My iPad's Demise

"32GB iPad, fall from extreme height, multiple injuries"

It is with great sadness and a heavy heart, that I bring you news of the passing of my iPad. On the evening of 12th May at around 23:30 my iPad met a gruesome, tragic end. Despite being surrounded by highly skilled medics at the time, they were unable to save the iPad. The decision was made that due to full body trauma and multiple fractures that surgery was just too risky. 

iPad was only 18 months old and still had many years of loyal service to give when she was cruelly taken away from me. I know accidents happen and if I was in any way responsible that would go some way to helping the healing process. But I wasn't. In a moment of madness 'The Student' picked up the iPad and then proceeded to drop it, from the iPad equivalent of 6 stories, onto a concrete floor. I have been assured that iPad's passing was quick and painless. 

Me and iPad have shared many great moment together. We have enjoyed countless Netflix movies, written many a blog post and wasted many an hour just pissing around on the Internet. These are memories that will stay with me and ones I will look back on fondly. 

I'm sure you will understand that whilst I need time to grieve, what I really need is new iPad. If you have a spare 32GB White iPad 2 with 3G capability just lying round and want to give it to me free of charge I will provide it a good home and solemnly swear to never let a student touch it. In return, I will say thank you and send reports and photos as and when you require. 

There was going to be a full service funeral later this afternoon. Unfortunately, no one from the ambulance service was able to attend because the REAP level is so high and apparently the death of an iPad doesn't entitle anyone to compassionate leave. Also, HEMS were not willing to do a flyby. Therefor I have taken the tough decision to have a private ceremony with just family and close friends. Unfortunately my family prefer Samsung and don't see what the fuss is about and my friends are busy laughing at my iPads demise. To quote a close friend:

'Hahahahahahahaha. Your life is in tatters.'

I'm sure you will understand my need for privacy at this troubling time. I'm still trying to come to terms with the fact I can no longer simply order Dominos from the comfort of my sofa via my Dominos app. There is indeed an app for that. 

Thank you all for your understanding, well wishes, sympathy and suggestions of ways to torture and kill 'the student'. You are a sadistic lot but I love ya! Let me leave you with these (modified) words:

"It is a curious thing, the death of an iPad. We all know that an iPads time in the world is limited, and that eventually all iPads will end up underneath some landfill, never to wake up. And yet it is always a surprise when it happens to an iPad we know. It is like walking up the stairs to your bedroom in the dark, and thinking there is one more stair than there is. Your foot falls down, through the air, and there is a sickly moment of dark surprise as you try and readjust the way you thought of things." 

~Lemony Snicket, Horseradish: Bitter Truths You Can't Avoid 

 

NB: I'd like to add, 'the student' was excellent. He (almost) felt  as bad as I did and was full of apologies and promises to replace. Accidents happen.

Circles

"45 year old female, abdo pain"

In this job you quickly get to know your regulars. People are frequent callers for a number of reasons. Some have complex medical needs that require frequent intentions, some have medical problems they don't control we'll, some are simply lonely, some are alcoholics who fall asleep in the street and others are addicts addicted to Entonox or Morphine and will try anything to get hold of some!

As soon as the address popped up on the screen we groaned! It was an extremely awkward patient who always insisted on going to a hospital a lob way away and always demanded Entonox for her ongoing pain. The fact is, she does get pain but the reason she calls ambulances is because she wants the Entonox. The hospital she insists we take her too, have said they don't want her brought there anymore and her GP insists she should only be taken to the nearest one. After many discussions a protocol was out in place for her which set out what hospital she had to go to and how much Entonox she was allowed. Neither are favourable to her!

When we arrived she was lying on the usual sofa in the usual position.

"I need Entonox, I can't move without it" was the first thing she said as we entered the room.

No 'hello' or 'thank you for coming'! As per recent visits we reminded her of the new rules. She swore a bit, had her 5 minutes of Entonox and then agreed to come to the local hospital. We drove her up there, handed her over to nurse and promptly received a tongue lashing for refusing to give her more Entonox. The duty Dr then entered the cubicle and lectured her about using an ambulance to get a fix of Entonox and told her she wouldn't be getting any whilst in the department. We left to the sound of her F'ing and blinding at the staff! Living the dream.....

We sat there for 20 minutes, did our paperwork, drank some luke warm coffee and then greened up for the next job. 10 minutes later.....

"45 year old female, abdo pain"

Same address, same info, same patient. Really?! I got straight onto control and they confirmed it was indeed the patient. Unbeknown to us, as soon as we'd left, the patient self discharged and had called a taxi and gone home. As soon as she'd got back she dialled 999 and said the previous ambulance crew and hospital had refused to treat her. Due to the symptoms that were described, she was getting another ambulance. And as luck would have it I would get to enjoy seeing the expression on her face when I walked through the door!

