Wednesday 9 July 2014

Four nights shifts and an egg and spoon race

I'm very tired after this latest run of four. These nights seem to be getting longer and longer as we are continually hammered from the moment we sign on duty until we make our weak attempts to get home on time.

There is virtually no respite now. Everybody and his dog wants (or thinks they need) an ambulance. I'm spending longer periods at scene with patients - some of them very unwell indeed - because there are not enough ambulances to cover the demand.

And this is going to become a not-so-rare event. I already feel like my time is running out and now a colleague has felt the impact of what is one of the most dangerous enterprises in the country; running at high speed to calls that may or may not be life-threatening (but that are very likely NOT to be) in traffic and conditions that are against you all the way. Some motorists simply don't see us, or acknowledge us any more. Do they think that because we are running around on blue lights so often that we're just going on yet another drunk call? Maybe so. Maybe they're right to be so unimpressed.

But every now and then I have to treat a seriously unwell person; someone I want to save. Occasionally I will be thrown into a dramatic and eventful call where it matters what I do and it matters that I do it right. Is the constant pressure we are under, responding under emergency conditions to those who've drunk too much alcohol or who've been nursing a cough for two weeks but now feel they have chest pain or 'DIB' eventually going to cost so many of those genuinely unwell people that the game is no longer safe to play?

I can't say what my heart feels; it would cost me my job and my career no doubt. But I am sick of risking my life for those who need to grow up or get themselves educated. Sometimes a little first aid training will do the trick but even that is flawed. There are first aiders out there who would rather call an ambulance to a sore thumb than risk being sued - or so they would believe. Back-covering is just one aspect of this disease of complete reliance on the emergency services.

I know I speak on behalf of the majority of my colleagues - especially my fellow paramedics. We are expected to help bring life into this world and to ease the pain of those leaving it, as well as everything in-between for not a lot of pay. We stand for everything that is important in pre-hospital medicine - patients tend to trust us more than they do their own GPs. We spend more time with them. We listen to them and we fix them whenever we can. But we are struck off and disabled from our careers in an instant if we make a mistake or say the wrong thing to the wrong person at the the wrong time. Yet here is an example of simplicity in brotherhood. It applies to doctors but doesn't apply to us.

I reserve judgement in this case of course because I don't disagree that the boy may not have been saved and that is not my problem with it (tragic and sad as it was), but I'm pretty certain that if that had been a paramedic, making the same errors in clinical judgement and saying that 'in hindsight' he'd have done something differently, he or she would not have a job the next day and would be off the professional register! He or she would probably have put in a 12 hour shift, without a break and would very likely have been given a late job, forcing him or her into overtime he or she did not request or want - ultimately making safe clinical judgements, never mind the ability to drive at high speed safely, a real problem!

On behalf of all my colleagues, all over the country - I applaud you. God knows, very few others will. And what is it you want? Respect, courtesy and understanding. No amount of extra money is going to make any difference to the way you feel, right? You want people to know that your morale is sinking, if not already in the gutter. No wonder people are leaving the profession almost as quickly as they are joining it!

I love my job; I don't particularly love the way it runs. I want us to be strict about how we send emergency ambulances to calls. I want us to be clever about how we deal with non-emergency patients. Most of all, I want support and empathy when I am out there battling with my brothers and sisters. I want to help sick people; genuinely sick people.

We need our own professional register, run by paramedics for paramedics. We need our practices and disciplinary procedures to mirror those of the other medical professions, without what appears to be an overbearing emphasis on striking us off for much, much less than the example I've given. It's simply unfair that such a drastic mistake in known procedure is apparently just going to 'go away' because it was a doctor involved.

At the end of my tour of nights, I went straight home and straight onto a grassy track where my son's nursery school sports day was being held. I held an egg in a spoon and ran like a tired man to the finish line with four or five other dads. I made it to the line second to last because I believed one of the dads who said 'right chaps, lets not run' and I was far too tired to run anyway!

Be safe.