Afro Circus

"3 year old female, crying"

Crying. The child is crying. It doesn't exactly fulfil the 'THIS is an emergency' campaign that's plastered on the side of most ambulances but hey, I'm not there. She might be crying for any number of reasons! All will be revealed!

To the chorus of sirens and the lighting extravaganza of blue lights, we rushed through the busy traffic on route to this seemingly life threatening call. I do often wonder, as the cars dive out of our way, what these drivers would think if they knew we were on our way to a crying child! Hardly the guts and glory Holby City would have you believe! Just before we arrived it updated to say that the child wasn't fully alert. Hmmmmmm!

We pulled up in the car park of the flats and unceremoniously abandoned our ambulance, blocking in all and sundry in the process. It is an emergency after all! We were greeted at the door my the patients mum. She rolled her eyes and kind of laughed as she led the way to the little girl. There was no sign of any crying so that was a good sign....

Sure enough, standing in front of a HUGE TV was our patient, dancing and singing to Afro Circus from Madagascar 3. I kid you not! I recognise the screeching of Chris Rock doing the Zebra's version of I Like To Move It because my son is also obsessed with that song! 

"What's the problem today? She doesn't seem to be crying now!" I exclaimed.

"Ahhhh don't! She's been a nightmare. She's been throwing tantrums all afternoon and it's driving me crazy!"

"Tantrums? What have you called 999 for?"

"Well she wouldn't stop crying, there must be something wrong with her."

"But she's singing, she doesn't seem too distressed."

"But she is singing more than normal."

"That maybe the case, the singing and dancing doesn't suggest an illness to be honest."

"Yeah, but look, it's uncoordinated dancing."

To be honest, it was no Sylvie Guilem but equally, she was a 3 year old mimicking the dance moves of a cartoon Zebra, I wouldn't expect miracles. 

"So just to be clear, your main concerns are crying, tantrums, excess singing and uncoordinated dancing?"

"Well.....yes, but honestly she wouldn't stop crying."

"I'll be honest with you, it doesn't look like there is anything wrong with her, and this isn't something you should be calling 999 for."

"Well I didn't know what else to do, it's not normal."

I wanted to tell her it wasn't normal to call 999 because your 3 year old is being out-danced by a Zebra but it wasn't worth it! I gave my 'inappropriate use of an emergency service' speech and left it at that. Blimey, if uncoordinated dancing as a determinate for an ambulance I'd be carted off every time I went near a dance floor! 

Despite the obvious frustrations, this job amused me greatly!

"Ra da da da da da da da circus

 Da da da da da da da da afro

 Circus afro, circus afro, 

 polka dot polka dot polka dot afro!"

It Happens To The Best Of Us

"23 year old female, ? drink spiked, vomiting"

It was ridiculous-o-clock in the morning and most of the night's revellers were either a) tucked up in bed b) tucked up in a hospital bed or c) lying in a pile of vomit in a park waiting patiently for a good samaritan to call 999. As far as night shifts go, it had been particularly torrid. Alcohol and drugs had been the stars of the show, with the police and the ambulance service run ragged all night long! Some of my highlights of the proceedings included being spat at and threatened by a crack head, having someones dog 'set on me' (the dog couldn't be arsed) and watching a great episode of domino vomiting (one goes, they all go) outside a club. Oh, spending an hour trying to convince a man in only Thundercat boxer shorts, that lying in the road with his hands in his pants wasn't conducive to good public relations and future job prospects was also one for the out-takes reel. 

It was about 04:30, I was resembling a wild banshee and looking rather dishevelled! My hair really was a thing to marvel at! Being sent to a vomiting drunk person with delusions of drink spiking hardly filled me with warmth, I must say. I was wildly confident that the only thing her drink had been spiked with was alcohol. We headed on up to the 'top floor' flat as instructed. We were met half way up my a drunk, scantily clad girl who was walking like a new-born giraffe. Funny it was, graceful it wasn't. We followed her, and the noise of crying / wrenching into a bedroom. 

There, lying sprawled on the bed, wearing a t-shirt a thong was our patient. Her head was hanging over the edge of the bed and she was indeed vomiting. Her makeup had run somewhat and her hair was....well, matted in vomit. She looked a treat! She was also crying. Stood in the corner of the room as a sheepish looking boyfriend, who wasn't drunk and seemed rather annoyed by the whole situation. 

"Hello my dear, good night was it?!"

"Oh my god, I'm so sorry, I can't stop being sick!" she slurred at me.

Between her and her friend they went on to explain that she hadn't drunk any more than she normally would and drunk the same amount as her friends. They just didn't understand why she was so drunk! Must be a spiked drink eh?! Not the lack of food all day and tiredness combined with any number of other things. Oh, and all the Jaegerbombs. And wine. And other spirits. Definitely, without doubt, a spiked drink! Hmmmmm!

Her boyfriend just rolled his eyes! He looked particularly unimpressed by the whole situation. I made a few jokes about the situation and he chuckled. It was then I noticed his shirt. It was white, with flaps on the shoulders for epaulettes and a velcro patch on the chest. 

"Is that a police shirt?!"

"Yep! I'm a cop, I'm on early turn, start at 7am, then get a call from this muppet!"

"Sleep's overrated anyway buddy!"

The patient started wailing / crying again! She was apologising profusely and stating how ill and drunk she was!

