Sylph

Wet mattress

2006-10-06T21:41:00.000Z

Yesterday evening I was cold. Cold to the extent that I made myself a hot water bottle before I went to bed so that I didn't freeze when I got into bed. Great idea. Well, it would have been if the hot water bottle hadn't split down the seam, leaking it's entire contents into my bed sheets and right through the mattress.

Just as I thought I could curl up in a nice warm bed I discovered that I had a soaking wet, and quickly cooling bed. I didn't know what to do. I stripped the bed sheets off, and mopped up as much of the water as I could. Then I turned the mattress over (no mean feat in a room that is barely bigger than the bed) and placed a folded towel over the damp patch (yes, the water had gone right through the whole mattress). I then put new sheets on the bed. I expected not to sleep very well due to the folded towel under my body. However, I discovered something - the underside of my mattress is much more comfortable to sleep on than the top. Either that, or I've had it upside down for the past two years!

Anyway, I'm going away for a few days tomorrow, so I'll stand the mattress up in an attempt to dry it out. My neice suggested that I tumble dry it. I'd like to see a dryer big enough!

Impressing myself

2006-10-04T23:18:00.000Z

I have to say, I am impressed with myself. Not only have I succeeded in posting photos onto the blog, but I've also updated the blog several days in a row! Unbelievable.

Proposal photos!

2006-10-04T22:47:00.000Z

This is the team that Simon recruited to dig the proposal! Note the gardan spades brought along too. A huge effort!

The writing in the sand.

The proposal as it looked from the cliff top. (It actually looked a bit larger, but the photo is deceptive).

Update

2006-10-04T22:41:00.000Z

On Sunday I told you about a cardiac arrest that I went to.

Today I was back in the hospital that we took him to, and I was able to enquire how he was. He's well. The cause of the cardiac arest was a large heart attack. He'd had surgery and is likely to have some more before he's sent home. Other than some slight confusion (which will probably improve with time), he is perfectly well. He has full use of all his body and brain, with no deficits. It really is incredible. I feel very lucky to have had a part (all be it small) in his survival. This is the sort of job that really gives you satisfaction as you see the results of your efforts.

Frustration

2006-10-03T21:26:00.000Z

Today, two of my patients were mental health patients.

These are the worst sort of patient. For two reasons. The first reason is that I get SO frustrated at how helpless I am to do anything for them. I am not a psyciatrist. I do not have any training in counselling. I do not know how to deal with a suicidal person. There is no easy option, no pill I can offer them, no cure and no answers that I can give them. There is nothing I can do except take them to hospital, where I am aware that they will often be ignored, belittled and shunned, the attention going to medical or surgical patients, in whom a treatment action usually results in visible improvements. The only other option is to get a GP to visit them at home. This option is not without problems. The GP will not give a time when he/she will visit, meaning that the patient may need to be left alone for a short (or very long) period of time, which is often not appropriate. The GP has very limited time to spend with the patient. in a short amount of time it is very difficult to establish the exact problem and find solutions. Especially when there are no easy solutions. Most of the patients that I see who have mental health problems hate doctors and hospitals. There are no emergency mental health crisis teams that are accessible to us, and the one that I tracked down once would not come out and visit the patient at the weekend (when they were most needed).

So, a very frustrating type of job.

The second problem with these patients is that I find it extremely difficult not to cry when they talk to me and tell me what the problem is. People are rarely suicidal without good reason. When they tell me how they feel and wy they feel that way, it upsets me. I don't know if this is a good thing or a bad thing. I don't know if I'm meant to be stoical and detached, or if it's ok to feel some of their pain and so hopefully be compassionate toward them.

The good thing about such patients is that however down I may be feeling about things in my own life, I come away feeling blessed, reminded that my problems are small in comparison to others, that I have friends and family who love and care about me and a God who knows me and loves me.

But still, when I leave them I feel sad and intensly frustrated about the lack of treatment, hope or options for them.

Blog

2006-10-01T20:52:00.000Z

This morning I was reminded that I have a blog.

Yet again, it's been nearly a month since I updated it.

This month I've been mainly looking for a wedding dress. I found it yesterday. Not bought it yet because I fully intend to ring round all the stockists doing some haggling first, to ensure I've got it for the best possible price. I don't normally haggle, but when the item you're buying is £400 I think it can't do any harm. I've already been offered it for £360. I'll try and get that lower if I can. I have, however, bought the bridesmaid dresses. We've also done the church and pastor/preacher booking and sorted a reception venue (Simon's back garden).

In other news, I'm really enjoying these day shifts, there's a likelihood that I'll be able to extend the temporary position to the beginning of January (an extra month) and a slight possibility that I'll be able to extend it further to the beginning of April.

On Friday, I had a great job (I didn't actually have to do a great deal). It was a cardiac arrest. Usually, the chances of surviving a cardiac arrest are minimal. Very minimal. This man (only 54 years old) collapsed at work. Fortunately for him, he collapsed outside the occupational health office, and he received immediate first aid (resuscitation). Within 5 minutes (as the place of work was within Bristol) there was a rapid response vehicle on scene, who attached a defibrillator, and proceeded to shock the patient. The one shock reverted the patient's heart to a normal rhythm, which also triggered the patient to start breathing again. Something I'd never seen before. He was still unconscious, but needed no further intervention as we rushed him into hospital. I don't know how he is now, I'll try and find out tomorrow. It depends what caused the collapse. It may have been a massive stroke or heart attack. Thankfully, the effective resuscitation, given immediately after his collapse, means that the supply of oxygen to his brain was almost un-inturrupted. Meaning that if he does recover, he has a chance of a full recovery.

If he had collapsed anywhere else, I suspect his survival chances would be extremelly reduced. I'll update you if I find out any more about him.

Day shifts

2006-09-04T20:21:00.000Z

Today I started on a days only rota. This is just for 3 months as I have managed to get someone to arrange a temporary swap with me. It's wonderful. No night shifts. Every evening off. Every other weekend off. An extra hour in bed in the morning.

I can make arrangements for my evenings. I can see Simon. I can go to church regularly. I can visit friends.

WOOOOOOOHOOOOOO!

What's the catch? There is none. Pay is slightly reduced. i.e. I earn about £100 less a month. A sacrifice I am more than willing to pay for a social life. Otherwise, there is no difference. The only dissapointment is that it is only for 3 months so that in December I have to go back to days and night shifts.

ENGAGED!

2006-09-04T20:05:00.000Z

Most (if not all) all you have probably heard by now that I got engaged just over a week ago.

It was an extremely romantic proposal and I'm surprised I didn't cry. In fact, if I'd believed it really was for me I'm sure I would have cried a bit. Instead I laughed in disbelief.

It happened like this. I went camping last weekend with Simon (my fiancee), my best friend Caroline, and her boyfriend. We went to Swanage together and were having a fabulous weekend. I felt really relaxed and it was lovely to spend some time with the people I love. The things we did included watching fireworks on the beach, open air cinema under the stars, eating out, nice walks, snorkelling and swimming. On the sunday afternoon we were wandering along from Lulworth Cove to Durdle Door. As we arrived at the top of the cliff by Durdle Door I wandered to the edge to look at the view. After aproximately a minute of staring out to sea and studying the horizon and surrounding headlands I glanced down at the beach. There, in letters about 2 metres high was the message HANNAH MARRY ME?

Having been with Simon for the entire weekend, I was sure that the message could not be for me so jokingly commented "Is that for me?!". With this he got down on his knee and produced a ring from his pocket, asking me if I would marry him. Strangely, although over the moon, all I felt able to consider was how the message got there! It eventually sank in that the message was for me. I said yes.

It turned out that Simon had arranged for 8 of his friends from work and uni to come down and dig the message into the beach. It took all 8 of them and hour and a half, using 3 spades! Simon had even taken a day off work earlier in the week to go down to Dorset and study the prospective beaches. He'd been meticulously planning it for about 3 months. Meanwhile I'd been grumbling to him that he never did anything romantic, and that he should surprise me occasionally!

The wedding is to be on the 7th of July next year. This is my ploy to enable Simon to easily remember our anniversary (07/07/07). It also happens to be the one date that I can get a guaranteed fortnight of annual leave after for a honeymoon.

Now we just have to do all the planning, related shopping, deciding who to invite etc. etc. It seems such a long time away, but I'm sure it'll come round quick enough.

Work...

2006-08-18T22:07:00.000Z

As I mentioned, work has been very busy.

A fortnight ago I had the nastiest job that I've been to yet. It involved an 18 year old girl who had not known she was pregnant and had got up to go to the toilet in the night and given birth to a baby. The baby was full term. She had (presumably in shock) taken the baby back to bed with her. We don't know if the baby was alive at this point but when her mother got up later, she found her daughter in bed, clutching onto a dead baby.

