The novel is finished (just about - about 500 words to go) but it's an uphill struggle getting a publisher because nobody is spending on books any more. So, I have put the first five chapters up on an e-book for you all to read and comment on.
There is a plot and a twist in the story ( a few twists in fact) and yes, for the sake of art and reality I have had to use profanity (I know some of you will disapprove - especially my mother) but please read what I have offered and give me feedback.
I still have to re-read to refine this draft but it's nearly there. The e-book will only be up on this link for 7 days, so there is limited time to read it.
If you are a publisher - get in touch! Otherwise I will publish it myself and put it on ebay as an e-book.
Thanks all!
Xf
Thursday, 21 April 2011
End of days - part 2
The 'P' word certainly stirred up some heated debate and I'm glad that, for once, something I've raised for discussion hasn't descended into abuse just because I have an opinion.
Your arguments against the privatisation of the NHS were largely sound but I wasn't arguing in favour of the slicing up of an entire system. Rather, I was looking for a debate on the removal of those parts that are costing us so much and which achieve, for the money we pay in, so little. A private company, employing medical professionals, to scrape up the drunk and wasteful from our street would be one idea. They could be taken to a hospital that has 'opted in' to the scheme to recover. Once it had been established that they had just been drunk, a fee would be imposed for the cost of their care. It's a work-in-progress idea but it's not very different from the principle of the 'Booze Bus' that my colleagues currently run, except that there is no penalty imposed and so a lot of youngsters think it's a badge of honour to get on it - like an ASBO - due to it's fame after lots of TV coverage.
And yes, some of the great unwashed would simply not pay and a solution to that problem would have to be found but, just like charging a fine for calling out the Fire Service inappropriately, most people would pay it and probably learn a lesson from it too. If the cost of getting drunk is going to be exceeded by the cost of recovery, then it may be best to temper your drinking behaviour. It's not ideal but it's never been tried, so it might be worth a go.
And for those of you who argued that health workers would be poorly paid in the private sector, you were obviously thinking of large companies with shareholders. I was not. Doctors, Nurses and Paramedics continue to earn more working for small, private companies, that's why so many of them can be found attending sports events and the like.
Nevertheless, it is very worrying that we have reached this juncture; where we cannot see, one way or the other, how our great health system can be fixed. There is a Utopian ideal and it's one in which the hospitals are efficient and clean. where staff are well paid, happy and dedicated to the care of their patients. One in which the person in charge is not a suit-wearing Manager but a senior Doctor with the right qualifications to understand the basics of economy and team-work. That, unfortunately, is a 'Carry-on' movie.
Now, to more nitty-gritty that you won't like.
I have received more and more emails by young people (and some not so young) who want to start University and get a degree in Paramedic Science. I get a lot of requests for information and advice but, unlike a few years ago, my recent feedback has been rather negative.
I have been saying for some time that the over-recruiting of new student paramedics in the UK would lead to a glut and that, sooner or later, there'd be too many cooks and not enough broth. This is now happening. There are not enough jobs for them and with the economy in its current state, there will be less prospect in the near future for those embarking on a career as a paramedic, or nearing the end of their course.
University fees are rising, with most of the establishments demanding the maximum amount (£9,000) for certain courses. So, things look even more bleak for a new generation of paramedics and it's a damned shame.
Sure, there will be retirement vacancies and 'dead man' shoes to fill but most Trusts won't be recruiting into those posts because it will save money not to... and they all have to save money.
I still believe this is one of the best jobs on Earth and I encourage those who want to become paramedics to fight on but the reality of the situation must be considered first. It's become an expensive career to embark upon; the cost of getting a C1 licence, which is a necessity, is almost £1,000... then there's the annual Uni fees and living expenses for 2 - 3 years. After all that, you may not even have a job to go to.
The private sector may still be an option and some services are filling posts that were unfillable during the good old days, when services like London were favoured by new paramedics, so all hope is not yet lost!
My advice to those of you who wish to become paramedics is this: think it through, talk to paramedics you know and find out about your local ambulance service - test the water and remember you are looking at the future, not now. What's it going to be like in two or three years time?
Remove thoughts of glamour or excitement from your mind and focus on the cost of becoming a paramedic, the possibility of failing the course at any stage and the reality of qualifying without a job to practice in. Then do what you think is best for you and if that means continuing on the path to becoming a paramedic, then at least you were very sure of your course.
I'm very proud to have been the reason many people became paramedics, including my own son. At least a dozen of you have told me that this blog has influenced your decision to join an ambulance service and help others... that's all great but I won't be the one who tells more of you to carry on without thinking it over.
I'm back on the road for a shift soon and will be reporting back more stories from the front-line. It's a weekend night shift, so expect the word 'drunk' to be used frequently
Be safe.
Your arguments against the privatisation of the NHS were largely sound but I wasn't arguing in favour of the slicing up of an entire system. Rather, I was looking for a debate on the removal of those parts that are costing us so much and which achieve, for the money we pay in, so little. A private company, employing medical professionals, to scrape up the drunk and wasteful from our street would be one idea. They could be taken to a hospital that has 'opted in' to the scheme to recover. Once it had been established that they had just been drunk, a fee would be imposed for the cost of their care. It's a work-in-progress idea but it's not very different from the principle of the 'Booze Bus' that my colleagues currently run, except that there is no penalty imposed and so a lot of youngsters think it's a badge of honour to get on it - like an ASBO - due to it's fame after lots of TV coverage.
And yes, some of the great unwashed would simply not pay and a solution to that problem would have to be found but, just like charging a fine for calling out the Fire Service inappropriately, most people would pay it and probably learn a lesson from it too. If the cost of getting drunk is going to be exceeded by the cost of recovery, then it may be best to temper your drinking behaviour. It's not ideal but it's never been tried, so it might be worth a go.