"What do you do for a living?!"

A sorry pout and half grin appeared on her face.

"I'm also in the police! I'm so embarrassed!"

I just laughed, and laughed hard! She started laughing, and her boyfriend was now seeing the funny side of it! 

"And what do you do?!" I said to the friend.

"And what do you do OFFICER!" she said bursting out in laughter!

As far as I was concerned, all her sins were forgiven! Sure, it's favouritism and yes, I have bitched and moaned about drunk people calling ambulances because they are drunk and YES, they should have known better. But, the thin blue line is spread so thin and they do such a great job day in, day out that getting smashed on a Friday night was probably just what the doctor ordered. We spend half an hour talking work, sharing war stories and we left her to wallow in self pity for the entire day before she started night shifts! 

Getting drunk and paralytic happens to the best of us at times, even the police. When not in uniform we are all just normal people making the same stupid mistakes as everyone else! I won't hold it against her when our paths cross professionally. I will however, mock her unreservedly!

Don't forget, nominations are now open for the MAD Blog Awards 2014. Please go and nominate me by clicking HERE. Just add my URL www.tryingmypatients.co.uk to the categories I'm eligible for! (Best Writer & Most Entertaining) Thank you! 

New Years Day

It was New Years Day and the people of our fine city were not feeling well. I spent most of the day observing the pained expressions on people faces as they struggled with the simplest of tasks, like walking. The previous nights celebrations had clearly taken their toll and as per the norm, the ambulance service were left to pick up the pieces! Here is a rundown of what treats the day gave us! Bear in mind, I too was tired. Like everyone else, I had seen the new year in with friends, had a few drinks, mindful I was on an early it was limited to a few! When my alarm went off at 4am I wasn't amused in the slightest but I got on my bike and headed into the night for my 6am start! 

06:05 - '23 year old male, collapsed. He was drunk and asleep.'

Not collapsed. A good Samaritan had called us. They didn't stick around though. Shocker! Taken to A & E to join the heap of drunken delinquents.

07:00 - '21 year old male, collapsed, head injury.' 

He was drunk. In a skate park. He'd fallen over and cut his head. His friends found the whole affair extremely funny and used words like 'wack', 'nang' and 'rad' with worrying frequency. Bandage on head, a large cannula with fluids and trip to A & E.

08:15 - '23 year old female, vomiting blood.' 

She wasn't. She was vomiting red wine. And 'Purple Rain' which I was assured was an 'aggy' cocktail. Her main problem was a hangover. I gave her 2 x Paracetomol, a glass of water, sound medical advise and a few of my best hangover cures. Left in care of friends.

09:06 - '29 year old male, chest pain.'

He did indeed have chest pain. The cause was the copious amount of cocaine, MDMA and skunk that he had taken with alcohol the night before. Due to the fast heart rate and various other things he was given Diazepam to treat his cocaine toxicity. He was promptly taken to the New Years Eve recovery centre for monitoring and further treatment.

10:32 - '30 year old male collapsed.'

He was indeed collapsed. He'd taken an overdose, presumably of heroin.  He was ventilated, filled with Narcan and then once the effects of his high were reversed we were left with an angry, verbally and physically abusive patient who was arrested and conveyed to hospital. 

11:48 - '24 year old male, chest pain.' 

This one was in a police station. He was claiming to pain to avoid being at the police station. Much to his dissatisfaction, once I'd assessed him, done his ECG and spoken to the duty nurse I told him he could stay in the comfort of his room. He called me a cunt. I left.

12:55 - '14 year old female, intoxicated.' 

This one was in a park. She was smashed, well and truly. He blood pressure was in her boots so she got treated to cannula, fluids and a journey to hospital. Because of her age the police had to attend. She vomited all over the ambulance. And my leg.

*change uniform, clean vehicle*

14:10 - '25 year old male, cardiac arrest. '

Sadly, it was as given. He was dead, nothing we could do for him. His friend found him sat on the sofa. He'd been there 2-3 hours. The nights drink and drugs had stolen a young life. A very sobering affair for all involved. Happy New Year eh? 

15:35 - '26 year old male, severe headache, pains in chest.'

He had a hangover. I told him to take his own paracetomol and drink more water. I told him I had just attended a 25 year who had died. I asked him if he felt us being there was a good use of an ambulance. He apologised. We left.

16:20 - '46 year old male, unconscious on bench.' 

He was drunk, on a bench. He told us to fuck off. We did. The caller hadn't stuck around.

16:40 - '19 year old female, feels weak, chest pain, vomiting.' 

She seemed genuinely shocked that her symptoms were caused by lack of sleep, no food, consumption of weed and too much alcohol the night before. I gave her a dose of health promotion and left her with her proud parents. 

17:25 - '40 year old, collapsed in toilet.' 

Clearly the best had been saved until last. We arrived outside a heaving McDonalds and headed inside. A member of staff met us and took us downstairs to the toilets. Hundreds of pairs of eyes stared at us as if they had never seen an ambulance crew, as they chewed their Big Macs. Despite all watching us head into the toilet, within seconds people were trying to come in and seemed utterly shocked that they couldn't use the facilities! Inside was the wonderment that was our patient.