It was a very difficult job to deal with. For many reasons. We had to get the police out. We had to try and pursuade a maternity hospital to accept both the mother and the dead baby. We had to deal with the hysterical Grandmother, the distraught Mother, the upset sisters of the Mother (one of whom was also hugely pregnant) and the dead baby.

Following this job I took my next shift off. My crew mate is still off. I was prayed for at church and felt a supernatural peace fall on me. That is the only way I can describe it. From that point on I have been able to think about it without bursting into tears.

I returned to work, and as my crewmate was still off I was sent to another station to crew up with some one else. However, on my way there, I was responded to a "driver only" job. (responded to an incident to provide treatment until a crew can arrive and transport the patient to hospital). In fact, not just one "driver only" job, but 4! And the crews were so busy that I was waiting a long time for an ambulance to arrive each time. I waited 40 minutes with an elderly lady having a severe asthma attack. I waited 45 minutes with a 45 year old lady having a suspected heart attack. I hate waiting so long on my own with such critically ill patients. There is only so much you can do with the limited amount of equipment that we carry and it makes me feel helpless. But I did the best I could, and both patients had improved by the time an ambulance arrived. (We often find that just our presence helps people to feel safer, and so more relaxed, less tense and less poorly).

Then on Sunday I was working with a trainee. I usually seem to be working with a trainee when I get the slightly more awkward jobs that require a bit more thought, and I wish I was was with somebody with a bit more experienced! The first job we got was to a middle aged female who was caring for her terminally ill husband and had damaged her back. Not in itself complicated. However, she was the only carer for her husband, who needed full care (i.e. needed washing, feeding, medicating, toileting etc.) She needed to come to hospital with us. He did not want to come to hospital with us, but could not be left on his own. What to do? After calling about 15 different numbers and being passed from pillar to post I eventually managed to get hold of an on call district nurse who promised to be over to visit him within the hour and assess his needs, putting emergency care into place. Hopefully she was true to her word because we then left to take the wife into hospital.

Later that same day we went to a mental health patient who was having a mental health crisis (usually well controlled by medication, but suddenly gone somehow awry). He was hallucinating, suicidal, paranoid, agitated and generally not himself. As he had been "well" for so long, he no longer had a psychiatrist or mental health nurse. His own GP was on holiday and he abhorred accident and emergency departments and did not want to be taken to one (which is our only option usually). It has to be said that an accident and emergency department is NOT and ideal place for someone experiencing a mental health crisis. With this in mind I contacted the mental health unit where he had been before. They had no beds, and even if they had, would not take a "referral" from me, it would have to be a GP. I tried a medical admissions ward (not much better than A and E but a bit more private and settled, with more chance of being taken seriously). To no avail. They didn't want anything to do with him. (They did have beds). I then managed to get a phone number for a mental health crisis team. They said they couldn't come out on a Sunday. I was shocked. But having tried all other avenues he did come with us to A and E. I hope they took him seriously and treated him well. I hope the mental health unit managed to make space for him with a "referral" from an A and E doctor.

In both situations we coped. But I do wonder what (if any) other avenues might have occurred to someone who's been doing the job for many years.

Rubbish!

2006-08-18T21:50:00.000Z

Ok, so I must admit I've been totally rubbish at updating this blog. As my brother has pointed out in his comment. It's due to a number of reasons, mainly that I've been trying to spend some time with my boyfriend, and also been seeing as much of my new neice as possible. She has actually now reached her due date (16th Aug) and weighed in at a whopping 9lb 14oz this morning! I'm sure Kati's pleased she was early as she would have been one huge baby to give birth to had she been full term!

Work has also been extremelly busy, as everyone seems to be off sick, or pregnant or stressed. As we seem unable to get any annual leave granted the morale is low, stress levels high, and sickness through the roof. For the past two weeks in my sector (a group of 3 stations) only 2 of us out of 9 on my shifts have actually been in. I realised the other day that the last annual leave I got granted was in January. I applied for 8 different weeks this year, of which I got two shifts granted! However, I have finally managed to get onto a day rota!!!! This will be from the start of September, for a temporary period of three months, which is not ideal, but better than nothing.

And, talking about holidays, the 2 shifts which I got granted are night shifts over the bank holiday weekend (the last ones I expected to get). I am planning a weekend in Swanage with Simon, my best friend and her boyfriend. It should be a good weekend and I'm really looking forward to it.

Unfortunately, I have not been busy with climbing, although I wish I could find time to. Also, my study has been much quieter since my exam a month ago, because I now only have one module on the go. But my time still seems to have been very short.

Simon and I took my older niece and nephew to see the ambulances at work last weekend. They were thrilled. I even gave them a ride around the car park with the lights and sirens on. After that we spent the rest of the day at Noah's ark zoo farm, which they enjoyed but think they found a bit of an anti climax after a ride in a ambulance!

Short Update

2006-07-18T20:40:00.000Z

This is my news in brief!

Yesterday I had my OU Human Biology exam, which seemed to go quite well, despite the exam room being sweltering and the pen sliding out of my sweaty hand constantly!

Work is going well, but there's no news yet on the day rota that I'm waiting for, and have been expecting to hear about.

My new niece is now home from hospital and doing well, but wanting feeding hourly, so exhausting my sister.

I am going to visit my older brother on Thursday with my Mum. We're staying til Sunday. It should be a pleasant few days away although I suspect that my brother will get us doing his decorating/gardening/DIY etc. to keep us out of trouble. I also hope to get some climbing in while I'm there and I'm looking forward to spending a bit more time with his girlfriend, who I've met once and seemed lovely.

I have had several interesting jobs recently, which I hope to get round to writing about soon.

My car (a 14 year old citroen AX) passed her MOT a couple of weeks ago. First time. Needing no work. That's the third time in a row! What a faithful car she is. I rewarded her with a new cam belt.

That's all I've got time for at the moment, I'll try and write a fuller posting soon.

Amelie

2006-07-04T15:23:00.000Z

My new niece (Amelie Constance Blossom W.) was born yesterday at 10.44 a.m. She was 5lb 15oz, a very good weight for a baby born 7 weeks premature. I went to visit her (and my sister) yesterday, a welcome break from revision. She is beautiful, so perfectly formed and looks far too large to have been inside the body of my petite sister! Although in an incubator at the moment, she is healthy and I'm looking forward to my first cuddle.

Apologies

2006-06-24T21:39:00.000Z

Firstly I want to apologise for not updating this blog for so long (over 3 weeks). This is because a) I've done nothing of note and had no life changing revalations. b) I have been trying to do revision in my spare time.

So, this will just be a quick entry, and I doubt I'll be posting much until after my exam (which is the 17th July). In case you don't know, the exam is one related to my Open University degree, it's an end of year/module exam in human biology.

Last night I stayed at my parents house and so did my niece and nephew. I always enjoy seeing them and they make me laugh lots. My nephew was quite concerned about where Simon was and kept asking "where's Simon?" (he's gone camping for the weekend with friends). Mum cooked me a roast dinner.

Last week I met my older brother's girlfriend, who seemed absolutely lovely. Good catch Pete.

On Thursday I went climbing (indoor) with my younger brother John and his girlfriend (she's also lovely, good catch John!). I still ache now. Not helped by the fact that I spent all day today revising in the park, and I had no sunblock as it was in the handbag I had stolen in Barcelona, so I am now a bit sunburnt ontop.

Other than that I've mainly just been working, but not even had any jobs of particular interest.

There is a possibility coming up of a temporary placement onto a 10 hour shift pattern, which is preferable to 12 hour shifts for all sorts of reasons. These include - no nights!, every other weekend off, shorter shifts (so will still have energy to do something with my evening after work), no more than 3 shifts in a row (currently I often do 4). This will mean I can have a social life again, including seeing Simon! I have not yet had this placement confirmed but am in the queue for a permanent 10 hour rota anyway. Unfortunately they are popular and there's only space for 12 people in the ambulance service to do it.

Anyway, I think that's all my news, must get to bed for another day of revision tomorrow!

Barcelona

2006-06-01T16:05:00.000Z

We had a lovely time in Barcelona, although we did encounter several mishaps along the way!

Our flights were via Germany as this was the cheapest way (£450 cheaper than flying direct). Unfortunately our flight from Heathrow was delayed on the way out and we missed our connection. Eventually arrived at our youth hostel at about 1 a.m., 7 hours later than intended and both shattered.

The following day (Saturday) I wasn't feeling too well, but we managed to get out and stroll around the city, visit the beach and the nearby park, including a ride on an impressive cable car with fabulous views across the entire city.

On Sunday we traveled out to one of the hills behind Barcelona and visited a communications tower. There was a glass lift which took us up the tower to an observation floor, where there were impressive views in every direction. We then had a lazy afternoon on the beach and I read my book (something I don't ever seem to have time to do at home). It was a book that I bought at the airport - The time traveler's wife. It was recommended by my brother. I rarely buy books new (usually from charity shops) but thought I might want something to read on holiday. It was a good book.

