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Calling in the Cavalry

You are not well. In fact, it’s safe to say you are very unwell.

We are on both in the road, me sat, you lying, with my bike stood in a fend of position, blue lights beaming out a warning to all around. This is not a fun place to stay, but I’ve got no choice. You have just finished fitting for the second time in ten minutes, and I have no way of getting you somewhere safe without injuring one of us.

The person who flagged me down has wandered off, muttering something about leaving it to the professionals. This is a nuisance, as I could really do with another pair of hands. I have a coat under your head, a blanket draped over the rest of you (now you won’t strangle yourself with it), and my radio microphone in my hand. This is the bit I really want. Two fits in a row is not a great sign, and my instincts say your going to do it again. Somewhere on the way down you seem to have bashed your head, you have road rash on your bare legs and arms (it had been a hot day, a lovely time to go to the beach), and I haven’t even attempted to check you for anything else between fits. I really need help, and I really need it now.

The problem is, there’s nothing available. We have over half our local fleet on the road, and every one of them is busy. It’s so busy I can’t even start talking on the radio to give Control an update (and to try to get an ETA on that vehicle).

A gap forms in the radio chatter, and I draw a breath to start talking. Naturally, this is the moment you begin to fit again. Immediately the mic is dropped, the blanket is whipped away, and I check your head is still safe. Grabbing the mic on its upswing, I cut in on a pause in the current conversation.

“Priority, priority, Control 992.” I release the mic to hear someone talking over me. Blast. Keeping both eyes on my shaking patient, I try again. “Priority, priority, Control 992”

“All stations, wait. Priority call. Go ahead 992.”

“Control, upgrade my ambulance request to emergency. Patient unresponsive, actively convulsing, query status epilepticus.” I technically haven’t been on scene long enough to make that judgement, but every instinct I have says that these fits aren’t going to go away on their own.

“All received 992. Be advised, NHS vehicle en route. Please confirm precise location.” I give a little prayer to any passing deity, thanking them for shared ambulance control rooms.

“Location unchanged. Bike in fend off location, you can’t miss me.”

“All received 992. Control out.”

The radio conversation that had been going on before continued, and I mentally switched off to the radio, listening only for my call-sign. Once more you’ve stopped fitting, and once more I cover you with my blanket, pouring reassurances over you that you are safe and that help is on its way. I don’t know if you can hear me through the chaos the fits have reigned in your brain, but if nothing else it makes me feel better to do something.

In the distance I hear a siren. I’ve heard a few going to and fro, but this one is definitely getting nearer. It is the most welcome noise I’ve heard all evening, well, after the heavy sighs coming from you when I checked your breathing. The junction down the road fills with the glow of blue lights, and an RRV comes around the corner. Getting down close to you, to check your obs one more time, I speak to both myself and you. “This one’s yours, mate. The cavalry’s here.”

Sound effect from Freesound.org, by guitarguy1985, released under the Creative Commons 0 License.


A collage of a couple of my recent patients, inspired by the WordPress Weekly Writing Challenge: The Sound of Blogging.

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Difficult Decisions

I am not very lucky with relationships. In fact,quite the opposite is true. I tend to fall for the straight guy, never really get asked out (well, by guys anyway), and never have the courage to ask someone else out (even if I’m certain they’re gay).

Last week, as i was trying to screw up the courage to ask someone out, someone else spoke to me first. I immediately said yes, and somehow (before we even went on a date) we slept together. We’re now trying to organise a proper date, but he is being a pain to pin down.

Now, a week on, I’m not even sure I am actually interested. Yeah, he got my attention a year ago, but as I’ve got to know him a little better, I’m no longer so sure I want to know him. Yeah, perhaps I thought I was interested. But I thought I was interested in my only girlfriend, and look how well that worked out… I’m also not convinced that he isn’t just in it for the sex. Or that my low self-esteem made me say yes only because he asked.

To make matters more complex, there is another guy. The one I was going to ask out. I already know I like him, have a feeling he likes me, and we have more in common than the organisation. Yes he annoys me sometimes, but mainly only when he’s showing off to others. I have also actually had more than one nice conversation with him.