And for those of you who argued that health workers would be poorly paid in the private sector, you were obviously thinking of large companies with shareholders. I was not. Doctors, Nurses and Paramedics continue to earn more working for small, private companies, that's why so many of them can be found attending sports events and the like.
Nevertheless, it is very worrying that we have reached this juncture; where we cannot see, one way or the other, how our great health system can be fixed. There is a Utopian ideal and it's one in which the hospitals are efficient and clean. where staff are well paid, happy and dedicated to the care of their patients. One in which the person in charge is not a suit-wearing Manager but a senior Doctor with the right qualifications to understand the basics of economy and team-work. That, unfortunately, is a 'Carry-on' movie.
Now, to more nitty-gritty that you won't like.
I have received more and more emails by young people (and some not so young) who want to start University and get a degree in Paramedic Science. I get a lot of requests for information and advice but, unlike a few years ago, my recent feedback has been rather negative.
I have been saying for some time that the over-recruiting of new student paramedics in the UK would lead to a glut and that, sooner or later, there'd be too many cooks and not enough broth. This is now happening. There are not enough jobs for them and with the economy in its current state, there will be less prospect in the near future for those embarking on a career as a paramedic, or nearing the end of their course.
University fees are rising, with most of the establishments demanding the maximum amount (£9,000) for certain courses. So, things look even more bleak for a new generation of paramedics and it's a damned shame.
Sure, there will be retirement vacancies and 'dead man' shoes to fill but most Trusts won't be recruiting into those posts because it will save money not to... and they all have to save money.
I still believe this is one of the best jobs on Earth and I encourage those who want to become paramedics to fight on but the reality of the situation must be considered first. It's become an expensive career to embark upon; the cost of getting a C1 licence, which is a necessity, is almost £1,000... then there's the annual Uni fees and living expenses for 2 - 3 years. After all that, you may not even have a job to go to.
The private sector may still be an option and some services are filling posts that were unfillable during the good old days, when services like London were favoured by new paramedics, so all hope is not yet lost!
My advice to those of you who wish to become paramedics is this: think it through, talk to paramedics you know and find out about your local ambulance service - test the water and remember you are looking at the future, not now. What's it going to be like in two or three years time?
Remove thoughts of glamour or excitement from your mind and focus on the cost of becoming a paramedic, the possibility of failing the course at any stage and the reality of qualifying without a job to practice in. Then do what you think is best for you and if that means continuing on the path to becoming a paramedic, then at least you were very sure of your course.
I'm very proud to have been the reason many people became paramedics, including my own son. At least a dozen of you have told me that this blog has influenced your decision to join an ambulance service and help others... that's all great but I won't be the one who tells more of you to carry on without thinking it over.
I'm back on the road for a shift soon and will be reporting back more stories from the front-line. It's a weekend night shift, so expect the word 'drunk' to be used frequently
Be safe.
Sunday, 17 April 2011
End of days?
The NHS is facing a major challenge. Cuts across the board may soon erode frontline emergency services to the point where privatisation of certain key parts becomes inevitable. But the raging arguments for and against out-sourcing patient care often lose focus when politically-motivated speakers debate the issues.
Looking at it from a pragmatic view, there is something to be said for opting out of a publicly-funded, publicly-driven service. Private companies exist to make profits, that much is true. That means they can be seen as less inclined to care about the service they provide, but in any competitive market and for the majority of companies, this is not actually the case. How can they expect to keep their customers if they provide a poor standard of service? You find many more examples of poor service in areas where competition is weak or non-existent; nationalisation proved that and, although we still have a lot to complain about with respect to our railways due to the fact that customers are tied to routes, rather than having much in the way of choice, it’s a world better than the ‘don’t give a damn’ attitude that pervaded staff back in those days.
Public services have an advantage in that they are not subject to profiteering but, unless the people working within them really care about what they do, there is no motivation for them, or their bosses, to bother about the level of service they provide. As long as there is a pay cheque and a pension at the end of the day, just doing the job to the minimum required level and no more is adequate.
I would argue that most people who need medical care would prefer to be treated with the highest level of professionalism and the best equipment money can buy, rather than any service where they are seen as a nuisance, or a mere cog in the big wheel of a State funded organisation.
I’m not for one single minute suggesting that we are surrounded by people who don’t care but I think there are far too many managers, there is far too much red tape and far too few opportunities for good clinicians to shine. There is not enough development in healthcare because the money vital to driving it forward simply isn’t there. A corporate framework, promoted by commercial competition, could create cleaner, wealthier hospitals and surgeries, with happier, more motivated staff. It may even help to build new hospitals across the country.
You will have other ideas, I’m just spouting mine. Your politics will differ from mine but I work on the inside of a machine that I honestly see as dysfunctional at times. Too many people call ambulances for nonsense things because it is free and very easy to do. If there was a charge, even to dial 999, I wonder how many lives we’d save.
Obviously, there are those among you – there always are – who will nit-pick this and argue that people would die if they had to pay to make that 999 call… or they’d simply not call us if there exists the possibility of being charged because their problem was deemed ‘not an emergency’.
I agree that there is a risk here; the vulnerable would probably suffer. But what if we charged the drunk, the drugged up, the violent and abusive among us for their care, instead of passing the cost to tax paying Joe P? They all still go to hospital, they all get the care they require but when they sober up, straighten out and calm down, they get a bill for the services rendered.
Would we discourage enough of these calls to stimulate a better service for those who actually need us?
My own boss, the Chief Executive, stated on the news that we were receiving too many inappropriate 999 calls – it is universally understood, from the top down, that public services such as ours cannot continue to be abused at the cost of it’s core function.