He was a big man, clearly an alcoholic and was locked in the cubicle. His head was slightly protruding from underneath was wall of the cubicle. He was well and truly unconscious. Oh, and his face was lying in a pool of other peoples urine. It appears McDonalds had fallen foul of their hourly toilet cleaning policy, much to the detriment of the patients big ginger beard and open mouth. We requested a chair to look over the top of the cubicle. 

I climbed on top and peered over. There he was in all his glory, trousers around his ankles, and lying in a pool of his own urine and faeces. He had literally keeled over from sitting on the toilet. It really was a wonderful advert for alcohol!

Unfortunately,  despite the treat waiting for us inside, there was the very real problem of how to get him out. I managed to reach down and unlock the door but we could only force the door open slightly, such was his position. My crew mate was slighter than I was so she begrudgingly agreed to be the one to squeeze through the gap and attempt to move him enough to get the door open. Despite her best efforts, the dead weight drunk man could not be moved and in fairness, such was his condition and covering in bodily fluids, she didn't bear hug him with gusto! Luckily for us he started to wake up of his own accord. His personality was every bit as endearing as his appearance. 

"What the fuck are you doing, get out of my cubicle!"

"You collapsed to the floor sir, we are trying to get you out."

"For fucks sake." he mumbled in a thick Scottish accent. 

"Sir, can you move your legs and sit up, we can't get the door open until you do!"

"Yeah.....I know......I'm not fucking stupid you know!"

It's at times like this I like to freeze frame the moment. Ideally I'd like to take a photo on a Polaroid camera and pass it to the patient for them to digest. I was curious as to which part wasn't stupid. Was it the amount he'd drunk? Or the falling off a toilet? Or the double incontinence? Or his face in puddle of strangers urine? All of the above smacked of stupidity, but who am I to judge?! 

Eventually he was up and out. With every passing moment he became more and more abusive and the smell got more and more offencive. After telling us both to, and I paraphrase, 'go away' he headed out back into the restaurant. After attempting to start a number of fights and verbally abusing everyone he passed he staggered up the stairs and out onto the street. During this short journey he only fell over 4 times so that should be looked at as some kind of achievement. He went off into the distance cursing at all he past. I never got his name. What a treat he was!

So, that was New Years Day! Entirely predictable, totally exhausting and all too familiar. Lives wrecked by alcohol and drugs again. When will people learn?! I could sit and reflect on the 25 year old that died but won't. He isn't the first and sadly won't be the last. Perhaps that's cold of me, perhaps it's just self preservation. I'm sure next weekend will bring similar. 

"It's like gambling somehow. You go out for a night of drinking and you don't know where your going to end up the next day. It could work out good or it could be disastrous. It's like the throw of the dice." Jim Morrison

No More, No Less

"RTC, car vs car. Injuries unknown. Police on scene."

We happened to be on the road the RTC was on when we got dispatched to it. It was about two miles away but due to the nature of the relatively narrow and winding road, any RTC always caused absolute chaos in the area. The traffic was already building up, even where we were so it took a little while for us to get there. For every five cars that move out your way, there is one that just sits there and doesn't move. It's most frustrating! Ahead, we could see the blue lights of a police car and after a final push we were there.

As far as RTC's go, this was a minor one. Three car were involved all with relatively minor amounts of damage. There were five patients, all with pretty minor ailments, but all needed assessing and treating. Injuries ranged from minor head injuries to mild chest pain. Once we had parked our 3.5 tonne vehicle traffic was now well and truly blocked in both directions, but whilst the two of us were working our way between the three cars, that was what was happening. The two cops were having to take statements, try and clear the road, act as mediator between the feuding parties as well as making sure everyone was safe until we had arrived. I didn't envy them one bit!

Sat in the traffic, near the front was a brand new white Audi. A guy, mid 20s leaned his head out the window and spoke at one of the coppers.

"Oi, how about you clear the road."

"How about you don't refer to me as 'Oi' for starters."

"How about you just do your job."

"Can you provide me with more officers to assist us, because that is what we need?"

"Ain't my job, I pay my taxes, how about you clear the road like you're paid to do, fucking idiot."

"We can only do so much. There are only two of us. We would love more officers to help but there aren't any. You'll just have to be patient."

"Just move the fucking cars so we can get on our way. It's your job, it's not rocket science. Are you all as incompetent as each other?"

"Stop swearing at me."

"Or what, what you going to do. How about instead of wasting time whining about swearing you do your job and clear the road."

At this point the copper walked away and continued doing the huge list of things that needed doing. I just stood there open mouthed. Had that really happened?! Some people are so unbelievably selfish! And arrogant. And in this case, just a total arse!

"Oi, move your ambulance so we can get past."

Oh, he's talking to me now! I felt that warm feeling inside, one full of joy and excitement! I composed myself for a moment and walked over to his open window.

"You are a rude, nasty, LITTLE man. You will wait like everyone else is waiting. There is nothing you can say, or do to make me move my ambulance any faster. All that you stand to achieve with this attitude is ensuring you wait longer."

With that I begun walking away! 

"Go fuck yourself."

"Very intelligent response. Well done." I said with a smile.

"Fuck off."

Clearly, I don't have the same levels of self restraint that coppers do. I am often found guilty of taking the bait but someone needed to tell him he was being an arse! The police face this abuse on a daily basis and most people get away with it, because there simply aren't enough officers to arrest and process these morons.

