Diagnosis? N.F.I.

Control Loses the Plot


How it should be done.

I had another ‘set-to’ with the control manager the other night. He’s one of the few people in the service that I genuinely dislike. He thinks I’m an opinionated, unhelpful, obstructive, git (true) and I think he’s a useless twerp (a sentiment shared by many of his staff according to the ones I’ve spoken to).

It all started in the early hours of the morning. I was down at the local DGH when Control rang. Would I start heading off to rendez-vous with an out of town crew coming in from Smallwood village.They’re a double EMT crew with a possible STEMI (ST elevation myocardial infarction) patient and have requested paramedic backup; you’re the only para available.”
“No problem”. I screeched away from A&E in a blaze of flashing lights and screaming engine hoping to impress the punters in the waiting room and those outside having a fag. I don’t suppose any of them even noticed. About 2 miles across town the bat phone rang.
“Cancel your current call and start heading on an ‘A’ cat ‘breathing difficulties’.”
“What about the rendez-vous?”
“We have the Poshtown vehicle ‘green’ at the DGH.”
“But they were still handing over in resus when I left. Besides I’m 2 miles ahead of them.”
“Negative, the control manager says you’re to go on the ‘A’ cat.”

I did a four wheel drift around the next roundabout; more due to the fact that the road was wet and the front tyres needed changing rather than any great feat of driving on my part. So off I headed to call number 2. I was just coming up to the road in question when the bat phone rang again. “Cancel your current call and start heading on another ‘A’ cat.”
“But I’m nearly at the address.”
“Negative, the control manager says you’re to start heading on the new call, we’ve got a nearer crew to do this job.”
HTF can there be a nearer crew when I’m almost there? To be fair this was not a great time for me to be arguing; it’s dark, the roads are wet, I’m trying to drive on blues, concentrate on Doris-the-bitch telling me where to go, the adrenaline’s pumping and now I’m trying to talk on the phone as well – multi-tasking gets me stressed. Very stressed.
“Can’t you lot make up your minds. You’re making me look like an idiot.”
I know, I know, I should have kept my big mouth shut. I slammed on the anchors, executed a crap 5 point turn, f-ing and blinding the whole time and headed off again. Half way down New Street I passed the ‘nearer’ crew heading off to the job I’d nearly got to. We waved at each other and shook out heads. Those guys in control don’t have a clue what’s going on!

I reached the required destination; the call was given as an unconscious patient by the zebra crossing. There was no one around. I drove up the road a little way; not a soul. I headed back to the crossing and checked out the nearby shops; no sign of anyone. I parked up and called Control; the line was engaged – now there’s a surprise. While I was waiting a young man, looking slightly the worse for wear, staggered up the road.
“Did you call for an ambulance mate?”
“Nah. Not me.”
“Are you ok?”
“Yeah, I’m just off home. I only live up the road there.”
Eventually Control answered. I explained the situation. The dispatcher said the call was from a passer-by who’d seen someone collapsed at the crossing.
“Have you been lying down near the crossing mate?”
“Nah, I sat down for a bit coz I felt tired though.”
“Seen anyone else around?”
“Nah, I’m just off home”.
I checked around. There was no one else. Our inebriated young man must have been the ‘unconscious’ patient. So while I’m chasing ghosts a STEMI patient is going un-thrombolysed and a ‘breathing difficulty’ is gasping for breath. I wasn’t best pleased and was even more pumped up by now.
“This is all a complete waste of time. Can you get the the duty manager to call me please.”

At night, when there is no local management about, we have a county duty manager based at HQ who’s there to sort out problems. Rather than have a barney with the control manager at least I had the presence of mind to ask for the duty manager first. As there were no other calls waiting I headed back to the DGH and met up with all the other crews involved in this fiasco.

Call 1: The Poshtown crew had indeed still been in resus and were never given the call. Instead a Churchend crew had been on cover at Poshtown station, which was only a mile or so from Smallwood and much nearer than me, and they met up with the STEMI patient crew. The patient wasn’t having an STEMI so no thrombolysis, but the paramedic travelled with the crew anyway. To top it all Control then rang the Churchend crew to ask them where they were when they got the call. “Do’h. You rang us at Poshtown station dope-heads, where do you think we where?”

Calls 2 and 3: The crew I passed had been assigned to my ‘unconscious’ patient and were nearly there when they got re-assigned to the ‘difficulty in breathing’. That’s why we passed on New Street. To make matters worse, the fact that I was now a solo responder going to a ‘collapse in a public place’, meant there should automatically have been a back-up crew assigned. There never was. The whole thing was a shambles.

The bat-phone rang.”Ah, this’ll be the duty manager.” Wrong! It was an irrate control manager. Given that I was still in ‘Mr Angry’ mode, starting the conversation off with “I hear you’ve got a problem with my decisions” was like waving the proverbial red rag at the bull. I told him what I thought. He shouted back so I shouted at him.
“We based our decisions on what the system was telling us.”
“Well the system was wrong.”
“No it isn’t.” “Yes it is.” “No it isn’t.” “Yes it is.” “No it isn’t.” “Yes it is.”
“You’re only worried about response times not patient care.”
“No we aren’t.” “Yes you are.” “No we aren’t.” “Yes you are.” “No we aren’t.” “Yes you are.”
“Admit it, you got it wrong.”
“No we didn’t.” “Yes you did.” “No we didn’t.” “Yes you did.” “No we didn’t.” “Yes you did.”
And so it went, on and on, like most arguments, with each of us just restating our position but in slightly different terms. It ended with the inevitable macho stand-off, he’s going to report me to my Divisional Manager and I’m going to put in an official complaint about his decisions.

I’m not back on ‘days’ for a while so we’ll see if I get called into ‘the office’ for a dressing down. In the ambulance service all the managers stick together. It’s the weight of all those ‘pips’ on their shoulders; produces kyphosis which in turn causes compression of the logic circuits in the brain resulting in idiotic decisions. We’ve all seen it.

Rant over. I’m off for a double dose of my medication.