Thursday, 24 December 2009

Holiday Handover


Due to an incapacitated MrsInsomniac, and an overworked and ever more underslept Insomniac, I have been extremely lax in promoting the latest Handover Carnival. It has been expertly and brilliantly hosted over at Ambulance Driver's site, and I thank him for including one of my posts along with so many other terrific pieces. In the spirit of AD's musings, I wish you all a happy, healthy and peaceful holiday season.

Tuesday, 22 December 2009

Prayers Answered?

Conversations with patients and their relatives often turn to the weird and wonderful whilst waiting, ever longer, on scene for an ambulance. Ambulances are scarce at the best of times, but especially at this time of the year.

There's an absurd fascination in this wintry weather with attempting to stand on that frozen stuff on the ground and see if it really is slippery, and really does make you fall over, and really makes you break your arm/leg/hip. Let me help. It is. It does. It will do. So unless you absolutely have to - don't. Enjoy the view from the window, hot chocolate in hand, heating all around. Don't get me wrong - I fully understand, appreciate and endorse the need for building snowmen. And snowwomen, if you prefer. But stay off the ice! (The publication of this blog has been delayed due to MrsInsomniac doing precisely the opposite...)

Anyway - I digress.

Marik was one of those I'd term the "Worried well". He bought himself a blood pressure machine, just in case. And he had an hour-long head-ache, so he checked his blood pressure, which was fine.

Which worried him. So he took it again. And it went up.

Which worried him more.

So he took it again, and up it went, and he panicked. A little.

He spoke to the doctor on the phone who told him he was having a CVA, or stroke. Thanks Doc.

Well, that was it. Full scale panic. The FRU (aka clock-stopper), was sent, with the promise of an ambulance as soon as one became available. It may be a while. A history was taken, observations checked and found to be in perfect order, advice was given, and a request to be taken to hospital made. For various reasons I was unhappy about taking him in the FRU, so we'd have to wait for the snow/ice/leaves-on-the-track delayed ambulance to arrive and convey.
Whilst passing the time of day, I have a good look around the room and check out all the books. I have a bad habit of doing that, as it gives me a very good clue as to who the people in front of me are. I find that you can learn a lot from books, and not necessarily just by reading them. I see books on all the sciences, especially physics and maths. Books about stars, planets, discovery, the world, and its place in the universe.
Then I see bibles. Dozens of them, in a dozen languages. Shelves of them, 3 books deep, each shelf holding one of the languages. I'm a little surprised. Not at the fact that there is a bible in the house, but at the sheer volume and variety. I'm forced into a corner. I try not to show my curiosity/nosiness or whatever you want to call it, but on the other hand, I have to ask.
"Do you sell bibles for a living?"
"Well, in a way, I guess you could call it that."
"OK. What do you mean?"
"As you ask, I have to be honest. I don't like to tell everyone, but I'm a Prophet of the Lord!"
Now, how do you respond to such a statement? I want to say "A What???" or "Are you sure???" or, probably less appropriately, I want to shout "What the hell are you on about???" I didn't say any of them. I was much more profound.
"Oh", I said. For good measure, I think I even added an "I see".
Then he went on to talk about how he uses his knowledge of science to help him spread the word of God, help him understand, help him make the world a better place. He told me how he received his information, how he knew what to teach. He told me about the messages he received. They were the equivalent of the Twitter Direct Messages. @Prophet. @God. Cool. Wish I had that sort of inside information.
I also wondered if he'd been sent to help out an old friend of mine. I wonder if his prayers have finally been answered.

Thursday, 17 December 2009

Someone, Somewhere...

...has been paying attention to what the workforce on the frontline has been saying for ages. You never know, we may actually have been right!

I know, it's not all as straightforward and simple as we'd like, but there has to be talk about the system. It isn't some sort of sacred cow that can't be criticised, and should be open to debate, investigation, and change.

Here's hoping.

Shock Tactics

It's a change in behaviour that we need to aim at the younger, grass-roots members of society.

Before they start exhibiting that behaviour.

Maybe, just maybe, this is one way of doing it.

Good Luck.