I don’t want to hurt anyone (or get myself a reputation). But, I do want a relationship for myself as well as my partner, and more than just what happens in bed…

I think, while writing this I’ve decided what I’m going to do. I suspect I’ll regret it, but i think I’ve got to follow my heart.

This could get interesting…

Worrying about Blogging

In light of my recent incidents involving Facebook, I recently got very worried about posting about, well, anything.  When I looked at my incoming referer logs, it was clear that people had come this way from my Facebook page.  Potentially a lot of people, based on the number of hits, though most likely only a couple who just browsed most of my blog.  For a brief while, I was paranoid that all of my friends (at least, those who can see my Facebook timeline) would be heading this way to see what I’d written.  Of cause, I clamped down on what could be seen very fast, and I think I limited the ‘damage’ (the only confirmed person who saw the blog I can cope with), but that didn’t make me feel that much better.  Suddenly, the perceived safety of a pseudo-anonymous blog had vanished.  Perhaps it was time to jack it all in.

Except, I then remembered why I set up this blog.  I write here to express myself, to vent, and because I enjoy writing for its own sake.  Sure, I might have blown my ‘cover’.  Sure, someone I know may actually read this.  I’ve realised it doesn’t matter.  Because this blog is mine, not yours.  I’m not breaking the law (as far as I know), so I can say what I like. You may not like it, but that’s tough.  I still have enough shreds of plausible deniability left to protect me from other members of the Organisation, and ultimately, it’s a free country.  As long as I’m not hurting someone, I can say what I like.

Of cause, this may not make me popular, but if I let that stop me, I’ve lost out, not them.

When I was thinking about all of this (and pondering over a few posts that I could write), an xkcd post comes to mind.  I think it covers quite well my final conclusion.  I think I’ll leave you with that, and, real-life permitting, normal service will resume shortly…

Dreams from xkcd.com

Dreams – from xkcd.com

Facebook

So, despite fiddling with settings and ensuring that all posts from this blog were directed to the Walking Plaster Dispenser page instead of my own personal timeline, WordPress yet again posted a status message onto my timeline.  Thankfully I spotted this one significantly faster than last time, thought not before at least one person came this way.

If you are them, I’ll point you in the direction of this post, and say no more…

In order to ensure that this doesn’t happen again, I have severed all connections between Facebook and this blog.  Seeing as I can’t trust WordPress not to cock it up again, this is the only real option I have to avoid dumping myself in the brown and sticky stuff. Again…  As a result, I’ve also taken down the Page (not that it was every particularly successful or useful).

If you still want to follow me, I’m still on Twitter, and there is always the RSS and email feeds.

Recent Facebook Post

This is aimed at everyone who has come this way via a recent post that appeared on my personal Facebook timeline.  If you didn’t come here from there, you can ignore this if you wish.

My previous post from this evening showed up in my personal Facebook timeline instead of the blog’s Facebook page.  This was an accident.

As I hope you have guessed, as at least one of you has wandered around this website, this blog is intended to be a semi-anonymous place for me to write whatever I feel like.  I have posted things on here that I do not wish to be made public knowledge just yet.  I would also draw your attention to page where it points out that half the stuff on here is made up.  Stories that you think you might recognise may not tally with what we may have discussed while sharing our ‘war stories’.

I have changed my settings so that this won’t happen again, and completely removed the post from Facebook.  I’m not going to ask you to forget what you’ve read.  You can keep reading if you want (though, keep in mind I tend to be very honest, and so may say things you won’t like to read).  Alternatively, you can put it all out of your mind.

What I will ask is that you please respect my desire for anonymity, and keep whatever you read to yourself.  If you try to discuss this in front of other people, I will deny that I have any idea what you are going on about.  This isn’t because I’m ashamed of what I’ve written, or because I don’t believe in what I write or do.  It’s because I genuinely believe this is the best way for me to operate this blog, to avoid getting myself into trouble, to protect my friends and my patients, and to ensure I don’t unintentionally the organisation I volunteer for into disrepute.

