Nee Naw

After reading Newbie At CAC’s tales of being a freshfaced newcomer at Nee Naw Control, I thought I would dig out some of my old diary entries from a long, long (well, not that long, it just seems it) time ago when I started work there. Here is one from when I was still training with a work based trainer in the room.

First of all, five am starts are not something I would inflict on my worst enemy. At five am it is dark and cold and it feel like the middle of winter or perhaps the middle of a nuclear holocaust because it is that grey and there are that few people around. It took me the full three days to get used to it and reach some semblance of normality (on the second day, I was hearing voices - mainly saying “I need an ambulance NOW” and “Yes, he is still breathing!” and feeling the floor move beneath my feet when it wasn’t) and now I have to adjust myself to going to bed at 8am because come Wednesday, I will be on nights!

I wouldn’t inflict the bloody uniform on to anyone either! Everyone keeps remarking on my too-large jumper but as far as I am concerned it is much too small - it does not even cover my bum and there is nothing worse in this world than too-tight jumpers, except perhaps prawns. My trousers, on the other hand, are definitely too big. They seemed tight when I got them, but I realise now this was the effect of two tonnes of starch keeping them in a pancake-flat shape that it was impossible to fit my legs into. Now this has subsided, they are utterly huge and make me look like a clown.

After a while all the calls start to blur into one. You have a second monitor on your desk which shows the London A-Z zoomed in on wherever the caller is calling from and you start to see these whenever you close your eyes or look at a blank wall. Your head turns into a swarming mass of key questions (”Is he breathing? Is he conscious? Is there any serious bleeding? Is he injured? Where does it hurt? Do you want an ambulance?” etc etc etc etc) and you can’t remember if the person you’re talking to is a diabetic or if the person who told you that was the guy who called ten minutes ago having fallen off a ladder and broken his toe. There are an awful lot of old people fallen out of bed, people with chest pain and tramps passed out in the road for unfeasible lengths of time. These are the “have you tried rebooting?”s of ambulance dispatch, and you forget about them pretty much as soon as you hang up the phone. The calls that do stand out, which I would say is approximately one in five, are the ones where there has been some kind of horrible Accident (as opposed to Illness), the caller is particularly rude or upset, or the ambulance is required for some utterly ridiculous reason and you really, really want to laugh. I could sit here all day and list the calls I’ve received, but here’s some highlights:

• The man who rang me to tell me his son, who has no arms, legs or eyes, had severe pain in one of his toes. I tried to ask how he could possibly have pain in his toe (Phantom Limb Syndrome, I wondered, but the man seemed quite insistent he did actually have a toe) and my work based trainer was in hysterics and I could feel a giggle rising in the back on my throat so thought it best to dispatch the ambulance before it escaped.
• The man (experiencing problems with his catheter, it emerged) who rang to inform me “My penis swollen up like a balloon, and I think it is going to explode!!”
• The man who rang after breaking up with his three months pregnant girlfriend who had promptly punched herself in the stomach “to spite him” and was now bleeding from her vagina.
• The sweet elderly lady who rang me rather worried that her heart might have stopped beating.
• The slightly hysterical woman who thought she had killed her friend — she had slipped and knocked her friend over, knocking the friend unconscious.
• The woman who rang from a hostel to say she had found one of the guests dead an hour ago. She said this in the tone of voice you would expect someone to say “My washing machine is broken”
• The woman who rang screaming that one could die waiting for an ambulance round here and that she was going to sue the ambulance service. The ailment emerged to be a cut finger.
• I didn’t actually get the call about the horrific bus crash in Golders Green (a boy and his father were hit by a bus, the father went under the wheels and was killed, while the boy was dragged along and was seriously injured but survived), which merited getting out the HEMS helicopter (as seen on Trauma), but about twenty calls came in and it was the talk of the room for a while. Apparently the father was seriously mashed in the way you might imagine someone run over by a double decker bus to be, and the first crew on scene included a trainee ambulance technician. Ouch.

