I'm not moaning about the transporting of patients, while I think that there are better ways to do so than the use of frontline ambulances I'm utterly at the bottom of *that* food chain. The psychiatric history that I am looking for is what is relevant for me to (a) transport the patient, and (b) handover the patient to the nurse at the other end. It doesn't need to be some nicely DSM IV diagnosis, but knowing that the patient refuses to get out of bed meant that trying to get her into a chair wasn't going to work, but that a stretcher would work fine. The nurses in this case just looked at each other and shrugged - their sole response to any question about the patient was to say 'the doctor knows/says so'. I'm well aware of staffing pressures - I do also work for the NHS... But that doesn't excuse things like not giving a patient who is in pain and is asking for painkillers a paracetamol. If it *does* mean this then we may as well all pack up and go home. Now, imagine that you are a unit manager - who would you pay more attention to? an 'ambulanceman', or the ambulance head of Complex who has spoken to your boss? It's not snidey sneering - it's me highlighting that there are some crap nurses out there, and if you don't believe that then you have had a very different experience to me - and you are lucky for it. Or should I let what I consider bad practice slide? Or should I raise the issue with someone who should know if what I experienced was bad practice or me just getting the wrong end of the stick. And if I get called to you should I assess you by grunting a "wot?" at you?