Wednesday, 16 December 2009

Anonymous

Dear All,
I have been toying for some time with the idea of blocking anonymous comments on the blog. Whilst I want to encourage conversation, I find it difficult to respond when, for example on the last post, there are FIVE anonymous comments. And then debate begins between them. So, in order to not turn away those who wish to hide, I haven't blocked them. Yet. But...
I'm now starting to moderate every comment that comes in, and every comment that doesn't arrive with at least initials at the bottom of it, be they real or even fake initials, will be rejected. You can use nicknames, daft names, real names, whatever (within reason please), but you must use at least some form of identification.
In the meantime, please keep reading, commenting, and debating.
Thank you!

Tuesday, 15 December 2009

Sim's Card

All around, festive lights are flickering. On trees, in windows, in truck cabs and shops. Some windows have candles alight. It seems that everyone needs some extra light at such a dark time of the year. The short days bring only temporary respite from the long nights. Even then they're merely a dim glimmer of hope, the cloudy skies preventing the sun from breaking through and showering some of its warmth. For so many, this time of year, far from being a time of joy and family gatherings, is a time of loneliness, fear, and heartbreak.

Having never before had the need to break into a house, I found it a difficult decision to make. It had always been the police's job to break doors down. This time they had no units to send, and the report I'd been given was one of a child, possibly a baby, crying continuously. The call had come from a concerned neighbour, who'd heard crying when they went out for the evening, and had returned hours later to still hear the same noise. There were no lights on in the house.

As we arrived (I was in the FRU (fast response unit), but had an observer -a nurse turned medical student- with me for the night), we could hear the whimpers through the letter box. We called, yelled, banged on the door, rang the bell, all to no avail. No lights came on, no curtains twitched, no movement. Throwing caution to the wind and cursing Health and Safety rules, I looked at Beth, my observer, told her she never saw a thing, and broke the door down with two swings of an oxygen cylinder. Note for future reference - they make damned good battering rams.

The first light switch clicked ominously like an empty rifle. No flash of light, just an echoing click. The second did the same. As did the third. I went back to the car and found a torch, and carried that and the newly redefined oxygen cylinder as self-defence. Just in case. I had a quick look up and saw that none of the light fittings had any bulbs in them. We searched every room, and tried to follow the sound of the cries. It was like trying to find the end of a rainbow. Every time we thought we'd pinpointed it, it seemed to move, and we started wondering if we were actually chasing a cat rather than a baby. Ominously, after a few minutes, the noise stopped.

Having found nothing downstairs, other than a framed photograph of a soldier standing proudly in dress uniform, we started up the stairs, a double flight, with a small landing half way up. The darkness seemed even heavier here, the torchlight making minimal difference. In the dull glare of the torch I checked the first set of stairs, skipped the landing, and looked directly upwards. My heart rate doubled and I could feel the sweat starting to build as the adrenaline pumped itself round my slightly terrified system. I still don't know why I kept going, rather than waiting for back up, either in the form of another ambulance or the police. Stupidity rather than bravery, I assure you. Reaching the top of the first flight, and stepping on to the landing, I tripped over a boot, and yelled in fright. The boot was attached to Sim.

Sim looked like a ghost, a pale, almost skeletal ghost, hands nothing but skin and bone, terrified, wild, bloodshot eyes sunk deep into his head. He was cowering in the corner, legs folded up into his chest. Then the tears streamed, and the all-too-familiar cry that we'd heard from outside returned. Sim was no baby, or child. He was a fully grown man, looking decades older than the mid-30s that he was, a shadow of what he probably used to be.

He wouldn't, maybe couldn't, talk for a long while. I'd informed control that we'd found him, that there was no child involved, and they in return told me that they had no ambulance to send, and that the police would be at least an hour as well. Beth and I were ready for a long stay, unsure of what to expect. We asked questions, made statements, promised help, if only he would talk to us. Beth tried to put an arm around his shoulders, a gesture that at first he repelled, horrified, but then accepted with a look of desperation. Sim cried into her shoulder for a full ten minutes, before at last regaining some composure, and whispering a barely audible "Sorry".

We talked some more, Beth and I, while Sim would only answer by nodding or shaking his head. There were intermittent sobs, long silences while we searched for the right questions to give us the answers we needed. The photo downstairs eventually registered in the recesses of my mind, and I realised that this shadow was once that same proud soldier.

"Is that you? In the photo downstairs?"

