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Random Acts of Reality
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Blog URL http://randomreality.blogware.com/
Description Random Acts of Reality is written by an E.M.T working for the London Ambulance Service. The majority of posts are based on real life 999 calls, giving the reader an insight into both the medical aspects and the sometimes difficult task of dealing with the people of london.
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Random Acts of Reality Latest Posts:

  • First Week

    Wow.

    My brain overfloweth.

    The new workplace is lovely, the staff are nice, I have a lovely boss and there is a real opportunity to deal with patients and make them happier and healthier.

    It's pretty much perfect.

    -----

    Well, I say it's perfect - but there is but one pubic hair on the bar of soap of pure awesomeness.

    All the patient notes that I make are typed straight into a computer, it is a paperless office (apart from the information leaflets that we give to the patients). I have no problem with that as, surprisingly enough, I'm quite happy around computers.

    The problem is... It's all Windows systems.

    Urgh.

    So there will be some retraining while I try to get used to typing on 'cherry' keyboards and remembering that the key commands are different from everything that I use at home.

    Also, due to being unable to install any software I don't think I can sync Outlook 2003's calendar with Mobile Me/Google.

    Oh, and the browser is IE6.

    -----

    More seriously though - I'm really looking forward to getting my teeth into working here, the boss is already trying to get me onto a week-long course for minor illnesses and I'm keeping my fingers crossed as it is apparently a really good one and gets me 35 points towards a degree (for my nursing is a lowly Dip(HE)).

    I've another three weeks of being 'supernumerary' which means following people around and generally learning things. For example today I learnt more about knee assessment than I have ever dreamt possible from a brilliant physiotherapist who is seconded to the Urgent Care Centre.

    My day ended with another man's testicles in my hands so I could examine them - which is a first for me as normally the only reason to have someone else's testicles in my grasp is for the purposes of 'self defence'.

    -----

    While I'm only working eight hour shifts at the moment I'm finding that I'm more tired than twelve hours of ambulance work - I suspect it's because my brain is, for the first time in ages, consuming huge amounts of energy while I take in both the formal learning and the more 'soft' informal learning that is necessary when trying to integrate yourself into a new group of people.

    So basically it's all brilliant (apart from having to use Windows) and I am incredibly happy to have made the switch.

  • My Last Shift

    I would like to start with an apology.

    A little while ago, I asked the question 'What is it that makes an ambulance'. I then went on to inform you that the only equipment that an ambulance requires is a defibrillator and a bag-valve-mask. I may have made the suggestion that this shows the priority that the LAS has on patient care.

    But I must apologise, for I made a mistake.

    You don't need the defibrillator.

    -----

    Yes, on my final shift I found myself on an ambulance without a defibrillator, going to calls of elderly patients with chest pain. Then our tail lift stopped working, so there was no way to use the stretcher.

    We we refused our request to go 'unavailable' in order to return to station in order to get replacement kit.

    So the last shift continued my tradition of trying to give good healthcare despite management policies.

    -----

    The patients were also a fair mix of the normal sorts of patients I've spent the last eight years going to - a fall, a drunken and abusive alcoholic, a homeless chap with chest pain, a runny nose, and two hospital transfers.

    My last call was for one of those transfers, an elderly chap that the doctors at a local hospital suspected was having a heart attack that we blue-lighted to the heart-attack centre.

    They didn't think that he was having a heart attack, but given his long, complicated and somewhat obscured medical history I still think that the local hospital did the right thing.

    -----

    So, no bangs, no whimpers, just a continuation of what my shift has been like since I joined the service.

    I'm going to hold off on writing about my new job for a while until I get settled in a bit, I think that it's important that I get the lay of the land, and besides, it's better to reflect than immediately report.

    I've still got a few things to write about the ambulance service sitting in my notepad, so that will keep me going for a bit.

    (Plus I need to work on a new banner for the blog, maybe a new layout and who knows what else...)

  • Nobody Likes Us

    I've not been writing because I've been incredibly busy of late, working my normal LAS shifts (my last shift is on Friday, three more to go and, yes, I'm counting the hours), plus the paperwork for my new job (currently filling out the second Criminal Records Check form because I was sent an out of date one earlier), as well as all the normal stuff that keeps us busy, like laundry and shopping and making sure my Sky+ box doesn't get filled up with too many programmes.

    Hopefully this will all soon change, giving me more time to put finger to keyboard.

    -----

    I've been talking to a lot of people about my upcoming change in jobs to the local hospital - both ambulance and nursing staff, and the thing I've noticed is that sometimes people just don't get on.

    For example - I explain to one of my ambulance friends that I was talking to Nurse Smith about my upcoming job change and that she was very happy for me. 'Ergh', says my ambulance colleague, 'Nurse Smith? I can't stand her...'

    And I find that on both sides, nurses and ambulance staff that I consider good clinicians and good people looked on with some disdain.

    I think I've worked it out.

    It's because we don't know what each other does.

    Many of the nurses that aren't liked by ambulance crews are those nurses that expect more. They forget that, for a great number of us, our training is 16 weeks in a classroom. We've never been taught 'reflective practice', or how to read a research paper, or learnt the meaning of the word 'holistic'.

    These nurses get annoyed when an ambulance worker doesn't know about a certain obscure disease, or something happens that highlights something that was lacking in our initial training.

    And if nurse gets annoyed, then you can be sure that the ambulance worker concerned will get annoyed as well.

    On the flip-side, there are the nurses who think that we are little more than removal drivers - we pick people up, wrap them in a blanket, and take them to hospital. They can't see the reason why we bring to hospital some of the dross that we do (personal favourite call from last night - '33 year old male with cold'). These are the nurses who have asked me in the past 'can you do a blood pressure'.

    To be fair, that is from a ward nurse, A&E nurses have a better idea of what we do, but can still have some strange ideas of what our work is really like. Some don't realise that we refer vulnerable children and adults to social services. They may not realise exactly how many patients we leave at home (endless panic attacks, diabetic hypoglycaemia and epileptics). They also may not know that if someone wants to go to hospital then we can't refuse them.

    -----

    It's not particularly anyone's fault - certainly it works both ways, ambulance staff don't really understand the pressures that A&E nurses are under. I know that I have a privileged knowledge, coming from both worlds.

    What is annoying is that the solution is very simple - nurses spending some observation shifts with ambulance staff, and ambulance staff spending some time in A&E, but it'l never happen because of those self-same pressures. Ours to hit eight minute arrival targets, and A&E to cope with understaffing and having too many patients to deal with.

    And our free time is precious - spent sleeping rather than volunteering to go rattling around London in an ambulance, or being asked to do ECGs on endless patients in A&E.

    Besides, it's not that important to deal with little episodes of misunderstanding brought about by not knowing each other's jobs.

    Is it?