A number of cases stand out in my mind from a number of the shifts, some of which will make interesting blog posts, some of which will never make my blog for various reasons.

One in particlar sticks out. We’re called to attend a 999 call which has been downgraded to a Green call – an incident that requires a response without blue lights. We turn up and have a chat. The gentleman is in his 40s and has parasthesia from the waist down. He speaks very little English. We ascertain through pidgeon English and gestures that he’s urinating blood.

I’m not attending for this one, but something strikes me as odd. His feet are bandaged neatly – apparently he’s burned them and has been to hospital for his feet already. I look around the room and spot a box of tablets on the windowsill with a hospital pharmacy label. I point to them and he nods. Antibiotics. Paracetamol. There’s a letter with it and again he nods and I read.

His feet are injured from a scald and he spent a few days in hospital. Whilst he was there they noticed the complaint of haematuria and investigated, finding nothing and eventually referring him to a specialist in a nearby hospital. The notes go into more detail – his condition and pain seems unchanged from the time of admission. He’s also seeking asylum in this country but has had his application refused. He has multiple presentations to multiple services over the past 8 months.

On the other hand, he’s complaining of pain and does have some blood in his urine. His obs are fine and he seems comfortable unless we ask him about the pain, whereupon his face screws up. We have a quick chat amongst ourselves and we decide to try and see if we can get the out of hours GP to have a look, and control is informed. We explain to the chap who indicates that he’s happy with this – he doesn’t really want to go to A&E, it’ll be a several hour wait and he can’t afford the taxi journey home.

We hear a knock at the door and in walks a paramedic. We have a brief look between us before enquiring why he’s here. Control sent him. A handover is made and the paramedic asks the chap about his pain, then spends the next 10 minutes or so convincing him he needs to go to A&E, much to our confusion. We look confused but are happy to take him – obviously the paramedic is the senior clinician on scene here.

So we walk the chap out to the truck and drive him up to A&E. The charge nurse gave us a shitty look and we looked suitably apologetic as she tutted over the patient for a few minutes. She comes over to us. We explain what happened.

“Right, I see. Well, being here serves neither his best interests nor ours. I’m referring him to the out of hours GP.”

We left quietly.

So after work, I grabbed some food and ironed my uniform before de-snowing the car and heading into Llanishen. Once I got out of our village the roads were ok – probably because there was plenty of traffic to keep them clear. Our end of the street was awful, but then we only have about 10 houses there. The trip wasn’t helped by the fact that my car has developed a hole in the exhaust from all the salt. It’s in the garage being fixed today…

So we jumped on the vehicle and completed our inspection very quickly – it’s easier when you have two people doing it, and we had three on the vehicle last night. I decided that I’d had enough time driving and wanted more experience in the back, so arranged to be the attendant for the evening.

We logged on and immediately were asked to hold on for a second while control checked what we should be sent to first. They called back and asked us to back up an RRV for transporting a patient, but when we arrived on scene, the RRV reported that the patient had already made their own way to the hospital. Clearing from that incident, we were dispatched to back up another RRV, about half a mile down the road. There we picked up a woman in her 40’s with “nonspecific abdo pain”. Once I’d coughed my way through the cigarette smoke, we prepared the carry-chair and she stood from her armchair and sat herself down. Mike and I packed her and moved her out to the vehicle with some difficulty – a scenario not covered in training was using our equipment in snow and we found it sinking through the snow and ice.

Mike had already started to attend to her so I took the keys and prepared to drive when whe woman asked for “gas and air”. We looked surprised and asked her, on a scale of 1 to… “It’s 10.” she interrupted us, sitting comfortably and not showing any signs of pain. I blinked and sighed inwardly, leaving Mike to it. Apparently, morphine didn’t touch her pain (hence why she hadn’t asked the paramedic for any), but entonox worked wonders. It was a quick drive to the hospital and we passed her over to the care of the nurses in A&E. There followed a discussion between the three of us on the ethics of witholding pain medication if you believe that there was no clinical need for it.

The next job was for a young woman who really did need us. A transfer into hospital, the GP had diagnosed “?DVT R leg”. Her medical history was long and she was currently just 2 months out of her most recent encounter with chemotherapy. From the way she held herself I could tell she was guarding herself against pain and I asked if we could help, but she politely declined analgesia in stark contrast to our previous patient.

