A few months ago I was promoted to the role of Clinical Support Advisor (CSA). This is an off-the-road position and I’m proud to be part of the small team that mans the desk in Control 24 hours a day, 7 days a week. The role involves giving advice to crews and Control staff on protocol, guidelines, drug use and many other aspects of the job.
I work on this desk as and when I can and have so far found it to be very different to my ‘normal’ routine in that advising from a remote position can be a lot more difficult than being on scene. On one call a crew requested support in making a decision not to resuscitate a terminally ill patient who was about to go into cardiac arrest at home. Her family were adamant that no action should be taken to revive her and I waited on the line as the lady stopped breathing and eventually slipped away in bed. This sort of decision, as you know, is difficult for me because my instinct, like that of the crew on scene, is to carry out my perceived duty of care but it was somehow easier to deal with the problem from afar; the facts of the matter were clearer because I wasn’t in the unenviable position of having to feel the emotions within the environment.
The role is one of support and not superiority over crews and I’m comfortable with that – the decision-making process is faster and needs to be 100% accurate because the CSA’s head is on the block if the wrong advice or information is given to colleagues, so in that respect, we risk losing our jobs on a more frequent basis. Having said that, we too have a line of support if we are unsure and can refer a query further up until it reaches our Clinical Director.
Watching calls coming in and listening to how they are handled by the call-takers gives me another perspective and it’s healthy for me because I can see both points of view. I can also see how badly the system fails us when a patently obvious medical problem is overlooked by the press-button processes and how innocuous or just-plain-stupid calls are blown out of proportion and turn Red as the computer decides to panic. The CSA’s can upgrade or downgrade calls at the touch of a button but only if we can justify doing so…and we’d better be right.
I also hear the abuse levelled at the call-takers on ‘the nines’ – angry people, sometimes understandably, simply don’t realise that questions have to be asked and that time is needed to complete the data input. An ambulance will be on its way but a lack of information is one of the reasons my colleagues and I complain when heading to vague calls. This is the root of it all; quality of input and that’s mostly down to the caller. Although there will probably never be an answer to the human issue of 999 frustration, this blog and the others that exist should go some way to educating the public about the way their emergency system works.
Have a read at Nee Naw and other despatcher blogs for more insight.