The cost of it all is what needs to be re-assessed – the pure, dirty financial cost. It’s always about money – even when it comes to public services. Those at the top of the tree of public services benefit from tax pounds and their job is to run the service and save more tax pounds from being spent if possible but there is no commercial impetus to do this; there is no competition. The public have no choice but to use what exists, whether that service is good enough or not. Try to bear in mind that public services do not generate money, they spend it.
It’s ironic that the public sector is being slashed to the bone and jobs are being lost but that the private sector is reportedly thriving and jobs are being created. I think it says something about the state of affairs in the UK. We get poorer by not making things for profit; we get poorer by using tax money paid in by those who generate new money to create jobs for the public sector, whilst allowing surplus and waste to leak much of the benefit out of them. A lot of that money is used by councils to employ private companies anyway – such as refuse disposal companies because it’s cheaper than using directly employed staff, with all the vehicles and equipment that goes with them. There’s also no chance of union action shutting it down and holding the very people it serves to ransom (like the London Underground does on a regular basis).
When I was growing up, I experienced a lot of the negative aspects of public service and nationalised industry; the power would be cut every night for hours at a time whenever the coal industry went on strike. Rubbish would pile in the streets, attracting vermin and encouraging disease, just because of a dispute that served no purpose for the people paying for it.
There’s nothing wrong with standing up for your rights as an employee, of course not, but private company employees have rights too and they don’t need to punish the tax payer to enforce them.
Where is the evidence that private services in the health sector would lead to worse healthcare? When, in recent history, have we tried it en masse? Comparing the services provided in other countries, such as the USA, is simply not viable because we are not the same. Most of it exists by the back door anyway, so the whole argument is moot. Even seemingly stand-up Socialist-Green-Communist propagandists have profit in their blood so blow-by-blow evidence for one thing or the other is neutralising to me. It may be time to try something different.
I work in the public sector of course, so I am benefiting from the tax pound but I also generate new tax money. The services provided by the ambulance service, hospitals and other healthcare sources are exceptional but they are becoming less value for money because they are subject to abuse and the cuts necessitated by Government in these days of debt. There have already been heavy job losses in the NHS and there are more to come. Frontline staffing will suffer a blow for sure and whether or not it directly affects the quality of care provided will be down to a couple of things; the slowing-down or complete end of abuse of services by those who don’t even pay for them and the privatisation of aspects of the system that are just too big and expensive to run efficiently and cost-effectively.
We all want to be protected in our jobs; we all want to continue to sustain our families with income but what if there simply isn’t enough left to keep it going? What if our service-driven economy, coupled with the behaviour of the banks has led us to near-financial ruin?
Be safe (and hopefully employed).
Looking at it from a pragmatic view, there is something to be said for opting out of a publicly-funded, publicly-driven service. Private companies exist to make profits, that much is true. That means they can be seen as less inclined to care about the service they provide, but in any competitive market and for the majority of companies, this is not actually the case. How can they expect to keep their customers if they provide a poor standard of service? You find many more examples of poor service in areas where competition is weak or non-existent; nationalisation proved that and, although we still have a lot to complain about with respect to our railways due to the fact that customers are tied to routes, rather than having much in the way of choice, it’s a world better than the ‘don’t give a damn’ attitude that pervaded staff back in those days.
Public services have an advantage in that they are not subject to profiteering but, unless the people working within them really care about what they do, there is no motivation for them, or their bosses, to bother about the level of service they provide. As long as there is a pay cheque and a pension at the end of the day, just doing the job to the minimum required level and no more is adequate.
I would argue that most people who need medical care would prefer to be treated with the highest level of professionalism and the best equipment money can buy, rather than any service where they are seen as a nuisance, or a mere cog in the big wheel of a State funded organisation.
I’m not for one single minute suggesting that we are surrounded by people who don’t care but I think there are far too many managers, there is far too much red tape and far too few opportunities for good clinicians to shine. There is not enough development in healthcare because the money vital to driving it forward simply isn’t there. A corporate framework, promoted by commercial competition, could create cleaner, wealthier hospitals and surgeries, with happier, more motivated staff. It may even help to build new hospitals across the country.
You will have other ideas, I’m just spouting mine. Your politics will differ from mine but I work on the inside of a machine that I honestly see as dysfunctional at times. Too many people call ambulances for nonsense things because it is free and very easy to do. If there was a charge, even to dial 999, I wonder how many lives we’d save.
Obviously, there are those among you – there always are – who will nit-pick this and argue that people would die if they had to pay to make that 999 call… or they’d simply not call us if there exists the possibility of being charged because their problem was deemed ‘not an emergency’.
I agree that there is a risk here; the vulnerable would probably suffer. But what if we charged the drunk, the drugged up, the violent and abusive among us for their care, instead of passing the cost to tax paying Joe P? They all still go to hospital, they all get the care they require but when they sober up, straighten out and calm down, they get a bill for the services rendered.
Would we discourage enough of these calls to stimulate a better service for those who actually need us?
My own boss, the Chief Executive, stated on the news that we were receiving too many inappropriate 999 calls – it is universally understood, from the top down, that public services such as ours cannot continue to be abused at the cost of it’s core function.
The cost of it all is what needs to be re-assessed – the pure, dirty financial cost. It’s always about money – even when it comes to public services. Those at the top of the tree of public services benefit from tax pounds and their job is to run the service and save more tax pounds from being spent if possible but there is no commercial impetus to do this; there is no competition. The public have no choice but to use what exists, whether that service is good enough or not. Try to bear in mind that public services do not generate money, they spend it.
It’s ironic that the public sector is being slashed to the bone and jobs are being lost but that the private sector is reportedly thriving and jobs are being created. I think it says something about the state of affairs in the UK. We get poorer by not making things for profit; we get poorer by using tax money paid in by those who generate new money to create jobs for the public sector, whilst allowing surplus and waste to leak much of the benefit out of them. A lot of that money is used by councils to employ private companies anyway – such as refuse disposal companies because it’s cheaper than using directly employed staff, with all the vehicles and equipment that goes with them. There’s also no chance of union action shutting it down and holding the very people it serves to ransom (like the London Underground does on a regular basis).
