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More Blood, More Sweat and Another Cup of Tea
MORE BLOOD, MORE SWEAT
and ANOTHER CUP of TEA
Tom Reynolds
Copyright
More Blood, More Sweat and Another Cup of Tea is not authorized or endorsed by the London Ambulance Service. Opinions expressed in this book do not necessarily reflect those of the London Ambulance Service.
The Friday Project
An imprint of HarperCollinsPublishers
1 London Bridge Street
London SE1 9GF
www.harpercollins.co.uk
First published by The Friday Project in 2009
Copyright © Tom Reynolds 2009
Tom Reynolds asserts the moral right to be identified as the author of this work
A catalogue record for this book is available from the British Library
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Source ISBN: 9781906321406
Ebook Edition © MAY 2013 ISBN: 9780007332694
Version: 2016-08-08
Dedication
Without my patients I would not be the person that I am today –and ultimately it is to them that this book is dedicated.
Contents
Cover
Title Page
Copyright
Dedication
Prologue: A Good Job
Introduction
Chapter 1 – Taxi
Chapter 2 – Leaving My Job
Chapter 3 – Zafira
Chapter 4 – NYE Night
Chapter 5 – Ten Deep Breaths
Chapter 6 – Taxi?
Chapter 7 – Chickenpox
Chapter 8 – Rough
Chapter 9 – The Black Dog Has Been Taken Outside and Shot
Chapter 10 – Complaint
Chapter 11 – Snapshots
Chapter 12 – Repeat Offender
Chapter 13 – Algesia
Chapter 14 – Back on the Car…
Chapter 15 – Wee-Wee
Chapter 16 – Swagger
Chapter 17 – Scent
Chapter 18 – Betting Shops
Chapter 19 – It Says ‘London’ on the Side
Chapter 20 – Good Job/Bad Job
Chapter 21 – Valentine’s Day
Chapter 22 – Tagged
Chapter 23 – Lost Words
Chapter 24 – Bleurgh
Chapter 25 – Free-Market Oxygen
Chapter 26 – Uniform
Chapter 27 – Abuse Your Ambulance Crew
Chapter 28 – Slow Suicide
Chapter 29 – I Wouldn’t Trust Them with My Dog
Chapter 30 – Laughing Policeman
Chapter 31 – Structural Collapse
Chapter 32 – Shorn
Chapter 33 – 12th November 2046
Chapter 34 – On the Power of Blankets
Chapter 35 – Friday Night’s All Right for Fighting
Chapter 36 – Gassed and Splinted
Chapter 37 – More Crap GP Work
Chapter 38 – Wasting the Time of a GP
Chapter 39 – Small Observation
Chapter 40 – (Another) Nan Down
Chapter 41 – More Madness in East London
Chapter 42 – Ethnic Relations
Chapter 43 – Lying to Patients
Chapter 44 – Patientside
Chapter 45 – Hit and Run
Chapter 46 – Happiness Is
Chapter 47 – Offering the Chance
Chapter 48 – Shaken Baby
Chapter 49 – On the Strange Thoughts that Assai I You at Five in the Morning
Chapter 50 – Taxi Driving
Chapter 51 – An Upsetting Job
Chapter 52 – Being Lied to
Chapter 53 – Clockwatching
Chapter 54 – Thank You Taxpayers
Chapter 55 – Helpful Demons
Chapter 56 – Absurd Council ‘Thinking’
Chapter 57 – Last Night’s ‘Off Job’
Chapter 58 – Wild Geese
Chapter 59 – Why You Should Pull Over and Let Us Pass (Or Hahahahahaha …)
Chapter 60 – Arranged
Chapter 61 – Sugar
Chapter 62 – F-off
Chapter 63 – The Standard Weekend Night
Chapter 64 – Moped Madness
Chapter 65 – Sucking Lungs
Chapter 66 – Persuasion
Chapter 67 – The Jobs We Do…
Chapter 68 – On Dealing with a Brain Surgeon
Chapter 69 – Forgetting Your History
Chapter 70 – A Warning
Chapter 71 – Bloody CPR
Chapter 72 – Stabbings and Sex Politics
Chapter 73 – New Terms
Chapter 74 – Rioting and Waiting
Chapter 75 – Not with Your Ten-Foot Barge Pole
Chapter 76 – Not All Bad
Chapter 77 – Minimalist Blogging #1
Chapter 78 – Minimalist Blogging #2
Chapter 79 – Minimalist Blogging #3
Chapter 80 – Minimalist Blogging #4
Chapter 81 – Minimalist Blogging #5
Chapter 82 – Community Care
Chapter 83 – Things that Make Me Want to Go Stabby
Chapter 84 – Why I Keep Telling My Mother that I Would Rather Wear Glasses to Work than Contact Lenses—Namely Their Protective Quality
Chapter 85 – The Usual Suspects
Chapter 86 – Maybe
Chapter 87 – Heatwave
Chapter 88 – Blue, Blue, Blue and Blue
Chapter 89 – Armed Siege
Chapter 90 – Working for Your Pay
Chapter 91 – Boating
Chapter 92 – Intermediate Tier
Chapter 93 – Double Fall
Chapter 94 – Fall-Not As Given
Chapter 95 – Faux Pas
Chapter 96 – ‘Cheating’ to Get Care
Chapter 97 – Oh FFS!