I asked the police officers on twitter how many units / officers would be needed in an ideal world to deal with a 3 car RTC with 5 patients on a busy road. These were some of the responses:

"I'd like 6. However I think that 4 is probably all I'd get. And that's on a good day." 

"Ideal world an officer per car, 2 for the road block and 2 for the witnesses so 7. That would almost be my whole team!" 

"6 in an ideal world, but you should be so lucky! 4 would be safe and manageable" 

"Ideally 6, but safe with 4. No less than that." 

"4-6 for scene management, arranging recovery, taking witness statements etc"  

"Depending on the road 6-8 ideally, not less than 4, too much to do." 

"Probably 6 I reckon but that would be most of my team!"

So, I think it's fair to say that the one police car with two officers was not enough to safely deal with the scene. Unfortunately, there was no one spare to send. In previous blogs Please Sir, can I have some more? and A Special Relationship I highlighted what effect the cut of 16,000 front line officers was having. Those two posts highlighted extreme cases which is easy to get outraged about but RTC's like this are part and parcel of every day policing and there simply are not enough to spread around. What you're left with is two officers trying to mange 3 angry families, a blocked road, the irate public, 5 patients, 3 drivers to process and breathalise, vehicles to help arrange recovery for and an ambulance crew to ensure are kept safe! It simply doesn't add up does it?!

As a bonus, as the road was being cleared the chippy chav opened his abusive mouth one to many times! The cop went over to the car and asked him politely to get out the car. The driver don't take kindly to this and his threatening manor and verbal threats landed him in handcuffs. To top it off, due to a faint smell of alcohol he too was breathalised. In what was a beautifully poetic moment, he blew over the limit and was promptly arrested for drink driving. One more scum bag off the road! If only he'd kept his mouth shut!

Despite the pressures, everything got done. The abusive moron was ignored, then arrested! The road got cleared, the patients got treated and discharged and after a good hour or so all that was left was the two cops with an absolute mountain of paper work, an ambulance crew and a clear road. The upshot is though, the public are left blaming the police for not doing enough to ensure their smooth journey! It's not the cars crashing, it's the police not working fast enough to clear the road. That moron happened to voice it but you can be sure others with thinking it. The emergency services shouldn't be left in a situation to just cope and muddle through. These ill conceived cuts to front line services have a huge effect on day to day services and there simply are not enough left to keep the public safe. Then again, lets not forget police should "Cut crime, no more, no less". These non-police matters will sort themselves out, eh Terese May....

A Life Of Grime

"59 year old female, collapsed behind closed doors."

There is that ominous feeling again! The one I get when those words appear on the screen. The apprehension that goes with the territory of entering someone's house, not knowing what you will find. Will the house be empty? Will you go from room to room hoping not to find a body? Will you find someone hanging? It's a horrible feeling and a job I never relish doing. 

We headed round to the house. It was an old Georgian terraced property in quite considerably disrepair. Flaking paint, rotten sash windows, dirty net curtains, ivy growing up the wall, an over grown garden, a boarded up window and a broken letter box. If I didn't know any better I'd have said the house wasn't occupied but we had it on good authority that someone was indeed inside. Two days worth of milk was in the porch which suggested that normally someone was there. I knocked and shouted through the letter box. To my surprise I heard a faint 'Help me' in reply. 

We couldn't get in and no one had a key so I requested police. While we were waiting a neighbour offered us access to her back garden. She also told us that the lady inside never goes out the house. We squeezed through a gap in the fence and peered through the window. Darkness! Luckily the old sash window wasn't locked and lifted up with relative  ease. I immediately wished it hadn't. The smell that hit me.....wow!

This job in general challenges your senses and often offends them. It is true that there are smells you can taste and this smell instantly made me gag. Covering my mouth and nose 

I pulled the curtain across and was met with literally a wall of rubbish. There was no way in, I couldn't see any part of the room. Back to the front!

By the time I'd clambered through the fence and got to the front door the police were on scene. After my explanation of the smell, we all donned masks and police forced the door in. I can't begin to describe the state of the house or convey the smell in words. It was beyond grim! As we made our way down the hallway, shuffling past the stacks of rubbish, I could feel the soles of my boots sticking to the floor. We followed the faint voice from the back of the house, all the while, the smell getting more intense. Maybe it's like touching something with a 'wet paint' sign on it, but despite knowing how vile the smell is I still found myself checking! 

My heart sank as I turned the corner at the end of the hallway. The piles of boxes and rubbish continued, making it almost impossible to get to her but my main concern was her! She was lying face down in the doorway of what I assume was her bedroom. When I say 'in the doorway', I mean literally wedged. She must have been 30-35 stone. There was no way to even roll her onto her back. She had also been there two days so was saturated in urine and faeces. For the first time in a long time, I didn't have a clue what to do, or where to start. How do we move her?! How do we get her up?! How do we get her out?! My crewmate checked her over and medically she was OK, apart from some dehydration. Clearly we couldn't manage on our own and our equipment wasn't large enough or strong enough to cope with her size. 

I phoned up control and had a discussion with our clinical support team. They decided to send HART (Hazardous Area Response Team) and an officer for starters. The benefit of HART, is like firemen, they tend to come on mass! There is normally six of them on their big truck so at least we'd have hands! Ideally we needed a removal company, pest control and a deep cleaning company but we don't always get what we want! Within 20 minutes or so the troops had arrived and like us, were perplexed as to what to do. 