Unfortunately Simon was ill on Sunday night, and feeling rough on Monday. Never-the-less, we went to visit Sagrada familia on Monday Morning - an extremely impressive church building which was started in 1881 and is still in the construction process now! We climbed the 400 stairs up one of the spires and (again) enjoyed wonderful views. For a picture click here.

We then sat on a park bench while deciding what to do with the rest of our day. While lifting my arm off my handbag momentarily to point to something in the guidebook, my handbag was stolen. It was done with such stealth and speed that by the time I had noticed it's absence there was nobody in the vicinity. Fortunately I had nothing of great value in it. In fact, the thief will probably be quite disappointed. The most annoying thing to be stolen was my mobile phone. It was old and decrepit anyway and I had been looking for an excuse to replace it. The worst part though was losing all the phone numbers that I had saved on it! And to make matters worse, I hadn't intended to take it with me, but Simon had persuaded me to, so that we could get in touch in the event of becoming separated.

Anyway, I now have a brand new phone (with the same number). It is an all singing, all dancing phone with camera, MP3 player etc. And because I hadn't had a new one for so long I got it for £20 instead of it's listed price of £70.

The other thing that was stolen with the handbag was the key to the padlock for my locker in the youth hostel. This locker contained all af the belongings that I'd taken on holiday. I was worried that I might not be able to get into the locker, or that I would have to pay a lock smith some extortionate fee. My fears were unfounded though. We returned to the hostel and I explained what had happened to the receptionist. Before I had finished explaining, she picked up a large pair of bolt cutters from behind the desk and called the bar man to come and assist me. He strode into my room, and cut through the padlock as though it was cheese. I'm obviously not the first to loose my keys!

On Tuesday morning, we managed to squeeze in one last cultural visit before returning to England. We went to look around Casa Mila "La Pedrera". Another of Gaudi's accomplishments, an apartment building with no angular walls or corners. Everything is made of curves and the whole thing is very light and airy due to two "air wells" going down in the centre of the building. Click here for more photos.

So, all in all an excellent weekend away, and it was wonderful to be able to spend more than just a couple of snatched hours with Simon.

Working with a Trainee

2006-05-23T19:50:00.000Z

In Febuary I became a qualified Ambulance Technician, which involved a year of experience and building a portfolio of evidence that I had done various jobs, a small audit on a chosen area of patient care and an essay on some social aspect of the job.

Now that I am qualified I can be sent out to work with anyone, including trainees (ambulance personnel who have been doing the job for less than a year).

I was working with a trainee on both Sunday and Monday. It really is hard work. And also quite worrying. I feel drained and shattered (even more than I usually do after working four 12 hour shifts in a row).

The problems which I encounter when working with a trainee are numerous. Those that cause me most anxiety and stress are:

- I still feel quite inexperienced at the job, and have not really had any properly nasty jobs like a peadiatric cardiac arrest (child whose heart has stopped). I would find a job like this hard enough to handle/manage working with an experienced member of staff, let alone a new person. Every time a job comes through I fear that it may be serious and hard to deal with.

- The trainee I have been working with this week has been out "on the road" for 6 months but has been working with different people all the time, so has low self confidence and everyone she works with tells her different things, sometimes contradicting. Thus her skills are not very well developed. She also lacks ability to think "outside the box" and is reluctant to take advice on board, making it tough to try and teach her things while not knocking her confidence, and still giving the patient good care and attention. A tough juggling act.

- I have had no training in how to "mentor" ar "train" people, and yet I am expected to devolop the skills of trainees (bearing in mind that I feel my experience is limited).

- When I work with a trainee, I am responsible not just for the actions that I take, but also the actions that they take. In practice, this means that even when I am driving a patient into the hospital and my colleague (trainee) is attending to the patient in the back, I still need to be aware of everything that they are doing and, to some extent, monitoring the patient's condition (from the driving seat!) If the patient is seriously ill, then I would probably take over the patient care and get my colleague to drive, but this way they will learn a lot less. Again, a tough juggling act!

- Some trainees drive appallingly. They get behind the wheel of an ambulance with blue lights and sirens and suddenly think they are Formula 1 drivers. It can be scary (terrifiying) sitting in the passenger seat in such situations. I find it particularly stressful because in that situation you have no control over the fate of the vehicle, it is in someone else's hands. Again, it can be difficult to say anything without feeling that you are having a go at them, or without knocking their confidence.

- There is nobody to turn to if I am unsure about something, or if I want advice. When working with a trainee, I am the most qualified person availiable to that patient, and if I miss something important then their life is in my hands.

However, all that said and done, working with trainees can also be a beneficial experience because you become far more aware of what you do and don't know, which areas you are weak in and need to brush up etc.

Also, some trainees are great, and can teach me a thing or two! Especially if they have had the benefit of working with an experienced crew mate for a while. In this situation they may have advice and tips to give me, and I'm always eager to learn more.

Anyway, I've made it through these shifts, and It's my birthday on Thursday. I'm really looking forward to lunch with my Mum and (hopefully) sister. Then on Friday I'll be off to Barcelona! YAY.

Camping and stuff

2006-05-19T20:14:00.000Z

This will just be a short post as I'm working tomorrow so need to try and get an early night (hopefully I'll be able to sleep).

I've just been camping in Croyde (north Devon). I just went for one night but had great fun. I went with my friend Caroline and her boyfriend. They've stayed on but I had to come back for work.

We arrived yesterday afternoon. It rained all the way there but was dry and sunny there so we managed to get our tents up in the dry. The receptionist ummed and ahhed for ages before eventually finding us two plots adjacent to each other, so we expected the camping field to be full up. We were the only people in it.

Having set up camp, we wnt to the beach went surfing! It was my first time and I was rubbish. Could hardly balance on the board lying down, let alone stand up. But it was good fun. I also did a bit of bodyboarding which was much easier and also extremelly fun. We had left our clothes on the beach and the tide had come rushing in, we only just managed to rescue them before they were washed away!

The rain begun as we were trying to change. It continued all night. Rain, wind and sea, howling around the tent. It was so snug and warm inside though. I slept so well. I only woke up once, and panicked, thinking that my tent was flooded, but then realised that I'd just been dribbling so went straight back to sleep.

Today, we spent the day at Lynmouth, which was very pleasant, and then I headed home.

I'm now shattered and shouldn't have any problems getting to sleep tonight. I've also managed to get sunburnt on my face!

Sleep and links

2006-05-10T09:30:00.000Z

I finally got to sleep at 04.30 this morning. Decided it would be safer not to go to work today, I don't think that half an hour sleep is really sufficient! So frustrating that it means I have to take a day off sick though, I hate being off work.

On a different note entirely, Roberto has taught me how to do advanced stuff like links. Just testing to see if I actually understood him (and to thank him by passing a potential reader or two in his direction).

What I have STILL not managed to do is post a picture to my profile. This is because the picture has to be less than 50kB and I cannot get the picture I want to become smaller than 350kB without cutting away all but a small corner of the picture. Don't think it helps that my photo editing programme was a free trial thingy and has now expired except for the most basic of operations on it. Grrrrrrrr.

Sleep

2006-05-10T01:07:00.000Z

I can't sleep. It's 2 a.m. and I've been in bed since 11 trying to sleep.

Normally this would not bother me but I need to be up in 3 hours to go to work.

The harder I try to sleep, the more awake I feel.

It's not like I'm not tired, I feel exhausted but just can't drop off.

I've even taken 3 times the recommended dose of herbal Nytol. To no avail.

Now I'm beginning to wonder, at what point do I call work and say that I won't be in tomorrow because I can't sleep? Is this a justifiable reason to take a day off or would it be better to go in, last as long as possible and then go home sick half way through the day? Or just hope that I make it right through the day. But with driving and patient's lives in my hands, is it wise to go in at all? And what would be the amount of sleep below which I'd be unsafe to work a 12 hour shift?

I JUST WANT TO BE ASLEEP!

It's so frustrating. I almost started crying because I was so frustrated about it. I don't know what to do. Hoping that this change of scenery (out of bed, cup of peppermint tea, then back to bed) will make a difference and I might finally drop off.

Agenda for change

2006-05-09T10:13:00.000Z

My Agenda for Change contract arrived on the doormat this morning.

Well, actually it didn't arrive on the doormat because there's one of those annoying cage things on the inside of the door that means the postman can never fit all of the post through the letterbox and has to scrunch it all up. But, the contract arrived in the annoying cage thing this morning, screwed up.

The long and the short of it is, if I accept the new contract (I don't have to) I'll receive a pay rise of £2 an hour and an extra 23 hours of annual leave a year, along with other benefits such as overtime paid at time and a half instead of flat rate, uninterruptable meal breaks and time off in leu for working Bank holidays.

I can see no reason not to sign it. Some females see differently. This is because our basic pay is actually DECREASING but we will then be paid an extra 25% on top of that due to unsocial hours worked, taking the pay to more than we currently earn. However, this does mean that if you become pregnant and are put on "light duties" (not involving unsocial hours), your pay will reduce accordingly, back to the new basic, which is lower than the current basic. (We do not currently get any extra for unsocial hours ontop of our salary).