10 minutes later we pulled up outside. As usual, the door was open, and in we went to find her lying on the same sofa in the same position.

"I need Enton......is this some kind of joke?!"

"You tell me, we just took you to hospital, why are you wasting resources?"

"Because they wouldn't treat me up there, I'm not going back there, you can take me somewhere else. I'm also allowed 5 minutes of Entonox."

"I'm afraid the only hospital we will take you to is the local one and you've already had your quota of Entonox."

"We'll f**k off then."

With that we left. I know for a fact that later in the evening she had at least one other ambulance. Whether they knew her I don't know, she may have got her own way, she may have had the same as she got from us. One thing is for sure, and that's the going round in circles will continue.

What can be done? Obviously, we can't charge her. We can't refuse an ambulance for someone in pain with a chronic condition. Equally though, it isn't sustainable to keep pandering to people to are simply abusing the system. It's not the call takers fault, nor the dispatcher. It's not our fault, the hospital can't feed her habit and the GP has tried to help. Now what? Where does the madness stop?!

In Sync

"36 year old female, going blue"

There has been a lot of talk recently about private ambulance services being integrated into the NHS. I have been rather vocal about my dislike for them, some of my reasons rational, some irrational. In general, my reasons are nothing to do with the individual staff or the service they work for. Nor is it really anything to do with the awful crews I have dealt with. It's to do with the 'big picture'. That picture of the systematic dismantling of the NHS. That is what I'm passionate about and personally I think any private service, be it ambulance or anything else, has no place in the NHS. Where the driving force is money, patient care, staff quality and staff training will suffer.

I was recently asked what my issue with their training was, and I was told in some cases they are better trained than we are. That is by the by. I disagree but am not in a position to comment as I don't know the content of the training the staff receive. There are so many different ambulance services that range from no training to excellent training. The point is, we don't know and therefor the trust and understanding will always be missing, rightly or wrongly. Maybe this will explain why......

I was working on an FRU with my student, We were sat on standby watching the world go by when we were sent a job a fair way away. On the car, you don't get the benefit of reading the updates you get as you are driving and as such, I thought I'd been driving to a DIB (Difficulty in Breathing). You can imagine my surprise when the radio started ringing and the following words filled the cab:

"Just to advise, this is now a cardiac arrest, there is another FRU on way who should be there the same time as you. CPR is in progress."

Well that got the adrenaline pumping! Within 2 minutes we were on scene, just in time to see the first FRU head through the door. I grabbed some spare oxygen and a few other bits and headed inside. The FRU had a student with her too so the were 4 of to be getting on with. The patient was indeed blue and as we were told in cardiac arrest. I'd never met the paramedic on the car, nor had I met her student. She took control of the airway whilst I started attaching pads etc. The students was on CPR duty. A minute late the crew arrived, again, I'd never met them or their student and they hadn't met the other FRU or her student. In effect, we now had a group of 7 people who didn't know each other but who had to

work together in a life or death situation! I really is that simple!

The NHS Logo is one that is respected and trusted.

The paramedic on the crew got IV access and took charge of drugs. The FRU on the airway looked up at me and asked if I could run things and write stuff down. The EMT from the ambulance was given the task of the runner, he would be getting the bed should we need, getting and removing kit and generally being useful. I was writing times down and vocalising everything that had been done and was yet to be done. As a resus goes, this is as smooth as it gets. We followed drug protocols, tried to reverse the causes of the arrest and after 19 minutes we got ROSC (Return of Spontaneous Circulation) ie: Her heart was now beating again!

We stabilised her before moving and by the time we were ready to go every i had been dotted and every t had been crossed. She continued to improve all the way to hospital. On mass we entered the waiting crash team who took over the patients care and she had a great chance of returning to 'tax paying status'. That is of course, the only statistic the government cares about!

The reason this job ran seamlessly was because of team work. We were able to delegate roles to each other knowing exactly what the others could do. We know that an EMT of any level in our trust is trained to the same standard as paramedic, the only difference being paramedics cannulate and give the drugs. Most can do the same airways as paramedics and they'll all have a minimum of 7 years experience as an EMT. We know by the epaulettes of the students what stage in their training they are in. We also know that they have had exactly the same training in advanced life support and are trained in all our local protocols and paramedic assist. Regardless of what staff from our trust arrives you know exactly what you are getting and can simply get on with it. You do things without being told, you pass things without being asked and seamlessly work with strangers because the uniform says you can.

This is where there trust is lost with private ambulance services. Their staff may well be trained to a high standard but equally they may not be. Some EMT's in private ambulance services have only been on a 3 day course. Some ECA's may be 18 years old with only a first aid course. We simply don't know and during a cardiac arrest you don't want to be learning the hard way that the crew sent to assist you has never even done CPR before. Ask yourself this, if your relative is in cardiac arrest, who would you rather see walk through the door? I know what I would want.

