Showing posts with label Guest blog. Big Fashionista. Show all posts
Showing posts with label Guest blog. Big Fashionista. Show all posts

Monday, 11 March 2013

The Thin Green Line

This is a post written by @FatManonaBike on his blog 'Fat Man on a Bike'. I felt it wonderfully sums up the struggle and reality that the NHS is facing and well worth sharing with one and all! Enjoy!

"The Thin Green Line"

There are few things in life about which I can speak (or write) with any kind of authority, and cycling certainly isn’t one of them. Neither, for that matter is politics, nor the subject of this post: the current failings of the National Health Service.

To be fair, that’s a little bit unfair. The NHS is not failing. Given the kicking the NHS receives on a almost daily basis by the men in suits that control the money, it’s an absolute miracle that the UK has a health service at all. Despite terrible funding cuts (or, no less difficult to manage, insufficient funding increases), inappropriate decisions made by people that have little idea what planet they’re on, and the ridiculous notion that healthcare is a profit-making scheme, the NHS still makes sick people well, and does so with dignity, professionalism and compassion. I work for the NHS. I’m one of those chaps in green outfits, as seen on Casualty. No…not Jimmy the Porter…more like Josh Griffiths, but good-looking and with hair. I’m frequently told, “Oh, I couldn’t do your job”, which clearly means I’m made of tougher stuff than some of you. This, in turn, means that I could duff you up in a fight and, therefore, unless you wish to find your nose bloodied you should stop what you’re doing and pay attention. This is your NHS, and like the punch-drunk boxer struggling to stay standing, it’ll only be a matter of time before a suited politician comes along to put it out of its misery.

Earlier in this post, I told a lie. It was unintentional, but a lie nevertheless. This isn’t about the failings of the NHS per se, but a small part of it. In fact, that’s probably a little inaccurate, too. This post is about inadequacies, not failings, yet such inadequacy will invariably lead to failure for the unfortunate minority. Sadly, such failure doesn’t mean that a business folds, a shop closes, or someone has to go back to working on the bins. Without being even slightly melodramatic, it means people die. Actual proper death. Gone. Brown bread. It could be you, your mum or dad, your wife or husband, brother, sister, girlfriend, boyfriend, etc. I think you probably get the picture without me listing all possible relationship statuses. Dead. To your terrible sorrow is now added bucketsful of anger. You watch, helpless to save your loved one dying, still waiting for the ambulance three hours after you called.

Ambulance delays are now an everyday occurrence. Fact. Lengthy delays. Life-threatening delays. 

There are always occasions when delays are inevitable. Ambulance services are not immune to bad weather, heavy traffic, or the overwhelming desire of the general public to get pissed, then have a fight on New Year’s Eve. Heavy snow can turn a six-mile journey into a three-hour affair, but this isn’t the shit I’m talking about. I’m talking about your average day. A Tuesday, perhaps, because nothing of note ever happens on Tuesday. On every single average day, many lengthy delays can and do occur.

By now, an Ambulance Service manager, hot under the collar and fuming at my words, may be preparing to lynch me. That’s fine, but I suggest that he or she reads on first. I have a point to make before I swing. The point is that such terrible delays are not our fault. On paper, provision of ambulance cover is just about adequate. In practice, it would be equally be just about adequate were it not for closing Accident and Emergency departments, false or shelved promises of new super-hospitals, reductions in hospital beds, forced redundancies of hospital staff, and a whole host of other problems created purely by penny-pinching, blinkered civil servants, keen to make a saving that ultimately ensures their job security in the next reshuffle. The city in which I work does not have an A&E department, and hasn’t had one for over ten years. In the last two years, the towns on either side have also lost their A&E departments. The super-hospital that was promised prior to closing those A&E departments is invisible or, more probably, unbuilt. So where do ambulance patients go now? Very simply, they go to an Accident & Emergency department. An Accident & Emergency department that can not, for very obviously-logical reasons, cope with the additional influx of the sick, dying and dead. An Accident and Emergency department in a hospital that has had the number of beds, nurses and doctors reduced. An Accident & Emergency department that has ambulances queuing for hours outside it’s doors. The ambulance simply pushes the first domino, and they just keep on falling.