Personally I think that females have been extremelly lucky until now, being able to maintain the same level of pay while doing 9 til 5 work as when doing shifts covering nights and weekends.

Anyway, I've perused my old Trust contract alongside the new Agenda for Change contract this morning and I've signed it, ready to be posted this afternoon.

Within the next few weeks most staff will have made a decision one way or the other and the new conditions can be implemented. The thing that I am most excited about is being able to take a meal break without the fear that a job will come through the moment I get my dinner out of the microwave. The station I work from is located beside a park, surrounded by countryside. I'll even be able to sit outside and have a picnic or go for a stroll.

10 things

2006-04-28T14:30:00.000Z

Ten things that you may or may not already know about me.

1) My favorite ice cream is Ben and Jerry's, chocolate fudge brownie.

2) I've never been paint-balling.

3) I wish I could fly.

4) I don't have a favorite colour.

5) Last time I went ten pin bowling (6 years ago), I let go of the ball too quickly and it went backward instead of forward.

6) I prefer tidying to cleaning.

7) I hate vacuuming (so I never do it!)

8) I've never been go-karting.

9) I'd love a dog (but it's not possible due to my extremely long shifts).

10) My Mum makes the best marmalade in the world.

Staying positive

2006-04-25T19:45:00.000Z

3 of our patients over the last few days have been terminally ill.

All three of them were incredible. They were cheerful, friendly, positive, apologetic, independent, dignified and content. I wonder why? We don't often come accross terminally ill patients, and when we do, cheerful is usually the last word I would use to describe them. Is a positive outlook the only way they have of coping? Or is it maybe a form of denial that they will die? Or just a front they put on to strengthen their nearest and dearest? I just don't know. None of them were old, ranging from mid 50s to mid 70s. All of them had been fit and active untill very recently.

I like to think that I would be this positive if I was diagnosed with a terminal illness. After all, I have lived a very good life, have seen a lot (my family travelled when I was a child), and don't really have any regrets. My life has not been perfect, but the mistakes I have made I have been able to learn from and I would not be the person I am now if the life I have lived was different. I also have the knowledge (call it belief if you'd rather) that when I die I will be going to heaven, which will be a place far preferable to this Earth, a place free of pain and suffering.

However, if I am honest with myself I have to admit that I don't think I'd handle the news brilliantly if I was told I had a terminal illness. I think I'd be far from content and certainly not cheerful. I'd wonder what could be achieved with my life if I wasn't terminaly illl. I'd worry ablut all the people that I love and would be leaving behind. I expect that in that situation I may even fear/question the existance of heaven because of the fear of what would happen if there wasn't a heaven after all.

I guess that you only really know how you'd react to such news when it's delivered to you. I admire these ill people we have been in contact with over the past few days, and it makes me realise how mortal and fragile we are as humans. It makes me want to make the most of my life while I still can as you never know what lies around the corner. It makes me think about the way I relate to people and the way I treat people. It makes me hope that nothing so cruel, painful and debilitating ever affects the people close to me.

How many blondes does it take to change a light bulb?

2006-04-25T19:29:00.000Z

I got up at 5am yesterday morning to get ready for work. I turned my bedroom light on and the bulb blew. My living room bulb had blown 2 days earlier, but I fortunately still had another spare bulb. Having never experienced any difficulty in changing a light bulb before (despite being blonde), I was surprised to realise that I was unable to remove the blown bulb from the holder. It seemed to be fused in. So I gave up and went out to work. I felt stupid - unable to change a light bulb! The typical blonde.

When I commented to some (male) colleagues about my difficulties in changing the bulb I got responses such as "It is a bayonet not a screw fitting, is it?" and "Have you turned the switch off at the wall" and "Do you know how to change a light bulb"!!! I mean, do they think that I get an electrician out every time a bulb has blown in the past?

Anyway, when I got home last night I had anouther look at it. As there was still some natural light left I could see much better what was going on. The old bulb had fused/melted into the holder. Unfortunately my living room and my hall lights had also ceased to work by this stage. The only light still functioning was my bathroom light. The trip switch in my flat was still on, and the fuse box for the house is in a locked cupboard.

I gave my land lady a call. She had just had an operation and is unable to drive. She sent her son over today to have a look for me. He has had to replace the light flex and the light switch which had also gone. I don't feel so blonde now. Relieved in a funny way that it was not a problem I could have fixed at 5am on my way to work. I would have felt so stupid if he'd come over just to find I'd overlooked some trip switch or other!

Weekend again!

2006-04-25T19:17:00.000Z

The last four days at work have been lovely. We have had no more than 4 jobs each day (we can have up to 10 on a busy shift). We have been doing standby's in Clevedon on the sea front and the weather has been mainly great. Me and my crew mate have got on well. All our patients have been genuine (no dross) and very lovely. We have finished on time every day except today, and even then were only half an hour late.

Now I'm on my 8 days off again. Hardly feels like I deserve it!

On Saturday Simon and I will be taking my niece and nephew to Longleat (an estate containing a safari park, a massive maze, a butterfly house, a mini train, a stately home and garden etc. I'm really looking forward to it. In fact, taking my niece and nephew is just an excuse to go, I'd haven't been for years and I recall loving it as a child.

Other plans for the weekend include getting an assignment done, giving some friends a hand with moving house, violin lessons, dinner with my parents (and scrabble with my Mum), and birthday drinks with a friend. Should be fun and relaxing.

Barcelona!

2006-04-20T12:01:00.000Z

I'm going to Barcelona!

The flights and hostel are all booked.

I'm going with Simon. We're leaving on the 26th May and staying for 4 nights. I'm really looking forward to it, lots of people have told me how lovely it is there.

Cows

2006-04-17T22:36:00.000Z

I'm on nights this week.

At 5.30 this morning it was just getting light and we were driving along the M5. Beside the M5 were fields. Some contained cows, others sheep and others horses. Almost all the animals were lying down (but appeared to be awake). However, some of the cows were standing up, grazing.

This got me wondering. Do cows go to sleep as soon as it gets dark and then wake up when it gets light? If so, do they therefore get less sleep in the summer than in the winter? And does this make them tired? And Ratty? (I get ratty when I've not had enough sleep). Do cows get cold at night? If not, what keeps them warm? Do sheep sleep longer each night than cows? Which is warmer, a sheep or a cow? (or a horse?)

If you know the answer to any of these questions, I'd love to hear from you! Strange things to wonder, I know. But then I had been up for nearly 24 hours by that point!

Update

2006-04-12T20:38:00.000Z

Following our Unison ballot, we were due to be commencing industrial action today.

We were going to be 'working to rule' all day, which would involve not doing standbys, not recording response times etc.

Tomorrow, and on two other dates there was to be a two hour walk out. I was not happy about this as I know that the patients would not get sufficient/any care during these three, two hour periods.

Fortunately, the industrial action was cancelled at the last minute, as the management have finally reached a satisfactory compromise with the union on most matters, and those still outstanding are only minor.

I am extremely thankful that a solution has been found and I thank those of you who were praying about the situation.

This means that we will soon be sent our "Agenda for Change" contracts and soon after that our rotas should change to something slightly more humane (we will get every other weekend off, rather than just one a month). We will also be entitled (enforced) to take uninterruptable meal breaks. This will be pleasant as currently you can guarantee that the moment the microwave pings as your food is ready, the buzzer informing us that we have a job will also go off and we have to leave our food until later (if we don't get interrupted again on the next attempt).

Seth Lakeman

2006-04-06T14:06:00.000Z

Tonight I am going to see Seth Lakeman - a contemporary folk artist. I'm really looking forward to it.

I nearly couldn't go. I bought the tickets ages ago and applied for a shift of annual leave as I should be working a night shift. I had the request granted and thought nothing more of it until the rotas came through last week. I was marked down as being off on the Wednesday night not the Thursday. So I checked my request form, only to discover that I'd accidently requested the wrong shift! What a nitwit! So I contacted CRO (Central Resourse Office) who deal with all the rotas, annual leave etc. and asked if I could change it. They said no. I frantically asked everyone I knew if they could do a shift swap with me. No luck.

On Monday I made one last ditch attempt to get CRO to change it for me in the hope that unexpected things such as sickness might have changed the situation. I spoke to a very helpful man who has worked out on the road but is in CRO temporarily while he has an injury. IT WORKED! He swapped the shift for me.

So, I'm going to see Seth Lakeman tonight.

Weekend off

2006-04-06T13:57:00.000Z

Strange, I seem to get less time to blog when I'm off work than when I'm working!

Had a lovely weekend off, went to stay with Simon's parents in Surrey. I always find it very relaxing going there because I don't generally take any study and I can't do things like my housework, cooking etc. so just have to relax!

