Duty of care

As you know I work on the Clinical Support Desk and most of the time I'm advising and supporting crews and other staff with issues that need resolved or clarified. Sometimes the decisions we make on the desk are tough and necessary but it improves me as a paramedic. It's also opened my eyes to the difficulties faced by my colleagues in Control; calltakers talking hysterical parents through the resus of their babies; stabbing victims who lose consciousness while talking to them and angry, awkward and abusive people who just want to insult and denigrate them. Hats off to the lot of you on the 9's.

I've also learned how difficult it can be to persuade someone with a minor problem to take care of themselves or to find another pathway for care when ambulances are in short supply or are engaged on life-threatening calls and really can't be diverted to their 'sore foot' call. In fact, it would be easier to sell a leg of lamb to a vegetarian than it would be to talk some people into growing up and considering taking responsibility for themselves and this is one of the biggest problems we have as a society.

Our duty of care begins when you call us and say 'I need an ambulance'. We are duty-bound to send one if you insist, even though someone else's mum is having a heart attack and might need that same crew in a few minutes as they trundle towards your 'boil on bum' call. Yes, your breathing may not be 'normal' because you have a boil and it hurts but you will NOT die. Someone's mum WILL die of that heart attack.

What about your duty of care for yourself? Why don't you consider the possibility that you could get a taxi to A&E, call an out of hours doctor or make an appointment for an in-hours doctor? What about a walk-in centre or Minor Injuries Unit, emergency dentist or vet, where applicable, for that matter?

There are lots of complex social and psychological issues surrounding certain calls I know, but we are neither a Social Services or Psychiatric tool - we are an accident and emergency service and while we remain steadfastly committed to sending you an ambulance simply because we don't want to make a mistake, the cost to us all is rising annually and the risk to people in real need rises with it.

I'm going to vote on 6th May, like most of you and I can tell you right now that I won't be touching the two main political parties because they are spineless, often lie and (as we all now know) frequently cheat us out of our hard-earned taxes by stealing it through expenses, giving it away to various 'fringe' organisations and individuals who really shouldn't get it or squander it needlessly on pointless campaigns and exercises designed to keep us all quiet while the economy dies and our poor and suffering people go without. Governments have a duty of care too - they are supposed to do what WE ask of them - not what a few minorities wish or demand.

I watched Nick Clegg talk his way through a TV debate that changed the face of the current polls - he was impressive but he still had lies under his rhetoric - he didn't answer every question fully (they never do). I've also seen UKIP's policies and their bold statement 'rights for the innocent, no rights for criminals' and I agree with that. I am NOT liberal minded I'm afraid. I think that if someone steals from you or kills your brother, their rights should be totally suspended and they should pay an equal price. If one person in a gang stabs someone, the whole gang should be punished equally. As I said, it's a bold statement but will never become a reality because we lack the backbone to do it. Too many people will argue, using clever language and laws of convenience, that it would go wrong or that all men (and women) are equal, regardless. I see very little equality as it is.

The Tories tell us they will give us back the power to change things; to sack our MP's and to run our local affairs - I thought we had that right anyway, now it's a gift from them? They want parents to be able to run their own schools and to sack the head teacher if they feel like it. What? I want my kid to go to school and do as he is bloody well told! I want qualified teachers and a head teacher to do that for his own good. I don't want a little gang of twisted parents to influence my son's education and upbringing.

Similarly, I want to be able to do my job for the benefit of the patient. I don't expect to be told how to do it because it might upset a few people. Most of all I'd like to see people decide for themselves that their cut lip, or finger splinter or minor nose bleed does NOT require an ambulance and that they can deal with it themselves.

I'm willing to bet that, statistically, the number of people that die as the result of 999 abuse is greater than the number who would die as the result of the odd error in judgment made when deciding NOT to send an ambulance. Nobody has the guts to try it out though, so we will never know.

The NHS ambulance services, in my opinion, are second to none and the people working behind the scenes and on scene are generally dedicated and professional and only there for the benefit of genuine patients. The same applies to teachers - they exist to educate your child. In a few instances there will be problems and errors but attempting to cover every base by not taking on the duty of care mantle and passing it along to others is futile. The whole health and safety culture works like that, as does the growing greedy litigation thing. If you slip and fall at work because you weren't looking where you were going, is that necessarily someone else's fault?

A duty of care exists as soon as you call us but it remains with YOU until you pick up that phone and dial those 9's. Think about other people before you do; consider a more appropriate pathway for your condition. Don't lie in a pool of your own blood and worry about calling an ambulance because you need us! Get yourself drunk and incapable, however, and then blame a 'spiked' drink or the weather and you are being wholly irresponsible. You had a duty of care to yourself when you left the house to begin that drunken binge.

Xf