The Last Post

Just in case anyone’s still bothering to track this blog then you will be aware that I’ve been absent for over a week. I suppose an explanation is called for and, in supplying that, I also have to announce that this blog will be no more. This is the last post.

It has been a particularly bad week. My cat decided to go 'walkabout' as the black dog returned with a vengeance last Sunday. (An expression I’d not heard of until Dr Crippen’s post on the same day). I spent most of the day freezing cold, curled up under the duvet on the settee, reading and watching DVDs on my lap top. In particular Dr Crippen’s post directed me to a posting by Dr Dork, a blog I’d only glanced at previously. Although I have very limited knowledge of mental illness I suspect that my decision to start a blog was, in some way, connected with my desperation to understand why everything in life seems so unjust. In fact the only time I ever seem to feel ‘alive’ is when my life is in complete chaos and going down the pan – rapidly. Perhaps blogging was a way to vent the frustration and anger I feel.

Things at work have also come to a head. If anyone’s read my introduction then you’ll know that I don’t enjoy being a ECP. It’s a lonely role and one that I don’t feel very comfortable with. Dr Crippen has railed at length on practitioners in the health service. He quite rightly points out that we “do not know what we do not know” Whilst that’s true I would reply that at least “I know that I don’t know it.” Consequently I find myself completely at a loss on many jobs, “just what the hell am I doing here? This patient needs a doctor”. I am a good paramedic, a specialist in pre-hospital care. That’s what I’m trained for, that’s where my strengths lie. I shouldn’t be messing about in GP territory.

Furthermore this week saw other events that have left me exasperated.

• A senior manager was on the radio extolling the virtue of ECPs, ‘super’ paramedics he called us. (I’d like to wring his neck!)
• All our response cars have had their cardiac monitors removed. Apparently, so the rumour mill says, our current supplier lent our trust a number of monitors so that all vehicles would be equipped with one, but they’ve now got wind that we’re changing suppliers; they’ve withdrawn their good will, and the monitors with it. So I get sent out on jobs to life-threatening chest pains with no monitor! Fantastic! Although I carry tenectaplase (a clot busting drug) I can’t administer it as I can’t diagnose a ‘barn door’ MI without a monitor – so I have to wait for an ambulance.
• ECP visits have, pretty well, dried up. My contacts at HQ tell me that this is because all ECPs are now just to be used as response drivers to meet our response targets. Firstly, goodness knows what the PCTs think of that as they help fund the ECP programme and secondly, this is how ridiculous it gets: A person walks into Dr Crippen’s surgery with chest pain. The good Doctor identifies a heart-attack or other serious cardiac condition, does a referral to the local hospital (medical assessment or cardiac unit) and calls for an ‘immediate’ ambulance to get the patient there. So what does our trust do? Sends a response car! For heavens sake the Doc wants the patient to get to hospital; what’s the point in sending me, in a response car, with no cardiac monitor, to a patient already with a GP? What do they think I’m going to do that the GP can’t? Answer, absolutely nothing! I’m just sent so that the trust can ‘stop the clock’ and put another tick in the ‘met response time’ box. It's a load of bollox! Puts us back to that old chestnut of “If we get there in 8 minutes but the patient dies – it’s a success. If we get there in 9 minutes but save their life – that’s a failure”.
• Now, because I don’t do ECP visits anymore and I’m just a ‘clock stopper’, I spend large amounts of my day on ‘dynamic cover’ aka sitting at the side of the road somewhere, bored out of my skull. It’s soul destroying!

I’ve pretty much reached the end of my tether. Managed to have a short talk with ‘management’ about going back on the ‘bus’ as a paramedic. Got the same old trite answer “there are no paramedic vacancies”
“Really? So how come the ‘Chief’ has just announced in last week’s in-house newsletter that he wants to train up another 80 EMTs to paramedic level this year. Where are they going to go?”
As usual management "don’t know." They’re not interested, couldn’t care less, as long as it doesn’t affect their stations or their planning. In short they’re not interested in my problems or accommodating me by letting me back on the bus.
In time honoured fashion they offered the usual helpful response. “If you’re not happy you could always collect your P45 and go and work somewhere else."

So…after 11 years on the front line I’ve decided to collect my P45.

Thanks to everyone who stopped by to read my postings and particularly to all those who were kind enough to leave a comment or drop me a line.

Magwitch