Another Toughie

2006-03-29T13:04:00.000Z

We had another tough job on Monday.

We were called to an elderly lady with breathing problems. There was an RRV (Rapid Response Vehicle) on scene when we arrived, and he had already cannulated the patient (inserted a tube into a vein, allowing drugs to be given intravenously).

The patient was an elderly lady with (seemingly) a chest infection. She had a raging temperature and har breathing was rapid (40 breaths per minute) and bubbly sounding. She was unable to talk or open her eyes due to the effort of breathing. Her husband had arranged for her GP to come and visit her later that day, but the home carer had called for us when she arrived due to her concern for the patient. When she called us, she had also called the GP surgery to cancel his visit. The GP called while we were taking the patient out to the ambulance and insisted that he speak to one of us. As there were 3 of us there altoghether, myself and one other continued getting the lady out to the ambulance while the other colleague went to speak to the GP. The GP forbade us to take the patient to hopsital, saying that she was terminally ill with lung cancer and should be left to die at home. My colleague explained that the patient appeared to have a chest infection on top of this and that surely the chest infection should be treated. The GP adamantly refused to allow us to take the patient to hospital.

In order to cover ourselves, my colleage called our control and asked them to speak to the GP (all calls to or from the control room are taped). This ensured that the GPs instructions were recorded on tape if we should be called into question about this job at any point in the future. Control then confirmed with us that we were to leave the patient at home, in line with hte doctor's wishes.

By this time we had carried the patient down the stairs. We had to carry her back upstairs and get her back into bed. We had to remove the cannula that had been put in. We had to explain to the patient's husband that his wife may well die before the doctor came to visit as she was struggling to breathe and becoming exhausted. We had to walk away from the house knowing that some intravenous antibiotics and paracetamol could well have returned the patient to her normal level of health. We had to obey the word of a doctor who had not seen the patient himself for several weeks.

A tough thing to do, and especially as it seems to go against the grain of helping and treating people, which is what we normally do. But then, the doctor had been treating her for 6 years, and we'd only know her 6 minutes. He's a doctor and we're just ambulance crew. At the end of the day, we have to accept that doctor knows best.

Tough One

2006-03-29T12:32:00.000Z

As mentioned in my previous post, I had a few tough jobs in the last few days.

The hardest one was on Monday. We were called to a GP surgery for an 8 week old baby who had just had his first immunisations. Apparently, about 5 minutes after the injection he suddenly went all pale and floppy (not good). The doctor had given him some oxygen and stimulated him and he had come round. The doctor had then instructed his mother to try feeding him, and the same thing happened again.

When we arrived the baby was screaming and filling his lungs. He was bright red and not at all pale. I (mistakenly) thought that this would be an easy job, just a matter of transporting him (and his mother and grandmother) to the children's hospital for some reassurance. A screaming baby is not a critically ill baby, just an unhappy baby. While he was screaming everyone was happy - he was getting plenty of oxygen into his body and there was no question of whether he was breathing or not!

I carried this screaming bundle out to the ambulance where I put him on his mother's lap. The safest way of transporting small children and babies in the ambulance is to sit "Mum" up on the stretcher, with "little one" on her lap.

"Nanny" was coming too, so we got her belted into one of the other seats and off we set.

Five minutes down the road baby stopped crying. Baby went floppy. Baby went pale. Baby stopped breathing. "Mum" started crying, "Nanny" leapt out of her seat and started shouting and crying. I tried not to panic.

Not really sure what I did next or what order I did it in. I picked up baby and pinched his fingers - HARD. I got no response from him. Likewise when I pinched his toes. I asked my colleague to put the blue lights and sirens on, I didn't want to hang about with this one. I told "Nanny" in no uncertain terms to sit down and put her seatbelt back on. I told "Mum" that everything would be ok (hoping fervently that it would). I did NOT tell "Mum" and "Nanny" that baby wasn't breathing. I frantically tried to recall my infant resuscitation procedure, having never needed to use it before. I tried to look calm and in control. I tried to comfort and placate "Mum".

Thankfully, just as I started reaching for the resuscitation equipment, baby took a gasp and started howling again. This was much to everyone's relief, especially mine! I think that was the most stressful minute or two of my life so far!

The rest of the journey to hospital was uneventful in comparison, baby did go quiet and floppy a few more times, but did not stop breathing or go pale again. Although these episodes scared "Mum" and "Nanny", I could sucessfully reassure them that baby was still a good colour and still breathing.

We arrived at the hospital and I was relieved to pass over responsibility to a team of children's nurses.

Reflecting about this job made me realise that I am not confident in infant rescusitation guidelines and procedures, having never had to put them into practice. I spent my evening reading up on this so that if it ever happens again I will hopefully be a bit more confident about what to do, and so will hopefully also be calmer. Not a nice job, but thankfully a sucessful outcome, and it pointed out to me an area of my practice which needed brushing up.

A Hundred And One!

2006-03-29T12:04:00.000Z

I've had a few tough jobs in the last few days, and some lovely ones too.

My favourite was an elderly lady that we went to on Monday morning. She had fallen over and was unable to get herself up. She was 101 but looked and acted 75. She lived in a warden controlled flat but she had fallen at about 7am and the warden didn't start work until 8. In this situation, the emergency cord pull usually goes straight to "care link" or "piper line" who can communicate with the patient and call an ambulance for them.

So, she had pressed her call button which was on a pendant on her neck, and we had been responded. We arrived and got her door key out of the key safe (a fabulous invention - a small container with a combination lock on. The container is placed on the outside of the house near the door and contains a door key. Care link or piper line are given the number for the combination lock and pass it on to us when they call us. This allows us to access the house without having to break in).

This elderly patient had fallen due to her knees giving out. She was not injured but had not been able to get herself up off the floor. We assisted her into her chair. We then proceeded to do several checks on her (blood pressure, pulse, respiratory rate, oxygen saturation level, temperature, blood sugar level). Myself and my colleague always try to do these checks on every patient, especially if we intend on leaving them at home. It allows us to assess the patient fully and ensures we are not overlooking any possible abnormalities. This ladies pulse was quite slow at 46 beats per minute (normal is usually 60 - 80). This may have contributed to her fall. She was not on any medication that would account for a lowered pulse. We recommended a trip to the hospital for a check over. She refused and burst into tears, having only just returned home from a hip replacement.

So, to get a better idea of what was going on I got our ECG machine from the vehicle and we did an ECG of her heart (heart tracing). It was not normal, but didn't look too bad considering she was 101. She insisted that she felt fine and didn't know what all the fuss was about. In fact, I began to wonder too as she got up and scuttled into the kitchen to make us all a cup of tea!

In the end we reached a compromise. We arranged for her GP to come and visit her in his lunch break. If he thought she needed to go into hospital he could arrange that. We left the ECG for him to have a look at when he arrived and arranged for her neighbour to keep popping in in the meantime to make sure that she was alright.

This sort of case shows how important it is to do all the checks we can on a patient, even if they seem irrelevant. Most crew would have helped the patient into the chair, made sure she wasn't injured and left it at that. I don't think my conscience would allow me to do that. It is on occasions like this that doing every check pays off.

E.U. Working Directives

2006-03-29T11:47:00.000Z

I haven't really had time to post for the last few days, due to the fact that I've just worked 4 days in a row.

Saturday was extremely busy. We went out on the dot of 7, got back to station for a cup of tea and bite to eat at 2.45pm, went back out at 3.15pm and didn't finish until about 8pm.

Due to E.U. working directives we have to have a minimum of 11 hours off between two shifts. Well, 364 days of the year we have to have a minimum of 11 hours off between shifts. On the night that the clocks go forward we are (apparently) exempt from this law.

As our shifts are 12 hours long, usually if we finish more than an hour late we are entitled to come into work late the next day to ensure we still have this 11 hour break. However, as we are exempt from this law on the night that the clocks go forward I still had to start work again at 7am on Sunday, just 10 hours after my previous shift had ended. Once I had got home, had a bath, eaten dinner and dragged myself to bed it only seemed moments before my alarm went off at 5.30am. I felt awful. Exhausted. But I got into work. Thankfully Sunday was a quieter day and I survived it. But it certainly made me realise the value of having 11 hours off between shifts. It just enables you to get an adequate amount of sleep as opposed to an inadequate amount. All of Sunday I felt tired, found it hard to concentrate, got irritable, and generally gave my patients care below my usual standard.

I can't understand why the law does not apply to us on this particular day of the year if it is in place to ensure the best treatment of our patients and our good health. Do these not matter on that one day? Could our company not make an arrangement for the night crews to stay on for an extra hour in the morning on that Sunday, as their shift is an hour shorter than usual? To me it just seems badly planned, but then, I was on the tough end of it. I expect I would have been delighted if I'd been one of the lucky people working the night shift that night and getting paid for 12 hours work, while only doing 11 hours.

