That's Life

"19 year old female, vomiting"

The ambulance service is no different to the police when it comes to 'one of those shifts'. No matter what you do, no matter what attitude you start the shift with, it is just a bad day at the office. Its non stop; everyone you meet is rude to you. People spit, people are violent, people piss and vomit over everything. Everyone needs carrying; no one needs hospital but want to go all the same. The shift drags and drags, when you look at the clock, already exhausted, there is another 7 hours to go. Passers-by are rude, hospital staff are dismissive, it feels like everything and everyone is against you, and no matter what you do or say it's wrong. Hitting your head against a brick wall is simply not satisfying enough. You find yourself accusing Murphy of being an optimist, whatever can go wrong, will go wrong, and then some! Only when the shift is over can you draw a line under it, it was just one of those shifts. 

• First job was a 22 year old with a headache; she wouldn't listen to our advice, refused to walk and threw herself on the floor so we ended up carrying her. She then complained because we had taken too long to arrive. The hospital staff asked why we had brought her in. BECAUSE SHE WANTED TO COME. That set the tone. 
• We moved off to a grim part of town to a 32 year old with a twisted knee. He was an alcoholic. He was lying on the floor. He was 25 stone+. He wouldn't help with getting him up. He refused to try and move his knee. We carried him. At hospital he simply got up, and walked, without limp, to the toilet. 
• Our next contestant was a MH patient. Suicidal and then obstructive. After 2 hours of coaxing we got her on board. A regular caller, known to us, the hospital and police. She had just been discharged. On arrival at the hospital the nurse in charge refused to accept her. The police had no units to send. The patient refused to get off our bed. We can't force her off. So we waited in the corridor for 2 hours. The hospital staff were extremely rude. What are we to do? Leave a suicidal woman who won't tell us her address, alone at night, in the street, screaming?! 
• Now we went 10 miles further out of area to a 19 year old, unconscious. He was drunk. Lying on the floor. The FRU had been waiting for us for an hour. We got the guy on our bed and in the warm. He promptly vomited everywhere.
• In unfamiliar surrounding we went to a 1 year old, unwell. The parents were obnoxious. They had called because the kid had a blocked nose. As if that wasn't ridiculous enough, they had already been to hospital and were discharged 3 hours previous with a prescription. As it was the middle of the night, no chemist was open so they called another ambulance to take them back. The mind boggles!
• Now to a police job. It was literally 20 feet from one of our trauma centres. Our patient was under arrest and unconscious for assault. His victim had already gone to hospital. We were not allowed to take him to the same one but as he had head injuries and was still unconscious we had to take him to a trauma centre. That meant a long blue light run across London. I say unconscious loosely. We thought he was but he wasn't. No response to pain, took an OP airway, didn't respond to all the other little tricks we do. On arrival at the hospital when the arresting officer came into view our GCS 3 patient jumped up and started fighting everyone. We got spat on. 

We had had enough. There was only time for one more job. We had cleaned the ambulance again. All I wanted to do was go home to bed. 

• 19 year old female, vomiting, intoxicated

My crew mate and I just looked at each other; Of course, what else would it be? A polite, little old lady fallen on the floor? Not a chance! Me and my crew mate have a great working relationship and have similar likes and dislikes. We also have little rituals we go through each day, music being one. We have various compilation CD's for different moods. As soon as this job came down, he shook his head and changed the CD. The song we played whilst driving through the empty streets is one we always play after or before a load of tosh. When things get too much it makes us feel better. It really does! Try it. Police, ambulance staff, nurses, Drs, in fact anyone having a bad day, sit down, turn up the volume, lay back, press play, and close your eyes. Just do exactly what the song says. Every time you find yourself flat on your face, pick yourself up and get back in the race. That's Life.

Frank Sinatra - That's Life

Silence Hides Violence

"33 year old female, chest pain"

NB: This post is about Domestic Abuse, so for anyone who has been a victim or knows someone who has, reading may cause distress and provoke painful memories.

We were trundling back to station towards the end of our shift when we got sent the job. We were only a couple of minutes away so were on scene quickly. The address was given as 'above the shops'. Flats above shops can often be very difficult to access, mainly because the entrance is nowhere near the corresponding shop number. This particular flat was accessed via the rear of the shop from an alley way. After a few minutes of looking we found it, but had walked a considerable distance from where we had left the truck. I went in to see our patient whilst my crew mate went to move the vehicle closer. I was greeted at the door by our patient's husband. He was a polite guy and gave me a very full handover of what had occurred. She suffers with anxiety and had a panic attack, but had some residual chest pain. Which seemed reasonable. I entered the bedroom and Claire was sitting on the bed. It was obvious she had been crying and appeared very timid. Her voice was quiet and shaky. I started asking my usual questions about the chest pain whilst trying to get her to slow her breathing down. She said the same as what I had already been told but wasn't giving me very clear answers about her symptoms or cause of her anxiety. I became aware that before and after everything she said she was looking over my shoulder. Her husband was standing in the door way and it was obvious to me she was holding back. 

