I must have upset management this week, because I found myself taking calls for the first time in ages. When you’re not used to taking calls it can be a bit of a culture shock to find yourself confronted with the entire spectrum of 999 callers – the rude, the polite, the stupid, the helpful, the suspicious, the infuriating and the plain bizarre. You start the day with your best “polite voice” on keep reciting things to yourself like “there are no inappropriate calls, only inappropriate responses” and “don’t take it personally, they are only shouting because they are upset” but after 12 hours the smile starts to slip. You realise that “I’ve picked my spot and it is bleeding” IS an inappropriate call, whichever way you look at it, and that the only appropriate response is unprintable and will have you on Advice and Guidance – and in fact, Spot Man is going to get an ambulance on blue lights within 14 minutes because he insists that the blood is spurting up in the air, as if from an artery. (It wasn’t. I checked the log afterward to make sure – the crew were on scene for ten minutes, “treated but not conveyed”. Just long enough to put a plaster on.) And the reason he’s shouting at me isn’t because he’s upset about his bleeding spot, it’s because he is rude and selfish and doesn’t care how many people die when he ties up the only available ambulance bringing him a plaster and AAARGH!

The job of the call taker is the most frustrating job ever. I know crews are always calling up and saying “Why have YOU made this a Cat A?” but it’s not us and it annoys us just as much as it does them.

Recently, I went on a call taking refresher course and there was a lot of discussion about how some call takers (not me, of course!) are less polite than they ought to be. The thing is that people (the training department, allocators, management, crews) forget the sheer frustration of being confronted with these awful calls and being effectively gagged and bound by the rules and script of AMPDS. I think if you were able to say, politely, “no, that’s not what we’re here for, so you can’t have an ambulance – but here’s what you should do instead” there would be far less instances of call takers losing their rag and speaking inappropriately to callers. Of course, I’m not saying that it is EVER okay for a call taker, who is being paid to be professional, to be rude, just that it is understandable. Unless you are taking calls 12 hours a day, 4 days a week, you cannot understand the pressure and frustration the call takers are under. And I think it’s good that us “upstairs” staff get stuck back on the 9s from time to time, because as much as I did not enjoy that shift, it was a reminder of what the call takers do for the ambulance service every day. Short of being out on the road, it’s the most stressful and demanding job you can do here. It might even be worse than being out on the road, actually – on the one hand, crews have physical danger and being out in the elements to contend with, but on the other, whilst crews work under their own steam and are fairly oblivious to how busy the service is (because they can only do one job at a time), call takers are under constant pressure to answer one call after another. Also, whilst patients/callers generally want crews to do their job (treating the patient) and are grateful to them, they see call takers as an obstacle to them getting an ambulance. Call takers are rarely thanked – in fact, I have never received so much as a thank you note even though there are several people wandering around today who wouldn’t be alive if I hadn’t been doing my job.

It’s not all rudeness and timewasters though – if it was, I’d have given up this job and gone and worked somewhere where I don’t have to wear green or sacrifice my weekends. The polite, helpful, kind people who call in make it all worth it. The mother of a severely disabled sixteen year old who’d developed serious breathing difficulties (“again”, she sighed), the passerby who stopped at a road traffic accident and took control of the first aid and the bystanders, the kind drug abuse support nurse who’d come round to check on a client on his day off and found him collapsed on the floor, the little old lady who didn’t want to bother us with that silly pain in her chest and down her arm, and even the man who rang because he’d seen a dog been hit by a car and didn’t know what else to do. (I gave him the RSPCA emergency number. There are no inappropriate calls, only inappropriate responses…) Those decent people are the ones who make it all worthwhile.

I expect I’ll be back upstairs tonight!

Published Sep 26, 2008 - 24 Comments and counting

24 Comments on “Some Thoughts on Call Taking”
  1. Natalie Says:

    I would last four minutes in your job. My hat is off to you for being as tolerant as you are! I’m glad there are some decent people who make it rewarding in the end.

  2. Corrvin Says:

    I’ve found that if you just cultivate a wide variety of pronunciations of “Oh,” it will get you through a good many situations where other responses would get you fired.