Petrol/Fuel

2006-03-26T05:16:00.000Z

My brother has made me aware of a web site offering a scheme that could save you up to 10p a litre on fuel. It sounds like a great idea. The more people that join up, the more effective it will be. For more information and/or to join just click on the banner below which will (I hope) take you to the web site. Please consider taking a look.

Neighbours

2006-03-24T16:21:00.000Z

I live in a house that has been divided into 10 flats. Each of these flats is self contained. Isn't it strange that I live in such close proximity to so many people and yet only know most of their names from checking the post in the morning.

I do actually know the resident in one other flat, as I knew him before he moved in (I knew he was looking for somewhere to live, so gave him the landlady's number when a flat became free). There is also another resident who chats to me in the hallway if we happen to be coming or going at the same time.

Yesterday I went downstairs to check the post and bumped into a resident from one of the other flats. I'd never really spoken to him before except for the odd "Hi" in passing. We started a conversation and were standing in the corridor chatting for about 20 minutes. On leaving I said "feel free to drop by for a cup of tea anytime". I meant this - I feel it is great to have good relations with your neighbours and they are often the closest people in times of need. However, I didn't really expect him to take me up on it. This afternoon I was just pottering about, washing up etc. when there was a knok on the door. He'd come to visit. We had a cup of tea and put the world to rights. It was lovely. (maybe he just wanted to have a nose and see what my flat was like!) I fully intend to return the visit in the near future (and see what his flat is like)!

Days off

2006-03-24T16:14:00.000Z

I worked Tuesday night, but didn't do any work at all so got plenty of rest, and it hardly felt like work really.

This meant I could make the most of my days off. I've really enjoyed them.

I am ahead with study at the moment, so although I have some that I can do, there are no looming deadlines to meet and no pressure. Therefore I have had a chance to relax, catch up with some friends (and parents) etc. I even went to the pub last night and joined in with a pub quiz (we didn't win). I had a friend over for dinner last night and I am going out with a couple of colleages tonight who I never see at work because they work on different stations to me, doing different shifts.

Back to work tomorrow, but for once I feel well rested and relaxed. Then just 4 shifts before I'm on my 'long weekend' off (7 days).

New niece

2006-03-24T16:11:00.000Z

My sister is pregnant again. She had her scan this morning. She's probably having a girl. I'm going to have another niece! (I currently have a 5 year old neice and a 2 year old nephew).

The only problem is, I will no longer be able to say to my current niece "you're my FAVOURITE neice!"

Mum

2006-03-24T16:01:00.000Z

I have just seen my Mum three days in a row. I don't think I've seen her so much since I left home!

On Wednesday I went over for dinner (she usually does me a roast). I played two games of scrabble with her, she won the first, I won the second. I generally play scrabble with her when I go over as our respective partners are not too keen on it.

After dinner I played two games of backgammon with my Dad, and beat him both times :-) He thought I was lucky.

My Mum had seen a window for sale in the Trade it (a local adverts paper) which she thought might fit her garage. As the person selling it lived fairly near to my house I arranged to go and have a look at it for her on my way home. It looked good and was the right size, so I squeezed it into my car.

I was a bit uneasy carting a large sheet of glass around in my car, so dropped it over to her on Thursday. I stayed for a cup of tea and a chat.

On Friday mornings my Mum takes my nephew swimming. I don't often get a chance to see my nephew, so I decided to go with them today. Thus I saw my Mum again!

I'm glad I don't live with my parents any more, because I'm just too independent. However, they live the perfect distance away - I can easily visit when I want to. It's very easy to overlook blessings like this.

Even Quieter!

2006-03-22T00:07:00.000Z

I am working again tonight. My crew mate is on annual leave and there is nobody else without a crew mate in the service tonight for me to work with. So, I'm all on my own. This is known as "driver only". They can respond me to calls, but if they do they also have to send an ambulance with 2 crew members, in order to transport the patient to hospital. They are only allowed to respond me to "red" calls, which are those that are considered life threatening e.g. chest pain, breathing difficulties, severe bleeding.

So far (5 and a half hours) I have done nothing! Usually I would use this opportunity to get some study done, but I've accidently left my books at home. In fact, I'm getting quite bored.

Fortunately, this is my last night, so I'll be attempting to get some sleep. If I can sleep for the rest of the night, I won't need to go to bed tomorrow!

Last night

2006-03-21T16:45:00.000Z

Last night was an amazing shift.

We started (as usual) at 7pm. Before we had been there 10 minutes, and while we were still ckecking that we had all the equipment we needed on the vehicle, we got our first job.

It was in Weston-Super-Mare. We dealt with that patient then were sent back to finish our vehicle check. Before we had gone 200 yards we were given another job. "It's going to be one of those nights" my crew mate commented. Meaning - "At this rate we'll be rushed off our feet all night".

The night continued like this until 10.30, when we were sent back to station for our first break (and to complete our vehicle check).

Then, nothing. Silence.

At 2.30 I was beginning to wonder whether the phone and the radio were broken, preventing control from contacting us as we had not been given any work for 4 hours. At that moment the phone rang. Control - "would you like to take your second break?"

At 3.30 the phone rang again, but still no job. This time we were asked to move to Clevedon for half an hour of 'standby'.

Then back to station where we remained until we went home at 7am.

I got lots of study done. (And I was being paid!)

A night like this is unheard of. I doubt it'll happen again for several years!

Delivery Men

2006-03-21T16:27:00.000Z

I live in a small flat (so smalll that my Mum calls it a furnished cupboard). In this small flat is a small fridge, the sort that fits under the work top. In this small fridge is a small freezer compartment, in which I can fit 3 ready meals and a bag of frozen peas. This is the usual contents of my freezer.

Last week I stopped and thought about the food I eat. Doing shift work means I don't get time to cook anything for 3 or 4 days in a row, so I just eat ready meals a lot of the time. I'm sure this is not healthy in the long run. Also, as my freezer is so small, I often run out of food and have to make do without until I can get to Tesco again. Not ideal!

So, on Friday I ordered a "table top freezer". This is a small freezer (it has to be to fit in my flat). It has a capacity of about 40 litres and is about half the size of my current fridge. The idea is that it will enable me to cook 'proper' food such as casseroles, lasagnas etc. on my days off, put them in portin sized containers in the freezer, and eat them as required, with fresh vegetables. If I can be disciplined enough I should soon be eating much more healthily.

The freezer was due to be delivered today. I am on nights this week so I was at home all day (although I was asleep for most of the day). I expected to hear the doorbell when they arrived as it is LOUD. I woke up at 12 o'clock, and spent about half an hour awake before falling back to sleep. When I got up at 4, I went downstairs to check the post. Lo and behold - a card from the delivery man saying "you were not at home when we tried to deliver". And they had tried to deliver at 12.15! If it had been any other time of day I would have assumed that I had just slept through the doorbell, but I had been awake at the supposed delivery time. They must have knocked on the door with a feather, then ran away quickly.

To make matters worse, the card gives an address to pick your parcel up from, and opening times. It also states that delivery will only be attempted twice. It does not state when the delivery will be attempted again. So, if I go tomorrow to the address from which to pick my parcel up, how am I to know it will be there, and not in a delivery van somewhere?

Industrial Action

2006-03-15T17:37:00.000Z

I belong to UNISON. This is the union that most of my colleagues are represented by. In my job it is highly recommended that you belong to a union. This gives you some legal protection if you are sued at any point by one of your patients.

The Ambulance service I work for is an NHS trust. All NHS trusts are having to implement "Agenda For Change". You may know all about this. It is a national scheme, for all NHS workers, in an attempt to nationalise pay scales and give equal pay for work of equal value. Agenda for change was meant to be implemented in October 2004. My ambulance service has not yet implemented this scheme, and are in "discussion" with the unions over several areas of these national guidelines. Basically, the management are trying to pay out as little as possible, and the unions are fighting for what they believe to be the rights (as laid out in the Agenda for Change guidelines) of us, as ambulance staff.

Discussions have been ongoing for at least 9 months now, with the management unwilling to shift.

A few days ago I received a ballot paper from UNISON. This ballot paper asks me if I am prepared to take part in industrial action short of a strike, and also, if I am prepared to take part in industrial action in the form of strike action.

It has led to me asking myself questions, soul-searching and getting nowhere!

My gut feeling was initially that striking was bad (but I don't know why!) However, the management is being unfair and treating different members of staff differently. Surely this should not be allowed to continue.

I did some further investigations, speaking to our UNISON branch secretary. He explained that "strike action" would not involve all of the ambulance service staff taking a whole day off work. Rather, it would much more likely take the form of a group of stations within the service "standing down" for an hour or two, followed by another station/group of stations "standing down". This would cause disruption to the service, but not an entire cessation of service. Even so, this does not sit well with me, as I would be worried that patients requiring care may have to wait longer than acceptable for an ambulance, maybe even leading to unnecessary deaths in extreme cases.

So, I think I've decided to vote against strike action. First hurdle over.