If you’re expecting me to have the answers to all these problems, you’ll be disappointed. Clearly, running the NHS as if it were a business, rather than as a publicly-funded healthcare-providing service, doesn’t work. Beyond massive cash injections, restoration (or an increase) of the pre-existing healthcare provision, u-turns in political policy, careful and considered spending, and people having the balls to admit that not all the implemented changes work, I fail to see how or when the NHS can pull itself away from the ropes and come out fighting.

Thursday, 31 January 2013

3am

I was a total surprise when the much vaunted and incredibly talented blogger Big Fashionista asked me to guest blog for her. Not only was I massively chuffed but was also massively nervous! A new audience, new people to critique my writing! I didn't have a clue what to write about so stuck with what I knew best. Blood and Guts! Thanks again to Kellie for inviting me onto her blog. It was an absolute pleasure. Please follow her on twitter @bigfashionista and visit we website www.bigfashionista.co.uk. You won't be disappointed! Promise! Anyway.....here is my blog that appeared on her website!

"18 year old male, fall from height, cardiac arrest"

I had been driving for the best part of 8 hours on the wrong side of the road. Not because the traffic was busy and I was on blue lights, but because I was driving back home from Europe after an impromptu few days away. The kicker was that I had a night shift to get back to. I got home at about 4pm, quick shower, ironed uniform and off I went for my 6pm start. In all honesty the prospect of a 12 hour night shift filled me with nothing but dread, but what's a girl to do!? Things started just as expected and just as they always do. A job, straight away; quickly followed by job after job after job after job. It was a typical Friday night; all alcohol or drug related, just a thoroughly exhausting evening. For those of you who have worked night shifts you will know exactly what I mean by 'the 3am lull'. Eyes are heavy; an overwhelming sense of fatigue engulfs you and the thought of another three hours, three patients, and three lots of paperwork makes you feel physically sick. Your handwriting is getting worse and worse, your mood is becoming more and more fragile and your patience is well and truly gone! You spend 15 minutes at hospital eating sweets, drinking coffee and doing anything you can just to stay awake. It really is a horrible experience and if you can go through life managing to avoid 'the 3am lull' I highly recommend that you do! 

Well, it was 03:11, the rain was pelting against the windscreen, it was dark and cold. We pressed the button knowing full well we'd get a job straight away and headed out of the hospital. If anything will wake you up, this job will. The words 'cardiac arrest' still gives me the adrenaline rush, the pumping heart and the excitement.  Two miles to travel, that was all. I lit up the roof, turned on the bells and off we went. There was still plenty of traffic about and with the torrential rain filling the roads it was a nervy drive. Visibility was terrible, road marking and signs were invisible and all you could see was the headlights and brake lights of cars. I have never seen rain like it to this day. We pulled off of the main road into some kind of alley way. 0.1 miles to go, surely we would see something soon? We got a message to say the response car was on scene as we turned around a tight left corner. That was the moment that I can see like a freeze frame. No more than 50 feet away was a silhouette of someone doing CPR, lit only by the strobe of the blue lights. The rain was cutting across the view at a 45 degree angle and there was a constant whistle of wind pelting down the alley. We ground to a halt about 5 feet from them, grabbed some kit and ran over. 

Lying on the floor, illuminated by headlights was our patient; he was in the gutter of this tiny cobbled street, a crowd was gathering a few feet away and to be perfectly honest, what they could see wasn't a pretty sight. Because of the background noise, there was a lot of shouting to let each other know what we were doing. All we knew was he had fallen, where from we didn't know. Apparently he had been breathing for a few minutes before, but had now stopped. There was blood everywhere; the guy had landed face first and had massive cranial destruction. It took two of us to vaguely secure his airway but no sooner as we had suctioned blood out of his throat more appeared. HEMS arrived within a couple of minutes and took the pressure off. The six of us worked on him for about half an hour, his chest was cut open, his lungs decompressed, drugs were given and I was just watching it all in a rather detached state. I was ventilating him; once the airway was secure it was a case of kneeling there, in a pool of rain and blood, just breathing for him. I remember looking and staring at his face. A young guy, good looking, an entire life time ahead of him and here he was. Lying motionless, dead in the gutter, doctors, paramedics and technicians tirelessly working to save him and I was thinking 'what a waste'. From his head, I could see every injury he had. It would need a miracle to survive the trauma his body had suffered. It was a very disturbing sight and one that still haunts me from time to time.