Chapter 98 – Shattered
Chapter 99 – Tilt
Chapter 100 – The Truth*
Chapter 101 – Why Your Train Yesterday May Have Been Delayed
Chapter 102 – Three Glass Stories
Chapter 103 – Hit
Chapter 104 – Allergic Reaction
Chapter 105 – After the Epilepsy Comes the Work
Chapter 106 – Snails
Chapter 107 – Mugging
Chapter 108 – Danger Bus
Chapter 109 – Dog (Or, Why I Like Animals More than Most People)
Chapter 110 – Thursday Night
Chapter 111 – Thank You West Ham
Chapter 112 – My New Plan for Hoax Calls
Chapter 113 – On TV Dramas and Documentaries
Chapter 114 – Dotty
Chapter 115 – Unknown Aggro
Chapter 116 – Church
Chapter 117 – Saviour or Service Abuser
Chapter 118 – Possession
Chapter 119 – The Humanity of the Officer of the Peace
Chapter 120 – Abandonment
Chapter 121 – Both Boxes Ticked
Chapter 122 – Cynical Minds Thinking Alike
Chapter 123 – Veil
Chapter 124 – A New Kind of Stupid
Chapter 125 – Forked
Chapter 126 – Hypo
Chapter 127 – Parklife
Chapter 128 – 9010
Chapter 129 – The Things that We Do
Chapter 130 – Helpful Passers-By
Chapter 131 – Government Targets
Chapter 132 – Hectic
Chapter 133 – Beaten
Chapter 134 – Beaten II
Chapter 135 – Inter-Service Relationships
Chapter 136 – Ghosts of the Past
Chapter 137 – Pitch Black
Chapter 138 – Google Health
Chapter 139 – Another Monday Night
Chapter 140 – Is It Wrong?
Chapter 141 – The Right Choice
Chapter 142 – The Slow Attrition of the Soul
Chapter 143 – Knee
Chapter 144 – Extended Role
Chapter 145 – The Stanford Experiment
Chapter 146 – Da Boss
Chapter 147 – Standing Back
Chapter 148 – Two in Two Nights
Chapter 149 – MHU Transfers
Chapter 150 – No Boom Today, Maybe Boom Tomorrow
Chapter 151 – A Little Good
Chapter 152 – Anger
Chapter 153 – A Night on the FRU
Chapter 154 – Attention
Chapter 155 – Meal-Breaks
Chapter 156 – Battered
Chapter 157 – The Long Job
Chapter 158 – Christmas
Chapter 159 – Man Down
Chapter 160 – Pre-Christmas Crisis
Chapter 161 – Bus/Follow Up
Chapter 162 – Curse of the Observer
Chapter 163 – His and Hers
Chapter 164 – On the Possible Causes for a Collapse
Chapter 165 – Non-Carers Who Care
Chapter 166 – Canvas, with Handles
Chapter 167 – Essex Boy
Chapter 168 – Parents
Chapter 169 – A Query on a Phone Call
Chapter 170 – Wheelchair
Chapter 171 – More of the (Shameful) Usual
Chapter 172 – Violence
Chapter 173 – Increasing Calls
Chapter 174 – Mr Grumpy
Chapter 175 – Yellow Card
Chapter 176 – Fat Bastard
Chapter 177 – On the Failings of My Stab Vest
Chapter 178 – Broken Finger
Chapter 179 – Returnee
Chapter 180 – Another Good Job
Chapter 181 – Infested
Chapter 182 – Small Annoyances
Chapter 183 – Friday
Chapter 184 – The Same Old Story
Chapter 185 – Yellow
Chapter 186 – Hive Mind
Chapter 187 – From Sun to Scum
Chapter 188 – More Real Work
Chapter 189 – More Strokes
Chapter 190 – Midwife to Tragedy
Chapter 191 – Rat Poison
Chapter 192 – Filth
Chapter 193 – Why I Like Old Folk
Chapter 194 – Cordoned Off
Chapter 195 – Invisible Dogs
Chapter 196 – Why the Government Hates Us
Chapter 197 – Thanks to a Bystander
Chapter 198 – Smoky
Chapter 199 – How to Fix the Ambulance Service (Part One)
Chapter 200 – HOW to Fix the Ambulance Service (Part Two)
Chapter 201 – Hidden Abuse?