Industrial action short of a strike is likely to be actions such as refusing to go on "stand-by" (when we are sent off our station to cover a different area, when there are no current emergencies to send us to) and/or not giving times to control (we have to give mobile time, at scene time, leaving scene time, at hospital time and clear time for every job). What else it will entail I do not know. These are the sort of actions that do not endanger the health of residents within our service coverage, but cause the management grief and problems.

So, I initially thought that this sort of action would be acceptable and I would be able to undertake it with a clear conscience. But...in the Bible (Romans 13) it talks of obeying your government and authorities. Does this mean that it would be wrong to cause trouble in this manner?

I've not yet reached a conclusion but the ballot paper needs to be returned by Monday.

The UNISON branch secretary also explained that it would be expected (but not a legal obligation) of union members to go along with the majority vote, if a strike became unavoidable.

Any comments or thoughts will be gratefully received!

Social Services

2006-03-15T17:07:00.000Z

During the working day (or night) we often get called to elderly people who have fallen in their home. Approximately 50% of the time they are uninjured, but just unable to get themselves up. If this is the case, we ensure that the fall was mechanical (just a slip or trip, not due to a faint/stroke/blackout/heart attack/severe hypotension) assist them up and make sure they are comfortable, make them a cup of tea etc. before leaving them. In the other 50% (ish) injuries are often sustained. These range from grazed elbows and bruised knees to broken spines. The injury we encounter most often is a fractured neck of femur. These are immediately apparent because they cause the affected leg to shorten and rotate outward, not to mention the excruciating pain they cause.

When a person suffers a fractured neck of femur, operating is the only option. It will not "just heal" if left to its own devices. I know this from my work on a trauma and orthopaedic ward. In fact, even for those patients that survive the operation, the survival rate of patients a year on from a fractured hip is low.

So, it came as a surprise to me when I discovered that a patient we went to last week has been on a waiting list for 9 months, waiting for social services to come and assess her needs in her own home. This patient knew that she needed a zimmer frame. She knew that her mobility was deteriorating and she could no longer cope with the two sticks of her own. She also knew that she needed a handle on her bathroom wall to aid her getting off the toilet. She had known this for a year, during which time she had continued to deteriorate. It had taken 3 months for her GP to persuade the social services to put her on the waiting list, and a further 9 months waiting, with no result yet.

We went to her because she had fallen when trying to get off the toilet in the middle of the night. Luckily for her, she had not fractured her neck of femur. Unfortunately, she had probably fractured a bone in her lower back. Not a life threatening injury. In fact, the sort of injury that probably won't be treated except for painkillers. But, never-the-less, an injury that meant we had to cart her off to hospital. An injury that would probably have been avoided if she had been assessed by social services and had the relevant equipment fitted.

So why on earth are the waiting lists so long? I don't know, but you would have thought that if it is due to short staffedness, employing more staff would be cheaper than treatment of the injuries incurred because of slow response to needs identified by the patients themselves.

Answer phone message

2006-03-13T11:50:00.000Z

I got in from work a couple of days ago and checked my answer phone. I had a message from my younger brother, John. He thanked me for posting his wetsuit to him. He finished the message by saying "hopefully I'll speak to you at some point in the future". It struck me as a slightly strange way to finish a message. It almost sounds (to me) as though he's not sure that he will ever speak to me again and is certainly not fussed much either way! However, I think this is probably just the way he is - laid back.

I hope I do speak to him at some point in the future!

Saturday nights

2006-03-13T11:13:00.000Z

I really dislike Saturday night shifts. They are ALWAYS busy, we often have to deal with drunks (even if the patient is sober and genuine, there is usually a friend or relative who is drunk and causing grief), and most of the calls are a waste of time. People seem to think that they can call an ambulance for absolutely anything these days.

Fortunately I only have to do one Saturday night a month. Unfortunately the Saturday night is the last one of 4 so I'm tired, my patience has worn thin and I just want to be in bed!

To make it worse, everyone (except me) has annual leave to use up before the end of March. The whole service seems to be off. Also, the Trust has banned overtime in an effort to save money. We're severely short staffed.

My regular crew-mate was off on Saturday night (annual leave) and I had nobody to work with initially. Control rang and said they were sending someone from Avonmouth to work with me as she had no crew mate either. This meant there would be no crew working from Avonmouth. I also know that there was no Churchill crew and no Falfield crew (annual leave). So there were at least 3 crews less than usual.

I checked a vehicle as I had no idea whether we would use my vehicle or that of the person they were sending to me.

Control called at 7.55 to tell me that S (my crew mate for the night) was 5 minutes away, and they had an emergency for us as soon as she arrived. So the night began.

The first patient was genuine - she had collapsed and was suffering with AF (atrial fibrillation) - where the two top chambers of the heart do not pump effectively, but instead quiver/fibrillate.

The second patient was a 16 year old female who had a stomach bug. She'd been vomiting all day and had diarrhoea. Her abdomen was painful just below her ribs. (Whose wouldn't be after vomiting all day). Her Mum had gone out for the evening and there was a very drunk lady claiming to be her mum shouting at us to do something, to save her etc. etc. It turned out that this lady was an acquaintance of the patient's mum. The patient's mum had taken her in earlier that day due to her husband being violent toward her. She was crying, shouting and making a scene. My colleague kindly took her out of the room and tried to control her while I carried out an assessment of the patient. The patient was extremely embarrassed. She had just wanted to see a doctor, but this lady had insisted on calling an ambulance (and it turns out, gave the call taker a lot of grief/verbal abuse). So, we arranged a GP visit and we got the patient to call her Mum and ask her to return home as there were 8 younger siblings and we felt it was inappropriate them being left in the care of this drunken woman.

And so the night continued. Picking up men from the side of the road who are too drunk even to know their own name and address, pacifying drunk and hyperventilating females etc. etc. Rushing from one side of the county to the other. We drove 220 miles. Generally we'll do 100 - 150.

We finally had a break at 2am. 30 minutes to grab some food and have a cup of tea. Then back out to the next job.

So, I really dislike Saturday night shifts!

My weekend

2006-03-07T00:34:00.000Z

I've had a wonderful weekend. Nothing out of the ordinary I guess, but time to wind down, see family, spend time with Simon and relax.

I had a violin lesson on Wednesday, my teacher seemed to think I was doing well, and I'm enjoying it, which is great. I think it's a huge help that I can already read music, as this would otherwise be a large hurdle.

I don't remember doing anything of note on Thursday and Friday, caught up on some OU study, did a couple of jig-saws that my Mum had leant me and watched a couple of DVDs ("Afterlife" and "Tales of a Raggy Boy"). Both were very good, but Tales of a Raggy Boy was excellent. It's based on a true story, which is often the soft of film I like best. I cried LOADS. I have a theory. It is this. If a film makes you cry it is a good film. It must be good because it has got you involved enough in the story to feel empathy/sympathy (I can never remember which is which) and stirred your emotions to the extent that you cry. Just a theory. I'm not saying that a film is bad if it doesn't make you cry.

I also had to go shopping on Friday. I hate shopping. I had to buy my neice a birthday present as I was seeing her on Saturday and it was her birthday on 28th Feb. I survived. Just. Made it back home and brewed up a gallon of tea to see me through the recovery period.

On Saturday I spent the day with Simon (amongst other things). When I arrived at his house on Saturday morning he said "do you mind if we just pop out to do some shopping, I need some hair stuff and toothpaste and things". AAAGGGGHHHH. I HATE shopping! And two days running! So I smiled and said, "That's fine darling".

However, the shopping became fun when he mentioned that he wanted to buy a salad spinner for some friends. Not my usual shopping trip. The kitchen shop had 5 different types of salad spinner. There was 3 different spinning mechanisms and some even had brakes! We were in a dilemma as to whether to buy the one with a mechanism like a lawn mower, where you pulled a string to make it spin, or the one like a spinning top, where you just pressed down the knob on the top, which caused the salad spinner to spin for ages (until you pressed the brake button). After 10-15 minutes of playing with the salad spinners we eventually made our selection (the one like a spinning top) and proceeded to the check-out. Simon was then highly embarressed to discover that our antics had been observed. The shop assistant casually commented as she wrapped our salad spinner "great fun to play with, these salad spinners. Aren't they?". Simon hurriedly tried to skulk behind me and hide.

We then spent a lovely afternoon/evening at my parents house. My sister came over too with my niece and nephew. Spent the evening playing backgammon in front of the open fire. Wonderful.

Sunday. I again spent the day with Simon, we went to church then out for lunch with some of his old uni friends. We went to the cinema in the evening and saw Lucky Number Selvin. I was disappointed. The first half was good and it could have been a good film, but they ruined it by giving it a twist which meant that they were glorifying revenge and portraying the idea that revenge leads to freedom and satisfaction. Which I do not agree with and felt uncomfortable watching this ethos being portrayed as a good and acceptable way of life.

