Voluntary services in the thick of it

I’m a regular reader of The Paramedic’s Diary and couldn’t help but notice the new poll question - Should the voluntary services support the ambulance service on frontline duties?

This likely comes from a recent diary post of his and I felt compelled to write just a bit about it.

Firstly, I’m commenting on this as it would be under usual circumstances - in the event of a major incident (London bombings, etc) then things are obviously different. I’m also basing this mainly on experience in St Andrew’s. I’ll be the first to admit St John’s are quite different on a number of aspects although I’ve tried to come at it from a combined VAS point of view.

The problem with this is how the definition of “support” is taken. If it means relying on a VAS crew attending any type of 999 call then I’d have to say no. Whilst training for some of the St John’s advanced courses (say Emergency Transport Attendant) is undoubtedly tough it is still nowhere near the level required for technicians and paramedics. A VAS crew turning up at a large RTC would, I feel, be quite overwhelmed and wouldn’t have the experience to help them.

Taking another situation, lets say a complication in late pregnancy, would possibly be worse still. Not only is there the medical condition to deal with but there is also a highly emotional situation that a number of professionals would probably not like to be in.

Further, what if there were complications in relation to the actions of the VAS crew? Insurance exists, yes, but to what level? What about regulation? A registered paramedic could face being struck off in a serious situation, but what would happen to a voluntary member? Would communication be effective enough to impose levels of discipline?

These may seem a bit far-fetched, but are foreseeable problems.

On the other hand if we take the situation where a patient is assessed by a technician/paramedic and that professional requests and is confident allowing the care to pass to the voluntary crew then that really is a different matter. Transporting a stable patient doesn’t carry quite the same risk as attending an unknown.

But in the event of a cardiac arrest when even basic lifesaving skills can help, this doesn’t really apply. I might even go as far to pick a VAS crew over a number of GPs I’ve met, basic lifesaving having long since left them.

I guess my point then is that VAS crews might have a use, particularly in busy or definite emergencies. The problems will start when they become preferential to qualified professions which, in today’s cost-effective health service, seems all too likely.

I often comment on St Andrew’s rather slow expansion capacity but if we ever get to the point of covering 999 calls I’d want to be damn sure we covered all the bases.

I’d be interested to hear other views on this and I’ll happily admit I’m not totally knowledgeable about the current policies.

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Needed update

So I’ve been neglecting this of late and I’ve kept meaning to post an update

The competition which I was trying to submit to has been sent away but I’ve yet to hear a result or even an acknowledgement. I emailed the contact I had before sending it and got no reply and she didn’t pick up her phone either. I don’t really know whether the time I spent on it was worth it or not which is really annoying. I’m hopeful I’ll still hear something back although I’m not convinced. Also hope that I’ll get my SSM result back sometime in the near future but I know that version of the essay was much weaker than the greatly extended one.

That doesn’t mean I don’t have plenty to do in the mean time. With only about 6 weeks to go till the exam the stress is really starting to hit. In fact I really shouldn’t be on here typing this but I need an excuse to stop revising now and again. I’m not quite as worried as some of my colleagues yet but I’m sure it’ll get that way soon. The breadth of topics we’ve covered this year is actually quite impressive, although I really feel I’ve forgot a lot of it. Trying to work out the best way to revise is also taking time. I’ve concluded that reading through my notes PBL by PBL just doesn’t work and becomes ridiculously boring. Mind-maps, questions and peer groups seem to do the trick a lot more.

The problem though is trying to fit it all in around the 5 or so weeks of teaching we have to go. How I envy those with study leave!

We’re also getting another final piece of coursework in the next week or so, just in case we didn’t have enough to be getting on with. My aim is to finish that hopefully the same day, although I anticipate yet more “original hand drawings” - grr!

Away from Uni I’ve been doing the odd first aid duty now and again. Went to my first old firm match last week which certainly opened by eyes a bit. Ended up meeting someone from my VS group as well which, in a crowd of about 60000, was pretty impressive. Managed to take a few phone quality pics of the night, the best of which being these 2:

I’ve still not heard anything about my phlebotomy job. My Disclosure is back and I’m expecting to need an appointment with occupational health. Hopefully I’ll hear something soon as I could do with some money….badly!

Finished!

6337 words, but it’s done!

I have no idea how many other people will submit something, but I’m guessing it probably won’t be more than about 10 or so. I also have no idea how good my article is. I was hoping that I would get the results back from the shorter SSM version before I submit this although it seems unlikely now. I’ve also found a good deal of things that just aren’t right in that version. Hopefully it won’t be too big a deal for the result and so long as I pass it’ll be OK.

That said, I’d feel annoyed if I get something lower or even the same as some of my colleagues who put a lot less effort and time into the module. This tends to happen with me and medicine. Guess I can’t do much but try that little harder.

Company, Attention!

