Because ambulance staff aren’t equipped with body armour or weaponry, we have to rely on the gift of the gab to get us out of threatening situations, which is why most of my colleagues are very effective communicators. We also develop an acute sense of when to stay away.
On another occasion, me and my partner are called to a male with a shotgun, who is threatening to shoot the next person who comes around the corner. We get the gig because someone has decided it’s a mental health case. But you could quite easily argue that while anyone who is threatening to commit a violent act is mentally ill, that doesn’t mean they should be sending us in to deal with it instead of the police. We’re lurking around the corner from this bloke’s house when the Old Bill finally turn up. For all we know, he could have had an air rifle, but we aren’t going to take any chances.
The copper asks us, ‘Where is he then?’
‘He’s round the corner. But he’s got a gun and is threatening to use it.’
‘I’ll go and have a look . . .’
This copper trots off and I turn to my mate and say, ‘What an idiot.’ All this officer has is a can of hairspray on his hip.
Thirty seconds later, the copper reappears out of breath and shouting, ‘He’s got a fucking gun!’ I raise an eyebrow.
My colleague says, ‘Yes mate, we just told you that.’
In the end, the police see sense and send an armed response team in.
When things go pear-shaped, sometimes we just have to hope right-minded members of the public have our back, because we can’t be sure there will be immediate police assistance. We have a great working relationship with the police. There’s a good deal of mutual empathy and a lot of crossover, at road traffic accidents, incidents of domestic violence and serious mental health jobs. For example, if someone is detained under Section 136 of the Mental Health Act, the police will travel in the back of our ambulance with the patient. That’s not to say they’re a criminal, but they are often a threat to themselves.
There is a mutual understanding that both services are run off their feet but will do anything to help each other. But police cuts haven’t just affected the police and the public, they have had an adverse effect on the ambulance service. When there were a lot more police about, they’d readily come and help us when we needed it. But now, the police are so overstretched that when we press our tits-up button, we can’t be sure we won’t end up in a lengthy queue.
Our control room might send us to a potentially violent patient and ask us to carry out a DORA, which stands for Dynamic Operational Risk Assessment. But how can you assess how much of a risk that potentially violent person is unless you’re face to face with him or her? And by that time, it might be too late.
There is more and more risk-taking creeping in. Nine times out of ten, the police are right not to send anyone. But it only takes that one time. I worry for the police as well. It can be a scary job, and they do the best with what they’ve got. And they must get frustrated with us, because sometimes they’ll be waiting for hours for an ambulance to arrive and take a patient from them.
I’m terrified the time will come when someone in the ambulance service gets seriously hurt, or worse. According to figures from the trade union GMB, 72 per cent of ambulance workers have been physically assaulted while on duty. There were 14,000 attacks on ambulance workers between 2012 and 2018.
I’ve been reasonably lucky. I’ve been punched a few times and had snowballs thrown at my ambulance, which doesn’t sound like much but isn’t ideal when you’re travelling at 70mph. But colleagues have been bitten, had bones broken and, in other parts of the country, stab wounds. I’ve heard of ambulance staff being taken hostage, attacked with samurai swords, having bricks and bottles thrown at them, blood spat at them by intravenous drug users and cars driven at them. I’ve even heard stories of ambulance workers being attacked and members of the public filming it on their phones rather than coming to their aid. Sexual assaults on ambulance workers are also more prevalent, including lewd remarks, verbal threats and indecent exposure.
Attacks on ambulances themselves have also gone up, including bottles and metal poles being thrown through windows and vehicles ransacked. There was even a phase of people nicking cylinders of pain-relieving Entonox from station stores and the back of ambulances, which they thought would give them a high. Unfortunately, our gas is mixed with 50 per cent oxygen, so doesn’t have the same effect as pure nitrogen and can give you brain damage if taken incorrectly.