    I also, occasionally, take great comfort in coming up with lists of things I have never been told not to do, and fantasize about doing them and then using the excuse “You never told me not to…” For instance, I’ve never been told that I am not allowed to bark like a dog at a caller. (I’m saving that for someone VERY special.)

  3. Phil Says:

    Spot man should be taken in the ambulance to a busy A&E far from home. Then made to watch patients with real bleeds and then left to walk home.

  4. Deb Acle Says:

    Really honestly, without fail I’ve always found ambulance call centre people (as well as paramedics and NHS Direct nurses) to be truly excellent: kind, patient, very competent, and compassionate. And this in an area where the Ambulance Service has been slated officially.

    It’s when you get to the hospital that the problems begin. Most of which created by out-of-touch managers and poorly supervised or over-stretched or arrogant medics.

    A 12hr shift is a bit much though. But thank you for caring about giving a good service – a lot of people in the NHS could take more than a leaf out of your book!

  5. Dullahan999 Says:

    Our call takers are in the same room, so we can hear everything going on and I’m always glad I’m a dispatcher.

    It is one of the most important but undervalued jobs in the service and they really deserve more recognition for what they go through.

    And … bone of contention … when road crews have been in the service for twenty years, they are awarded a long service medal. when control room staff have been in the service for twenty years they get nothing*. However it’s not down to the individual trusts but originates from Buckingham Palace (or so we’ve been told). Not quite sure how to approach the Queen and wag my finger in a “that’s just not fair” way.

    * apart from the whip-round and oversized cards

  6. Petrolhead Says:

    I love my job, I have done since I started nearly a year ago.
    I’ve had one ‘proper’ thank-you, and that was from the parents of a 6-month-old boy having a febrile convulsion. They asked the crew to pass on their thanks, and by the time their gratitude was passed on to me at the end of the shift I’d actually forgotten the call. I’d treated the caller no differently to usual, which must mean I treat everyone kindly!

  7. Always Tired Says:

    Yes funny isn’t it how all the dispatchers, duty managers and management give themselves praise for such great ‘performance’ and yet it is us taking the calls day in day out who take the flack from said dispatchers, duty managers and management as well as the public. And yet who are the ones who ensure the right response through AMPDS…yes us the call takers.
    Giving thanks is all very well but it rarely filters down to the call take at the start of the process, the one who has calmed down the caller, the one who has given basic first aid advice, the one who triaged the call and gave the crew time and the one who has to start the process all over again for the next call, the next call, the next and the next until the shift is over.

  8. Erin Says:

    I have to say, it’s really lovely to hear a dispatcher say that. There is such a huge us and them mentality, and when you’re a call taker all ready pissed off about a stupid time waster, having a dispatcher breathe down your neck and tell you off when the crew get to that supposed abnormally breathing male who just needs a slap round the face rather than oxygen, really does not help.

    I’ve only been in this job a short while, and one of my very first experience of a dispatcher was one of them yelling at me for not asking if a surgery has a defib for a CVA case where the pt is alert. In front of everyone–while I was on another call.

    I know everyone gets stressed, and I do my damn hardest to respect that. But when you get shit from callers and then turn around to people you work with, and you get shit from them… all I can say, every time I’ve really wanted to quit it was purely treatment from dispatchers and management and the upper management types. Never the abusers and the time wasters.

  9. Trooper Man Says:

    Hi Mark

    Being out on duty most weekends throughout the year, I reckon we must require the use of the ambulance service at least 40 times. That’s nearly one every weekend.

    At the end of every seasons duties I always write a letter of thanks to the ambulance control for our area and thanks all crews, call takers and evryone else who assists us with our needs.

    I just ope the letter is passed on to all concerned.