Chapter 202 – The Term of the Day
Chapter 203 – A Good GP
Chapter 204 – Twit One and Twit Two
Chapter 205 – Two Amusing Things
Chapter 206 – Deceased
Chapter 207 – Fuming
Chapter 208 – Night Swimming
Chapter 209 – A Sheet of A4
Chapter 210 – Tough as Old Boots
Chapter 211 – Strength
Chapter 212 – Lexicon of the Ambulance Service (or What ‘Punter’ Means)
Acknowledgements
About the Author
Also by the Author
About the Publisher
Prologue: A Good Job
Two a.m. and we are standing on the side of the road waiting for the fire service to take the top off the car in front of us. The wind whistles across the flats making us all shiver despite our fleeces and our jackets.
Two cars have been involved in a high-speed road traffic accident (RTA), the parked car that was hit has been shunted forward leaving ten-yard-long skid marks. The cars aren’t too damaged but the seats inside have shifted around, trapping the occupants.
There are seven ambulances here, four fire trucks, half a dozen police and three ambulance officers with clipboards. There are eight patients, all but one need cutting from the cars and collaring and boarding. The only woman involved is ‘walking wounded’.
The reason that it is taking so long for our car to get its lid removed by the fire service is because of the position of one of the patients inside. He looks rather unwell and the crew looking after him really would like to get to him sooner rather than later.
Our ambulance was fourth on scene. When I arrived I spoke to a stationmate to see what he wanted us to do, who he wanted us to look after. Normally he is the station clown, now he’s all serious and professional, no fake beards or silly glasses.
Everyone gets checked over, all the ambulance crews are calm, it’s serious but it doesn’t look like anyone is about to die; more a case of being careful moving the patients ‘just in case’.
The roof comes off the car and with the help of another crew and some firefighters we get our patient out safely and strapped to a board. He is freezing cold. He is not wearing warm clothing so the delay in getting him out and the terrible weather have us concerned for his body temperature.
We are in a new ambulance so the heater works. Turning it up to full we are soon sweating as we assess the patient and prepare for transport.
I get on the radio to pre-alert the hospital. For some reason the radio isn’t working properly and our Control can’t hear me, so I use my phone instead. Thankfully it works.
I travel a mile over speed-bumps to get to the hospital; there is no other route and every bump makes me aware of my patient in the back being jostled around. It’s not the first time that I curse the council.
After all our patients are safe at the hospital we stand outside and laugh and joke. We reconstruct the accident, we talk about the more injured ones and we mock the driving skills of one of the officers.
We occasionally help people.
It’s a good job sometimes.
Introduction
I’m not special. All I am is one of the faceless people who work for an ambulance service. If you are lucky you’ll never meet me in a professional capacity. Most of the time you won’t even think about us; perhaps only occasionally sparing a thought for our work when an ambulance whizzes past you on the street, lights flashing and sirens sounding.
This book is a series of snapshots from the life of one ambulance worker. For the past few years I have been writing about ambulance work on the internet, regularly updating my website. From around the world people have come to read, and comment on, the sorts of jobs that I go to on a daily basis.
This book is not special—there are no tales of heroics, no exciting derring-do, nothing to compare with what the dramas on TV and film would have us believe. This is what ambulance staff the world over deal with day in and day out.
This is a book that lets you understand some of the situations that ambulance staff encounter every day, some of the pressures, and some of the humour that we use to let off steam.
Every time I talk about a patient in this book that situation has happened for real, to a real person.
Taxi
The staffing of ambulances at the moment is…to put it bluntly…poor.
Working on the fast response unit (FRU—a car that is designed to get to the sickest patients quickly) means that I often get to an emergency call within minutes of it being made. Unfortunately, with so few ambulances on the road, the patient and I are often left staring at each other for long periods of time; in a couple of cases up to an hour.
I was sent to a young man having an asthma attack. It was late at night, and he had been queuing to get into a nightclub when he had started to feel his breathing getting tight, the sign of an asthma attack, so had headed to a taxi office in order to go home. Unfortunatel, his asthma progressed and so an ambulance was called. What he got was me, on my own, in a car.
After dealing with the drunken group of teenage girls that had taken time out of waiting for a cab to start loudly ‘caring’ for my patient, I started my assessment. It was a cold night so I sat the young man in the taxi office and listened to his chest. I could hear a nice loud wheezing from his lungs so I started him on the first dose of our asthma medication. I got his details and checked his vital signs, and waited for the ambulance to turn up.