I hope you understand this.

My Future as a Leader

As I have mentioned a few times now, I am currently the leader of the local Organisation unit for young people.  This means I am in charge of two other adults and twenty 10-18 year-olds, and am somehow responsible for making sure they become disciplined, confident and well-rounded individuals (which most of them are).

Now, I have been a member of this organisation for just under five years.  The first three-ish years were spent in the university unit, which was fun at first, but in the end I had a falling out with two of the more influential members, and it became more trouble than it was worth to stay put.  Somehow, I convinced myself (and was convinced) that it would be a good idea to work with young people, and I transferred to, and eventually ended up leading, the my current unit.  In short, this was the best thing I could ever have done.  While trying not to be over-dramatic, I am convinced that, had I stayed at the University unit, I would since have left the organisation, or at the very least be very fed up.  Instead, I have had two of the most enjoyable years of my life, and I have grown very attached to all of the young people I work with.

Unfortunately, now that I am graduating, life gets more interesting.  With my upcoming graduate program, I could end up changing where I am working every three months.  I could end up spending three months working in the US, or Germany, or anywhere else that my company operates in. Add on to the fact that I won’t know where my first placement is until after my housing contract has ended, and this level of uncertainty is not really conducive to being a good leader.

I don’t want to leave my unit.  I feel like I have really achieved something here, and without all the hassle of the politics involved in working with adults, and I also feel really guilty about being the fourth leader to leave them in as many years.

That said, I am about to embark on what could be a really exciting start to my career, and I am worried that if I feel tied down to a specific location, I am going to be unwilling to take up some of the opportunities I could get.  I would love to go work in the US, even for a little bit.  While part of me is keen to stay in the UK, I think I would be doing myself a disservice if I let these chances pass me be.  It’s not as if I wouldn’t be able to volunteer in EMS elsewhere (even if I ultimately end up living outside the UK).

I think I’m going to have to have a long hard think about this, when all my university stuff is done, and I have a feeling I know what the answer will be.

It totally sucks, but I have a feeling I won’t be a youth leader for much longer.

An Update

I know I said I would do a series of posts on observations, and I still intend to, but at the moment real life is just getting in the way. This is just a quick update of what’s happening, and the next post will be about something I really need to get off of my chest.

So, I am rapidly approaching the end of my degree. My final report is due next Tuesday, and after the Thursday after that, I am done. Finished. Leaving my university and likely not coming back (except for graduation based stuff).

I’m not going to lie, it’s a scary prospect. Not accounting for my work placement, I’ve been in full-time education for 19 years. It is literally the only thing I can remember doing. As of September, I start on the beginning of what (at the moment, at least) will be a career in Engineering. Real engineering (it doesn’t get any more real than jet engines…), where the work I do actually has a real purpose.

I will be leaving behind what I know and am comfortable with, a huge number of my friends, and all the other benefits of student life. This is scary beyond belief…

In other news, I am currently bike-less again, as some idiot drove over the front wheel of my bike (fortunately while I wasn’t on it). Needless to say, this is very annoying, not least because I am currently sat on a bus that takes the most roundabout route home possible.

This year I am not going to the graduation ball. In fact, this is the first time since starting university that I’ve not been there in some kind of first aid capacity, and I have zero interest in going as a punter. I had intended to go as first aid, but I haven’t been asked yet, and the unit has upset one of my good friends, so we’ve decided to go on duty the next morning instead. The person who did the upsetting is now also not going, but I have managed to persuade my friend that it isn’t her problem any more (and so she doesn’t need to pick up the pieces after the very likely meltdown).

Speaking of meltdowns, the local adult division is currently having a very slow one. Three of the more progressive members have been made to feel very unwelcome, and so have walked away. As a result, their training program is steadily going down the pan, morale is going to drop (as people realise what they’ve lost), and its all going to go to hell. Of the units six-ish active ambulance qualified volunteers, they now have two actively refusing to do events, two prioritising county level events (me and CycleGuy), leaving two to (fail to) meet the units commitments (meaning other units have to help out).