A nod of the head confirmed my suspicions.

"I was a soldier once. Miss it too! Miss the friends, the closeness, the action. Would go back tomorrow if I could." I told him a little of where I was, what I'd done, what I'd seen, and what it meant to me. Slowly, the tears dried.

For the first time, Sim looked me in the eye. I'd found it. The connection we needed. And then he talked. For the next 20 minutes, uninterrupted, he talked, and we listened. About the Army, about his life without it, about the injury he'd received that meant he could no longer serve his country. He spoke of the nightmares he has, the flashbacks, the friends he'd lost. He told us that the Army was not only his life, but his friends, his family, his support. He cried about being jealous of his friends who were still serving, how they couldn't visit him while they were away on a deployment. How he was left all alone, now that they'd been away for three months. He had no food, no electricity, no money, and not a soul in the world to turn to. He couldn't bring himself to leave the house, the thought of the outside world terrifying him. Tonight was the night he was going to end it all, but he couldn't bring himself to do it. He sat on the landing and cried for hours, until we arrived.

We talked some more about how we could get him some help, and reluctantly he'd agreed to try. He'd come to the hospital, talk to the doctors, the crisis team, the social workers. He made no promises about succeeding, but at least he'd give it a go. "At least I'll try to get to see one more Christmas."

Weeks later, and after a few days off, I returned to station for my next shift to find a card and an almost empty box of chocolates, just sat on the table. I looked in the card, expecting to see another "Merry Christmas" or "Happy New Year" message from a grateful member of the public, or maybe even from our management. Happens sometimes. Instead, it had two sentences inside.

"Thank You for understanding and saving my life. From one ex-soldier to another".

Sim's chocolates were gone.

Sim's card is still safe.

Hopefully, Sim is too.

Sunday, 13 December 2009

Wednesday, 9 December 2009

GD

Chaos.
Smashed glass.
Fuel all over the place.
Unconscious, probably drunk driver.
Lots and lots of bystanders who all come rushing out.
*****
I'm always amused by the fact that when attending the scene of a serious RTA, as this one was, there are people who still insist on waving frantically to show the ambulance where to go. I mean, do you really think I can't see the upside down car with the steam pouring out of it? I know, I know they're only trying to help, so I shouldn't really complain, but still. It's weird.
One of the bystanders, we'll call him GD (the reasons will become clear shortly), comes over to tell me proudly that he and one other person dragged / assisted the driver out of the upside-down car, and after a few seconds of drunken yelling and thrashing about, he collapsed into an unconscious heap, where I found him.
GD then stands watching me and talking to me as if I'm his best friend. I complete an initial assessment, sort out a collar, some oxygen, do some basic obs, and assess for any immediately life-threatening injuries. None are apparent. Had he not have been drunk, this would never have happened, but the fact that he was, probably saved his life. Ironic really.
The whole of the local fire department turn up, and look sorely disappointed when the car wasn't on fire as had been originally reported. Apparently. They're closely followed by the ambulance. We package our drunk friend, who's starting to come round a little. Frankly, it was easier when he was unconscious and wasn't claiming to be one of several Hollywood heroes whilst fighting everybody off.
The ambulance leaves, and as I start my paperwork, I'm left watching the fire brigade turn the car back onto its wheels and then sweep up the mess. A voice behind me startles me a little, and I turn round to see GD standing there, proud as a peacock. "You don't remember me, do you?," he says. "You were at my house six weeks ago!"
I search the recesses of my brain but in the chaos can't place him at all. He must have seen the blank look on my face. "You were at my house", he adds, "for something completely different. Just as messy, though. Don't you remember? You delivered my... "
"Grandson!" we both said, simultaneously.
I'd delivered his grandson not two months previous, in the house right by the scene of the crash. I knew the house looked familiar.
"Don't you remember? I floated round the house yelling to everyone on the street: I'm a GrandDad! I'm a GrandDad!"
Cue huge grin.
Oh yes, GD. I do remember.

Tuesday, 8 December 2009

Ever Before


She holds her eldest child close.

Closer than ever before.

Her sobs are pained and silent.

Quieter than ever before.

She needs him as he needs her.

More than ever before.

They've said goodbye to the baby.

They'd not said it ever before.