The officer, rightly said we needed the bariatric ambulance to convey her, so he arranged that. Due to the lack of bariatric ambulances and the ever increasing number of obese people who need them they can only be requested by an ambulance officer, so they are not used inappropriately. Meanwhile, the head scratching continued. Eventually a plan was made!

It involved clearing the hallways for starters! Unfortunately, there was no space to put any of it! We ended up having to line the pavement with it all. Almost an hour later, the bariatric ambulance had arrived, a path was cleared, dead rats had been found amongst other unidentified dead creatures and we were all filthy. As for the smell, what smell?! We'd been around it for so long, I was over it! 

With a configuration of straps, sheets and a hoist we managed to get her onto her back, then to sitting, then onto a chair, out the house, onto the bed and off to hospital. We all then went for showers and a uniform change.

I've blogged about obesity at length and apart from saying how much this has cost the NHS in resources, I won't discuss the obesity issues. They are obvious enough. However, there are huge social issues and obvious failings in a flawed system. How can anyone be allowed to end up in a state like this? The council WERE aware of the situation and had done nothing. It was a council property and there was a resident clearly not able to cope. Why had social services not intervened? Time and time again we see people that have 'fallen through the cracks' in the system. I'm not being funny, but this isn't falling through a crack, this is simply not caring for people who need it. This hasn't happened overnight. This is the result of a lifetime of self neglect and being overlooked by the services that are in place to help. No one will be answerable for this situation. It's been left for the emergency services to sort out, again. No one should be allowed to live in such squalor, regardless of how obese they are, regardless of whether or not they are a hoarder and regardless of whether or not they can afford or want the help they need. Allowing anyone to 'fall through the cracks' is neglect. End of. 

Bemused

"63 year old female, cardiac arrest"

There's that all to familiar ominous feeling when we get dispatched to a cardiac arrest. There is a heightened tension in the cab and my senses are much more focused on the drive. I can feel my eyes fixed on the road ahead, assessing the movement of everything ahead of me. What our advanced driving course taught me most was awareness and hazard perception. After 5 years of practice it's all second nature but still requires concentration. At any one time on a blue light drive we are planning our movements based on everything in the distance and just in front of us. It's changing constantly. 

I was racing through the high street, watching for pedestrians on both sides of the road, scanning the parked cars for potential movement, monitoring all 3 sets of traffic lights and looking for gaps in the traffic for me to weave through. A car 100 meters ahead on the other side of the road flashed to let me through. They were just before a traffic island which had a pedestrian standing on it. I pulled out onto the wrong side of the road, my lights and sirens were on and headed towards the gap the car had created for me.

As I approached the island, I could see a man waving at me. I started to slow down in case he was flagging us down. As I got closer I could see the expression on his face. I could also see it wasn't a wave. He was doing a 'wanker' hand gesture, whilst mouthing expletives at us. His eyes full of of hate and anger. As we were drawing level with him he raised his middle finger and spat at the ambulance. We continued on our way.......bemused.

Please, someone explain why people like this exist! How can anyone have such hatred for the ambulance service?! You could see the hate in his eyes. Is it a uniform thing?! I genuinely don't get it!

I'd loved to have stopped and asked for an explanation or to hear what he was saying but a lady was dead and we needed to fix that! We arrived, fixed it, she survived and wrote a thank you letter. I wonder if he would have behaved the same if he'd walked past us doing CPR! Hmmm......

Thoughts on a post card please. I'm looking for answers and solutions! Sensible or not!

Keeping Up Appearances

"48 year old female, (ironic) chip on her shoulder"

Q. What do cars need to run on?

A. Fuel & Water. Right?! Run out of fuel and they stop. Run out of water and they overheat and eventually stop.

Q. What do humans need to run on?

A. Fuel & Water. Right? Run out of fuel and they stop. Run out of water and they overheat and eventually stop?

Q. What do you do if the petrol light appears on your dash board?

A. Refuel right?

Q. What do you do if you're hungry?

A. Refuel right?

OK, science lesson over kids! Our petrol light was on. We didn't have enough fuel in the tank to safely do another job so were shown 'unavailable' to go an refuel. It was 5:30pm. I'd been at work since 6:30am. I had not had a break. I had not had a hot meal for almost 24 hours. The venting machine at the local hospital was out of order. Petrol stations sell sandwiches. I needed a sandwich. My headache also told me I probably needed something to drink too! As gin is frowned upon whilst on duty some Ribena would have to do! As luck would have it, in the petrol station they do a meal deal where I can get a sandwich, crisps and a drink and save 19p off the total price! Win! 

I parked up on the forecourt and stuck £101.01 in the tank. Wow, we were low! I headed into the shop, grabbed my BLT, a pack of steak McCoy's and my Ribena light (yes, I'm watching my weight and 'light' makes all the difference). I joined the queue. Eventually I got to the front and first of all paid for the fuel with my fuel card. I then started to pay for my lunch / dinner combo when I was interrupted by a woman behind me.

She was late 40s early 50s, wearing some kind of ill fitting business suit and blouse. It looked like she'd had a team of 10 people shoe horn her into it. One of her chins hung well below the neck line of the blouse and she was wearing a grotesque broach. Her hair was a big curly think, clearly dyed and badly. There was a tell tell stain across her hair line. She also looked and spoke like she was sucking a lemon.