On the bright side, my unit of young people is going strong.  We have just had a very successful sponsored walk (where I got to legitimately play tag for the first time since I left junior school), and have half a dozen things planned for the near future.

Work is still being its normal irritating self (but that’s retail for you), and I’m doing far too many hours for the Organisation (no change there, then), and for the most part I’m enjoying myself.

When things start settling down, I will try to post more frequency.  For now, I will get on when I can, and I’m still on Twitter (my lifeline when drowning in my project).

Now, to finish, another musical interlude.  Enjoy 🙂

Anonymous Blogging

I wrote about this a while back, but I am having serious thoughts about my pseudo-anonymous blogging policy.

Under no circumstances am I going to give out my real name, or where these events happen in the country.  That’s too much of a risk to me, and makes it more difficult to protect the confidentiality of my patients.  If someone seriously wants to find these things out, they probably can, but even if they do I have plausible deniability on my side (the fictionalised elements of all my treatment stories also seriously help), if nothing else.

That said, I have had serious thoughts about revealing who I volunteer for.  I recognise that it puts me in a compromising situation, I certainly haven’t pulled my punches on here.  However, it also lets me openly support some of the wonderful work and campaigns the Organisation run.  And while I know my comments aren’t going to make a real different to the Organisation, I do recognise that even little things can have far-reaching and unintended consequences.

I think (after actually writing this out) I might leave things as they are for the moment.  Reading back, my reasons for changing just aren’t strong, while my reasons for staying the same (not least, patient confidentiality) are.  Sounds like a conclusion to me.

Automated External Defibrillators

Automated External Defibrillator

Image via Wikipedia

An automated external defibrillator is a device designed to take a heart rhythm not suitable for sustaining life and converting it into one that is more useful. They work much like restarting your computer when it crashes: turning it off and on again. Contrary to popular belief, they can’t restart a heart, so they aren’t especially useful when the heart has stopped, but, for a couple of relatively common abnormal rhythms, they can be very effective.

Now I am very much in favour of everyone receiving emergency first aid training. I strongly think the national curriculum should include first aid, and think everyone should consider doing a first aid course at least every three years (they aren’t particularly expensive, if you stick to the basics). I also think public access AEDs are a wonderful idea, especially as it is almost impossible to hurt someone with one.  With the emergency services giving instructions, they can become a valuable part of the chain of survival.  A lot of research has shown that, along with early effective CPR, the early use of an AED can improve the chances of a patient who isn’t breathing.

In summary, AEDs are great things and I think they should be as widely accessible as possible. However, I do have a bit of an issue with a policy the Organisation is about to bring in.

By the end of the year, all our uniformed adult members will have an AED qualification.  This is good.

By the end of the year, all young people over the age of 11 will also have an AED qualification.  This I’m not to keen on.

It is all very well teaching these children (and let’s not forget that they are children, not little adults) CPR and other life-saving skills.  In my mind, this allows them to approach a scene with the confidence to deal with whatever they find until backup (in the form of an adult, ideally an adult first aider) gets there.  Part of the protocol for a patient who requires resuscitation is to summon an AED and someone who can use it.

In principle, giving these young people this extra skill is fine.  They can’t really hurt themselves with the AED (short of hitting themselves over the head with it) and it could help save someone’s life.  On paper, that’s brilliant, but, if you think the entire scenario through, there are real issues here.

You are expecting this 11-year-old child, who may have never known someone who to die and has probably never seen someone this unwell, to take charge of this scene and deal with it. This includes handling with the emotional family member, the do-gooder who’s just getting in your way and the wanna-be doctor who tells you that you’re doing it all wrong.  Not to mention calling the ambulance, working out how they are going to get to the patient, and everything else that needs doing when you are the one taking charge of the scene.  And don’t forget, they’ve got to deal with their own emotions, both now and once the adrenaline has worn off, and they probably won’t think to call the youth leader, who has access to the brilliant support structure in place in the Organisation for just such a situation.  In some cases, even their parents won’t know anything until someone spots something on Facebook and passes it on.