He was declared dead on scene. There was that moment when the decision has been made, you have all agreed to end the resus, CPR is stopped and you take away the mask. That's it. His final lifeline. Until that point there is hope. Until that moment you have the distraction of the situation. Now you are aware of the crowd again which is now 100 strong. They had watched on in the rain. Just staring, in silence. They had seen every compression, every ventilation, every incision, every needle, every shock, every drug, every effort we had made. It is most likely the single most distressing thing most of them have seen and will ever see. In many ways I felt like I'd let them down. Stopping a resus is always a bit of a tough moment, doing it in public you can feel all eyes on you as you step away from the body. And that is all it is now; a body. He was covered in the blanket and as we stepped back, all in a daze, we found out what had happened. He had fallen from the roof, the roof of this 4 storey building. A 70 foot plunge. No one knew what happened. Was it suicide? Was it an accident? Was alcohol or drugs involved? What was his name? Why did no one know him? I don't want to think what was going through his mind as he fell. I hope nothing. I hope no one has to suffer that fear of inevitability. That moment before death. A young man with endless possibilities ahead of him had lost his life and whatever the cause, it was tragic. We all piled into the ambulance for the debrief. Everyone just sat there feeling thoroughly dejected. The saturated, blood soaked uniforms a stark reminder of what this job can throw at you. One thing was for sure, I was very much wide awake now. Only an hour and a half until the end of the shift. A quick uniform change and time for one more...


Since writing this blog, I was send a newspaper article, detailing the circumstances of this tragic accident. It spoke of a talented young man who fell to his death after a night of alcohol and cocaine. What a awful waste of a life. 

Monday, 28 January 2013

Have Yourself a Mental Little Christmas

After a recent spike in mental health calls I thought it would be good to do a blog on the police and ambulance service working hand in hand to get the best outcome for a patient. Mental health doesn't have to mean someone who looks like Freud, making chicken noises while head-butting a tile wall. (I'll post that shortly.) It encompasses a wide range of people & conditions, some permanent, some temporary. Some require intervention, some don't. The police service and the ambulance service generally work together trying to try and get the best, less restrictive and most appropriate outcome for the patient. I asked my friend and fellow blogger Mental Health Cop (@MentalHealthCop) if he had any suitable blog fodder for me! He sent me a tale of a job he had done at Christmas and said I could make something up to suit my needs! Having read it though, I thought it would be much better coming from the horses mouth, so asked him to guest blog for me. A few hours later it arrived in my inbox accompanied by the following:
"You can blah on your intro about what an honour it now is to have an award winner from the best emergency service!"
He would want you to see his badges ;-)
I can't really argue. He has won awards. And deservedly too! It didn't surprise me he has tried to use the titles to try and add weight to his ever failing argument that the Police are better than the ambulance service. Bless him! 

So. without any further ado and with as much pomp and circumstance as I can muster; to the sound of fanfare and drum rolls and a dose of pained sarcasm,  I welcome the one,  and the only, Inspector Michael 'The Guvnor' Brown, author of the award winning blog Mental Health Cop, winner of the Mind 'Media Award 2012' (presented by Stephen Fry) and holder of This Week in Mentalists 'Best Mental Health Not Otherwise Specified Blog' award. I wish that one day I can be as cool as he is! It really is an honour to have such a well respected member of the second-best emergency service come to my blog! 

*cue the cheerleaders*

Enjoy ;-) x

*          *          *          *          *          *

"Male, u/k age, lying in road, ? intoxicated"

My last guest post for Ella was "Policing Violent Healthcare" - and against that backdrop I'd like to tell you a Christmas Story ...

I got to work the Christmas Eve night shift last year, finishing at 7am on Christmas Day. It was the busiest shift I've had for a very long while. By about 3am, all I wanted was some hot coffee and hot food and an easy descent to 7am so I could get home to watch Master MentalHealthCop ripping into presents with yet more coffee for me. Instead, I got to work hand in glove with some awesome paramedics at a difficult job.

Just prior to 3am, two uniformed officers in a plain car were driving down a street when they came across a man lying in the gutter. Initially presuming they'd found a Christmas Eve drunk, they got stopped and got out to check him. He was pretty motionless lying over the kerb, legs in the road. Upon closer inspection, they saw a massive, gaping wound to his neck. The split flesh was inches apart, underlying muscle exposed and bleeding profusely. The guy was in and out of consciousness and it was obvious he was under the influence of something, but no smell of alcohol.

