Stacey Booth on her day with a West Yorkshire Ambulance Crew
The build-up to my first ambulance shift had filled me with lots of emotion. I was excited at the thought of being inside the ambulance as an observer, not just a passenger! The excitement turned to nervousness at what I might encounter and if I could deal with it.
I arrived at station 30 minutes before my 10-hour shift and was welcomed by Jamie and Andy. Jamie gave me a tour of the station and then provided me with my hi-vis jacket and it suddenly felt very real. Andy was carrying out the safety checks and ensuring we had the required drugs and that they were fully stocked and in date. As soon as the checks were done we were ready to go; we drove out of the garage and into standby position in the car park, ready for a job.
The crew keyed on to let the EOC dispatchers know they were available, we proceeded to the mess room and no sooner than getting inside the bleeps went to indicate an emergency. Jamie read out the description “Patient fall at care home, bang to head, bleeding heavily from wound”. We got in the ambulance as the feeling of anticipation built. The lights and sounds from the sirens only heightened the experience. I witnessed the weaving in and out of traffic at rush hour in order to get to the patient as quickly and safely as possible.
It was once we were inside that I got to see the professionalism of these guys. We were escorted to the patient who was elderly but that didn’t stop her being full of life, even when sporting a lump to the back of her head the size of a tennis ball and covered in blood. The staff explained that they had found her laid on the floor in the corridor. They informed us that she had dementia so when she was explaining how she came to be laid on the floor, nothing could be ruled out. The floor was also damp and this was due to her having a UTI which had caused her incontinence. Jamie and Andy bandaged her wound and helped her into a wheelchair and then took her out to the ambulance. She was made comfortable and safely strapped in. The crew shared the driving and completion of the paperwork during the shift and the teamwork was evident. We drove to Leeds General Infirmary and waited to hand over the patient to hospital staff. The handover was relatively quick and we moved the patient into a cubicle. As I looked at the elderly lady, laid all alone, I asked Jamie if that part was difficult, but of course there is no time to reflect on this as the next job comes in and he said that as they attend so many incidents that they can’t retain all the jobs and who the people were. They set about cleaning the ambulance, ready for the next job.
We keyed back on and a job came through straight away; this time the journey was longer, we travelled from Leeds to Wetherby for a lady who had fallen from height down three steps at home. We arrived and went into the living room, the lady who had tumbled was 69-years-old and a carer for her daughter who was present in the room with her mother and appeared not to be very mobile. The lady informed us that she used to be a nurse in the community before she retired or more commonly known then a “Matron” which gave us all a smile. The in-depth assessment drew from the patient that this was her second fall in little over a week and her blood pressure was also very high, so coupled with the fall and bump to the forehead and nose it was decided admission to hospital was required. This was not before an additional assessment of the scene of the accident took place. This was to assess how high the fall had been as the clinical pathway can change dependent on the fall from height. The attention to detail again was noted by me. We escorted this lady to her local hospital in Harrogate and this was where the lengthy handover occurred. A smaller hospital with less capacity under pressure can see delayed handovers whereas the handover in a larger acute hospital can usually be rapid unless there are an unusually high number of admissions or short staffing as we are seeing more recently in the NHS. But in a smaller hospital with much less bed capacity staff can struggle to hand over due to lack of beds or space, and they were upgrading their A&E whilst we were there.
We waited 58 minutes to hand over and this was where you can see how frustrating it is for the ambulance staff as they are needed to go to more poorly patients, but until handover is complete they can only wait stacking up crews in corridors. When we did get back in the vehicle we were in the “meal break window” a term I have only heard about in meetings when negotiating policy changes but now I understood the issues that can occur. The “meal break window” covers a two-hour period where staff need to take a break. Jamie and Andy asked if had brought anything to eat but I hadn’t so we stopped on route at a takeaway shop. As soon as I hopped back in the vehicle a ‘priority 1’ job came through and all of a sudden my baguette was the furthest thing from my mind. The call was for a gentleman experiencing chest pains who had previously had a cardiac arrest. The blue lights were on and we were weaving through busy Friday night city centre traffic to arrive as quickly as possible.
This visit was the most emotive for me; we arrived at the sheltered housing complex and were called through to meet a 71-year-old man sat upright on his sofa. The ECG equipment was being set up by Andy whilst Jamie asked him some questions. He was asked when he last took his angina spray which he informed us was an hour prior to our arrival, however his blood pressure was very low which Jamie explained could have been due to the spray but within 10-15 minutes it should have returned to normal. It was whilst all these checks were happening that the gentleman explained that he was feeling suicidal and he had thought about taking his own life. That moment was so poignant as we were treating him for chest pains, but there was a real likelihood he called us out due to these feelings of helplessness, a real cry for help. There are many individuals who are lonely and sadly their only outlet is to call the emergency services. Once the disclosure was made the information was included as part of his notes and I could only hope that this guy would receive help with his mental health. His ECG was normal but Jamie explained that his previous heart attack was only identified through blood tests so it couldn’t be ruled out at this stage. He was given a dissolvable aspirin and we escorted him to hospital. Handover complete we were back on the road and managed to get back to station for our tea, literally as soon as I had my last bite another ‘priority 1’ call come through.
I was now starting to feel tired and began to wonder how these guys do this for 10 hours at a time, nevertheless I was here for the duration and I wasn’t going to give up so soon. We set off to a job when we were diverted to a higher priority call. We travelled 15 miles and arrived at the end of a town hall function and were informed by the individuals who greeted us that it was a charity event and the gentleman in question had drunk one too many brandies. He had tumbled down a flight of stairs and was laid in a heap at the bottom. I’m not proud to admit it but I have required the emergency services in the past when I drank too much one night. Whilst I stood there watching Jamie assessed his condition and endured abuse as he explained that due to the fall and bump to his head the patient would need to go to hospital on a stretcher and complete with neck collar even though he just wanted to go home. He was in drink and so his view was impaired and there was a possibility of a spinal injury due to the fall from height. He was not too impressed but not in any position to refuse in-between vomiting; this was not the time to negotiate.
Jamie and Andy wheeled him into the ambulance and I sat exhausted and listening to the abuse Andy was now getting for carrying out his clinical duties. At no point did Andy lose his cool or show any frustration, he just got on with his job. We arrived in the early hours at Pinderfields Hospital and were lucky to be the only crew coming in. Our handover was quick but Jamie could see all the jobs coming in on screen. The ambulance was cleaned up one more time and paperwork completed. We keyed back on with 10 minutes of the shift to go and sat patiently awaiting the end of shift. Jamie informed me that if a job came through now they would have to take it; he told me that he was once 30 seconds from finishing when he received a job that took 2½ hours. I could now see how easily a 10-hour-shift could turn into 12 or 13 hours.
With my observer shift over I did reflect on all that I had experienced. I have been a GMB organiser with NHS responsibility for two years now and each day I work with these people my respect increases. I feel privileged to work with them and honoured to represent them. The job itself is enough pressure for anyone, but coupled with overstretched and understaffed A&Es and closures of local hospital services the pressure doubles and the health and wellbeing of these workers is at risk; services are understaffed and in some areas at breaking point. We need to keep up the pressure on this government to adequately fund our NHS. NHS staff have not had a pay rise above 1% under this government and only this month have we heard that the pay freeze is here to stay. It is an outrage when inflation is at 2.3% so a real-terms pay cut yet again. Highly skilled staff are leaving and we cannot afford to lose any more. GMB have launched the pay pinch campaign to highlight the losses and encourage everyone to get involved in our campaign and sign our petition. Please visit our website at www.gmb.org.uk/pinched
Stacey Booth - GMB organiser