When I was growing up, I experienced a lot of the negative aspects of public service and nationalised industry; the power would be cut every night for hours at a time whenever the coal industry went on strike. Rubbish would pile in the streets, attracting vermin and encouraging disease, just because of a dispute that served no purpose for the people paying for it.
There’s nothing wrong with standing up for your rights as an employee, of course not, but private company employees have rights too and they don’t need to punish the tax payer to enforce them.
Where is the evidence that private services in the health sector would lead to worse healthcare? When, in recent history, have we tried it en masse? Comparing the services provided in other countries, such as the USA, is simply not viable because we are not the same. Most of it exists by the back door anyway, so the whole argument is moot. Even seemingly stand-up Socialist-Green-Communist propagandists have profit in their blood so blow-by-blow evidence for one thing or the other is neutralising to me. It may be time to try something different.
I work in the public sector of course, so I am benefiting from the tax pound but I also generate new tax money. The services provided by the ambulance service, hospitals and other healthcare sources are exceptional but they are becoming less value for money because they are subject to abuse and the cuts necessitated by Government in these days of debt. There have already been heavy job losses in the NHS and there are more to come. Frontline staffing will suffer a blow for sure and whether or not it directly affects the quality of care provided will be down to a couple of things; the slowing-down or complete end of abuse of services by those who don’t even pay for them and the privatisation of aspects of the system that are just too big and expensive to run efficiently and cost-effectively.
We all want to be protected in our jobs; we all want to continue to sustain our families with income but what if there simply isn’t enough left to keep it going? What if our service-driven economy, coupled with the behaviour of the banks has led us to near-financial ruin?
Be safe (and hopefully employed).
Saturday, 2 April 2011
Vicious sweets
We’ve reached a new low in society when pathetic incidents like this provoke a response that triggers such expensive and embarrassing circumstances. The cops are not to blame here; they have no option but to follow up on reports like this. It’s the child and, more importantly, the parents who need a good talking to about getting real. Why on earth would the kid want to run to his parents about this?
And what notion do grown adults have of common-sense when they report incidents as innocuous as this to the police?
Are we now at a point where, if a child accidentally bumps into another child, the police will visit and begin a full-blown investigation? I think the Chief Constable needs to send a letter out to the community asking them to grow up.
There’s only one word to describe this – ridiculous.
Image above created by Daneboe
This guy found out all about his medical condition after surfing the Web. He had no choice apparently because none of the medics he’d gone to seemed interested in exploring the possibilities. I’m not defending them to the hilt and this young man had every right to be concerned and discover for himself what was going on but, again, I’m sure we’re not getting the full story.
The average GP is busy. Let’s face it, they have hundreds of patients to deal with and a lot of nonsense to get through, just like we do in the ambulance service. Tests would have been carried out I’m sure. The docs probably found nothing untoward and that’s why he got ‘fobbed off’.
He was found to have POTS but it’s not all as clear-cut as the newspaper is trying to make out. In the same Wiki article you will find this statement: POTS can be difficult to diagnose. A routine physical examination and standard blood tests will not indicate POTS.
The guy was unlucky enough to have been seen and ‘fobbed off’ by doctors under a lot of pressure and no time to go tilt-table testing. Arguably, they could just have laid him down and then sat him up, testing his heart rate and blood pressure changes as they did so but this is not a very scientific way of diagnosing anything, so they probably did all the tests they were required to do and considered his condition to be anomalous.
Lots of things are going undiagnosed every day by doctors. Forgetting that they are human and very often unable to spend the quality time they could with each patient is a major mistake to make. There’s nothing wrong with a bit of research and suggestion to see if you can move things along for yourself but be wary of online ‘facts’. Even Wiki informs us all that it cannot guarantee the accuracy and validity of its articles without proper source references that can be checked.
The Sun has printed a perfectly good story for the purposes of shocking its readers into vilifying the medical profession, whilst promoting the virtues of online medical information. I’m not saying that was their intention but the average Sun reader probably won’t do any background research into this or even think twice about the possibility of other arguments. It’s just so much more fun (and a lot easier) to say ‘damned doctors – they don’t know what they’re doing!’ when you are not one yourself. I stopped slagging off astronauts long ago for the same reason.
This really tickled me; the photograph just leapt out as soon as it loaded
I know, it's not very medical or society-related. But it's funny.
Be safe.
Wednesday, 30 March 2011
The mire
Small minds
Hoax calls, made by children are usually benign and can be dealt with on the phone but a few of them are well-planned and executed little scenarios that require a lot of nerve to sustain under interrogation.
The caller sounds like she’s 12 years-old but she’s claiming to have murdered her husband. She says she’s 28 years-old and her husband is in his thirties. She is calm and repeatedly states that there is a lot of blood and that he has been stabbed through the heart and is dead. She even goes through the motions of giving CPR under instruction but it’s obvious that no effort is being applied and when she counts to 30 for the compressions, she misses the numbers 10 to 12 for some reason.
Resources are deployed, including the police because no risk can be taken with calls like these; it can be very hard to be sure of a person’s age or whether they are telling you the truth or not. When the crew arrive, they can be heard banging on the door in the background shouting 'Hello?' - to them this is a genuine call and they have good reason to be concerned when there is no response. But the child is in the room; she's still on the phone but now she's silent.
What was particularly disturbing about the call was the cold, callous voice of the child on the line. At any age in childhood the words ‘murder’, ‘killed’ and ‘dead’ should never enter the vocabulary for imaginative use - certainly not in this context, where an emergency service is being summoned on the pretext. Where were the parents of this kid? What kind of mind does the child have and how far would she go to get excitement like this?