Our last patient was a hospital transfer for another “?DVT” patient. 97 year old lady, she was a real card. I had a great time chatting to her on the long trip to hospital. She reminded me a lot of my own grandmother (who’s 92) except that she got a little repetitive at times. She confided to me that she didn’t mind what we did to her so long as we told her first. She was a little deaf and I found myself being her closest friend as I was the one who got confirmation that she’d heard me before we did anything. We got to the hospital and found that there was no bed for her – a bit shocking as this was a transfer from another hospital. We sat in the corridor for a while, chatting with her until we were given a trolley for her. Her condition needed treatment, but it wasn’t a surgical emergency (according to the Surgeon who reviewed her later as well as the nurses) so there was some confusion as to why she had been transferred at that time of night. The constant bouncing around annoyed me, though not near as much as the paramedic who bumped our stretcher out of the way just to get past us, casuing our patient to call out in pain. We may only be “Jonnies”, we may only be carrying an old lady while you’re dealing with a patient going into resus – that’s no reason to hit our trolley out of the way instead of walking around.

We said our goodbyes and headed off for a break – things seemed to be calming down. We’d not long finished our break when we got our last job of the night – back to the hospital to pick the same old lady up. We looked at each other and shook our heads – this was the second time in two days she’d been passed back and forth from one hospital to another – completely unacceptable. We picked her up again, much to her delight, though this time I drove and passed the responsibility of looking after her to a colleague – I was tired and felt a bit drained from looking after her – she really did remind me a lot of my grandmother. My colleagues said that they’d transferred her less than a week ago as well.

We dropped her off and got her settled before cleaning our kit and checking in with control. They thanked us and sent us home, which was nice since the temperature was dropping fast.

This was the busiest shift I’ve had so far. I really enjoyed it, though it left me feeling drained both physically and emotionally. Looking forward to more shifts now.

I sat down and re-assesed my options, talking to Sean. I felt as though I was still missing something and Sean was still happy with me doing somethign in addition to Mountain Rescue. I’ve always enjoyed the medical side of Mountain Rescue and I really missed dealing with patients as I used to in the First Responders. So, what could I do?

Enter St John Ambulance. I called national headquarters, based in Cardiff and was referred to Father Andrew, the Divisional Officer In Charge (DOIC) of Cardiff Central. After a long conversation with him, it sounded like I’d hit on the perfect unit – they perform mainly front-line ambulance duties and don’t have a cadet contingent which mean the unit concentrates on training and duties for their adult members.

The first night set the tone really – they’re mostly insane, much like Mountain Rescue. I passed them all the information I could about the training I had complete with Mountain Rescue. Things were looking great…and then a letter came through the door.

South Wales Police had started up its recruitment again. This caused a bit of a dilemma – leave St John and concentrate on the Police? Stop the recruitment process with the police? What to do?

I carried on with both (well, all three including Mountain Rescue) for a while, but this really wasn’t sustainable. Coupled with the fact that I had changed jobs and was considerably busier than I used to be, something had to change. So, after a long conversation with Sean, I decided to withdraw my application to South Wales Police for now. It’s something I’d still like to do, but I’m limited in how much time I have in life – I do like to sleep occasionally!

Last weekend, I passed the 7th course I’d taken in 5 weeks. It’s been a hectic month, but passing my PTA course now means that I can go out with St John Ambulance to do what’s called HDS duties (High Dependency Service) – these are thigns like Doctor’s urgents (when a patient needs to go to hospital urgently but isn’t life-threatening enough to call 999) and hospital transfers. I’m also one of our division’s two drivers currently – so looks like I’m going to be kept busy driving a lot.

On Thursday my uniform arrived – that’s right, look out for me wandering the streets of Cardiff in a natty green uniform. In fact, my first duty is this Saturday, when I’m joining two experienced members for my first HDS duty.

So, er, yeah, that’s where I am, that’s why I haven’t been blogging much of late. Work is taking me to London again this week which means I won’t (again) attend Mountain Rescue on Thursday. Look out for updates on the weekend from the HDS duty, as well as a whole bunch of rants and other stuff I’ve got queued up ready to post.

Tally ho!