A couple of moments later there was a knock on the door. My crew mate had returned. Claire's husband went to let him in and I turned to her and said:

"Do you want me to get you out of here?"

She simply nodded and the expression on her face said it all. She was desperate to get out of the flat. She was terrified. I offered to take her to hospital and her husband was very quick to interject.

"She doesn't want to go to hospital, it was just a panic attack"

"That may be but she still has some chest pain and at the very least we need to do an ECG"

"Then do it here, she doesn't need to go to hospital, she needs to rest. The last crew did the ECG here"

(Lying through my teeth) "I'm afraid we can't do it in here, we have no batteries so it needs to remained plugged into the ambulance"

His tone had changed, it was rather intimidating. He was a big guy and clearly objected to my suggestions and started acting in a very aggressive manner saying she didn't need to go anywhere, and that we were no longer needed.

"Look, she has chest pain, she needs an ECG, and that's what we are going to do. One of the best cures for a panic attack is leaving the environment in which it occurred. In this case, stepping outside for 10 minutes could do her the world of good."

With that, I basically ushered her out of the room and out of the flat. He began acting rather frantically and marched out after us.  We got Claire on board and he tried to push his way on. We managed to close the door on him and lock the truck. My crew mate clambered through to the front and started driving off out of the alley way. Her husband was screaming and shouting, punching the back door. I called for urgent police and we drove off down the road and out of harm's way.

Claire burst into tears. While we waited for police she disclosed years of abuse. She showed me the bruises, strangulation marks & scratches. She had suffered since the day after their wedding 6 years previous. He was controlling, possessive, she had no freedom at all. He used to take her to work and pick her up afterwards but had stopped her working 2 years ago. If she did anything he didn't like he would beat her. If he got drunk, he would beat her. If she answered back he would beat her. She feared for her life but was too scared to walk away. He had threatened to kill her should she leave him. She had no friends and no family in the country and not a single soul knew of her suffering. She wasn't allowed to socialise, she wasn't allowed any money. She was basically his prisoner. She had suffered physical, emotional and sexual abuse on a daily basis for her entire marriage. It was gut wrenching to hear. How can anyone cause so much pain and suffering to another? How can anyone be that cowardly to torment and abuse someone who is so powerless to stop them? How can a man do that to his wife? She had attempted suicide on a number of occasions as it seemed the only way out. Each failed attempt came with it a beating and more threats. As she sat there pouring out everything she had been bottling up, I could see what a relief being able to do so was. She was still terrified but had finally found the strength to put an end to it. Her suffering would end here, although it would be a long journey of psychological recovery ahead. 

Domestic abuse is far too common. I see it on a number of different levels at work, be it emotional, physical, economical or sexual abuse. It is horrible to see and often very challenging to deal with. That said, the emotions I feel when seeing the consequences of it, pale in significance when I think about what the victim has suffered. So often the abuse is painfully obvious but denied by the victim through love or a continuing sense of loyalty. This particular job was some time ago. It was one of the first instances of abuse I had seen and it wasn't until I decided to write about this topic that I found out exactly how common it is and what effects it has, not only on the victims, but also on the NHS too: 

• Domestic violence accounts for between 16% and one quarter of all recorded violent crime. 
• One incident is reported to the police every minute. 
• In any one year there are 13 million separate incidents of physical violence or threats of violence against women from partners or former partners. 
• Women are much more likely than men to be the victim of multiple incidents of abuse, and of sexual violence.
• 54% of UK rapes are committed by a woman’s current or former partner. 
• On average 2 women a week are killed by a male partner or former partner: this constitutes around one-third of all female homicide victims. 
• The cost of treating physical health of victims of domestic violence, (including hospital, GP, ambulance, prescriptions) is £1.2 billion, 3% of the total NHS budget. 
• Between 50% and 60% of female mental health service users have experienced domestic violence, and up to 20% will be experiencing current abuse.
• Domestic violence and other abuse is the most prevalent cause of depression and other mental health difficulties in women.
• Domestic violence commonly results in self-harm and attempted suicide: one-third of women attending emergency departments for self-harm were domestic violence survivors; abused women are five times more likely to attempt suicide; and one third of all female suicide attempts can be attributed to current or past experience of domestic violence.

