had in the service have constantly been overshadowed by new policies and ways of working that seem to exist only to destroy morale and chase unscientific government targets. We are being expected to do more for a frozen pay and with equipment that is falling apart.***

Why should I care any more? I can't do anything to change anything. Instead I should just turn up to work, pick up people who think that they are sick and take them to hospital. Then come home and watch some TV and forget about the feverish children that I couldn't record a temperature on because we didn't have a working thermometer.

Why should I get angry over it when I can't change it?

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*LAS management don't talk to me, they mostly ignore me, so I don't expect any confirmation/denial. Here is a challenge to my management - deny that either of these rumours are going to happen - here and in public. I'd ask you myself, but the organisational chart is so complex I don't know who'd I'd need to talk to.

**Sadly not only is my face such a strange shape that I can't get a mask to properly secure, but in attempting to get it fitted I managed to break my glasses.

*** An example - We drove the newest ambulance in the fleet, around 1,500 miles on the clock. We had to take it off the road twice in two days for various faults and, looking at the logbook, these were not new problems. Thank you Mercedes.

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Re: Two Rumours

by Nick on Thu 12 Nov 2009 12:27 PM GMT | Profile | Permanent Link

Well that's what happens when the money has run out. Gordon Brown has borrowed hand over fist and invested the money in things like speed humps. Quite how you sell off a speed hump when you need the money for a blood moniter. Quite how that speed up is an investment that pays more than the borrowing cost is only known to the prime minister.

It's going to get a lot worse, and the road leads clearly to Labour and Brown.

Re: Two Rumours

by alieneyes on Thu 12 Nov 2009 12:57 PM GMT | Profile | Permanent Link

Two things about the blood glucose meters your crews are using;-
1. They are extremely limited in their performance outside of any environment other than in a home setting of a well diabetic. In a critical care situation or even a moderately sick patient, the result becomes influenced by other clinical factors such as haematocrit and tissue perfusion. This leads to misinterpretation and ultimately mis diagnosis and erroneous treatment

2. However, many studies state user bias of visually interpreted strips is even worse. You must have a chief medical officer endorsing this decision - or face ending up on the receiving end of an MHRA inquiry if it goes wrong. The majority of hazard warnings from point of care testing come from misuse of blood glucose testing equipment.

Re: Re: Two Rumours

by Reynolds on Thu 12 Nov 2009 01:19 PM GMT | Profile | Permanent Link

1) I didn't know that. Is there a link to that info, I'd be quite interested in reading it. (Although I suppose that it does make sense and in the absence of lab testing of venous blood it's better than nothing)

2) Agreed, visual strips are bloody awful - 'Your BM is somewhere between 4 and 15', isn't really that helpful.

Re: Re: Re: Two Rumours

by alieneyes on Fri 13 Nov 2009 07:15 AM GMT | Profile | Permanent Link

To make this informed decision, you have to collate some information to support the analysis - its all ancient history now. The pack inserts of all glucose test strips list a whole host of limitations, which "my cause an erroneous reading". If you list these against the sick patient you just picked up, who may well be afflicted by more than one of these, then you will start to doubt the accuracy of the BG you you just documented. Every device/strip combo used to be evaluated by th MHRA and have its own report and they did a thorough job of pulling these limitations out. However, the device evaluation bit has been handed off to PASA and the evaluations have been taken off line! The evaluations used to be done by the Wolfson Applied Technology Laboratory at Birmingham Uni. - they still do them for PASA today. They might be able to get you copies.

Re: Two Rumours

by DC on Thu 12 Nov 2009 02:08 PM GMT | Profile | Permanent Link

Why is it that all political parties are intent on huge change every few years? Gerry Robinson pretty much proved that small, focused, locally-relevant changes are the solution - not a national change to grab headlines and let the politicians convince themselves they are actually doing something.

Do you think that one day a politician will emerge that genuinely cares about this country and has a reasonable set of brain cells with which to formulate sensible, workable policy? What is more worrying is do you think the British media would notice if one did emerge?

Re: Two Rumours

by DSO on Thu 12 Nov 2009 06:19 PM GMT | Profile | Permanent Link

Tom,

No idea on the funding stuff although cuts in the public services have been widely discussed in all the media, how else can we ensure that the bankers have a very happy Christmas!

To be honest the issue with the BM kits comes down to taking personal responsibility. I'm tired of listening to the moaning, maybe if people looked after the damn things (for that please read - if only staff didn't just take them home just in case) then we wouldn't even need to consider the problem.

Its a job and is it really too much to ask that you look after the tools you need to do the job!

So there you go, at least you can be reassured that it isn't just front line staff that get frustrated and sometimes we all get the service we deserve.

DSO

Re: Re: Two Rumours

by whodareswins on Thu 12 Nov 2009 07:46 PM GMT | Profile | Permanent Link

Think you'll find that normally the machines themselves are quite cheapas the manufacturers make their money on the packets of strips.

I can understand the not taking home bit, but as for looking after the kit - who is gonna worry about a bm kit when the vehicle they are using is held together with duct tape and micropore?

Re: Re: Two Rumours

by Reynolds on Fri 13 Nov 2009 02:59 AM GMT | Profile | Permanent Link

Why they didn't make them personal issue in the first place I'll never know. Then you can keep track of who loses theirs.

But I can see why people might want to keep one - after all the HPC doesn't like it if you don't have one, and to get one restocked onto an ambulance takes too long - and that's if there is any in stock in the first place.

Besides - I've never lost one, so why can't I moan that it seems impossible for the service to properly kit a vehicle?

(This shift? Sat on station for over four hours because we didn't have an ambulance alongside another crew for the same duration and for the same reason. Why no 13:00 start vehicle? Because Make ready took *our* 13:00 start to give to a 13:00 start on another station. This is why it's easier for me not to give a damn, hold my hands up and say 'at least it's not my fault')

Re: Re: Re: Two Rumours

by DSO on Fri 13 Nov 2009 07:34 PM GMT | Profile | Permanent Link

I agree about the whole Mark Ready/VRC catastrophy and I think thats a very fair critism that regularly leaves me holding my head in my hands.

As to personal issue, clearly there is a big shift in numbers from vehicle to personal issue (almost 10 fold in fact). Yes, some people look after personal issue a bit better, but just cos you can identify WHO lost something doesn't mean you can do anything about it (except order a replacement). Equally just how far do you go in deciding what is to be personal? Once day its a BM kit and tympanic but then what other shiny object will start taking peoples fancy.

Not saying you're to blame just pointing out that whilst its easy to think that those responsible are wearing pips and stuff, sometimes they're sitting in the seat next to you!

DSO

Re: Two Rumours

by Guest Blogger on Thu 12 Nov 2009 10:10 PM GMT | Profile | Permanent Link

Thermometers? Bah! Tempadots are the way forward (Well, at least in WMAS that's all we use)

Welcome to Random Acts Of Reality, a Blog based in London, England, written by an E.M.T working for the London Ambulance Service. Also, number one search result for "Womble porn". All names have be changed to protect the guilty. This Blog was previously known as "Why I Hate Humanity" but the antipsychotic medication seems to have kicked in.
All opinions on this website are mine alone, and may not reflect those of the L.A.S or other ambulance crews
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