Sunday, 6 December 2009

Used and Abused

With apologies to, well, everyone. You really probably shouldn't read this either on a full stomach or an empty one. It's 3 in the morning, and I can't sleep. Again. And I can't use work as my excuse this time. The news is showing endless loops of drunks in public places, private parties, and excruciatingly humiliating themselves. It's led to some sort of worrying muse. However - I have to say, hats off to the boys and girls who man (sorry) the Booze Bus. I don't know how you do it.
*****

The Season has begun.
You know what must be done.
You must go to the office do,
And start off at a run.

To drink all that you can,
Will show you're such a man.
It's just the greatest thing to do,
From pint, to glass to can.

You'll vomit like a tap,
Wake up and feel crap.
Won't remember a single thing,
Was it worth it, dear chap?


No connection - brain to feet,
You'll fall down in the street.
They'll call for you an ambulance,
That has someone else to treat.

You really couldn't care,
Whether it should be there.
The ambulance is there for you,
So your vomit you can share.

We'll cart you in the back,
You'll shower us with flack.
Both words and stomach contents,
A hurtling attack.

You'll wake in A&E,
Desperate for a wee,
And do it in the cubicle,
"The bog's too far for me!"

That's how you'll end your night,
In bright fluorescent light.
A black mark on your record,
And your friends nowhere in sight.

And the crew that you abused?
They're feeling somewhat bruised.
We really have much better things,
For which we should be used.

Thursday, 3 December 2009

Swings

I like swings.

And roundabouts.

And slides.

But I don't like swings.

So please don't take one at me. I won't take to it kindly.

Thank you.

Monday, 30 November 2009

Five Days

I don't do pets. Never had a pet. Don't understand why you would. Never had to feed a cat, clean out a litter tray, walk a dog, or even open a tin of dog food. Nothing. It's just not me. Don't mind other people having them, but won't ever have one myself. And wouldn't know what to do if I did.
*****
Five days. They didn't know that at the time, but the newspapers on the doorstep gave it away. As did the calendar with the changeable dates that was still showing the date from the weekend before. Gladys had been on the floor for five days. Unable to summon help, she remained trapped between the bed and the chest of drawers where we eventually found her.
"Oh, you found me then", she said. I felt like I'd just closed my eyes, counted to twenty, and started to seek whilst Gladys hid. She was in surprisingly good spirits for someone who'd been stuck on the floor for so long. In a warped sort of way, she'd been lucky. She fell as she was holding a bottle of water, so she had that to keep her going. But still. Five days is a long time on half a litre of fluid.
She was another one of the stubborn generation, but this time, a lonely one. She refused any offers of help, had no carers, no emergency lifeline to call. Most distressingly, she had no family either. Her neighbours did what they could, but she would hardly let them in, either literally or figuratively. It was, eventually, one of these neighbours who noticed the post box was overflowing, and decided to call for help.
These sorts of calls fill me with no small amount of concern. All too often we enter to find that there is nothing left to do. Nobody to help. Only coroners' arrangements to make. This time, there was a yell from upstairs, closely followed by a whimper. Gladys was sat on the floor, where she'd been for the whole five days, unable to lie or stand. Only sit. So she had slept, read, drunk and chatted where she fell. The yell obviously belonged to Gladys.
The whimper belonged to her conversation partner. There he was, laying next to Gladys, guarding over her. "Only ever left me to get some water, he did. Probably drank from the toilet. He's kept my mind busy. Knows a lot about the ancient philosophers he does. He turned on the telly and found out the weather report for me every day too, just to keep me up to speed. Amazing how much you learn from a well-read dog! The conversation's tailed off a bit though. He's probably hungry, he hasn't eaten for five days and can't be bothered any more. Anyway, he probably thinks I'm barking mad."
I can't help but laugh. She fusses his head and then looks back up at us, eyes smiling and full of mischief. "How long have you been down there then?" I finally ask when I'm able to get a word in, both of us aware that I probably know the answer.
"Oh, seen more than a couple of sunrises, missed a couple of loo appointments, must be five days at least. I tried yelling, but no-one hears you round here. Too much traffic. Wasn't like that when I first moved here. No cars then. Only bicycles and the odd milk float. You try being nice to everyone but eventually you just don't know who anyone is any more, so you stop. They're all nice round her, they offer to help. I'm just too head-strong. You know how long I've lived here? 60 years! Can you imagine! That's probably three times your age... Can you understand that? I bet you can't!" I thank her for making me much younger than I really am.
She talks like someone who hasn't spoken to a soul for five days. In the meantime I check her basic observations, which all seem to be healthier than mine. One of the neighbours helps me get her off the floor and we change her out of the clothes she's in, clean her up a little, and get her ready for a dignified journey to the hospital. If for no other reason, it'll give the system time to catch up and find her the necessary help, should she finally choose to accept it.
The ambulance arrives and Gladys is carried down the stairs and gives out orders like a queen sitting on her throne. "Will you make sure the doors are locked?" she asks one neighbour. Another is ordered to turn out the lights, and a third is instructed to tidy the post and the newspapers. "So I can get back in here later", she adds.
"Oh!" she suddenly yells and points at me as we're loading her into the ambulance. "It looks like he likes you. Can you make sure he gets fed some dog food?"
You couldn't pick on someone else? A pet lover maybe?
Oh well. First time for everything I guess. After all, it has been five days.