Today (Monday). I tried to do some study, lacked motivation so ended up practising the violin, making cheesecake etc. etc. instead.

This afternoon I had a visit from a friend of mine with his girlfriend and their 4 month old baby. I hadn't seen them since before Christmas. He's asked me to be their daughter's Godmother. I am so touched. It's not like they're my best friends or anything, just that I know them and care about them. She spent an hour sleeping in my arms and by the time they left I was reminded of how broody I am! (It may have been a different matter if she'd screamed the place down for an hour).

Simon and I (yes, I saw him again - 3 days in a row, must be a record) went for dinner this evening with a young couple from church. Had a lovely evening. I always feel a bit bad that I can't reciprocate such invitations. I just don't see any way I could fit 4 people into my flat, let alone cook for 4 in my small Baby Belling oven!

Anyway, that's my weekend off gone for another month, only another 180 hours or so of work until the next one! (not that I'm counting or anything).

Long weekend

2006-02-28T22:10:00.000Z

Yippee, I've finished work for the week and I don't have to go back until next Wednesday night. This is my "long weekend" which I get as reward for hard work once every 4 weeks. I think I deserve it this time, having worked over 50 hours in the past 4 days and over 175 hours in the last 3 weeks.

I have no great plans, although me and Simon (my boyfriend) are visiting my parents for dinner on Saturday and seeing my sister and her children at the same time.

I have a violin lesson tomorrow morning, which I'm looking forward to (I've only just started playing it), but I've not really practiced since my last lesson as I've been at work so much!

Simon and I are then going for dinner with a couple from church on Monday evening. I'm looking forward to it.

If it snows enough I'd love to go sledging, but don't have a sledge. If any of you have one and fancy sharing it?....

All in all it should be a relaxing weekend and a chance to get on with some OU study.

Home

2006-02-28T21:27:00.000Z

Sunday. About midday. A lovely patient, another 96 year old lady. She had had 3 falls in 3 days and her neighbours were worried about her. Understandably so as she lived alone with no living relatives. During the time we were in her house 6 different neighbours came to knock on the door and make sure she was OK. This was in addition to the 4 that were already in her house having come over to check on her and picked her up off the floor.

Her temperature was so low when we checked it that it didn't even register on our thermometer (which means it was less than 32 degrees C). Anything below 35 degrees C is classed as hypothermia. Her blood pressure was also so low that we couldn't get a reading on it and her pulse was low (between 40 and 50 beats per minute). Astonishingly she was still fully conscious although slightly confused about what day it was (as I frequently am!). She did not want to go into hospital and was only persuaded to do so by us telling her that her neighbours would worry about her if we left her at home.

We wrapped her up in several blankets and got her into our ambulance where I had the heater roaring. We piled all of our blankets on her and took her to hospital. When we arrived a nurse checked her temperature. Despite our attempts to warm her, her temperature was still only 29 degrees C.

Unfortunately, it's incredibly unlikely that she'll ever leave hospital again. And if she does, the likelihood of her ever returning home are extremelly slim. She might have more chance if she lived with some relative, but she has no relatives. I think most people of her age realise that this is the case and is probably one reason why they are so terrified of going into hospital. It is very difficult to know what to do for the best in such a situation. We cannot force people into hospital against their will, even if they will otherwise die.

Fortunately this particular patient agreed to come into hopspital with us. Not all do. If they do not, I arrange for a GP to visit them. This is for two reasons. 1) Passing the buck. 2) Most patients are less likely to say no to their doctor than to us. In this case we usually get the same job back later in the day when the GP has been out and persuaded (or rail-roaded) the patient into going to hospital.

My final thought on this patient, I hope I have neighbours like hers when I'm old. They were all telling us how much she meant to them and what part she had played in their lives (e.g. "She used to babysit my children when they were small", "She'd always look after my dog when we went away"). What a wonderful community to live in, where everyone looks after each other. I hope she does go home, and dies surrounded by the people who love her, rather than in a hospital surrounded by strangers who don't know her. I like to imagine the happy ending.

Don't die at the weekend

2006-02-28T20:53:00.000Z

As I mentioned in my previous post, my shift started early on Saturday.

The job that we went out to was a DOA (dead on arrival). The deceased woman had been fortunate enough to slip away quietly in her sleep, having been perfectly healthy the day before. She was 96. Such a dignified death is rare nowadays. Unfortunately she chose the early hours of a Friday morning to die. She had only been admitted to the nursing home which she was in two days previously (on the Thursday afternoon). The nurse who was working the shift on the night she died only did occasional shifts so had never met the patient before. As she did not know the patient she had been making regular checks on her throughout the night to ensure she was comfortable and dry. At about 0530 she went into the room to find the lady dead in the bed. As a qualified nurse she was certain that the lady was definitely beyond help. Unsure who to contact she attempted to contact the patient's GP. She got an answer phone. She looked through the patient's scanty notes for any information but there was none. The out of hours GP service told her to call NHS Direct for advice. They immediately passed the call onto the emergency call centre, who dispatched an ambulance (us) on blue lights. They also advised the nurse to get the patient on the floor and attempt resuscitation (at least an hour since the patient passed away). The nurse had more sense than to do so.

When we arrived we confirmed that the patient was most certainly dead and there was nothing we could do. However, we are unable to 'certify' death, this has to be done by a doctor. This is where the problems start. Getting hold of a doctor at a weekend is not easy. However, we were pleasantly surprised when the on call GP turned up on the doorstep within 10 minutes (it was nearly the end of her shift and I think she wanted to get home). The next problem - the patient had died 'suddenly' in that she had not been unwell within the last fortnight and was not suffering with any fatal illnesses. The on call GP was not willing to sign a death certificate and said it would have to be done by the patient's own GP, or alternatively, to get the police involved (as should be done in the case of sudden death), who will pass it on to the coroner, and a post mortem is then likely.

By this time the nurse had managed to contact the daughter and break the news. The daughter explained her Mother's wishes, including the undertakers that she wanted to use. The undertakers would not remove the body without a death certificate. The only person who could issue this was the patient's own GP who would not be at work until Monday. The nursing home could not have a body in a room for two days. The only option left was to involve the police and the coroner. None of the patient's family wanted her to have a post mortem.

At this stage we left, there was nothing else we could do, and there were other jobs waiting where we could make a difference. But it got me thinking. I don't want to die at a weekend, it's too much hassle.

Patients.

2006-02-25T21:18:00.000Z

This will just be a quick entry as it's been a long day and I should be off to bed.

I worked today. A day shift is usually 7am to 7pm but I often get in a bit early to relieve the night shift. Today I was in at 6.30. At 6.33 a job came through so me and my colleage took it so that the night crew could finish on time. We finished this evening at 7.45 pm. A long day. However, we had a couple of lovely and genuine patients which makes it all worth while.

Earlier in the week (The very early hours of Monday morning) Jo (my crew mate) and me took a man into the A and E department. His stools had been full of blood for three days and he looked dreadful, extremelly pale. He could not stand up as this caused him to collapse due to falling blood pressure. He was at the top of his four storey house. He crawled down the stairs because he didn't want us to carry him (and the stairs were tight and windy). We had been kind enough to put some fluid up (a drip of salty water into his vein) to try and make him feel slightly better. Today we were back in the same A + E department so decided to find out what had happened to him. The receptionist told me which ward he was on and I gave them a call. The person on the end of the phone want to get a nurse that "knew the patient" and the next thing I knew, the patient himself was on the other end of the phone. He explained that he had had a burst vein somewhere near his stomach. Apparently it is very rare. They had had to open him up to fix it. Following surgery he then had a collapsed lung. However, he had made a vast recovery and despite spending two days in ITU this week he should be going home on Monday or Tuesday.

I know that the NHS may not be the best health service in the world, but to me that's incredible. What a quick recovery. It is fantastic to be able to follow patients such as this up, find out what their diagnosis was/is, discover if our treatment was the best possible option (it was in this case), and best of all, to discover that people are getting better, and continuing with their lives.

Up again for another shift tomorrow, hopefully to make a difference to some more people.

First Posting

2006-02-24T08:45:00.000Z

Well, I've just spent the best part of an hour trying to find an origional blog title that was not already taken. Eventually landed on "sylph", which, according to Collins dictionary is 1. a slender graceful girl or young woman. 2. any of a class of imaginary beings assumed to inhabit the air.

I am neither of these, but would happily be either.

Why have I decided to start a blog? I'm not really sure yet, except for the fact that I should be doing an assignment and it seems like a great way of procrastinating. Also, my brother writes a blog (motherofdeath.blogspot.com) and this is the place I find out what is going on in his life. Maybe writing a blog will enable my friends and family to keep up with what I'm doing and what I'm thinking. Hopefully it will also enable me to clarify my thoughts as I try to articulate them.

I have no idea how to do things like inserting links, posting pictures and other similar high-tech things. Maybe I'll work that out next time I'm meant to be doing an assignment!