I'm just a Fire Starter

"25 year old female, mental breakdown, setting fire to her room"

This had all the ingredients to be 'one of those jobs'. By that, I mean a job needing diplomacy, co-operation from mental health services and patience. It may also need police and fire, the latter of which I could happily do without! Mental health jobs kind of excite me in a weird way. I know that it will be tough to deal with, I know I will end up getting frustrated and wound up by the lack of options available to me and ultimately I know I'll probably end up blogging about the shoddy mental health care that patients have access too! Then again my fascination with mental health and psychology makes me gluten for punishment!

We pulled up outside to see a police car parked up. As we got out Trumpton pulled into the road, sirens blaring, causing curtain twitches galore to appear in their windows. Bear in mind it was 2am. There was absolutely no need for sirens on residential streets, but that's 'pet rescue' for you. As we approached the front door one of the coppers came out. 

"Evening ladies, she's upstairs, I'll send Trumpton back to bed!"

It's as if he was reading my mind! I headed up the stairs and followed the noise that was coming from one of the rooms. It was a halfway house for people recently discharged from the local mental health unit and there was an office at the end of the landing with a rather fed-up looking woman sitting inside. She just pointed at the room where the noise was coming from with a shake of the head. 

The police explained that she had been discharged for the mental health unit about 6 hours previous and had been 'freaking out' ever since she arrived here. She had been setting fire to documents and her mediation and was doing so because the voices in her head were telling her to do so. I made various attempts to talk to her without success. I like to think I can talk to mental health patients, some can and some can't. Normally I am able to, but sometimes patients either won't engage at all or will only engage with people who have gained their trust. In this case, she wouldn't engage with anyone. Stupidly I turned my back to talk to my crew mate and a water bottle came flying across the room and got acquainted with the back of my head. No cut, no lump, no harm done, but still.....uncalled for!

The police were savvy enough to know that jumping on her for assaulting me would have been of little benefit so it was ignored. She was scared, unsettled to say the least and was surrounded by police and an ambulance crew. We were all there to help her but I imagine it didn't feel like that. She said she wanted her case worker and that he was back at the mental health unit. As far as we were concerned, that's where she should be and as she had only just been discharged the plan was to take her back. With that suggestion she frog marched herself out of the room and downstairs towards the ambulance. I simply followed! That was easy!

Once on board we convinced her that it was in her best interest to let us check her over medically so that the unit would have no qualms about accepting her. She was medially fit as far as I was concerned. No alcohol in her body, no unauthorised drugs, no injuries, nothing! Excellent! Off we went, police in toe! 

So, there we were, 1 x patient, 2 x ambulance staff, 5 x police officers and 1 x mental health worker from the half way house. All 9 of us bundled into the lobby of the mental health unit. Behind the security glass that would rival most banks was a collection of staff. We were ushered round to the door to hand over. I explained what had happened and why we were her. Her response:

"She's not coming in here."

"Why not?"

"She's been assessed and discharged. There is nothing wrong with her mentally. It's just behavioural problems and attention seeking."

"We are called to a young woman, discharged from a mental health unit hours previous who states she is hearing voices and is setting fire to her room. She has anti-depressants and anti-psychotic medication. She clearly does have some kind of mental health problem and that is why we are here."

"Well she doesn't. I assessed her myself, we aren't here to sort out peoples behavioural problems."

"But you are here to help sort out voices in someones head."

"She doesn't have voices."

"She says she does."

At this point, one of the coppers took over.

"We believe she is suffering a manic episode, the employee at the mental health half-way house agrees. If she doesn't have any mental health problems why are you putting her in a building for people recovering from mental health problems?"

After a brief pause..... "She'll have to go to A & E first. We can't accept her until she has been cleared by A &E"

"A minute ago you said you couldn't accept her because he hadn't got anything wrong with her! We have brought her here to you, this is the most appropriate place for her and the fact you discharged her less than 5 hours ago, to me, makes it a failed discharge. I suggest you re-assess her because your initial lack of diagnosis has been found wanting."

Another brief pause...... "Bring her through."