When she was told that the call would be traced and the police would be sent to her, she said ‘don’t do that’ in an almost panicked way but it was all part of the game and she was soon back to her original story that her husband lay dead on the floor after having been brutally stabbed through the heart by her. We have some very, very sick children on the way to adulthood.
Thank God for the Press (at times); the news footage of the Libyan woman being hand-gagged and obstructed from speaking out against the Regime in her country was truly shocking but if the Press hadn’t been there, filming every detail and reporting the incident, who knows what would have happened to her. She was taken away by security men in a car and reporters were told she was safe; the Security men knew that harming her would result in consequences for them individually when this thing blows over. If the press hadn’t been there I’m pretty sure she would have simply disappeared forever.
In contrast, in a country where you can speak your mind without recrimination, we have a hardcore of mainly young men rioting and polluting every peaceful protest, not because they have an argument or a point to make but because they simply hate everything. They hate the Government (it doesn’t matter which party is in power), they hate the police and they hate anything that doesn’t pander to their unrealistic belief that a society can run safely without authority. They think jobs can be wished into existence without bankers and rich employers. Although I will concede any point made about greed in these professions. It's not really the argument, it's the way it is being 'protested'.
The vast majority of us do not behave like this. More than a quarter of a million people turned up to protest spending cuts that would affect their lives – they were trying to make a point but it was washed away in the tide of hooliganism that followed. I watched it all unfold at work, as did many of my colleagues and it was unbelievable that we had to use phrases like ‘be careful’ and ‘avoid’ on a night that is usually full of routine. Anything with a blue light bar on it was going to be a target for these idiots.
But let's get all paranoid and out of perspective; Trafalgar Square has been the site of more than a few riots instigated by those who wish to break the law. In 1848, protestors with no alignment whatsoever to the planned income tax demo (which was officially cancelled), gathered to use the meeting as an excuse to do what they would probably normally do if they lived in a society without police – they set about damaging property and stealing whatever they could lay their hands on, after a good deal of violence. Protests with a small group of hooligans, intent on chaos has been a repeated event over the past couple of centuries. What magnifies it to this generation is the fact that it is being perpetrated by 'intelligent' young people who honestly think, while they are naive enough to bathe in the bubbly bathtub of ideology, that everything can be solved by making everyone equal. When they grow up and get into middle-age, with a job, debts of their own and a family to raise, they will be different people - if they can get a job with a criminal record. It’s all so familiar.
So, while my colleagues once again put themselves in harm’s way to help others – and I include the police in that statement – a couple of hundred individuals, whose opinions are of no promotional consequence to the well-being of anyone but themselves, destroyed whatever they could because there were a lot of them and they knew the police would not lay into them heavy-handedly. There was, in effect, no immediate consequence for their actions (the result of bleating hearts complaining about former police actions to quell disorder – a job we pay them to do).
I have an eighteen-month old child. If there are no consequences for his bad behaviour, he will continue with it. I don’t need to physically hurt him to make my point but he will understand, very clearly, that his wrong-doing will be punished. Everyone has the right to protest and everyone has an opinion but if we smashed up private property and lit fires in the street because we had something to prove, where would society be and what kind of job would we, as paramedics, have? We'd be riot medics.
We don’t need a police state but we can’t have a stupidly tolerant one either. We need a middle-ground of understanding and a realistic approach to how we act and react to situations that threaten us or our society.
The Press may have saved the life of a Libyan woman who spoke out but they are also part of our current problem in this country – strategic photography and reporting has demonised the police to the point where we now no longer have the right to walk freely when a protest may go wrong. Not because the police are stopping us, but because they are wary of stepping too hard on top of those who are.
Be safe.
Saturday, 19 March 2011
Fitters
I had an observer with me on my clinical mission today – a driving instructor who wanted to see what the difference was between the tidy lesson-method and the only way to get around on blue lights in London town. She had a thoroughly good day by her own account.
A 15 year-old insulin-dependant female was the recipient of my first visit of the morning; she’d left hospital in the early hours without taking a new batch of insulin with her and I was to taxi her back to get it. When I got into the little flat, Gran was moaning about her and she was cooking food while her teenage mate slumped on the sofa looking very uninterested.
‘I don’t need to go back to hospital’, she told me. She spoke with that new-south-London accent that teens, especially white girls, use; it’s a kind of pseudo-black popular twang that I find very annoying to listen to – it smacks of I don’t care.
I checked her BM and she showed me that her insulin was in the fridge. Gran looked powerless and a little nervous to be honest. This was not a cosy little family and I’m convinced the girl and her mate had been out all night. She probably ended up in A&E drunk and the insulin was a side-issue. Gran’s place was very likely the reasonable excuse for not being at home all Friday night.
That was followed later on by a drug addict who wandered into a tourist shop and promptly fell, hitting is head and causing mild panic. A police officer was on scene when we got there and she explained that she was asked to help him when he tumbled.
The man looked stoned to me – tiny little pupils and hardly awake – he had to be prodded back into life regularly; a sure sign that he was on something. He denied this of course. A police officer was there, so of course he denied it.
As I collected information from him and checked his obs, the store Manager (he looked like a manager) tried to get him to stand up and leave the shop because he was (a) in the way on the steps and (b) untidy looking and therefore bad for business. I asked him to be patient and walked the addict out of the shop and onto the back seat of my car, where he tried, again and again, to become unconscious.
The crew arrived as other cops landed to help out and I handed the man over for Narcan and a quick trip to A&E. I was told that he was a Misper (missing person) – he’d been reported missing by his friend, who was elsewhere worrying about him.
I managed to find out that the patient had met someone and wandered off with him, probably to get the drugs he now had in his blood. This is typical behaviour and so his mate shouldn’t really have been worried about it.