There were members of the public nearby. The officers didn't know whether they were witnesses, suspects or just people watching the police. They shouted up for more resources and an ambulance, but there was a tone of anxiety in their voice on the radio. I got down there ASAP, the next police car to arrive - it always pleases me when I get there before the sergeants! By this time, one officer was focusing on the victim, the other on the other people present and the scene management. I confirmed to control that we needed at least four more officers (and the sergeants!) to manage everything. There wasn't a clear picture about what had occurred, but he'd obviously been slashed or stabbed in the neck by someone.

West Midlands Ambulance Service - officially the best in the country (sorry Ella!)  - were there quickly after we'd called them. Two paramedics were out of the truck and assessing this guy very quickly. They didn't do much before saying, "We've got to get him to hospital." A pressure bandage was applied to his neck area and officers and the other paramedic tried to help him to his feet. I asked an officer to accompany the man to hospital with standard instructions: seize clothing, pre-transfusion blood sample request; early updates on condition to indicate life-threatening or not; any account that the victim provides to medical staff and if / when authorised ask him what happened.

They then disappeared into the truck and I focused on getting the scene sorted and getting the people present properly questioned. The sergeants took charge of it once I'd briefed them and we started to really notice how cold it was - once of my officers told me off for not wearing a jacket, but I pointed out, as a Geordie, that until the temperature hit minus four, I wasn't allowed. Suddenly, the back doors of the ambulance flew open and out leapt the patient in some considerable stated of excitement. He was, by now attached to an IV line with dressing half applied and this was trailing in the wind as he attempted to speed away and the paramedics were out of the back just after the officer who was half-holding on to his trailing arm.

I really worried about this guy. He was still bleeding profusely, he was quite obviously under the influence of something and his communication indicated that he was struggling to process information. Yet he was a victim of crime, not a suspect. Were we going to let him run off from medical treatment into the Christmas night, or not? No - it took me about two seconds to decide that if we have to sit on him and handcuff him to ensure the paramedics can work and take him by force to hospital for proper assessment, that's what we were going to do.

Where is the law that supports this? The Mental Capacity Act 2005. I have written about this on my blog and in this case it was clear cut, although I had to explain it to the officer who restrained him with me. "Yes, you can handcuff him - get the cuffs on!" I understand why officers who are not obsessed by the Criminal Justice / Mental Health interface are nervous. There's is no obvious legal authority to restrain victims and no training on the Mental Capacity Act for the police. Yet legally, it's clear and it applies to paramedics too, if they had to take action when the police are not there.
  • We can safely say this man lacked capacity: he appeared to be suffering a disturbance of the mind (temporary) because of suspected drugs.
  • He was struggling to communicate, understand, retain or employ information.
  • This is a quick capacity test made known to me by a paramedic: "ID a CURE" 
And so he was restrained all the way to hospital. In A&E, the urgency of the need to treat him was reflected in the fact that he was quickly sedated and taken for emergency surgery. Had he not been taken, he would have died in the opinion of the doctors.

This shows how the Mental Capacity Act can be used. When we debriefed it, the officers there 'knew' the (morally) right thing to do, was restrain him and force him to A&E. They worried about the legalities, as do some paramedics, but it was perfectly legal and totally proportionate to the (life-alterting / life-threatening) risks involved of not acting.

Incidentally, Mrs MentalHealthCop bought me a funky new coffee machine for Christmas - she's a good girl and knows what flicks my switch after a night shift! ;-)




Thursday, 21 June 2012

3 am




This is an ambulance blog right?! So, you can imagine my surprise when I was asked to guest post for Big Fashionista! She is a powerhouse in the blogging world so it was a real honour to be asked to write for her ,but what about?! Fashion, beauty, lifestyle, her much vaunted Nom or Vom?! Luckily for me, and probably you too, it was none of the above! She just wanted a blog, about a job I've done, that I wanted to share with her many readers!


"18 year old male, fall from height, cardiac arrest"



3 am is a cold, dark, wet, blood soaked account of one of those nightmare jobs that stay with you. Go have a read on Big Fashionista's website and while you are there enjoy some of her fabulous posts!




A big thank you again to Big Fashionista for inviting me on to her blog. I am not ashamed to admit that I did a happy dance when no one was looking!