The statistics alone speak volumes but seeing it first-hand makes me extremely angry. Any kind of bullying is disgusting and seeing someone so gripped by fear emotes all sorts of feelings. Sadly, it is prevalent in all walks of life, across all age groups, and can take a number of different forms including emotional, verbal and physical abuse. As the world develops so does bullying and with the ever growing world of social media it is becoming more and more prevalent; be it subtle digs and intimidation online or physical violence in person, the lasting effect on the victims are the same and domestic abuse is merely bullying within an intimate relationship. It is picking on someone and making their life a misery for personal satisfaction. Intimidating someone to the point where they put up with it, through fear of repercussions, is what these thugs rely on. I don't know the outcome of his arrest, but the police were confident that he wouldn't get away with it. What also concerns me is the reliance these women (and men) have on the NHS, especially that of the already under resourced mental health services. I shudder to think what effect the inevitable NHS Bill and subsequent privatisation will have on the accessibility and affordability to these services. Only time will tell. There was an interesting article in the Guardian regarding the impact the government cuts will have on the help that is available to victims (click to view). The suffering of many will not stop though. It will continue behind closed doors and will continue to go unreported, often until it is too late. That is the tragic reality of the world we live in. All I can do, and all anyone can do, is encourage victims to come forward as and when we become aware of it.

If you, or anyone you know, is suffering or has suffered domestic violence or abuse please please please contact the 24 National Domestic Violence Helpline either by phone or on line.

National Domestic Violence Helpline

0808 2000 247

What is Experience?!

I have a list as long as my arm of blogs I want to write. I can assure you that this wasn't one of them but needs must. Before I started my blog, I had never written a thing. One day I had a rant at my crew mate and he said;

"Seriously, you should write a blog, seeing you that angry was funny as fuck"

So I did! I haven't looked back since. I thoroughly enjoy it and that is why I do it. It's a forum where I can share my feelings openly and that was an outlet I'd never had. I read various blogs beforehand, some of which inspired me to write mine. They can be found in the 'Top Blogs' page on my website. I never thought my blog would become popular and from the outset I said very clearly the purpose of my writing;

"I’m writing this blog to vent frustrations, share experiences, provoke debate and educate people as to what life on the road is like. I don't have the wealth of experience that many do but I don't think you need that much to form opinions. I may have only been on the road for 3 years but in that time I've seen and learnt more than my entire life before that."

I also stated that they were my opinions and didn't represent anyone else. A few weeks ago someone sent me a message on twitter telling me they had just nominated me for the EMS Blog of the Year 2012! I had never even heard about it so it was especially nice to be considered for someone's nomination. Someone liked my ramblings enough to recommend me! After an amazing week of support I got an email from EMS1 to say that I had been shortlisted to the top 10 EMS blogs and voting had now begun. I was honestly gobsmacked and so grateful to everyone who nominated me. I really do feel it is one of my best achievements to date. Today however, I got a rather nasty email from 'Anonymous' which took the edge off what had been an enjoyable couple of days.

"You might be under some illusion that by getting yourself nominated you've earned the right to call yourself a blogger. Let me tell you, you have not. You don't belong in the blogging community, your lack of clinical experience alone makes you ill placed to share your views. You have no place in the EMS blogger of the year competition and I can assure you that you will not win. I don't like your blog, I'll make no secret of that but what I don't like is seeing the writing of others overlooked because you managed to hoodwink your way onto the short list. Just think about that."

OK. I will indeed think about that. I don't care if 'anonymous' doesn't like my blog. As much as it annoyed me, I didn't really care about apparently not being part of the blogging community or having "no place" in the competition. If that's the case then I won't win. I probably won't! I am up against 9 other great blogs; blogs that I myself read and recommend to others. As for this 'blogging community'; I have had guest bloggers, I've written guest blogs, I share other peoples work and have had many discussions with other bloggers on a variety of topics. What one has to do to be accepted I don't know and frankly don't care. If people do like me then great, if not so what. I can't please everyone. I also didn't put myself on the shortlist, others did; that to me is enough to nullify that ill -conceived comment. What did get me really riled was the suggestion that I wasn't experienced enough to write about what I do for a living. It got me thinking a lot about experience and what counts as experience.

I've made it no secret that I'm a student paramedic. I've also made it no secret I've only been on the road 3 years, but does that make me any less qualified to talk about a job that I have done; a job that affected me physically or emotionally, or a patient that I interacted with? Opinions can only ever be based on personal experience and personal feelings. I know for a fact that mine differ from others, that is the point, surely?! That is how a debate occurs. That is how democracy works. That's life! Because I've only worked on ambulances for 3 years can I not talk about the politics of the NHS? I'm not a politician but I have opinions. Experience is relative and constantly evolving. Yes, there are people with 20 years' experience but what if that person stayed in the same role for 20 years; what if they never tried to better themselves, never learned new skills, never moved with the times? In effect their 20 years' experience is just 1 year's experience, repeated 20 times. That's not me. It may be only 3 years but it's been a great 3 years. 3 years where I have learned a lot about myself. I'm not satisfied with the amount I have learnt, nor will I  ever be. If you don't strive to better yourself you'll never gain new experience. That is part of what my blog is about. It is somewhere to reflect; look at the good, look at the bad, look at what can be learnt, and try and dissect what the hell just happened. Yes I'm new to blogging and have a lot to learn. I look back at the first few posts I did and they are in a completely different style to what they are now. I'm learning from my experience. 