This isn't an attack on the private ambulance services or the people that work for them, it is simply highlighting the issues that we as road staff are having. If they have to be used then it should be kept to patient transport and assistance services, not front line 999 work. There simply just isn't enough quality control and parity in training to make it a safe, viable option and nor is it in the best interest of the people who use the service. Until such a time that all roles are registered professionals, they cannot be integrated successfully with the NHS. There are too many people calling them selves EMTs, ECAs and  trainee medics when all they have done is a three day course.

In MY opinion.

Bloody Immigrants

"48 year old male, cardiac arrest in street, CPR in progress"

Our Greatest Ever Team

It is not often that I agree with anything David Cameron has to say, however, when he describes UKIP voters as “fruitcakes, loonies and closet racists” I'm inclined to agree. They seem to be getting carried away with their recent success but the better known they get, the more skeletons from their dirty closets keep appearing. I have every faith that the great British public will see the light and this will be nothing more than a puff of hot hair and a protest vote against austerity.

It's 2013. Any party that expels their members for being pro gay marriage has no place in politics. However, quotes like “I just wish they would keep their homosexual nature and practises to themselves and stop trying to ram it down my throat telling me they are ‘normal’ when they are not.” seem part of the UKIP norm. Then again, that is little surprise when UKIP candidates like Alex Wood are photographed doing neo-nazi salutes. How very British! Last night I was told by someone from UKIP that "people fear the volume of immigrants in the UK" and when pushed he said it was "the fear that the UK they grew up in is changing beyond their control. It's just not England anymore." Ah yes, immigrants making us less English! Sound familiar? Sounds very BNP to me! Personally, I think they put the Great into Great Britain.

The England I grew up in was was a multicultural one. I lived in a nice part of the city and went to a good school. In my primary school class there were two boys from Nigeria, one from Pakistan, a few from India, one from Egypt, one from Ireland and *deep breath* one from Somalia! (UKIP voter shivers!) Some of them were born here, some weren't, to some of them English was their first language, to some it wasn't. Who cares?! Certainly as a 7 year old I didn't, they were just my school friends and still are. Perhaps the innocence of a 7 year old personifies what this country has stood for. It doesn't matter where you are from, what colour your skin is or whether you fancy boys or girls, you can be part of this wonderful country. By the way, forgot to say, there was also an American girl in my class but she doesn't count does she, because she's not considered an 'efnik'.

THIS is the NHS. THIS is Great Britain

This country is held together by 'immigrants'. The NHS alone, would implode without them. They do the jobs that these 'proud to be English' types won't do. Rather than sit there scrounging off the state, never doing a days work in their lives, do you see any of them offering to do a cleaning job? Becoming nurses? Becoming police officers? Doing anything to improve themselves or the country? No! They sit there and bitch about all the 'foreigners' taking their jobs. Well jobs don't fall from the sky, you have to go and earn them. The only reason an 'immigrant' has a job is because they applied for it. They met the criteria, did the training and work bloody hard to keep it, in the face of constant criticism and abuse from the uneducated racists this country harbours. 

This country has done a good job of demonising the BNP over the years and quite rightly so. Sadly UKIP has given these racists a legitimate party to vote for and a forum to start airing their far-right views. As far as I'm concerned, UKIP supporters are a bunch of racists who are pleased that their evil ways are being validated by a political party. 'Oh it MUST be OK, the politicians said so,' Well let me share a little story with you.....

Dear UKIP voter, 

UKIP see a turban. The rest of us see 3 coppers.

Last year I was called to a man who had collapsed in the street. A police officer was on scene and was doing CPR. (This CPR would go on to save the mans life.) The patient was a white man with an English name. Do you think he would have cared that the police officer doing the CPR was wearing a turban? Blooding immigrant eh?  

The guy I was working with that day was gay. Not just a little bit gay, very gay. You know the type, the gay that is proud to say he is. Don't worry, he won't try and turn you with his dirty gay ways, instead he will help try and save a mans life (without ramming his gayness in your face). Amazingly it doesn't effect his job, or prevent him contributing to society. He is also one of my closest friends. He may even want to get married one day! *shock horror face* Bloody homos eh?  

We started the resus and another one of our colleagues arrived. English was his second language. He was born in Kenya. KENYA! Proper immigrant eh? He suctioned the vomit out of the patients mouth and then secured the airway. (This action would contribute to saving the mans life) Can you believe he was allowed a job as a paramedic when English is his second language?! I'm starting to understand the fear. Bloody foreigner not speaking proper English eh?