  10. Karen Says:

    Hi Mark

    I have nothing but praise for our call takers. They are the hardest workers in the room and the ones that get the least thanks. It is very rare for “management” at the dispatch end of the room to come down at the end of a shift to thank them for their hard work. But they come down very quickly when there are calls waiting in the system expecting those on the supervising desk to give a reason why it is happening. Sometimes this is due to multiple calls on the same incident but sometimes all calls are for different reasons coming in at the same time. Short of telling the general public to stop ringing in there is nothing the call takers can do about the rate of calls and I wish managers would reaise this and stop jumping on call tackers backs when the call rate goes up.

    When new staff come into the room their first job is on the 999 lines, therefore the most inexperienced staff are working in the most pressured and difficult part of the room. They do a fantastic job and it is about time this was appreciated.


  11. Toast Says:

    I have never read a blog post like this before that has struck such a chord with me,thanks from a very appreciative calltaker!And you are absolutely right Mark,those decent callers are what make it worthwhile.I took a call last night about a baby having a febrile convulsion and although the caller was understandably upset she was polite,calm and listened to and acted what on i was saying to help her child out and she was very thankful at the end of the call for me waiting on the line with her until the ambulance arrived.’Thank You’ means a lot to me and no doubt all calltakers!!!

  12. Coffeeholic Says:

    @Always Tired – Couldn’t agree more. Call taking is a thankless job, so it’s nice to be recognised for our hard work once in a while instead of being ticked off by management for having calls waiting, being less than sympathetic towards drunken chavs and that most heinous of crimes… eating sweeties.

  13. Off_the_road Says:

    Whilst I sympathise with call takers for the amount of grief they get from callers and management I have to point out that it cannot possibly be compared to the type of abuse road staff have to deal with face to face. Please don’t make this type of comparison until you’ve had a 6’2 junkie screaming in your face so close that you’re being sprayed with spittle or have been chased out of an address with a man who has just told you he’s going to get a knife because he wants to stab someone. Admittedly we probably do get more thanks on the whole but it’s few and far between largely depending on what area you cover. As for being oblivious of how busy the service can be, do you really think that we’re that unaware??? Some of us do make an effort to pull our finger out when there are calls stacking up and we also get hassled by managers at hospital if calls are being held and we’re at the hospital for too long. Having said all of this it’s nice to get to hear your side of things about life at control and I must admit I have been one of the crews questioning why you’ve categorised something as a cat A when it’s blantantly a waste of time or a regular caller. I’ll hold my tongue in future. Is there no discretion for the call taker as far as AMPDS goes?

  14. Mark Myers Says:

    Off the road: I don’t mean to demean what you do. I know nothing can ever compare to being in physical danger. But if you come and listen to call taking on a Friday night (I’m assuming you haven’t – and I *have* been out on a truck on a Friday night. You’re welcome to come and sit with me while I call take, any crews are) you will see what I mean. Talking non stop for twelve hours to people who aren’t listening and call you every name under the sun and don’t want your help is REALLY soul destroying and so stressful. You come out of it hoarse, hallucinating, hearing the callers’ words over and over again, and running through all the calls in your head worrying about what you could have done better. You don’t get time to think about it at the time because it’s relentless. And our management don’t just send annoying messages down our MDTs, they come and stand behind us and listen! It’s not the same as the stress on the road, of course it isn’t, but it’s a different sort of stress and it DOES compare. Come and try it and you will see what I mean! Us up at EOC will make you very welcome, we like to meet our victims, I mean, crews.

    The call taker has no discretion at all on AMPDS, although as you get more experienced you can kind of manipulate the caller into giving the answers that give the call the correct category. Sometimes. But sometimes they swear blind they have are “Not Breathing Normally” and there is NOTHING you can do.

    Dispatch can upgrade calls, but not downgrade them. It frustrates us too!

  15. Delayed At Hosp! Says:

    Im very sorry you feel your job is more stressful than the crews out on the road.

    It must be awful for you to have to sit there, in the warmth of a call centre with a cup of coffee, reading a script and having a chat on the phone. Clearly it is far more stressful than turning up at someones doorstep holding their dying child in their arms and being expected to ‘put it right’ or faced with a little old lady wondering why her husband isn’t moving and having to tell her that the love of her life has died, not to mention dodging the occasional punch, projectile vomit and other bodily fluids determined to land on your face.

