Sunday, August 18, 2013

the day is

Five to six in the morning, worn out, but safely back on base. Or semi-safe; we finish in just over half an hour, and the sweat dread of A Late Job has come upon us. But really, it’s looking good. There are two crews due to start in five minutes, a night crew ahead of us. What can happen? We allow ourselves to settle.

All the radios sound at once.
The first crew’s job: round the corner.
Great. Crank this out, we’re done.
Our job: twenty miles cross-country, with the prospect of a trip to the A&E department ten miles further on. A late job from hell.

I’m on the radio as we’re walking out the door, squeezing it like a sponge and struggling to keep my voice steady.
Obviously we’re mobile on this job, Control, but what’s the likelihood of a more local crew coming clear and relieving us? Otherwise we’re looking at a significant overrun.
-          I’ll do my best, but they’ve had a strange job spike over that way and I’m afraid they’re a bit light on resource at the moment. Leave it with me and I’ll see what I can do, but it’s not looking good.

A one-hundred-year-old lady who is semi- conscious, breathing / son on scene for access.
‘A hundred?’ says Gary, turning the engine over. In this crazed funk of exhaustion and despair, it feels as if the poor woman has had a hundred years to make the call and only chooses to make it now out of cussedness. ‘Jeez.’

Gary drives faster than anyone this side of the Bonneville flats. The nose of the ambulance ripples, glows red. No talk; no room, not for anything that would slow us down. Everything else burns away in our wake, leaving Gary, pure driver, me, pure attendant, and a fissile heart of injustice.

But five seconds – and five miles – further down the road, I make an effort to break out of that way of thinking ,which actually is just making me feel grey and quite sick. I put the clipboard away, relax my hands.
I focus on my breathing.
I try to pay attention to what’s happening right now rather than what I would like to happen. To let it all go.
It’s morning, and will be, regardless of who I am, what I think, or don’t think.
Things are as they are. That’s it.
The radio remains silent, goddamn it. But that’s okay too.

When we eventually pull up outside the house – a faded but solid family home in a quiet street – the son is waiting for us by the front door. An elderly man himself in trousers belted under his armpits, socks and sandals, he stands aside as I hurry up the path.
Into the front room, and at first I think his mother has died. She’s sitting slumped over in a high-backed chair by the French windows, partially covered by a blanket, perfectly still.
‘Mrs Duckworth? Hello?’
I pull the blanket aside and gently touch her hand. She wakes up.
‘Oh! Who are you?’
‘The ambulance. I’m Spence, this is Gary. How are you feeling?’
She pushes herself upright and grips the armrest.
‘Have you come to take me away? Because I don’t want to go. I want to die here, at home.’
‘We won’t do anything you don’t want to do,’ I say to her. ‘We just want to see how you are. If there’s anything we can do to help.’
Mr Duckworth is standing over me, smiling in a fixed and slightly hazy way, looking tearful.
‘Mother fell over at the beginning of the week,’ he whispers. ‘But she didn’t want me to call anyone.’
‘Did you hurt yourself when you fell?’ I ask her.
‘I can’t walk, if that’s what you mean.’
‘She’s been in the chair ever since,’ says Mr Duckworth.
‘How have you managed for the toilet?’
‘I’ve been changing her pads and cleaning her up.’
‘Eating? Drinking?’
‘Yes – she’s not too bad with that.’

Mrs Duckworth agrees to let me check her over.
Gary fills out the paperwork.
All her obs are fine, but the fact remains she’s off her legs.
‘You know what I think we should do, Mrs Duckworth?’
‘What’s that?’
‘I think we should arrange to get you to hospital so you can see a doctor and a thorough examination. But I think we can afford to do it in your own time, so you’re not rushed. In a couple of hours, say, when you’ve had a chance to change your things and have some breakfast. We’ll order up another ambulance, they’ll help with everything. They’ll take you to hospital, get you settled.’
‘But I don’t want to be kept in. I want to stay at home.’
‘You won’t have to do anything you don’t want to do, Mrs Duckworth. But hospital’s the best option. The doctors and nurses will have a chance to see if anything’s wrong. They’re the experts. They’ll know what to do to get you back on your feet. And if you need a little help at home, they can arrange that, too. So don’t worry.’
‘All right then. But I’m coming back home.’
‘Great. We’ll order that second ambulance.’

Control are happy. It gives them a chance to cover the changeover and deal with the last minute flurry of calls. Mr Duckworth looks relieved.
‘I’m sorry for calling you like that,’ he says. ‘I thought you’d tear me off a strip.’
‘You shouldn’t worry. Glad to help.’
Everyone shakes everyone’s hand.
‘And happy birthday for next month, Mrs Duckworth. Happy one hundred and first!’

Outside, the day is as bright as it was when we set off, and drove, and arrived.
We throw our bags inside the truck.
I drive back

It feels good.


tpals said...

How often do you end a shift exhausted, Spence? If it's normal then something needs to change.

jacksofbuxton said...

It's a very rare treat Spence when all goes well and all is right in the world.

Spence Kennedy said...

tpals - A very good point! Actually, every night shift. I think it's a symptom of working 12 hr shifts. Nights are hard anyway, but even if it's quiet we'll get moved around between standby points, so you never get a chance to rest. So yep, something does need to change. I'm working on it!

Jacks - And that's the other thing I'm working on - how to make things go right more often!

Eileen said...

tpals - I don't know a good paramedic who DOESN'T end a 12 hour shift exhausted unless they have been very lucky and had a shift with maybe just 2 or 3 callouts or a simple variety. Just like I don't know a good nurse who hasn't given their all during a shift.

Yes, something does need to change, there needs to be enough staff to realistically provide cover for the number of calls/patients there may be. I imagine Spence works in a urban area. Rural calls may be even worse - that 20 mile drive is fairly standard for my daughter for most of her calls. In the last couple of months she has had more shifts finish late than on time - 2 or 3 hours late, not a few mins. Two days ago she was still waiting at A&E at a hospital 25 miles from her base. But all the hospitals she uses are over 20 miles from home.

What is it they need? MORE MONEY - and that ain't going to happen is it?

Spence Kennedy said...

I would opt for an 8 hr shift if I was given the chance. I know it means going to work more often, but you do feel markedly less tired. As it is, you try to pace yourself and take it easy when you can - a cup of tea round a patient's house (where the situation allows of course) or a chat at the hospital after you've handed over - all these things help keep you afloat.

I do work in an urban area, so we don't suffer the dreadful overruns that our colleagues further out in the sticks do (quite regularly).

Apologies for the rather downbeat read the last few months - symptomatic of the need for a change, I think. I've been doing the job for seven years now (this month, actually), and I think it's probably time I found something else. All suggestions gratefully received!

Joe said...

I'm a reporter on a paper in Essex and long-time reader of this blog, Spence - I had the fortune of being able to spend a night shift (12 hrs) out with your Essex colleagues.

I managed 11hrs - and was exhausted. A thoroughly enjoyable evening though - and one that was very interesting and really gave an insight into what you guys do day-in, day-out.

My respect for you guys, already high, rose that bit more.

Keep up the good work!

Spence Kennedy said...

Thanks very much Joe!

Glad you had a good shift out with the Essex crew. It is an interesting job, despite the usual gripes that any job has to one degree or another. I definitely think ambulance crews are the 'grunts' of the health service, covering everything from Mental Health & social stuff to the whole range of accidents and medical emergencies. You never know what you're gonna get (to be all Forrest Gump about it).

Mind you, reporter sounds like a pretty interesting line of work, too!