"Ha, so this is where the tax payers money is going then?!" she said with an arrogant smirk.

"I'm paying for this myself, is that OK with you?"

"I'm not talking about WHAT you are buying, it's the fact there are people out there waiting for an ambulance and you're in here only concerned with feeding yourself."

"I beg your pardon?!" I said in utter disbelief.

"See, that's the best you can say while you think of a way to justify yourself."

"The ambulance needs petrol and we are entitled to eat you know!"

"Don't waste your breathe, I know your type, carry on, stomachs to feed."

Was this really happening?! Is this what people think?! Was getting a sandwich really that unreasonable?!

"Do you not eat whilst you're at work?"

"Of course I do, but I don't risk lives in the process, I don't know how your lot sleep at night. No wonder the NHS is in crisis. To think my tax is being wasted on you."

"I also pay tax."

"Hurry up, you're boring me now, run along with your lunch."

Discuss.......

Please Sir, can I have some more?

Dear David

I'd like to start by wishing you and your family well in these tough economic times. You and Samantha's combined salaries of £400,000 plus shares and bonuses must be really getting spread thin. I empathise, I really do. Like you, I seem to work all the hours god sends yet that £25,000 seems to just disappears! Still waiting for my mileage expenses to come through though, so that will be an extra £42 in the piggy bank! I love expenses! Anyway, the point of this letter is one of a more serious nature. 

I have waited a long time to write this too you. Let me draw your mind back to your first assault on the Police service. In case you'd forgotten you cut 16,000 officers. Less is more! Quality over quantity! Needs must! Look at the bigger picture! We will all feel the pinch! No one is immune from cuts! All very very true. We must indeed all pay the price for the bankers and politicians sticking our country in the economical dark ages. But, there are consequences to your ill advised cuts. Let me share a story. A story that brings back painful memories. A story that still bears real scars. 

As a paramedic, one who has been through years of training and sacrificed friends and family for such a fulfilling salary, I understand that part of my job, in fact, part of my salary is danger money. Well, not officially, but being abused is part of the job, right? As the Right Honourable Ann Widecombe, recently said, "Public servants worry more about their own safety than that of the public, Britain has sunk to a new low". I'm guessing by your lack of condemnation of these comments you must agree wholeheartedly. So, as an 'ambulance driver' (yes, we are that low in the food chain), a bit of danger comes with the territory. One afternoon, I was called to a residential address to a man who had 'passed out'. 

When I arrived that man was lying on the grass. I approached him, on my own, and he appeared drunk. I went about my business, checking him over, when the ambulance crew arrived. We began to get the bed off the ambulance all the while making sure the member of the public was OK. We are public servants after all and serve we shall. Without warning the patient stood up and swayed a little, then staggered into a fence. Poor guy eh?!

He then beat me with a fence post. He also beat the other members of the ambulance service. Three of us in all. Do you know what it feels like to be helpless against a man beating you with a lump of wood? Despite all of our broken bones we managed to press our emergency button. Let me share a conversation with you.

Me: "Red base red base, urgent police, we are being attac......." I stop because the lump of wood has been broken over the back of my head and then broke my hand.

Crew 1: "Red base, my crew mate has been hit over the head, urgent police" he says with 3 broken ribs.

Red Base: "Getting the police for you now, are you all OK, can you get to safety."

Crew 2: "I'm now locked in the car, I think my wrist is broken, he's still attacking us."

Crew 1: "We are away from him but he's coming after us. Are the police on way?"

Red Base: "The police have no units to send, try and maintain a safe distance."

Crew 2: "He's trying to get in the car, he's hitting it with the wood"

Crew 1: "I think he's stopped, he's lying in the road but we can't drive off."

Crazy stuff isn't Dave! No units to send?! But aren't the police supposed to be there to protect us? Surely in a real emergency they have someone to send. Surely you didn't cut too many? It's OK, 9 minutes later two undercover officers arrived. Part of their job is getting abused too. I should probably mention now that in their efforts to protect us from the patient they too both got broken bones. They were struggling to restrain him on their own so much, that we all helped. We all restrained him for 10 more minutes until more help arrived. Guess what we did then Dave? We all took the patient to hospital for treatment. With our broken bones and bleeding wounds, we checked his blood pressure, he even got to travel on the bed. He is of course a member of the public and we are all their servants.

Now, do you still think less police is the right answer? What if you or your beloved family were trapped somewhere in real fear for your life? What if you called for help? What thoughts would go through your mind when you heard those terrifying words "No units to send." The officer who came to my aid told me that it used to be a team of 25 to police the borough on this shift. Today it was a team of 7. No doubt they got complaints from the public for not coming to their aid quick enough whilst 2 of the 7 were sat in A & E with me and my colleagues. Tut tut. We really must all work harder.

The good news from all of this, was our patient was treated professionally by us and the hospital. He was arrested and charged. He was sent to prison. However, because of your cuts to the prison service he has already been released and I could bump into him anytime of any day.  Oh wait....in fact, only last week, I was sent on a job to his house. Can you imagine the fear Dave, can you? Luckily he wasn't there. 