    Please consider doing a few more shifts out on the road (with me if your man enough), id really like to help you put your position into perspective and hopefully you’ll be more happy and content in your work life, after all, call takers sometimes need ambulances too!

  16. Mark Myers Says:

    I didn’t say it was more stressful! I said it was a different sort of stress. (And it’s absolutely freezing in the control room, by the way!) It’s simply not true that it’s just “reading a script and having a chat”. If control work is so cushty, why are so many dispatchers leaving to go out on the road, some of them taking a pay cut in the process? How many crews do you know who have come off the road to work in control?

    Don’t forget call takers are also expected to “fix” these impossible situations – and we have to get the hysterical caller to try and resuscitate their baby and try to work out what is going on too – not an easy job. And I am NOT saying that it is harder than being the crew that turn up on scene and have to deal with it. It is not a competition!

    I go out on the road as often as I can and I would be glad to do a shift with you if you’d like to take me. Drop me a line at mark@neenaw.co.uk if you’re really up for it. I will badger you to spend some time with me taking calls in return, though! I think it could do us both some good to see each other’s perspective.

  17. Off_The_Road Says:

    Didn’t mean for this to turn into a competition about who had the hardest job! I think shifts for control staff out on the road and vice versa is something that should be more common place, might even stop us being shitty to each other on the radio. Whilst I’d love to take up your offer of a shift up there, a lot of us are having a serious problem with a certain female on east central at the moment. I can’t put it into words because there’s a lot of swearing involved and i’m not sure it’s appropriate on your blog, lets just say she can be a bit rude and unhelpful. Not sure I could restrain myself in person so I’ll wait til the dust settles if that’s OK and in the meantime will give it some serious thought. She’s already been kicked off one desk for her attitude, give her a little dig for me if you’re in the vicinity :)

  18. Mark Myers Says:

    Ooh, now I’m wondering who the offending person is! Pretty sure it’s not someone from my watch as I work on the North East which is right opposite the East Central and all the people who usually work there are lovely! There are some not so lovely people there but I cannot think of one who regularly works on the East Central.

    Of course if you could give me a clue (by email?) that would put me out of my misery ;)

    Sorry to hear you are having grief and if it’s any consolation, if she’s that awful she’s probably awful to her fellow control staff too and has no friends! Offer of a visit to control remains open if you get it sorted out!

  19. Alan Says:

    Control in London does sound very busy. I am just a member of the public, but once I got to visit the ambulance control for Oxfordshire for an evening. Only one 999 call came in during the entire evening (a false call with good intention – medical students who misdiagnosed a faint as an MI(!)). But I suppose that that evening was abnormally quiet even for out here in the sticks.

  20. Andrew Says:

    Hi, I help out with the local St John Cadets, and a question came up a few weeks ago regarding making a call to the emergency services.

    Tha Cadet Leader said that it was better to phone 112, rather than 999 from a mobile phone, as aproximate location information would be provided to the emergency operator by the mobile network. I was under the impression that when any valid emergency number was dialed from a mobile, the network would send the call through as a priority call (terminating an existing call if necessary), but that the handling would be the same regardless of which emergency number was dialed.

    I have been reading your blog for some time now and I thought that you might be in a position to give a definative answer to this. When a call from a mobile phone is received at NeeNaw control, do you get any differnt information depending on if it is a 112 or 999 call?


  21. Mark Myers Says:

    I’m afraid your leader is talking nonsense. 999 and 112 (and 911) calls go through exactly the same way. We can get the approximate location for any mobile call.

  22. Andrew Says:

    Thanks Mark

    That was a very quick reply!


  23. Mark Myers Says:

    You caught me when I was sitting by the computer ;)

  24. buki mosaku Says:

    I'm doing some research for emergency services in west africa. Does anyone have or you know where I can get a sample training agenda for emergency services call handlers (or better still a manual/curriculum)

    Nee Naw
    Nee Naw was a blog about life in the London Ambulance Service control room. It was written by Suzi Brent from 2005 to 2010. The blog is no longer being updated, but the archives will remain here.
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