While the crew was dealing with him in the ambulance, the police officers were asked to assist with something across the road and out of my vision. A few minutes later, I was asked to help someone who was fitting in the street. This is where the cops had been taken and I crossed the road to find them trying to hold down the man as he seized on the pavement. A small crowd had gathered around him but the place was heaving anyway, so people were going to be an obstruction, no matter what.
A few more cops arrived and another FRU pulled up to assist. My driving instructor observer helped out too; she became an expert at getting certain bits and pieces for me by the end of the shift.
It took a couple of minutes to change the status of the young man on the pavement – a bit of oxygen was required. He stopped fitting and became agitated and confused, which is pretty much par for the course. Another ten minutes went by as we asked him questions and tried to ascertain his medical history – he wasn’t epileptic and I suspect that he’d probably taken something. He’d been out all night.
An awkward job next; a woman fell down a set of steep steps in a shop. She didn’t see the first step and simply tumbled, head-over-heels until she hit the bottom with her head. She had two nasty bumps on her cranium. She hadn’t been knocked out and there was very little blood around but she’d come down at a high angle and must have hit hard when she landed, so I asked for a crew to bring a spinal board down.
Unfortunately, taking her out on the board wasn’t going to be safe, for her or the crew, so we collared her and made use of the chair while she was still in a sitting position. At the top of the steps, she was transferred onto a board and strapped in securely. She had no neurological deficit and no neck pain or tenderness. Her status didn’t change during the lift up the stairs. It was all precautionary.
Another 15 year-old girl, this time with less attitude, and a normal accent, albeit American, was waiting for me at a tube station. She’d collapsed after being sick into a bag – she felt generally unwell and it may have been down to something she’d eaten. I put the blame on ice cream.
Her mum, dad and older sister were with her and everyone seemed happy enough. I spoke to her while we waited for the ambulance and I chatted to her parents and her sister (who is very nice and apparently doesn’t bully her sibling) while still waiting for an ambulance.
Eventually, after being told that it was ‘on scene’ but not seeing a crew appear, I walked the girl and her family to the car. There was no ambulance outside. They were at a completely different station. It made more sense to take her in the car now.
Big sister and dad walked across the bridge to the hospital and I drove the patient and her mum but, as the direct result of paperwork, I was beaten to the hospital by the walking party. So now the people of Colorado think the London Ambulance Service is slower than a snail in a headwind. Not true though… ask the driving instructor!
The young lady was left in the gentle care of the paediatric nurses and her family waited with her. I said goodbye and left for the next mission. Before I finished this call however, I made enquiries on behalf of the young lady. So, just for you and because you didn’t know – your name means ‘Towers’.
The shift ended with another fitting. This time we had to run and descend deep into the underground to get to the patient. It was busy with people of course and not many of them cared to move out of the way so that we could reach the platform quickly. A tannoy announcement had been made just as we arrived, informing passengers of a medical incident but it made no difference to the people who were obstructing us by standing in the middle of the escalator.
The lady was with her family and friends; she had been fitting on the train and was taken off to recover on the platform. She was very confused and very strong, as she thrashed and lashed out when I tried to give her oxygen. This was to be expected and I won’t fight with someone in that condition, so the mask was left off until she was a little less combative.
The crew was on scene soon after I’d started my obs and the woman was less agitated by the time she was placed into the chair for the long trip up to street level.
I have a few more shifts on the road coming up, so I’ll report as and when. In the meantime I’ll continue to comment on the issues that make a difference to us here.
Be safe.
A 15 year-old insulin-dependant female was the recipient of my first visit of the morning; she’d left hospital in the early hours without taking a new batch of insulin with her and I was to taxi her back to get it. When I got into the little flat, Gran was moaning about her and she was cooking food while her teenage mate slumped on the sofa looking very uninterested.
‘I don’t need to go back to hospital’, she told me. She spoke with that new-south-London accent that teens, especially white girls, use; it’s a kind of pseudo-black popular twang that I find very annoying to listen to – it smacks of I don’t care.
I checked her BM and she showed me that her insulin was in the fridge. Gran looked powerless and a little nervous to be honest. This was not a cosy little family and I’m convinced the girl and her mate had been out all night. She probably ended up in A&E drunk and the insulin was a side-issue. Gran’s place was very likely the reasonable excuse for not being at home all Friday night.
That was followed later on by a drug addict who wandered into a tourist shop and promptly fell, hitting is head and causing mild panic. A police officer was on scene when we got there and she explained that she was asked to help him when he tumbled.
The man looked stoned to me – tiny little pupils and hardly awake – he had to be prodded back into life regularly; a sure sign that he was on something. He denied this of course. A police officer was there, so of course he denied it.
As I collected information from him and checked his obs, the store Manager (he looked like a manager) tried to get him to stand up and leave the shop because he was (a) in the way on the steps and (b) untidy looking and therefore bad for business. I asked him to be patient and walked the addict out of the shop and onto the back seat of my car, where he tried, again and again, to become unconscious.
The crew arrived as other cops landed to help out and I handed the man over for Narcan and a quick trip to A&E. I was told that he was a Misper (missing person) – he’d been reported missing by his friend, who was elsewhere worrying about him.
I managed to find out that the patient had met someone and wandered off with him, probably to get the drugs he now had in his blood. This is typical behaviour and so his mate shouldn’t really have been worried about it.
While the crew was dealing with him in the ambulance, the police officers were asked to assist with something across the road and out of my vision. A few minutes later, I was asked to help someone who was fitting in the street. This is where the cops had been taken and I crossed the road to find them trying to hold down the man as he seized on the pavement. A small crowd had gathered around him but the place was heaving anyway, so people were going to be an obstruction, no matter what.