We just accept verbal abuse as a run-of-the-mill occurrence. Certainly, most of it goes unreported. It tends to be linked to drugs and alcohol, and people can be almost intolerable when they’ve had too much to drink. I’ve never understood it, because when I have a drink, I turn into a lover rather than a fighter. But it turns some people into maniacs. And it’s not just that they become aggressive, they also become non-compliant. You’ll ask them to sit down and they’ll stand up. You’ll ask them to stand up and they’ll lie down. You’ll ask them to be quiet and they’ll start shouting in your face. Should we accept it? No. Do we? Yes, because we don’t have a choice.
I think some people speak to and treat us like rubbish simply because we’re wearing a uniform, which dehumanises us. What they don’t seem to understand is that, despite the uniform, we’re real people with real feelings. And some of the abuse is down to an ingrained hatred of authority. These people see us as part of the establishment, and therefore the enemy. They are unable to distinguish between us and the police. But we’re not there to ask difficult questions or arrest anyone, we’re there to hopefully save a life, or at the very least help someone.
I should stress that the vast majority of people are nice and understanding. But there is enough disrespect for it to become very wearing. The voices and blows of the abusive are so loud and concussive that they sometimes drown out everything else. Someone being nasty can make me feel so low and despairing of humanity, especially if all you’re trying to do is help them. And in practical terms, the verbal, physical and sexual assaults are putting yet more strain on the ambulance service. A fifth of the ambulance workers polled by the GMB took sick leave after an attack and 37 per cent said they had considered quitting the job because of the threat of violence.
People will stick notes on the ambulance’s windscreen: ‘DO NOT PARK ACROSS MY DRIVE AGAIN!’ I read them and think, Sorry, mate, but your neighbour has just had a cardiac arrest. We honestly do the best we can not to park like idiots and inconvenience anyone. It’s not as if we turn up to a job and say, ‘Tell you what, Dave, reverse a couple of feet so that BMW can’t get out,’ but we have to park as close as possible to the scene. An ambulance is even bigger than it looks because it has a tail lift, and we also need room to manoeuvre a stretcher. So there’s more to it than just parking up, and when there’s a lack of space, we sometimes end up blocking one or more cars in.
What people don’t seem to realise is that leaving nasty notes can get you nicked. In 2018, a woman in Stoke was fined £120 for leaving a note on an ambulance, demanding it be moved, despite the fact it had been sent to her next-door neighbour who was having breathing difficulties. To her credit, she had a beautiful way with words: ‘I couldn’t give a shit if the whole street collasped [sic]. Now move your van from outside my house.’ What a charmer.
I once turned up at a block of flats for an elderly lady with chest pains. It sounded like she might have a problem with her heart, so I returned to the ambulance to grab the wheelchair and lower the tail lift. I went back to collect the patient and, while I was bringing her out, a woman started banging on her car horn and screaming at us: ‘You can’t park it there, you dickheads! I’ve got places to be! Shift the fucking ambulance now or I’ll fucking kill you both!’ As I said, these people tend to have a wonderful way with words. The poor woman in the wheelchair didn’t have a clue what was happening. For an easy life, I wheeled her back inside while my partner moved the ambulance to let this other woman out.
I fi
nd it impossible to understand the mentality of people like that. In that particular case, it wasn’t just a lack of love for her fellow humans, it was lack of love for the woman who lived next door and had fallen ill. We phoned the police, gave them her car registration and they gave her a ticking off. That’s all we could do, because you can’t afford to snap in situations like that. They can call you every name under the sun, but if you tell them where to go, you’re just adding fuel to the fire. Besides, we had a patient to look after and arguing the toss over a parking space isn’t really a priority.
Only the other day, we received an email telling us that a complaint had been made about an ambulance driving on the wrong side of the road. To be fair, the sender of the email did suggest the complaint had no merit. But they still felt the need to tell us to drive carefully, despite the fact we’re trained to drive on the wrong side of the road. Where else do you want us to drive when there are massive traffic jams and we’re trying to reach a critically ill patient?
