Let’s get this straight here, there’s an armed man who’s wanted for murdering a number of people and has made threats against both the police and members of the public in general. He is likely to be highly stressed, emotional, tired and not really thinking clearly. Oh, and he’s got a gun. Police have found him and they’re “negotiating”.

Great, fine, important news. How do you think that should be reported?

How about by broadcasting a live telephone interview with someone who has a line-of-sight view to the proceedings? By having your presenter stood at the edge of the inner cordon after being asked to stay in his vehicle? By trying to catch a glimpse of the gunman through the trees? By intervewing an emotional woman about the fact that her mother was told in no uncertain terms to stay indoors for her own safety and rebroadcasting the clip where she says her mother had a gun shoved in her face?

Am I the only one that believes that those tactics are completely irresponsible?

I see that Northumbria Police have now created a 10 mile exclusion zone.

I hope they enforce it. I also hope that the BBC gets a damn good lambasting for its behavour – I’m just as disgusted with Sky who apparently have been doing similar things, but I expect this kind of sensationalist US-style news reporting from Sky. I don’t expect it from the BBC.

Coming so soon after the recent episode of the EMS Handover on Respect, this post brought the whole topic back to the forefront of my mind again. I know what it’s like to care for people who are responsible for their condition yet refuse to take responsibility for their actions. I know what it’s like to try and help someone who refuses your help. So I’m not unsympathetic to the plight that Buckman describes – it’s an impossible situation at times, made worse, it seems, by the litigious nature of American society. I’ll try my best to not let this descend into a rant on what’s broken about the US healthcare model in my opinion – I’ll just say that I’m glad that I live in the UK and work within the British healthcare system.

The extreme polarisation of the term “patient care” you write about at the start is something that I haven’t seen in the UK – perhaps I haven’t been working with the system long enough. But I find that extreme views are rarely beneficial to anyone, mainly because they seem to define the issue in a very monochrome way and, as Dr Ben Goldacre says so often “It’s not quite that simple…”. I’m not suggesting that the care that you personally offer is deficient in any way, just that any extreme is bad.

I do think that the concept of patient care is somethign we should hold dear to us and is key to providing effective treatment to our patients. There’s a difference between clinical treatment of a medical condition and actually caring for the patient. I think I’m lucky that coming from a first aid background, there were and still are times when there were no interventions that I could make within my skillset that would help that patient, so caring for them was the only skill I had left.

Having said that, I agree that we shouldn’t mollycoddle patients – some people need some tough lovin’ to get the point across and to help them make the jump across the uncomfortable gap of change. If your description of your medical system is accurate, that it’s a system where you can’t be honest without patients for fear of reprisals when that honesty is truly in their best interest, then I fear for that system. The system is failing to provide the best care for the patients and is crippling your ability to do so. Somethign needs to change.

I don’t think that “Do what I say or else” is an appropriate stance for a medic to take. Yes, let’s move them out of that ICU bed into a ward where they can receive palliative care, but don’t make them pay for it. This gives far too much power for a doctor who is of a bullying nature over the patient’s decisions.

I agree, something needs to be done to curb the growing trend of patients who absolve themeslves of any responsibility over their condition – but this is a problem that we see in society as a whole, not specifically in healthcare. Forcing people to take a specific course of action in their healthcare is like using a sledgehammer to crack a walnut when you’re trying to fell a tree – it’s both overkill and yet far too little at the same time.

We’re facing a growing problem where the lack of personal responsiblity in society is stressing our healthcare systems to the limit and we need to find new solutions to these new problems without compromising the care that we offer patients.

Just my tup’pence.

I feel very strongly for freedom of speech. I believe everyone has the right to an opinion* and that they also have the right to voice that opinion. Free speech is what a functional society must be based on, the open and frank discussion of ideas, of faults and of mistakes. If one person makes a mistake that harms someone, then everyone should learn from it. I commented on this on Mark Reeves‘ blog this week and I’ve made my position clear before numerous times.

Most importantly, this doesn’t absolve the individual from their responsibility to keep private information that should not be made public. For example, when I attend an incident and want to blog about it, I have to weigh up free speech against an individual’s right to privacy as well as my own professionalism in the approach that I take to whatever topic it is I’m writing about.