HURRAH!!!! Oh the joys of a mental health unit! To be fair, I knew it was never going to be easy! With my blood pressure suitable raised and my mood suitable lowered we trundled off to the ambulance so I could have an expletive filled rant in private! Good times!

Unhappy Trumpton.....Bless!

"Fire Brigade concerns at ambulance delays"

I woke up this morning after a long 12 hour shift, to see a BBC article about the fire brigade YET AGAIN trying their best to undermine the ambulance service about response times. Don't for one minute think, that the complaint actually has anything whatsoever to do with them waiting for us. It's part of their ongoing attempt to assume control of the ambulance service so they can play the part of 'Action Hero' and deal with fire and medical emergencies like they do in America.

Last year I wrote a blog called Fire Brigade: Hands of our Service detailing their attempts to take our work away. And they didn't want to take everything, oh no. Just the high categories of calls. The juicy traumas, the cardiac arrests and the sick children. Basically, all the stuff the public would hear about. Funny that. 

Today's tripe wasn't their own story either. It has basically been copied and pasted from an article about how the police service are having to wait a long time for ambulances, which in fairness, they do! Equally though, we often have to wait for police. What gets me though is that the fire brigade take this stance and justify it by saying that they are never delayed. I've said it in previous posts but I'll say it again! THAT'S BECAUSE THEY ARE WAITING FOR CALLS! We are not. The police are not. Both services have more calls than there are resources for and proportionally both have much smaller budgets than the fire service. Not wanting to sound like a broken record, but in London alone there are 1.8 million calls a year to the 230,000 the fire service receive. London ambulance attend 1.3 million of those. The LFB refused to attend over 110,000 of those calls (almost 50%), only 29,000 were fires and they also charge for a lot of the calls they do attend! Their budget is eight times ours! We can't compete and should not be compared!

They speak of 'desperation' when following up on the status of emergency calls! Do they think the ambulance service forgets about them?! An ambulance will arrive when there is one available, no matter how many times you ring and moan, it won't speed up the process! One thing that was also omitted from the report was the amount of fire calls the ambulance service attend unnecessarily! In my ambulance career I have been to in excess of 30 'House Fire, persons reported' jobs, and only once have we had a patient. The rest we have been there just in case. What a waste of a resources. Only last week, I went to a cardiac arrest and there were no other units to assist me and my crew mate. We were on our own for 40 minutes. 800 yards away was a 'house fire' with an ambulance and an FRU standing by because the fire brigade had requested them. There was no patients at all. Looking for causes of delays?! There's one!

Yes, there is a problem with responding to all the calls the ambulance services up and down the country receive. There are not enough ambulances and not enough staff, but that is no reason to jump on the band wagon, for personal gain, with no real point other than undermining the work we are doing. Air your complaints at the government, not the ambulance service. You'll notice that in the article, all the speculation they made, not one incident was reported where the delays in getting an ambulance caused anyone to die or suffer in the long term because of it. No where did it say that the private ambulance that was dispatched, with 'untrained' staff, to an RTC didn't in fact deal with the patient they had. The article, like most others that the fire brigade release as part of their propaganda campaign, is baseless. 

Perhaps as a solution they could offer up some of their exorbitant budget to us! Apparently us paramedics agree with the fire service but are afraid to speak out! Funnily enough, they had no anonymous quotes! I certainly don't agree, and I know most of my colleagues will feel the same way.

Stop this nonsense, concentrate on ducks in ponds, dogs down badger dens, cats in trees, cows in ditches and the odd fire and if given the infinite resources you have, we'll match your response times and come and wait on standby at your fire calls even quicker than we do already. It's worth remembering that whilst the fire service deals with fires, pet rescues and major RTCs, we also deal with the fire's and the RTCs too. On top of that we deal with the millions of emergency medical calls, we are an OOH social service for GPs, mental health teams & patient transport services. We are addiction councillors and a taxi service to the nations drunk people. I'm really looking forward to writing a post about the paralytic fireman I picked up from a bus stop last week!

So, yet again my dear fireman, get your own house in order before you try and take ours! Hands off our service!