Saturday, 28 November 2009

Close Calls Handover


The Close Calls Handover has been posted over at Happy Medic's HQ. As always, the Handover makes for some good reading. There's even an honourable (and I'm duly honoured) mention in dispatches for your local Insomniac.

Go.

Read.

Be inspired.

And, as always,

Stay Safe.

Wednesday, 25 November 2009

Armchair

"Oh - it's you again". Sometimes it's a phrase said with genuine affection. Sometimes relief. Sometimes it's just downright disdain.
*****
"Armchair", you grunt, as an afterthought to the opening phrase.
Well, yes. It is me again. And again. And again. I keep coming back here when you've had enough of another one of your clients. But this time, I can bite my tongue no longer.
This time, you left her in the armchair, in front of all the other residents, for a whole day. And night. And most of another day. Almost 36 hours, and none of you thought to check on her.
You just "assumed".
You just thought "she doesn't do much usually".
You just presumed "she was in one of those moods".
None of you thought that it was unusual that she hadn't asked for help to get to meals.
Or back to bed.
Or even to the toilet.
Three shifts went by, and she was still sat in the armchair.
When you finally took a look, you saw she was barely breathing.
You saw she was covered in vomit.
You smelt the strong smell of urine.
So you told her off. Like she was some sort of small child.
Like it was her fault that she'd possibly been unconscious for the best part of two days.
Like it was her fault you ignored her.
Well you know what? It's your fault. Your job is to care, to pay attention, to tend to needs. That's why she was there, so you could look after her. That's what you have chosen to do. That's what you're paid for. So don't tell me that you're "not paid to think, just to clean them". The "them" you refer to are people. Not animals or the cages that they're kept in.
You were charged with her welfare, when she had no where else to look, and no one else to turn to. And you failed.
And I hate to say it - I get the feeling you're almost glad.
Glad that she's taken off your hands.
Glad that you're no longer responsible.
Glad that she'll probably never return to that armchair.