The 4 of us worked tirelessly. We all communicated well together and were working to one purpose. Eventually we got him back! Wow! The guys heart was beating again! And he was breathing? So, me, the gay, the turban wearer and the immigrant got the guy onto the ambulance and rushed him off to hospital. This guy was a fighter. So bloody English eh?  

We burst through the doors of resus. Well this is awkward, the Consultant in charge was not only a woman, but a Muslim one wearing a Hijab! Surely she shouldn't be allowed to wear that?! Not in THIS country. We handed over anyway and she took charge, continuing the excellent treatment this tax paying Englishman deserves. Still though, bloody Muslims eh?  

As I looked around at the doctors, anaesthetists, nurses and HCAs there was a huge mix of backgrounds. Some born in England, some probably were not. Some were brown, some were black, one was even chinese! One might have even been a lesbian. *shocked face* (She may also want a wedding). My gay crewmates gaydar was working overtime! Anyway UKIP, here is a question for you. If this was your dad, your brother, your uncle or your friend would you care that he was being saved by a bunch of bloody homos and immigrants? Do you think the patient would give a dam? Or the patients family? This man lived and returned to tax paying status. His life was saved by the people of Great Britain. 

You really should have a long hard think about that, because it isn't just a one off. This wasn't a hand picked job to make my point. That is every job I do, that is every hospital in the country, that is every police force that protects you. In fact, that is every school, GP surgery, dentist, supermarket, fire service, coast guard, builder and every other single business, service and institution in this country. England is a multicultural country, always has been and always will be. Your racist policies will not stand up. We pride ourselves on the fact that no matter what the colour of skin, sexual orientation or religious beliefs that someone has they are no less valuable or have any less right to be here than you and me. 

Oh did I mention. I'm a second generation Eastern European. I should probably go back where I came from. Bloody foreigners eh?  

Go on, say it, I know want you, don't be shy, all together now.... 

"We are not racists, we just don't want immigrants in our country." 

Well UKIP, without invoking Godwin's law, your party is starting out in the exact same way as the German Workers Party (Deutsche Arbeiterpartei - DAP) began in 1919. In 1920 Hitler became a member and shortly after that it became the Nazi Party (Nationalsozialistische Deutsche Arbeiterpartei - NSDAP) and we all know how that ended. 

Lots of love 

Ella Shaw (part immigrant, proud brit) x

Poster Boy

"36 year old male, diabetic problems"

This winds me up! Diabetic problems?! Could they be any more vague! That could literally mean anything. The patient could be hyperglycaemic, hypoglycaemic, have retinopathy, diabetic ketoacidosis, hyperosmolar non-ketonic coma, renal failure, some kind of neuropathy problem, who knows! How are you supposed to prepare for a job if you have nothing to go on! Anyway, rant aside, off I went. Within a few minutes I was outside the house and ready to walk into the unknown.

After navigating my way past the 3 cars on the driveway (1x new Golf, 1 x Porsche Boxter and 1 x BMW X5) I knocked on the door. You'd think that when you dial 999 you'd be prepared for the imminent arrival of an ambulance or some kind of responder. It should never, ever, take over a minute to answer the doors unless the patient is disabled or frail. Anyway, annoyance at the delay aside, the door was eventually opened by the patient. He was well dressed, well spoken and going by the furnishings and accessories in the house he certainly wasn't short of a few quid! I followed him through to the lavish kitchen.

"What's the problem today sir?"

"I just need my blood sugar levels checked."

"OK, but why? Are you diabetic? Are you unwell?"

"I don't think I'm unwell, I mean I feel fine. I'm a tablet controlled diabetic."

"OK, but what did you need an emergency ambulance for?"

"To check my blood sugar! Keep up!" he chuckled.....

"I get that, but why do you think your blood sugar level needs checking if you're feeling fine?"

"Because I'm supposed to monitor my sugar levels and I've lost my test kit."

"So you've lost your kit, so phoned us to get your blood sugar checked?"

"Exactly!" he said in a condescending manor.

"I will check your blood sugar but do you really think it's an appropriate use of the service? You could have just gone and bought another one."

"Who do you think you are to tell me what I can and can't do? Lets not forget that I pay your wages."

Oh, he went THERE. I bit my tongue, did his blood sugar, cancelled the crew who were on route and offered him a full check over through the most hideous fake smile I could muster. Thankfully he refused. He signed my paperwork and I left without even receiving a thank you. I was surprised he didn't pat me on the head and say 'good dog'.

I sat in the car, heart pounding, steam coming out of my ear and a vein pulsating on my forehead! I was livid. Why is this tolerated? Why can nothing be done about it? Why can people be so rude and disrespectful. Then it all clicked into place. The nice cars, the nice house, the elitist attitude, the disrespect......and the Vote Tory poster in the window. How did I miss THAT when arrived?! I should have known I'm just a public servant.

We're all in this together!