Nee Naw

Ugh! What a horrible shift! Last year, we were on days for Christmas, and we had a party kind of atmosphere in the control room, with people wandering in and out the room with plates of food and everyone falling asleep in front of the messroom telly whilst a steady trickle of (mostly rubbish) calls came in. Steve came up to the room with a bunch of mince pies, and we all had fun with a raffle and a Secret Santa.

Well, what a contrast. This year, staffing levels both on the road and in the room were at an all time low. The call rate, however, was relentless. I don’t know what it is about Christmas these days. When I was a child (growing up in a suburban, middle class, almost exclusively white/Christian-ish area) absolutely NOTHING was open and it was unheard of for people to do anything other than sit and eat turkey and play board games with their family. These days it’s all different — as I made my way to work, I noticed shops and pubs open in every street, and even on one occasion an open hairdressers! Those shops and pubs were later full of fights and stabbings and people generally not full of festive cheer. There was not one Christmas Comedy incident such as “choking on mince pie” or “impaled on Christmas tree” which was very disappointing. There was instead a steady trickle of green calls (because of the lack of public transport and increased taxi fares), a whole bunch of chest pains (indigestion, anyone?), plenty of Domestic Incidents and a couple of rather sad cases, such as a woman whose sister, far away in Scotland, had taken an overdose alone in her flat, and a homeless lady who had rung for an ambulance in the hope it would take her to a hostel in Central London so she would not have to spend Christmas night on the streets. We felt sorry for her, but not sorry enough to send the ambulance ten miles out of its area when we had a screenful of sick and injured people waiting.

Festiveness was also spoiled by the fact that two lovely girls from our watch had been beaten up for no apparent reason by a gang of horrible teenagers whilst out drinking on Christmas Eve, and whichever Scrooge had pulled my name on the Secret Santa had FORGOTTEN to bring in my present, meaning I had to sit and watch everyone else open theirs whilst I sat empty handed. Bah humbug! By the middle of the night, I had completely forgotten that it was Christmas at all and even caught myself looking at the wall clock to find out what date it was.

Crap call of the night: “My girlfriend has developed a stomach ache after we had sex! No, I can’t drive her to the hospital, I have been drinking all day!” As you can imagine, someone who had been able to spend time with their partner and enjoy a few drinks whilst we were all stuck in Control Room Hell inspired no sympathy WHATSOEVER!

Perhaps you’re reading this sipping a glass of mulled wine and nibbling on a mince pie whilst taking a break from the relatives — or perhaps, like me, you’re unlucky enough to have copped a Christmas Nightshift. Or perhaps you’re reading it a week later back at work whilst someone takes the decorations down. Whatever the case, happy Christmas to all my readers, thank you for visiting this site and for making it such a success. I really appreciate everyone reading my ramblings and the supportive comments you’ve all left on my posts over the last year, and I wish you all lots of festive frolics which under no circumstances go horribly wrong and cause you to call for one of my ambulances.

Love,
Mark Myers and All The Nee Naws in London
xxx

Friday was one of those horrible days when there are more calls than call takers, and there is always a red flashing sign above our heads telling us how many calls are waiting to be taken. Frustratingly, I always get seem to get stuck on a call with a dozy carer who doesn’t understand English (or any other language) or an RTA where no one knows where they are while ten people are waiting to be answered. You are always conscious of the fact that the calls waiting could be a lot more serious than the one you are “stuck” on.

Unfortunately, my fears were realised as I took a call which had been queueing for about a minute. The call was a panicky nursery nurse.

“This is Snowball Nursery in Southall, ” she said, “we have a little boy choking on a rice cake!”

This was a proper case of complete obstruction choking — quite rare for us to come across as call takers, as most people realise that they have to do something straight away and don’t have time to wait for an ambulance. Most of the choking calls we get are cases of partial obstruction, where all we do is encourage the patient to cough it up themselves and wait for the ambulance (back slapping in this case may encourage the obstruction to move and completely block the airway). The toddler was completely unable to breathe, turning blue and losing consciousness. The nursery staff had tried backslaps and the Heimlich manoeuvre without successful.

I was glad I had the AMPDS software in front of me to prompt me, because this was a situation I had never dealt with before. I could give the instructions for an unconscious or suspended patient without even glancing at it, but definitely not a choking patient. AMPDS may be useless for categorising calls but as far as giving instructions goes, I can’t fault it. After telling it the child’s age, current condition and what the nursery had already done, it told me that the next thing they should try is to straddle the child (who was now collapsed on the floor) and give an abdominal thrust from above. I passed this on to the nursery nurse, who instructed the child’s mother to do that. It’s not often that you get to tell people to punch a toddler in the stomach! She did this, making a delightful squidging sound, and the nursery nurse went to inspect the outcome.

“He looks a little less blue… yes, I can see that he’s breathing!” she exclaimed.

I told her to look in the little boy’s mouth and fish out the offending rice cake. This she did.