It takes between five and ten minutes for the asthma medication to finish, and by the end of it there was still no ambulance.
I listened to his chest again, still an audible wheeze, so I gave him a second dose of the medication. So there he was, sitting in a cab office at three in the morning with a mask over his face, ‘smoke’ pouring from it, and all around us were intoxicated people getting cabs home.
It was not very dignified.
We started chatting, and I was impressed by this polite young man with good manners and common sense. The second medication finished and so we continued to wait, and wait, and wait for the ambulance. I phoned up my Control and asked if there was an ambulance assigned.
‘Sorry EC50, we are still holding calls in that area.’
I was on my own with this patient for the foreseeable future.
Sometimes I can transport a patient myself to hospital, it’s not technically allowed. Actually, we’ve been told that we shouldn’t do it at all, but in some cases I think I’m doing the right thing for the patient. So I will load them into the car (which only has the front passenger seat, the rest of the car is taken up by equipment) and nip into the nearest hospital. Control is often happy for me to do this, as it means one less job that it needs to send a proper ambulance to.
I couldn’t transport this patient, though, because he wanted to go to his local hospital, which would mean driving past two other emergency departments and out of my area. I couldn’t see Control, or my bosses, being too happy with that.
So the patient, at his insistence, got a cab to hospital. The double dose of medicine had cleared his lungs up nicely, but he would probably need some short-term steroid treatment. I rechecked my assessment of him, and was happy that his physical condition was good enough for him to get a cab to hospital. I wasn’t happy, though, that there was no ambulance for this patient who actually warranted one.
As I write this I wonder what would have happened if he hadn’t responded to the medication that I gave him.
Leaving My Job
I think I’m going to be leaving my job soon.
I went to a six-month-old baby with possible meningitis. The baby had the right sort of rash (although it was only on the back of the knee and, after checking, nowhere else). It had a temperature, but was one of the happiest, most alert children I’ve ever had the pleasure of meeting. It just didn’t seem as if it had meningitis, and trust me, I’ve seen a fair few children and adults with it so I have a pretty good idea what it looks like.
Then, as in the past, I was left waiting for an ambulance.
For around 45 minutes.
There was no way I was going to be able to transport the patient in my car. It’s just not equipped to carry such a small child. We don’t have baby seats and as the family didn’t have a car they didn’t have one either.
So the family ended up phoning a friend to take them to the hospital. The ambulance turned up just as they were getting into their friend’s car.
All I had going through my head was the potential newspaper headline ‘No Ambulance For Baby Dying Of Killer Bug!’
Later that night I went to a woman who was having an extremely painful miscarriage. There is nothing I can do for that on scene, the patient needs to be in hospital. Thankfully the ambulance wasn’t too far behind me, but if I had been waiting on scene then it would have been a very awkward and distressing wait (again, because of the pain, it would have been impossible to transport her in my car).
More and more I’m looking at my watch as an ambulance fails to arrive. It’s only a matter of time before I have someone die in front of me while waiting for an ambulance.
So, I’m seriously considering leaving the FRU and going back to work on an ambulance. That way I can pick up sick people, and take them to where they need to be: a hospital.
So after the holiday season, I think I’ll be sending a memo up to the office asking to return to my ambulance role.
Zafira
I’m not perfect.
I arrived at work to find that my FRU car was nowhere to be seen. There was no one on the early shift, so where had my car got to?
The week before a friend of mine had had an accident in the Newham FRU car (in front of a load of police officers, which had given them some amusement I would imagine). So the car that I would normally use was being borrowed by Newham station.
So the plan was for me to get picked up at my station by a station officer, go to Newham, get the keys to the brand-new Vauxhall Zafira, return to my station with the car and start working.
The station officer met me and drove me down to Newham station. He asked me, because I was leaving my secondment on the FRU, if I could write up my thoughts on what was good, bad and what could be improved about it.
I told him that I’d be more than happy to point him in the direction of where my thoughts lay.
The brand-new Zafira was parked in the garage at Newham so I hopped behind the wheel and, after some struggling with the new design of handbrake, managed to reverse it out and into the parking area.
Where to the absolute horror of the station officer I drove into another car.
Oops.
Luckily there was no damage to the Zafira (which had less than 600 miles on the clock) and very slight, if any, damage to the other car.
The first accident I had in over 18 months and it was in front of a station officer…
Not a good start to the shift.
My thoughts on the Zafira are these; if you wanted a rapid response vehicle, the Zafira shouldn’t have been chosen. It is too top heavy and wallows like a hippo in thick mud. The acceleration is awful, you hit the pedal and it takes one and a half seconds before the diesel engine gives you any sort of power. It is comfortable to pootle around town in, and the high-up viewing position is quite nice.