Sunday, 22 November 2009

Lifesaver

The darkness is compounded by the cloudy, moonless sky, the heavens showering down their vicious tears with all the contempt they can muster. At least it helps the house stand out like a beacon. It's the only one in the street with all the lights on, shedding some brightness on the otherwise depressing night. As I approach the house through the overgrown jungle that covers the garden path, the door is already open. Standing on the doorstep is Rita, leaning forwards, hands on her knees, struggling for breath. She can barely get one word out at a time.
Rita's man is there, comforting her, encouraging her, keeping her calm. He's doing a good job of it too. It's especially impressive, as Ryan is only 10 years old, and Rita's his mum.
"I'm used to it", he claims. "She sometimes gets very sick and I have to help her".
"Did you call the ambulance?" I ask him.
"Yup. I've done it before. They always ask me the same questions, so I know what to tell them now".
It's about 4 o'clock in the morning. Ryan is wide awake, dressed, has got all of Rita's medications together, and written down the details that we need. It took me less than 5 minutes to get to the call, so he's obviously well trained and very organised. His little sister is half asleep on the couch, still in pyjamas, but with her coat on, ready to go.
While I prepare the nebuliser for Rita, he tells me that his mum has bad asthma attacks sometimes, and that she always has to go to hospital. He was woken up by the sound of a loud wheeze, and knew immediately what he had to do. He'd got everything ready while he was still talking to the call-taker at control, all the while doing his best to calm his mum's anxieties.
Rita's condition and observations mean that she's going to need some aggressive treatment and to be blue-lighted into hospital, and there's no-one else to look after Ryan and his sister, so I'm left with the babysitting duties. The crew and I decide that it's best if they don't travel in the ambulance, as we don't want to distress them any more, so they watch mum being loaded into the back of the ambulance, stare as the blue lights of the ambulance reflect off the vertical sheets of rain, and then climb into the car and out of the deluge. I've got the duty of transporting them to A&E until another responsible adult can be found to look after them.
On the way there, they both remain calm, although Ryan's sister is a little teary. Ryan tells me all about the schools they go to, how he helps at home, how he looks after his mum. More importantly he tells me about the football team he supports, and laughs when I threaten to throw him out of the car for supporting a team that are the sworn enemies of mine. Although, I have to admit it, they're much better than mine. But then, most teams are...
We arrive just after the ambulance, and the kids say a quick hello to mum and see that she's looking a little better and in good hands. They're happy to find the kids' waiting area and go to find some toys. Ryan keeps up his role of babysitter and looks after his younger sibling, finding toys that he knows are her favourites. I watch from outside and am impressed by all I've seen and heard. At just ten years old, this young man is so much already.
Son, big brother, mini-dad, carer. And, of course, whether he realises it or not - a lifesaver.

Saturday, 21 November 2009

Mag-num-ificent!


This is my endorsement. Not anybody else's. Not where I work, not who I work with, not who I work for. There. I've said it. Now, for the review.

*****


I, along with several others on blogsphere, was asked to review a pair of boots. A Magnum, Ion Mask, pair. They duly arrived, free and beautifully packaged, a couple of weeks ago, and I decided to take my review very seriously.

First things first, they're huge! They're a much higher (no, I don't mean heels, I can't walk in them) than I'm used to. They also had no steel-toe cap, so I couldn't really test them at work, but I was determined to put them through their paces (sorry).

So I took them with me wherever I went for a few days, through all sorts of weather systems, doing all sorts of DIY, moving boxes, driving, walking miles, dealing with the kids. Whatever and wherever.

The idea of these boots is that they are totally fluid repellent, be that rain, oil or, as is particularly important in my job, bodily fluids. I thought it only fair to try this out too. A bucket of water, some torrential rain, and then a sandstorm later (I was away for a few days where they have sandstorms at this time of year...), and they seemed to be very much up to the task. I liked that. I also liked the fact that they were surprisingly light-weight.

All in all, I would highly recommend them. The only thing that concerns me, is the fact that I have an almost OCDish compulsion to have polished boots, and I wonder what that does to the the special Ion-Mask coating, and whether normal boot polish would ruin it. That's it. That's my only query/concern.

Otherwise, come on Magnum - bring out a pair with a steel toe-cap. I want them for work!

Thursday, 19 November 2009

Sleep is Overrated

This is what happens when you sleep.
Admittedly, not when you're in your own bed, but at the wheel of a truck.
Not recommended.
Although, seeing that as we rounded the corner made sure I was wide awake.
Told you sleep is overrated.

Sunday, 15 November 2009

Congratulations

You know what? I understand.
I understand that you have strong religious beliefs. And I respect that.
I understand that you have a long list of do's and don't's. And I accept that.
I understand that you'd rather not have a man deliver your baby. And I can deal with that.
But only because there happened to be a female paramedic with me.
What would you have said if there wasn't?
What would you have done?
Would you still have slammed the door in my face?
No. I don't know either.
Oh, and by the way -
Congratulations.

Tuesday, 10 November 2009

Growing Up

When I was a kid (the Boss will probably argue that I haven't got past that stage yet), I wanted to be all the things a normal boy wants to be when they grow up. A fireman, a policeman, a soldier, even a famous footballer. I have to admit that being a paramedic was no where in the line-up. Probably because I was the most squeamish person you've ever come across.
I did however, strongly consider becoming a train driver. At least I now know why I didn't go with that one.