This week, a controversial topic has arisen on a website that I’m an admin on. There have been some comments made in public on what is essentially a private matter between two management groups. Although I don’t believe that such comments should be made public since the issue is an internal one and it’s not in the public interest to air it. What’s worse is that the comments that were made were immature, inflammatory and unprofessional. They managed to serve no purpose than to bring their own organisation into disrepute. After a brief conversation with the appropriate managers, a decision was taken to remove them – a decision I did not take lightly.

At the moment I’m furious. Removing those comments left a bad taste in my mouth. However, I cannot condone their behaviour and the comments were harmful to the entire organisation. What disgusts me most is that some of these are people that should know better. They are professionals and they have achieved nothing other than to inflame an already difficult situation and make themselves look like fools.

People should stop and think before putting fingers to keys. As someone once said to me “Don’t ever say anything on the internet that you wouldn’t say in an interview on TV.”

* When I say opinion, I mean just that. Opinions should not be presented as fact, and if you present rumour as fact you should be prepared to stand up and apologise as loudly as you shouted your fact in the first place when you’re proven wrong.

Every organisation has its own internal politics – it’s just how life is. Some play power games, some want money, some build empires, and some just want to get on with the job. Politics in voluntary organisations can be particularly bad – it’s not that surprising when you get a bunch of people together who all believe passionately enough in a cause to donate that amount of time and effort. It’s the main reason I stopped my work with the First Responders – between the voluntary side and the involvement with the ambulance service, there was just too much politics. Mountain Rescue in this area has traditionally had some interesting politics, but never let it get in the way of the job.

So when Mountain Rescue politics did kick up last week, it caught me by surprise and annoyed me. More than that, it blindsided Sean. As a result he’s now announced that he’s no longer interested in joining the team, which is a shame – I was really looking forward to working with him on jobs and seeing him do well on the team.

Thing is, it’s got me thinking and has got me pretty angry right now. Do I really want to be part of a wider organisation who can treat people like that? I love the job that we do, I love getting in there and doing the job, and I know that 99% of the people in the organisation are there to do the same as I am – get on with rescuing people. But I find myself questioning my membership over the event. I’m sat here at the moment while there’s a rescue going on a few valleys away thinking about my membership and my commitment and other things – my hayfever, my contribution. Hayfever’s stopped me halway out the door today because I realised that if I wandered up a hill with the pollen this thick, I’d be collapsing in a heap of mucus, sneezes and wheezes before I reached the casualty. No drugs can stop that amount of pollen from affecting me.

So my head’s in a mess with a million different thoughts going through it right now. I’m damn well sure however, that I’m not going to let politics or the team come between Sean and I.

Postscript: I toyed with the thought of posting this for a while. I’m aware that several people will read it and feel like I’m airing the organisations dirty laundry in public. However, I feel strongly that since I started this blog that I would comment on the things that I came across that mattered to me, whether positive or not.

Wherever I go, the pager goes. It goes on vibrate sometimes, other times it even goes on silent. But it stays on, ready to receive its little message.

At night, it sits next to the front door, where it has reception. It’s piercing tone set to beep continuously until I get to it and hit a button – it’s the only way it will wake me up. It’s very loud, especially in the early hours of the morning.

Three nights ago, it went off and interrupted my sleep. Meh, it happens. I can’t respond during nights this week – I’ve got a big project to finish off at work and sadly, Mountain Rescue doesn’t pay the bills. So, when the pager woke me at 0631 on Tuesday morning, I wordlessly padded downstairs, turned it off, set it to silent – because I knew there’d be more messages – and went back to sleep. It was a search in Carmarthenshire – no way I was going to get there and do anything useful before work.

Wednesday morning, it was about 0145 when it went off. This time, it was followed rapidly by a “555″ message – stand down. Fine, back to sleep, grumbling lightly.

This morning it was 0146 when the initial alert came through. Frustrated and tired, I shut it up and went back to sleep. 0200 the message came through – missing person in Caerphilly, all of a 3 minute drive away. Ten minutes later – stand down.

Can I get a decent night’s sleep tonight please?

I have to say that I think this is the most disgusting, embarrassing series of images I’ve seen of Cardiff. I love the city, there’s plenty to be proud of – but of a weekend night it seems to descend into hell.

Where is the local authority – those rubbish bins are far too small and too few. Where are the landlords and licensees that they’re selling alcohol to such inebriated customers without consideration for the law? Where is the Welsh Assembly in the lack of funding available for the police to deal with this kind of behaviour?