As for 'anonymous' whoever you may be:
 "I don't want to talk to you no more, you empty headed animal food trough wiper. I fart in your general direction. Your mother was a hamster and your father smelt of elderberries." (Monty Python)
 I raise two fingers and blow a raspberry!

I'll make no apologies for my opinions, they are mine and mine alone. Whilst ever I still enjoy it I will keep writing. If you agree with what I write about, leave a comment. If you don't agree, leave a comment. I welcome all opinions, for and against. If you feel like you have no choice but to insult me, please leave a name, even if it's a fake one, so I can give as good as I get! As for the EMS Blog of the Year 2012, you decide. There are 10 great blogs to choose from each with their own unique identities and their own great writers. Whichever one does win will be a more than worthy winner. Obviously, if I don't win, I'd like to see the title come to the UK! Have a read:

Diagnosis: LOB

Insomniac Medic

Mobile Intensive Prayer Unit

EMS Office Hours

Trauma Queen

Siren Voices

Rogue Medic

Paramedic Pulp Fiction

EMS 12 lead

EMT Spot

Pick your favourite! 

EMS Blog of the Year 2012 - VOTE NOW! 

Walk-in, Drive-through or Both?

"46 year old male, cuts from broken window"

It was a busy Saturday night like every other Saturday night. We'd had a steady flow of the usual when this popped up on our screen. The location was at a drinking hot spot in the centre of town. We headed over, slurping down the last few dregs of our luke warm hospital coffee, and were greeted by a scene of absolute carnage. It turns out that the location was a kebab shop & it was full of late night revellers queuing up for their post beer Doner kebabs. There was a large crowd gathered outside, about 50 strong, most of which flagged us down as we came into view. Oh yeah, there was also the rear end a car hanging out the front of the shop!

We stopped in the middle of the road, partly because there was nowhere else to park and partly because so many people were stood in the road flapping their arms around. With the adrenaline was pumping and a suitable adjusted emergency face we power walked over, expecting to find multiple injuries on multiple people. Everyone was shouting at us and I couldn't make head nor tail out of anything I was hearing. It was crazy!

"Right, if you are not injured or not directly involved with whatever has happened, please move away and wait for the police"

Nothing! No one budged, and with the considerable amount of alcohol running through most of their veins, no one shut up either. Luckily the boys (and girls) in blue came screeching to a halt outside and dispersed most of the onlookers swiftly. Now it was triage time. My crew mate was already dealing with one of the kebab shop staff, treating him for some small cuts to the hand. 

"Right, who else needs medical attention?"

I looked round at the 15 or so people who were left in and outside. Nothing! Not a twitch! No one had a scratch on them, despite the car completely demolishing the shop front, the glass counters, the grills and burners. Incredible! We finished up with our 1 patient and left him at scene. What made this job all the more amusing was the circumstances surrounding the car ending up using the kebab shop as a drive through!

A family of 3 had parked on the opposite side of the road, the mother and daughter and gone in to get their food whilst the dad waited in the car. In a moment of sheer brilliance he had decided to turn the car around and park outside the shop. Mid-manoeuvre he had tried to brake but in his haste his foot had slipped off the break pedal and on to the accelerator. From that point he simply ploughed across the pavement and parked the front of his car in the salad bar. There's being impatient for your food and then there is taking matters into your own hands! I'd love to know how long he spent in the doghouse after that little stunt! Massively awkward!

While you are here, can I please remind you to vote for me in the EMS Blog of the Year 2012 competition! If you have already then thank you ever so much! 

EMS Blog of the Year 2012 - VOTE NOW!

Voting Now Open

Dear all,

I’ve just found out that after a week of nominations my blog has been shortlisted for the Fire and EMS blog of the year 2012. To say i’m surprised is an understatement! There are some excellent blogs out there which all have their own identities and to be included in such a list is humbling. Like I said, this whole blogging thing is very new to me and i’m ecstatic that my ramblings have become so popular in such a short space of time. Never in my wildest dreams did I think it would take off like it has. I’m so grateful to everyone for the positive comments and support i’ve been given. 

Obviously, now that i’ve been shortlisted winning would be awesome. It’s a long shot I know, as i’m up against some fantastic, well established blogs but if you think i’m worthy then vote for me. 

Voting is open until 21st March and can be done by following the link below. It's just a couple of clicks!

EMS Blog of the Year 2012 - VOTE NOW 

Thanks again for everything. I really do mean that. I’m seriously bloody chuffed!

Ella xx