I am proud to say that in this country we have by far the best police service in the world. The things they do and the dangers they face without a gun on their belt. The professionalism they show at all times is nothing short of amazing. That is in the face of your assault on their salary, their pensions and their working conditions. Now you are making a career in the police as unappealing as possible by slashing the starting salary and rushing through the 'Eton Old Boys' to top ranking jobs without ever having to be spat at, kicked, punched, stabbed, shot, sworn at, had missiles through at them and put their lives on the line. It is plain and simple Dave. There are not enough of them any more. Not enough by a long shot. So, in the words of Oliver Twist, 'Please Sir, can I have some more?'

Just a thought, you know that publicly owned bank, RBS? You know, the one we all bailed out with our taxes. Well they are paying their staff £950,000,000 in bonuses this year. As they are PUBLICLY owned, why not use the money to fund the salaries for 38,000 new police officers on £25,000 a year. I think my maths is right. There are other banks to you know. Other ones we all helped fix. How about they now help fix us? I know, I know, I'm probably not looking at the bigger picture, but in that big picture I just see the words 'No Units To Send'. Silly me.

By the way Dave, this wasn't a work of fiction for effect. This actually happened. To me. Have a read. http://www.barnettoday.co.uk/news.cfmid=3449&headline=Man%20in%20court%20for%20paramedic%20assault

Good luck with the economy Dave, there are tough times ahead.

Your Sincerely

Ella Shaw (Public Servant)

Me, Myself and Ambulances

"27 year old female, bored, hacked off, fed up and tired"

This is my blog. I have have been writing it for about 15 months and it has helped me no end. It gives me focus at work, it has made me a better clinician and has helped my health in a number of ways. I may be opinionated, I may be judgemental and I may be hot headed but that is my way of venting about what I see. This blog isn't real life. Look on it as a work of fiction if you will loosely based on real events. 

I'm bored of having to tell a select few people that I AM NOT breaching patient confidentiality when I write. I'm not stupid. I would never write anything which could be linked back to specific person. 

I'm fed up with people leaving insults and threats because they disagree with me. If you have a different opinion, share it. Ask me a question. Don't spit feathers at me, don't climb on a high horse and get all your mates to leave similar comments and don't patronise me.

I'm hacked off with having to write this post to explain myself AGAIN. I have never received a complaint letter. I have received plenty of thank you letters. I have received commendations. I act professionally at ALL times and treat ALL others how I'd like to be treated.

I'm tired of losing sleep because of trolls, bullies, intimidators and those that threaten me. No more. Until now I have never blocked anyone on twitter and I have never deleted a comment on my blog. That ends today. I'm not taking crap from a tiny, tiny minority. It may only be about 5 people who have moaned out of the 70,000 who have viewed by blog this month but it's those 5 that have ruined various days and various much needed sleeps. 

So, to everyone who is unclear and thinks I'm full of hatred, classist, unprofessional, discriminatory and whatever other term of endearment you can come up with, this is ME from the 'about me' page on my blog. Read it, absorb it and if you don't like me, or my blog please please please go away and don't come back. 

*          *          *          *          *          *          *

My name is Ella Shaw. I work on ambulances somewhere between Lands End & John O'Groats and in my spare time, own a 5 year old boy. 

Ambulances: I didn't always want to do this. I'm not going to lie and say it was something I dreamt of, in fact, until I saw the advert in 2008 the thought hadn't crossed my mind. I suppose I applied on a whim; just looking for something to get me out of the dead end 9-5 I'd been in. To my amazement I got the job. I completed my training and off I went into the big wide world of ambulances, and I haven't looked back since. It was by far the best decision I have ever made.

I have always been the type of person that questions right and wrong and in this job you experience a lot of both: politics at local level, government policy, patient behaviour, staff attitudes, life or death and everything in the middle, and I find myself asking questions. Invariably that involves an indignant rant and grumble but that's me. I'm a full time cynic, part time pessimist and a conspiracy theorist at weekends. I love a good moan but I can't stand moaners. That's my right. Deal with it.

The Boy: The boy means everything to me, part of why I wanted this job was to have a career to support him, the security of a job that will always be needed and the regular salary and pension to provide for him. I am immensely proud of him, he is funny, intelligent and happy. He has also sleeps through the night which has helped with shift work! He is a huge part of my life and when you ask him what I do he replies

"My mummy is a paramedic, she works on the ambulances and looks after the ouch. And if someone falls of their bike you call 999 and my mum comes. And looks after the ouch."

Need I say anymore!

The Blog: I’m writing this blog to vent frustrations, share experiences, provoke debate and educate people as to what life is really like on the road as I see it. I don't have the wealth of experience that many do but I don't think you need that so much to form opinions. I may have only been on the road for 4 years or so but in that time I've seen and learnt more than my entire life before that. I’m lucky enough to have a great job; I work with great people and strive to be the best I possibly can be for my patients. Some patients were sent to test me, some were sent to amuse me and some just baffle me, and despite my ramblings I generally look forward to work each day. I love my job. 

All my blogs are loosely BASED on real experiences and feelings, though I do use poetic license to protect the identity of my patients, their families and my colleagues. All names, ages, nationalities and locations have been changed as to uphold their anonymity. Please do not read a post and think that I am talking about an actual patient. I use my experiences to create a post to express how I felt at the time or how I feel about a certain topic. It's my way of dealing with what I see. All opinions shared are mine and mine alone. I hope you enjoy reading and welcome any comments and opinions. That said, there is a big difference between offering a different opinion and having a debate, to trolling, bullying and threatening me. That WILL NOT be tolerated. I am not representing any particular ambulance service (I work for 3) or any professional body. 