“Youch!” she cried. “He bit me! Oh well, I suppose that’s a good sign…”

At this point the toddler started to cry.

“Oh, thank god for that!” said the nursery nurse, “I’ve never been so happy to hear a child crying!”

Suddenly she burst into tears and so did the child’s mother. It’s not often you hear people crying with relief/happiness so I even started to feel a bit misty eyed myself. I was really glad that they waited until the child was okay to fall to pieces. Actually, this is something I have noticed before — people crack up and are useless when their parent is the patient, but when it’s their children they somehow manage to hold it together and do as they told. Perhaps it’s some kind of primitive instinct which makes you protect your offspring, but expect to be protected by your parents. Anyway, it was a couple more minutes until the ambulance arrived, so I had a nice chat with the nursery nurse as she pulled herself together. She asked for my name, so perhaps they will send me a thank you letter. I hope so; I have never had a thank you letter before and if someone sends you one you get your name in LAS news!

Anyway, that was one of the most exciting calls I have ever taken. I do love happy endings!

I’m guessing a lot of you will already have read Reynolds’ post about the news that ambulance crews are now allowed (shock, horror) official tea breaks — half-an-hour in a twelve hour shift, unpaid — and the fact that The Sun apparently thinks this is “barmy”. Here are my views from the Control side of the fence — I would be interested to hear the views of any LAS crews reading this.

Before the new rules came in, it wasn’t that ambulance crews didn’t get any breaks at all, but they certainly didn’t get the kind of breaks most people would find acceptable. Crews on q***ter stations would be able to return to station between calls, and crews on busier stations would take a few minutes out at hospital after each call, listening to their radio to see if Control are holding any serious calls in their area. In both cases, crews would find their breaks frequently interrupted, with Sod’s Law dictating that if any of them were to attempt to eat any hot food or light a cigarette, a call would come in straight away. At q***ter times, we would ring stations to officially put crews “on break” but these breaks could be interrupted for any call. If crews got no break, or an interrupted break, they got a small payment (about £5, I think?) to compensate them. It seemed to me that everyone was content with this system.

The new system dictates that each crew must have a break in a certain time slot. The first twenty-minutes are uninterruptible whilst the last ten can only be interrupted for a Suspended. (Incidentally, what is this “code red” business the press keep going on about? I heard it first during the Kayleigh Christie case, and now again with meal breaks. It’s not a term we actually use…) I haven’t worked a shift on Dispatch since this rule came in, but I hear the rumblings coming down the stairs, and it seems no-one is happy. In particular, there seems to be a record level of antagonism between crews and control staff. I am not even sure what they are arguing about; it just seems to be a source of constant conflict, with confused controllers trying to interrupt uninterruptible breaks, crews not wanting to go on break, crews wanting to go on break, crews saying they are still on break when control think they are not on break, crews being on break when we are holding fifteen Cat A calls, etc, etc, etc. It has got so bad that people are actually getting to work and asking to be on Call Taking, because they are more likely to get into a slanging match with a crew than with an arsey caller.

From the Call Taking perspective, all I keep noticing is that whenever I get a really serious call, there’s always a FRU a few metres away… on its sodding break!!!

In summary, crews are entitled to their breaks, and I think it is completely ridiculous for the Sun, Control or anyone else to complain about them being given them. We all get our half hour lunch break without interruption and I am sure the Sun journalists get a lot longer than that. On the other hand, I’d like to see the system become a bit more flexible and somehow be revised in a way that stops all the aggro. In most professions, one gets one’s uninterrupted lunch break most of the time, but when things at work get hectic or there is some kind of emergency, lunch is sometimes postponed or cut short, and it does seem a bit ridiculous that if someone drops dead outside the ambulance station, we can’t even ask the crew on break inside if they could put their sandwiches down to go and help.

Hopefully this is all just teething problems, and in a few months everyone will be all smiles again.

Thanks to everyone who has emailed me about the fact there is a big gap appearing at the top of my blog. Unfortunately, I’ve been unable to work out what is causing it so therefore have been unable to fix it. I’m pretty sure it’s something in one particular entry, so when the offending entry goes off the bottom, it should right itself.

The gap only appears in Internet Explorer 6 and below, so if you find it really annoying you could try upgrading to version 7 or using Firefox instead. Or if you can see what the problem is, please tell me!

Sorry for any inconvenience caused, etc!

Every morning (or evening), when we arrive at Nee Naw Control, we check the manning list to see what we are doing that day. I will either be placed in Call Taking, or on one of the regional dispatch desks, manning the radio and/or the ambulance crews’ phone line. Everyone “belongs” to a particular sector, but if staffing is short, or you are on overtime, you may have to work on a different one. There are no sectors in call taking; calls from all over London come to the same place. Anyway, over the last two-and-a-half years I have managed to work on every sector for at least one shift. Except one: the FRU desk.