Most of our fellow road users know the drill when they see and hear an ambulance. I assume some of the problems we have on the road are down to a lack of awareness among new drivers. Although I think others simply have difficulty understanding that the 5-ton vehicle coming up behind them, painted yellow and with a screaming siren and flashing blue lights, isn’t doing all that just to show off, it’s on its way to help someone in need. I’ll be driving along, five cars will yield, but the car directly in front of me will speed up and overtake the cars that have pulled over. Do they really think those cars have pulled over especially for them? Or do they just see it as an opportunity to get home that much quicker? Then there are those who think it’s fun to follow in our slipstream, as if we’re bombing round Silverstone. I honestly don’t know what goes on in these people’s heads.
The lack of respect for staff in A&E never ceases to amaze me and I have no idea where it came from. I’ve witnessed terrible abuse aimed at doctors and nurses – ‘I’ve been waiting here for hours, you fuckin’ bitch!’ – although I’ve never seen a physical attack, probably because hospital security is pretty good and there are usually quite a few coppers milling about, having brought injured suspects in for assessment before taking them to the station.
Whenever I see someone mouthing off in A&E, I’m reminded of that episode of Only Fools and Horses, in which Del Boy punches a drunk bloke who is being abusive in the hospital. That’s exactly how people behave, and I’m not surprised the studio audience gave Del Boy a round of applause (if I remember rightly, one of Del Boy’s next lines was, ‘I bet you wish you’d gone private,’ which was bang on as well).
In real life, Del Boy probably would have been arrested and the drunk walked away scot-free. I had a colleague who was former army and had served in the Middle East. He was great at his job and one of the good guys, just a lovely bloke. One night, somebody flicked a cigarette at his partner. In the military, you’re trained to look after the man on either side of you. So he followed this idiot into the hospital and dragged him out by the scruff of his neck. He didn’t hit him, he just deposited him outside. But as night follows day, he got suspended. This is a military hero, who put his life on the line for the country. And for that, he’ll always be a hero to me, whatever happens next.
Older people tend to be more respectful. They understand what a fantastic service the NHS provides and tend to be very stoic. But that love has slowly been eroded. I’m not about to start bashing millennials, but a lot of younger people don’t see the NHS as a marvel to be thankful for, they see it as an entitlement. People break a finger, march into A&E and want it seen to immediately. And when they are told they will have to join a queue, because there are other patients who are critically unwell, they take it as a personal affront. There will be old people sitting there with broken hips and pelvises, not saying a word, while a young mum is kicking off because her child, who has grazed his knee, has been waiting fifteen minutes.
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Town centre, Sunday morning, about 1 a.m. A girl in her mid-twenties is in a heap on the floor, her foot facing the wrong way. We jump out of the ambulance, introduce ourselves and advise her that she really needs to go to hospital to get her ankle seen to. Somewhat surprisingly, she tells us to leave her alone, or words to that effect. When we tell her that we’re only trying to help her and that if she doesn’t come with us she might lose her foot, she starts screaming, ‘Stop touching me!’
Now we’re a bit spooked. I request a female crew but there aren’t any. Eventually, and after soaking up ten more minutes of dog’s abuse, we flag down a passing police car. They try their best to get her to see sense, and she tells them to sling their hook as well. Eventually, I assume because the alcohol is starting to wear off and the pain is kicking in, she agrees to get in the ambulance. But she’s still not happy about it.
We wheel her into A&E and she’s shouting and screaming about how horrible we’ve been to her. The head sister comes to see what all the commotion is about and the girl barks at her, ‘When are you going to see me? I want to be seen now! I want to go home!’ This girl is one of the vilest people I’ve ever dealt with – think Veruca Salt from Charlie and the Chocolate Factory, except after ten bottles of Blue WKD – but the ability of A&E staff to let this kind of abuse just slide off their backs is nothing short of miraculous. Later, I discover that she’s a primary school teacher. I’m confident she doesn’t behave like that in her classroom, so I’m not sure why she thinks it’s acceptable to behave like that in my place of work.