You can also follow me on Twitter @diagnosisLOB or join me on my Facebook page. If you don't like what I have to say, don't read it. I will make no apologies for my opinions. Though I welcome all comments, good and bad, if you over step the line, insult, patronise or get all high and mighty on me, your comment will be deleted. I write this blog for me and the people who enjoy it. It's that simple!

Thanks for taking the time to read,

Ella x

The Three Stooges

“43  year old female, chest pains”

This job set the tone for what would turn at to be a very familiar night shift. I exhaled in frustration when I saw the address. It was one of the many regulars on our patch. She was a wine-drinking alcoholic; she always called for chest pains, always went to hospital and was always rude and obnoxious. Tonight would prove to be no different to the norm. We stomped up the concrete stairwell, navigating our way past the vomit on the stairs. Lush! Her door was wide open like it always is. We walked down the landing to her bedroom like we always do and found her lying on her bed smoking a fag like we always do. Then followed a very familiar conversation.

“Hello again”

“Alright luv”

“What’s the problem tonight?”

“I got chest pain”

“Same as before?”

“Yeah”

“Can we do an ECG?”

“Yeah, go on then”

We do the ECG and all her obs. They are all normal like always. 

“Shall we pop you up to hospital?”

“Yeah, I need to see a doctor.”

"Still got the pain?"

"Nah, but it should be checked out."

So, without any fuss he all walked (she staggered) arm in arm to the ambulance. We drove to the same hospital as we always do, where I gave the same handover as I always do. On to the next!

“37 year old female, suicidal, taken an overdose, police on scene”

We all say that the first job sets the tone and shifts have a theme but they really really do and I don’t know why! This address was also well known to us. It was the residence of the most abusive drunk in our area. I say abusive, she abuses the police and most ambulance crews but for some unknown reason she loves me! We pulled up next to the police car, which seems to be a permanent fixture outside her flat. In the hallway outside was one of the coppers.

“Good luck, she kicks off every time I go inside”

Sitting there in her underwear and dressing gown, she swigged vodka while smoking a roll-up. Her face lit up as soon as she saw me.

“Heya babe, tell the pigs they can go and you don’t need them”

As much as calling the police 'pigs' wasn’t acceptable, in all honesty, their presence was only going to make things worse and I knew they’d be only to happy to leave.

“I’m happy to deal with this, I know her well, she’ll be fine with me”

They were only too happy to leave and were gone near enough before I'd finished the sentence! It was the same story, drinking vodka to excess, self harmed her forearms, refused hospital and then there was a 45-minute battle to convince her to go. Sometimes she wins and sometimes I win. Tonight I won. Hospital was the plan and all we had to do first was go through the charade of collection her ‘valuables’ (vodka) and hiding them so they can’t be stolen. After completing this ritual we headed off and handed her over to the less than enthusiastic nurse. 

We left the hospital to go and get fuel and hopefully a Wild Bean coffee and a pre-packed sandwich. It really is 'gourmet on the go'! Well actually it wasn't because we never made it. We were flagged down by a member of the public for what appeared to be an unconscious man in the street.

“u/k male, unconscious, running call”

We called it in and were sent down a CAD number. It shouldn’t have surprised me that he was well known to us. I had picked him up yesterday about 200 yards down the road. In fact, he was being picked up 3-4 times a day, each time by an ambulance and each time taken to hospital. The problem is, each time, the hospital sober him up enough to be able to walk and then either sit him in the waiting room until he walks out or discharges him. He walks up the hill to the shops, buys more booze, drinks said booze and passes out again. The hospital are not willing or able to invest time in fixing the problem & we have no ability to anything else with an unconscious drunk person other than take them to hospital. The cycle will continue until he stops drinking or dies. The latter seemed most likely. 

Tonight, he was lying at the bus stop next to his empty bottle of scotch. He was face down and had wet himself. I often wonder what he was like before this. What kind of life did he lead? What family does he have? What friends did he have? Now there appears to be no one. The only people around him are the members of the public who call 999, the ambulance crews that take him to hospital and the nurses that kick him out. What can we do?! We scooped him up off the floor and onto our bed. We did the usual obs and then drove the half-mile to hospital. We got the usual looks of distain from the nurse and rolled him onto the bed. To be fair to the nurse, we had just brought in three abusive alcoholics in as many hours, but still……not our fault!

Alcohol is something that the NHS does not do well, a bit like obesity. We only treat in the short term when it is too late. Very little is done when warning signs are there. Accessing services is far to difficult and it is a lot easier to just give a bag of fluids and let them go than find out the cause and refer to the appropriate places. It’s a shame, if they invested in prevention rather than cure, the long term saving could be huge. Shame no manager or politician is ever that long sighted.

Off we went for fuel, this time we made it. The sandwich was rank and the coffee was a poor substitute to Costa but beggars can’t be choosers! After the start to the shift we had had it was a necessity! We went off and did a few more jobs to a different hospital and at about 2am came back to our area. We handed over our drunken teen to the staff and booked them in. I walked through the busy waiting room and what did I see?! All my regulars sat in a line on the bench together! The Three Stooges! That image summed up how the NHS treats alcohol and mental health. A sad sight but one that amused me! 

“Evening all!”