(FRU = first response unit, otherwise known as “ambulance car”, sent to all category A calls in order to reach them faster.)

Well, on Friday I got to work and found I was on the FRU desk for the first time! It was a bit like being a newbie again because there are all sorts of different procedures going on there that I had to be taught before I could do any work. There’s a new electronic dispatch system called FRED which, at the moment, is creating more problems than it solves, but which hopefully will reduce response times and our workload when it is fine tuned (though I hope it doesn’t work too well, or they won’t need us at all!!) All the FRUs have to ring up and give you their initials, hours and whether they are paramedics or technicians when they arrive. They keep in touch via mobile phones, and because they’re encouraged to stay in their cars rather than going to an ambulance station, and don’t have a crewmate, they tend to get a bit lonely and ring us up every ten seconds when they are not on a call, with queries like “How come I got seven jobs today and my mate in Woodford Green didn’t get any?” (me: “Because you’re in Newham, and that’s where all the accidents are, of course.”) Some of them even end up sounding like the psychiatric patients who call up in the middle of the night for a bit of a chat. I wouldn’t like to be a FRU, it sounds like it drives you a bit mad.

Because FRUs are sent to the highest priority calls, there is more drama on this desk than any of the others. Early on in the day, one was dispatched to a hanging. Soon after, he called up to speak to us:

FRU: “The patient’s purple plus (obviously dead and beyond help) - the crew and I are going off the road for a cup of tea, if that’s alright with you.
Me: Yes, of course. Are you alright?
FRU: Yeah, it was just a bit of a nasty job. It was a young man, and he’d hung himself from a canal bridge. He had photos of his children with him, and a suicide note addressed to his children. Bet that’s ruined their Christmas…

Half an hour later, the crew and FRU were back on the road, recovered and ready to take their next call. Got to marvel at the healing properties of tea…

Several suspendeds, a cot death, a collapsed wall, a stabbing and a one under later, there was a frantic call from another FRU, on his way to a pedestrian hit by a car in North London. He’d been belting down the main road on lights and sirens when another car (possibly rubbernecking at the accident he’d been sent to) pulled out in front of him, resulting in a high speed crash. This is an occupational hazard of FRU driving — because they are faster and smaller than ambulances, they are involved in more accidents. As he got out of the vehicle to call us, the engine suddenly went up in smoke. Within a few seconds the whole car was on fire. We arranged the fire brigade, the police, two managers, another FRU and another ambulance in addition to the one which had just been dispatched for the original patient. The entire road must have been filled with emergency vehicles. Fortunately, the FRU guy was not badly hurt, just incredibly shaken — thank god he got out the vehicle quickly. The same cannot be said for his vehicle, which was certified Purple Plus and towed away by the police.

I am no longer in charge of my trainee… because she is no longer a trainee! She is a fully fledged competent call taker and no longer needs my help. Thank you to everyone for your advice when I was struggling with the training. It really helped and things got a lot better from then on.

Last night was our work Christmas party, out in the wilds of Kent. I vaguely remember telling everyone that I was going to blog about their antics in minute detail as soon as I got home, but in the cold light of sobriety, this no longer seems a good idea. So I shall not tell you about the row that broke out in the hotel lobby, nor the bout of scandalous snogging that I witnessed. I think I can just about get away with mentioning the lairy policeman who kept asking stupid questions and the mysterious toe accident that lead to there being blood all over the dance floor. My last memories are of telling all the females present how much more attractive they were out of their uniform (”my god, you’re not a minger after all!”) and hugging the FRU guy. Then I passed out.

Many thanks to the fabulous Kelly for organising B-Watch’s part of the fun. Without her, we’d all have been down the chippy.

‘Dead’ for 21 minutes, then saved by family.

A nice, positive article about the ambulance service in today’s Metro, in particular showing the importance of CPR whilst waiting for the ambulance. Only three cases of Metro-ese spoiling the article:

• Rob Tait, 61, had a massive cardiac arrest… A massive cardiac arrest? Do they come in different sizes? Is it possible to have a small cardiac arrest, then?
• … their father became one of only ten per cent of Londoners who survive a serious heart attack… A serious heart attack? I would have thought all heart attacks were pretty serious! Not sure where they are getting their figure from here - the percentage of people who survive a heart attack is more like 50%; the percentage that survive a cardiac arrest is more like 5%. Maybe they made it up on the spot!
• Joel got on the phone to call an ambulance… the ambulance crew told us to concentrate on the heart So they called 999 and spoke to the ambulance crew, did they? How irregular! Normally 999 comes through to Nee Naw Control, not direct to the cab of an ambulance. I must have a word about these pesky ambulance crews doing our jobs for us.

Anyway, I shouldn’t be so cynical, at least they had something positive to say about us this time!

The Islington Gazette has a less nonsensical version of the same story.

(Oh, and by the way, the first responder on scene was an Emergency Medical Technician…)