We had our inspection this week as planned and, thankfully, a new inspecting officer had to be drafted in at the last minute. She hadn’t, so I guessed, severed any length of time in the forces and as such wasn’t quite checking whether both boots had enough polish on them or not. Once she checked the line of members we got taken in to another room 3 at a time and asked just 3 questions, mine where:

• What is angina? (Would’ve been killed if I hadn’t got that right)
• How do you treat a nosebleed?
• How do you treat food poisoning?

In all, pretty painless and a lot less stressful than I was expecting. It was followed by a rather small buffet and then that was that. Done for another year.

Personally, I’d make it much more practical. Get people to attend in uniform and ask them to demonstrate a number of tasks as a company on each other. Then walk through them and ask questions. Would’ve been done so much quicker and probably highlighted anyone struggling (which there would be, under pressure).

In the morning I had a duty in the Kelvin Hall with my other medical student colleague. As we (and 900 primary kids) arrived we realised that we didn’t have access to our trolley beds and carry chair which are in the Kelvin Hall. If any relative serious happened (fracture or dislocation is what we were thinking of) we would have no real option but to keep them on the floor until an ambulance arrived. Since we were rather new we felt it would be the exact time that something serious would happen, but thankfully it didn’t.

Ice, plasters and TLC got us through the event.

We did manage to entertain a local newspaper photographer/journalist. He decided to take a picture of us with the possibility of it being included. Unfortunately I have no idea where I can get it so I can only hope it’ll catch my eye.

After that we both went to HQ (my first visit!) to get some uniform sorted. The fact it’s taken 5 and a bit months for me to get this bit of uniform (it’s technically what we wear outdoors) speaks volumes. The money (£60!) also comes out my expenses so for 15 duties I will receive no contribution towards travel. This really annoys me, since the event organisers are paying what I don’t imagine will be a small amount to get cover. I have no real problem with being a volunteer I just feel that out-of-pocket expenses should be covered, especially by an association which is in the position to do so.

In the evening I was attending the Scotland vs. Croatia friendly at Hampden. Unlike my last big match at Hampden, I was much more confident for some reason and we had a greater number of first aiders available. The event went without any significant injuries. We had a young (perhaps a bit younger than me) French-turn-Scottish fan start chatting to us before the match and he dutifully returned at half-time. I wasn’t too sure if he was drunk - I couldn’t smell anything - or just very excited to be there but he was an interesting character and I hope he enjoyed it.

As far as casualties went we had a middle aged chap looking for some paracetamol for a migraine. He got sent to the docs and got some co-codamol instead. We were expecting him to be back later in the game but that must’ve helped as we heard no word from him again.

Radio problems were all the rage on the night. We had a visit from two other first aiders to tell us our radio wasn’t working. By the end of the match we had to go back and tell them the same thing. Thankfully my colleague was dealing with the radio and was happy to do so because I could hear a lot of interference.

I was almost not going to be allowed to go to the game as our company were at odds with the exec over nothing other than money. I don’t even pretend to be interested in these debates - we’re volunteers and we’re not concerned about money. When we’re not allowed to go to an event we want to (and they’re struggling to get first aiders to cover it) then I don’t see why I shouldn’t move. In the end we were allowed and we made up about a 1/5th of the first aiders.

The form for covering T in the Park has been made available on the website. I really do want to do it (it may be my only year!) but I just don’t know what days I can do due to my (*shudder*) job. I’m thinking of just putting down the Friday/Saturday and sort work out when I’m actually employed. Will wait and see if I can gather up any support.

Pure gold

It’s so bad, it’s good.

Fresh blood

So yesterday I was around for the Applicant’s day again. I think it was a bit busier than last year, but doesn’t really compare to the Open Days which are far busier. Managed to get a couple of people around for tours, hopefully they helped some people make their mind up about where to go. Someone had heard of this blog, which is quite interesting to me as it gives me an idea of who’s reading.

We also talked to the admissions secretary about a certain admissions forum which she wasn’t even aware existed. She was googling her name when she found it, so we started discussing certain cases. So I can almost certainly say that Uni staff are aware of what’s going on online.

Perhaps more relevant was a general discussion about immediate/pre-hospital care I had with a 3rd year who’s quite interested in the topic (and a BRC first aider, and a phlebotomist…) as well as a paramedic/ALS trainer. I have a view that there will be a change in immediate care in the future where a greater number of doctors will be involved in pre-hospital medicine, similar to a recommendation I read today (as opposed to revising) in a report. Neither of my colleagues agreed, the paramedic keen to get out of pre-hospital care and the 3rd year considering moving to somewhere with a greater emphasis on the topic.

Following on the subject we had a practice drill for our annual inspection next week at training. I personally find it both embarrassing and highly amusing at the same time. To make volunteers parade in a military drill so their uniform can be inspected is a bit over the top if you ask me. Fair enough, if people turn up on duty without reasonable uniform, deal with it, but lets get out of the military eh? That’s great in theory but when our inspecting officer and chief are all from a military background, it’s not happening any time soon.

I’m not looking forward to the inspection, but anything could happen.

When is something “urgent”?