A few more cops arrived and another FRU pulled up to assist. My driving instructor observer helped out too; she became an expert at getting certain bits and pieces for me by the end of the shift.
It took a couple of minutes to change the status of the young man on the pavement – a bit of oxygen was required. He stopped fitting and became agitated and confused, which is pretty much par for the course. Another ten minutes went by as we asked him questions and tried to ascertain his medical history – he wasn’t epileptic and I suspect that he’d probably taken something. He’d been out all night.
An awkward job next; a woman fell down a set of steep steps in a shop. She didn’t see the first step and simply tumbled, head-over-heels until she hit the bottom with her head. She had two nasty bumps on her cranium. She hadn’t been knocked out and there was very little blood around but she’d come down at a high angle and must have hit hard when she landed, so I asked for a crew to bring a spinal board down.
Unfortunately, taking her out on the board wasn’t going to be safe, for her or the crew, so we collared her and made use of the chair while she was still in a sitting position. At the top of the steps, she was transferred onto a board and strapped in securely. She had no neurological deficit and no neck pain or tenderness. Her status didn’t change during the lift up the stairs. It was all precautionary.
Another 15 year-old girl, this time with less attitude, and a normal accent, albeit American, was waiting for me at a tube station. She’d collapsed after being sick into a bag – she felt generally unwell and it may have been down to something she’d eaten. I put the blame on ice cream.
Her mum, dad and older sister were with her and everyone seemed happy enough. I spoke to her while we waited for the ambulance and I chatted to her parents and her sister (who is very nice and apparently doesn’t bully her sibling) while still waiting for an ambulance.
Eventually, after being told that it was ‘on scene’ but not seeing a crew appear, I walked the girl and her family to the car. There was no ambulance outside. They were at a completely different station. It made more sense to take her in the car now.
Big sister and dad walked across the bridge to the hospital and I drove the patient and her mum but, as the direct result of paperwork, I was beaten to the hospital by the walking party. So now the people of Colorado think the London Ambulance Service is slower than a snail in a headwind. Not true though… ask the driving instructor!
The young lady was left in the gentle care of the paediatric nurses and her family waited with her. I said goodbye and left for the next mission. Before I finished this call however, I made enquiries on behalf of the young lady. So, just for you and because you didn’t know – your name means ‘Towers’.
The shift ended with another fitting. This time we had to run and descend deep into the underground to get to the patient. It was busy with people of course and not many of them cared to move out of the way so that we could reach the platform quickly. A tannoy announcement had been made just as we arrived, informing passengers of a medical incident but it made no difference to the people who were obstructing us by standing in the middle of the escalator.
The lady was with her family and friends; she had been fitting on the train and was taken off to recover on the platform. She was very confused and very strong, as she thrashed and lashed out when I tried to give her oxygen. This was to be expected and I won’t fight with someone in that condition, so the mask was left off until she was a little less combative.
The crew was on scene soon after I’d started my obs and the woman was less agitated by the time she was placed into the chair for the long trip up to street level.
I have a few more shifts on the road coming up, so I’ll report as and when. In the meantime I’ll continue to comment on the issues that make a difference to us here.
Be safe.
Sunday, 13 March 2011
Slow to act
http://www.telegraph.co.uk/news/uknews/terrorism-in-the-uk/8374581/77-inquests-emergency-services-should-use-plain-English.html
It has been suggested that the emergency services (some of them) showed a little too much caution on 7/7; some, apparently, were slow to take ‘calculated risks’ in order to save lives.
I personally do not believe that any of us on that day stopped to think too long about whether our involvement was too risky and that the lives of others were not of paramount importance during the terrorist attacks but I would like to tender this reasonable presumption on behalf of those who are being seen as ‘slow to respond’ – maybe there were too many unknowns. We don’t get bombed every day (thankfully), so we don’t have the experience necessary to activate a train of thought that superintends our sense of caution for our own sakes. We are, however, reluctant to rush in without thinking because that too will cost lives.
Believe me, this is not an excuse for alleged delayed response but, from a human point of view and knowing how it all unfolded for real, I can see why people may think that too much caution was exercised. I’m sure that in the first few days of the Blitz, emergency services and ordinary folk were unexercised and slower about their decisions to commit themselves to immediate danger – I’m confident, without knowing for sure of course, that they began to get braver and more involved with the thick of it as they grew accustomed to the effects and aftermath of the German Luftwaffe actions. They’d be taking risks based on their experience and knowledge, gained over the period in which they managed to survive previous risk-taking activities, which would have been slower and more cautious. It would have been a learning process borne out of self-preservation.
Would we be criticising the response to 7/7 if it was carried out without caution and many emergency services personnel died as a result? How many of the brave Fire fighters in New York would have been ordered to stay in the Towers if their bosses (and the public) had known of their imminent collapse? I’ve actually received an email from someone stating that ‘paramedics should expect to risk death for their patients’.
I remember carrying out a mock exercise at university, the year before I graduated and qualified, where we were to respond to an explosion (a bomb) at an underground station – one of those that had, in fact, been targeted in 2005. I recall how unlikely it seemed that it would ever happen in reality but it did, only a year later. Everything in that mock exercise had to be planned precisely so that errors would not be made, or at least they could be reduced in number. Such calculating takes time.
If terrorists strike again and they put into place secondary devices and other traps, would we be foolish to exercise caution? Or would it be okay to lose ten or twenty members of the emergency services instead of the risk that we’d lose two or three victims who had to endure until they arrived? It’s a horrible balance to achieve but it is a regrettable function of mass casualty emergency medicine; saving the greatest number possible, without needlessly risking the lives of others.
I hope I made sense there.