On Sunday morning, the call I have both been looking forward to and dreading came - my first “suspended”. In other words, a dead person. We call them this because on some occasions, you can get them back, but it was fairly obvious from the outset that this would not be one of those cases. The caller was a surprisingly calm elderly gentleman who reported “I’ve just gone upstairs to take my wife a cup of tea, and I can’t wake her up. She’s a little blue in the face too. She’s just come out of hospital after having a heart attack”. My first thought was that he was so calm because she was very old and sick and he’d been expecting this, but on further questioning I realised that he actually had no idea what had happened. After reporting that she had no breathing or pulse and that he hadn’t seen her for a few hours, he said “I think she’s had a stroke or something” and kept impressing the fact that she was still warm upon me — I got the impression that he thought dead people would be instantly cold and stiff, but of course it takes a while for these things to set in, and once someone has been without pulse or breath for three minutes, there is almost certainly nothing you can do for them. Of course, we’re not allowed to say over the phone that someone is “dead” or similar, but once we know this, the next step is to give instructions for CPR, which is as good as saying “Oh dear, I think she’s a gonna!” I think at this point, the man began to twig what had happened — he was very old and it was obviously physically difficult for him, but he made a valiant effort with the CPR — because his voice started to break, and I think he was crying a bit, but not in a hysterical way or anything, just in a sad way.

The ambulance crew arrived at that point — it must be so much harder for them, having to look the man in the eye knowing that his wife is dead, and that he doesn’t know, and having to tell him that there’s nothing more they can do…

I felt a bit sad after this, but not in a traumatised way, and I was able to carry on taking calls without having to go and cry in the toilet or anything (they said we were allowed to do that if we wanted to!) even though I did feel a bit like it. This is a good thing; if I can cope with this I can cope with pretty much anything the job throws at me, although I’m still glad I didn’t get the Bus Accident on my first week!

Yesterday afternoon was time for my first assessment, which consisted of the head work-based training guy listening into my calls for an hour and writing a report. As luck would have it, I got lots of really taxing scenarios during this half hour, although this is not all bad, as it gave me a chance to demonstrate my ability to deal with difficult calls. First of all the computer crashed midway through a call, which means I was scribbling all the vital details down with one had, scrabbling for the manual triaging set with the other and still trying to talk - by the end of the call I looked at what I’d written down and it all appeared to be in Greek! Next a doctor rang up and tried to book an ambulance which broke all the rules for Doctors Ordering Ambulances and I had to tell her to sort it out and then ring back (we are allowed to say that to doctors but not the general public). Finally, I got a call from The World’s Rudest Man. It didn’t matter how many times I told him that, through the miracles of modern technologies, I could ask him questions while someone else arranged the ambulance, or that asking him questions would help his poor injured wife and make sure I didn’t miss anything, he just kept bellowing at me “STOP ASKING STUPID QUESTIONS! JUST GET AN AMBULANCE HERE! WHAT DOES IT MATTER HOW OLD SHE IS? IF SHE WAS BLEEDING, I WOULD HAVE SAID SO! YOU *()^*&%*&**S!!!!!!!!!!” I felt a bit like retriaging him to the lowest category out of spite, but you’re not allowed to do that.

My report was much better than it had been at training school: for a start it was very long, most of it was very positive and that which wasn’t was objective and constructive. I meant to write it out but I accidentally left behind. It said things like “Mark has made a very good start to call taking” and that I was more competent than they would expect someone to be at three days, and that my medical terminology and use of the triaging system was very good. The things I need to work on are: talking loudly, taking control of the situation (not letting people babble their life stories at me), remembering to verify addresses and phone numbers and not to fill in postcodes even if I know them, and asking the caller to verify breathing at the end of the call, even if it is only a cut finger, because you can’t be too careful.

I also had a surprise visit from the Quality Assurance Office, who randomly pick on people, listen into their calls and mark their performance out of 100 according to whether they remember to do everything. I got 100% for both my calls so I am therefore brilliant at this.

I would also like to point out that I have not received one single call from the M4 or Heston yet. Every single exercise we did at training school involved a road traffic accident in said place, and every single time I struggled to get a map reference. This is a great relief.