Wonderfully, the head sister sent the teacher a letter, something along the lines of: ‘You attended our A&E department on Sunday morning and I was disgusted with the way you spoke to my staff and the ambulance staff who brought you in. I suggest you review the way you behaved and send a letter of apology to the people you insulted.’ I thought it was absolutely brilliant that the sister had done that, not least because it was the kind of thing a teacher would say to a disobedient pupil. The teacher never sent an apology.
However, for the sake of balance, I should point out that older people don’t always get it right. I’ve been to a lot of jobs in bingo halls – for the obvious reason that a lot of old people play bingo. On one occasion, me and my partner were attending to a lady who had become unwell and people were shushing us and telling us to be quiet. One of my colleagues attended a cardiac arrest in the local Mecca and, while he was doing CPR, the caller carried on reading out the numbers. It was like a scene from Phoenix Nights: ‘Never been kissed, one and six. And could the lads attending to the stroke victim kindly keep the noise down . . .’
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We’re called back to the guy who punched me in his flat. Alas, he’s a regular caller. We knock, he opens the door and says, ‘Piss off!’ before slamming the door in our faces. We knock again, he opens the door and I say, ‘You phoned for us, mate.’ He replies, ‘Stop molestering me! Leave me alone!’ before slamming the door closed again. Knock. Knock. This time when he opens the door, he’s holding his phone above his head and clicking away, as if he’s taking pictures of us. Every time he clicks the button, he shouts, ‘Evidence!’ But it’s one of those old Nokia phones with no camera. David Bailey impression over, he slams the door closed again, and we can hear him on his phone: ‘Police? I’ve just been raped by two ambulancemen . . .’ Not ideal.
For whatever reason, mental illness has gone through the roof. I’d go as far as to say it’s a pandemic. I see an awful lot of mentally ill people living on the streets or on their own without much support and unable to cope with the daily stresses of life. It’s not unusual for me to spend a large chunk of a shift dealing with mentally ill patients. They’re often people at the end of their tether, who have cut their wrists or taken an overdose. It’s humbling to be the first port of call for people such as this and hopefully be able to help them take the first step on the road to recovery. And I can often draw on my own experiences to help understand their predicament. But we don’t get an awful
lot of training in how to treat mentally ill patients, including what or what not to say.
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I’ve taken people into hospital who have been sectioned or were feeling suicidal, returned two days later and bumped into them again. I’ve said to them, ‘How come you’re back?’ And they replied, ‘I’ve not left.’ They’re essentially living in a medical hospital, waiting for a mental health bed to become available. It’s not uncommon for people to go to their GP and get a referral to a mental health professional, only for it to take three or four months. The GP might give them some pills, but they’re not going to cure you, they’re only going to mask the symptoms. And, once again, it’s the ambulance service that picks up the pieces, when people waiting for an assessment, desperate for support and guidance and crying out for help, harm themselves. Whatever is wrong with someone, we do everything we can. But sometimes it’s just not enough.
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THE SEEMINGLY HUMDRUM
Even an ambulance person’s everyday jobs can be deeply unsettling. When you’re trained how to do CPR, your patient is a dummy. Dummies don’t have emotions, or eyes that stare straight into yours, or friends telling you what to do. Dummies don’t foam or vomit, they don’t have ribs that break or cardiac arrests in tiny bathrooms. When you’re doing CPR for real, the patient won’t be presented on a nice flat bed, at exactly the right height. He or she might be curled up in a toilet cubicle or face down under a pier on a beach.
Name a place and the chances are I’ve done CPR there, or know someone who has. And when you start pounding on their chest, you will be able to feel and hear their ribs popping, crunching and cracking, as if they’re nothing more than twigs. Some elderly people have a DNAR order in place, but many don’t. That means we don’t have a choice but to do CPR on them, which is highly unlikely to work. It’s the law, but is it morally right? Either way, it’s not nice for whoever has to do it.
999--My Life on the Frontline of the Ambulance Service Page 10