And what if the patient doesn’t survive?  What if the paramedic (perhaps quite rightly) calls the patient on scene.  Imagine the harm that could do to the young person, knowing they’ve ‘failed’.

The first step on my plan of what to do if one of my young people present at a critical incident is get them to a safe place as far away as possible from the incident.  The next step is to activate that support structure, get the parents involved, and have a good long chat with the young person to ensure that they are okay.  If I allowed them to remain at the incident, I’d get strung up, and rightly so.  There is a reason we train them all to get help straight away.

I know that this is a bit of a ‘think of the children’ argument, and perhaps you think I’m doing them a bit of a disservice.  People die, despite our best efforts, and this is one probably of the hardest lessons to learn when trained to the level we aim for. Thankfully, patients of this severity are rare but it does still happen, and we try to ensure our older, more emotionally mature young people realise this.  However, in the main, the patients they see will be fine.  They might not be very well, but they’ll recover, and what we do will be useful.  This is what I stress to my charges, as I want them to feel proud of what they do, to know that their skills are useful and that their input is valuable.  After all, this is why they have joined the Organisation. This is why we all joined the Organisation.

Don’t get me wrong, I think some of my youth members might be able to deal with a resus and come out shining. Unfortunately, they are in the minority, and we have to cater for everyone.

This training will almost certainly go ahead, and despite my misgivings my young members will have the same access to it as everyone else.  This has been decided at a level high above my line of management.  Hopefully none of my young people will have to use it.  Hopefully, if they do, they’ll talk to someone afterwards.

Another Door Closes

Yesterday I emailed by project supervisor, who had been pestering me about doing a PhD.  I basically explained that I don’t currently want to do a PhD, and that I have been looking for and found a graduate job.

This was not an easy email to send.  Despite being pretty certain that I want to take up this job offer, a part of me won’t let up on pointing out that I am turning down an opportunity that may not come up again.

Looking at it, I see this:

  • Doing a PhD allows me to pursue something I’m probably interested in, to a level further than anything else I can do on my own.
  • Doing a PhD will mean I can call myself Dr, which is kind of cool (even if it’s Doctor of Philosophy)
  • I will essentially be being paid to do a PhD, and so start working off some of the mountain of debt I seem to have acquired

However:

  • I can earn twice as much doing a real job as I can doing a PhD
  • I still don’t know if I want to stay in engineering, and if I don’t, this is another few years down the pan
  • I can do a PhD later if I wish, so if I stay with engineering the opportunity probably isn’t gone forever
  • Other than being slightly more prestigious, I don’t see any benefits that a PhD can give me that experience doing the job won’t

I’m not saying it would be easy to take up a PhD later, and I’m not saying that it would be a complete waste of time.  I’m sure that, if I actually went for it, it would probably be fun.  But that wouldn’t answer the question of whether or not I want to do the job. The only way I’m going to work this out is by giving the whole job thing a go.

I decided a long time ago that I wouldn’t settle for a job I didn’t enjoy, just because it paid well.  I know full well that I can earn more as an engineer than as a nurse or a paramedic.  Perhaps if I was willing to go the whole hog and become a doctor of medicine it would be different, but I don’t, so that’s that.  I also know that as an engineer I’ll get nicer hours (or rather, not shift work), probably have a more comfortable life outside of work, and potentially be very successful.  However, none of this means very much if I don’t enjoy my work.  I’m sure I can live a comfortable and happy personal life on a nurse’s wage, and if I enjoy work more as well I think I’ll be better off.

And because of this, I won’t change my plans.  I will give engineering its chance.  I’ve invested too much into it now to not, and all this disenchantment may just be from uni course burnout.  However, if a couple of years down the line I decide that enough is enough, I will move on and do something else. And, in the mean time, I will work to put myself in the best possible position at that time.

I just have to keep reminding myself that while I might be passing up opportunities now, it’s all so that I can keep my options wider in the future.

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