So there I was, dashing from shop to shop in the rain (although, thankfully, nothing like that’s been hitting our friends down south) when I receive a text message from my commandant. Normally when I receive a message at this time of day when we have training at night it is to tell me it has been cancelled. However, not so on this occasion.The message read something along the lines of “please attend tonight, letter received, urgent”.

My companion at the time started asking me what I had done wrong, assuming the message had been sent to just me. I racked my previous duties to consider if I had done anything worthy of a letter from above. They best I could come up with at the time was this poor blog. I wondered if someone somewhere had found it and had a problem with what I was writing.

As we pondered, I dropped a quick message in to one of my colleagues who also happens to be a Glasgow medic. They eventually got back to me to let me know that they might struggle to make it, being out of Glasgow and having a fair bit of work to do and I inferred (correctly) that she too had received the message. I also had a lot to be getting on with as my essay at that stage was far from finished. However, being urgent, I attended dutifully.

Was it urgent?

No.

I don’t think so anyway.

It was referring to the possible increase in insurance that might happen due to a lack of people attending moving and handling courses. This fee might even have to be paid by members! However, if that was to happen the company would pay it on our behalf. So all in all the letter was meaningless.

My colleague was really annoyed at this, as she could’ve been doing her work due in tomorrow. I was only mildly annoyed as I hadn’t really expected anything big. However, it raises a point.

If this is to keep happening for trivial matters (we have an AGM in 3 weeks, could’ve waited till then, no?) then when something that is actually urgent occurs I may be inclined to ignore it.

That said, something positive did take place which fully justified attending. We each received a new and improved first aid bag. They’re only about a month and a bit behind, but that’s not too bad I guess. Here’s a snap of the new (left) and old bag, with a pen for size comparison.

Ignoring the fact it’s a really bad picture, you can see why it’s such an improvement. Now all I need is some stuff to put in it. I think I’ve bought enough so I’ll just keep my eye of for free supplies.

Another benefit of attending was the chance to put my name down for a rather big event at the end of the month. Not 100% sure I can make it, but I’ll hopefully find a way to get there. All I need to try and do now is get a hard hat and blue suit before then. Heh, one can dream.

Busy and stressed

Quick post before I head off to my bed.

I’m having a hell of a week, trying to finish essays and presentations before Friday. I’ve also got 3 birthdays on Thursday and Friday which needed sorting.

Despite all of this, however, I’ve managed to spend time signing up for things like Twitter. I’ve got absolutely no friends on there at the moment (very sad!) so if you’ve got an account please feel free to add me. If not, why not? No possible excuse not to sign up for yet another social networky thing.

I finally got a new first aid bag! But that’s another post I’ll hopefully get to sooner rather than later.

Oops!

So I managed to ignore all the many emails and let this domain expire. Thankfully no-one cared enough to steal it off me so I’ve got it back safely. This means it must be a year since I set this up, doesn’t seem that long at all.

I also have a job!

Kind of. Technically it’s all depending on references and a(nother) Disclosure. I’ve lost count of what number I’m up to now. I may have to pay for this one though, grr.

That aside, the job is based at the Southern General, which is actually a bit of a trek for me. Thankfully, the night subway bus goes right next to me to close to the hospital, so it shouldn’t be too bad. When do I start? Who knows! May take a while due to Disclosure and references, plus I need to find training time in there somewhere. I’m wondering whether, during the summer, I could work part of the week in Stirling and the weekends doing this. Either way, I aim to be pretty rich come September and not waste it on something like a laptop. Or an iPod touch….

Or a car.

A few good days

Quite rare, but they do happen.

Just yesterday, when I talked to my mum and decided not to work at all over Easter and instead face financial mayhem, do I hear about an interview for a phlebotomy job. Considering I’ve applied for that about 3 times in the past, it’s progress. It’s next Wednesday and I just so happen to be free that day. Call it fate. We’ll see.

Even more impressive was my mum taking me to see cars and end up buying one. Sadly it’s not for me but I was still amazed at the abruptness of her decision.

Pain management is rolling along nicely. We have only one more clinical day outstanding and it’s paediatrics, which should be excellent. I have so far this SSM seen - people in pain, gynae day surgery, more people in pain, impressive surgery involving blood with colourful stuff in it, difficult intubations and difficult sedated patients, 2 caesarian sections (both girls, all well), fractured femurs and difficult hips, knee replacements and acupuncture. Quite a lot for 2 weeks! It’s been an excellent module and now I have to start thinking more about the report. I’ll probably stick with PCA as it’s quite a wide topic. Not sure if I’ll get it buffed up to the size required for the essay competition - it’s possible.

We have a tutorial tomorrow to discuss it with our supervisor so I’ll see what’s mentioned then. Following that I have what can only be described as a weekend of first aid - kids hockey, adults boxing (both Friday), Saturday football and helping out at a first aid class on Sunday. I didn’t quite plan it to happen like that, but if phlebotomy goes forward I may not have many free weekends left!