I don’t tend to focus too much on what we did or did not do on that day because, although there needs to be a thorough inquiry for the sake of the victims’ families and I do appreciate that, I tend to look at the bigger picture. As long as we tolerate self-segregation by those who come to our shores, have families, create generations of new ‘Brits’ but, throughout the entire process, refuse to integrate and whilst loathing our systems and beliefs, teach their children the same poisonous stuff, we will be at risk from attack from within. We will see more photographs of smug, smiling men who believe they will get to heaven by murdering others on the say-so of their religion (a religion they tarnish by doing so) - men who hold small children and who will ultimately leave them with the shame of what they have done.
The 7/7 inquiry is important. I would want to know how and why my loved one died on that day, of course I would. Everything needs to be analysed because it’s how a civilised society behaves after disaster but let’s not overlook the fact that none of it would have happened if the young men being bred to do it were not here in the first place; if our civilised way of life did not extend to allowing them to attend hate classes and berate our soldiers on the streets as they bring home their dead.
The Inquiry has to hear the views of everyone with a voice and I guess the caution perceived on the day is a matter that has to be addressed. However, at the risk of sounding unreasonable, is the primary thinking here that emergency services personnel are, by merit of uniform, salary or rank, expected to take risks without thinking?
If I get to a call and there is a problem – there is smoke billowing from the entrance of a tube station – I will have a look and see how far I can get. If I see flames and know that entering further will get me burned and possible killed, I will back off and re-think my strategy; I’ll wait for the Fire Service to arrive. Members of the public will then recount my actions and say that I acted too cautiously or that I refused to act at all when people were dying below ground, although none of them would have ventured inside either – the one wearing the uniform is the expendable one.
I will gladly risk whatever I can to save someone else – we all would - but I challenge you to find many who would thoughtlessly give up their own lives, their families and loved ones, for a stranger.
Be safe.
It has been suggested that the emergency services (some of them) showed a little too much caution on 7/7; some, apparently, were slow to take ‘calculated risks’ in order to save lives.
I personally do not believe that any of us on that day stopped to think too long about whether our involvement was too risky and that the lives of others were not of paramount importance during the terrorist attacks but I would like to tender this reasonable presumption on behalf of those who are being seen as ‘slow to respond’ – maybe there were too many unknowns. We don’t get bombed every day (thankfully), so we don’t have the experience necessary to activate a train of thought that superintends our sense of caution for our own sakes. We are, however, reluctant to rush in without thinking because that too will cost lives.
Believe me, this is not an excuse for alleged delayed response but, from a human point of view and knowing how it all unfolded for real, I can see why people may think that too much caution was exercised. I’m sure that in the first few days of the Blitz, emergency services and ordinary folk were unexercised and slower about their decisions to commit themselves to immediate danger – I’m confident, without knowing for sure of course, that they began to get braver and more involved with the thick of it as they grew accustomed to the effects and aftermath of the German Luftwaffe actions. They’d be taking risks based on their experience and knowledge, gained over the period in which they managed to survive previous risk-taking activities, which would have been slower and more cautious. It would have been a learning process borne out of self-preservation.
Would we be criticising the response to 7/7 if it was carried out without caution and many emergency services personnel died as a result? How many of the brave Fire fighters in New York would have been ordered to stay in the Towers if their bosses (and the public) had known of their imminent collapse? I’ve actually received an email from someone stating that ‘paramedics should expect to risk death for their patients’.
I remember carrying out a mock exercise at university, the year before I graduated and qualified, where we were to respond to an explosion (a bomb) at an underground station – one of those that had, in fact, been targeted in 2005. I recall how unlikely it seemed that it would ever happen in reality but it did, only a year later. Everything in that mock exercise had to be planned precisely so that errors would not be made, or at least they could be reduced in number. Such calculating takes time.
If terrorists strike again and they put into place secondary devices and other traps, would we be foolish to exercise caution? Or would it be okay to lose ten or twenty members of the emergency services instead of the risk that we’d lose two or three victims who had to endure until they arrived? It’s a horrible balance to achieve but it is a regrettable function of mass casualty emergency medicine; saving the greatest number possible, without needlessly risking the lives of others.
I hope I made sense there.
I don’t tend to focus too much on what we did or did not do on that day because, although there needs to be a thorough inquiry for the sake of the victims’ families and I do appreciate that, I tend to look at the bigger picture. As long as we tolerate self-segregation by those who come to our shores, have families, create generations of new ‘Brits’ but, throughout the entire process, refuse to integrate and whilst loathing our systems and beliefs, teach their children the same poisonous stuff, we will be at risk from attack from within. We will see more photographs of smug, smiling men who believe they will get to heaven by murdering others on the say-so of their religion (a religion they tarnish by doing so) - men who hold small children and who will ultimately leave them with the shame of what they have done.
The 7/7 inquiry is important. I would want to know how and why my loved one died on that day, of course I would. Everything needs to be analysed because it’s how a civilised society behaves after disaster but let’s not overlook the fact that none of it would have happened if the young men being bred to do it were not here in the first place; if our civilised way of life did not extend to allowing them to attend hate classes and berate our soldiers on the streets as they bring home their dead.
The Inquiry has to hear the views of everyone with a voice and I guess the caution perceived on the day is a matter that has to be addressed. However, at the risk of sounding unreasonable, is the primary thinking here that emergency services personnel are, by merit of uniform, salary or rank, expected to take risks without thinking?
If I get to a call and there is a problem – there is smoke billowing from the entrance of a tube station – I will have a look and see how far I can get. If I see flames and know that entering further will get me burned and possible killed, I will back off and re-think my strategy; I’ll wait for the Fire Service to arrive. Members of the public will then recount my actions and say that I acted too cautiously or that I refused to act at all when people were dying below ground, although none of them would have ventured inside either – the one wearing the uniform is the expendable one.
I will gladly risk whatever I can to save someone else – we all would - but I challenge you to find many who would thoughtlessly give up their own lives, their families and loved ones, for a stranger.
Be safe.
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