I'm an NHS paramedic... AMA

[wherethewestwindblows]

I don't feel that the public have the greatest understanding of the realities of the job in the current climate, so I thought I'd open up the conversation. My answers are obviously my own opinion, however I believe many of them reflect that of a large proportion of my colleagues in the service I work for too (which is about the only question I won't answer for anonymity).

I will answer every question that is posted, however it may not be straight away.

What proportion of your work would you say is due to a lack of access to acute mental health support, or a breakdown in social care ?

I'd say we attend less mental health related incidents now than we have done over the last 5 or so years, but that predominantly comes down to the sheer amount of time most mental health cases are required to wait. Often these patients are no longer in need of an ambulance by the time one would arrive or have been signposted to alternative pathways in the meantime (again, because they have been advised it'll be a significant wait for an ambulance and most people don't want to wait or they want to go to bed and don't want to be disturbed in the middle of the night sort of thing).

Social care is a difficult one. The elderly are, unsurprisingly, a large proportion of our work. Sometimes we attend for strictly medical cases that are less of a social care issue and more of an issue with accessing primary care which could have mitigated their need for an ambulance/emergency care. Sometimes it's for people who wouldn't be calling if they had better care, but then you may or may not be surprised at how many of the elderly are too stubborn to accept help being offered (or in sad cases, feel as though they are not in a position to accept it/finances). I've attended a lot of individuals whose family are on their knees because they cannot provide the support necessary but the person refuses to have external carers or leave their home, even though they are at risk. And then there are those that are a bit of both, which I think is where the state of the social care system is highlighted - that is, if carers weren't as stretched/were given more training, they may have noticed an issue that needed addressing before it became an ambulance issue.

The biggest impact the failing social care system is having on the ambulance services though is when it comes to patients being discharged from hospital. There are a massive number of beds being occupied in hospital by people fit for discharge from a medical standpoint, but there isn't the support in place to ensure they can go home without being at huge risk.

What’s the worst thing you’ve seen or experienced?

How do you distress after a dreadful day

Worst in what sense? Emotionally impactful, gory, unbelievably disgusting?

One of the things that has stayed with me above all is the scream from the husband of a lady who took her own life when the realisation that she was gone hit home. It was the most agonising and harrowing sound I've ever heard a human being make, something I couldn't fully describe with words.

When you arrive at hospital, what is the average wait time before a patient is seen.? Is the late longer or shorter after midnight?

I hope you know that the majority of us really respect the work you do.

As an ex community mental health nurse, I found paramedics and police the most/only helpful and empathetic when I was calling for help with one of my patients.

How do you and / or your colleagues drive so expertly at such speed around often completely unaware / unhelpful drivers and pedestrians. We were in awe of an ambulance today who managed to navigate through very heavy rush hour traffic.

Did the Better Care Fund increase Ambulatory Care as it was designed to do? The funding was brought in to streamline and automate care services, increase pharmacy one to ones to avoid GP appointments and help reduce queues at A&E. It was also meant to provide additional care for mental health services for those in need like retired males who were using massive GP resources for depression. Did anything ever come of all this? NHS England » Better Care Fund

Another question if I may. If you are behind me at traffic lights or a pedestrian crossing and you are on blues and twos what is the procedure for moving out of your way if the lights are on red and we are stuck in front. This happened to me a while back and I crossed over the pelican crossing after making sure pedestrians were stationary and were not crossing so I could let you pass. If a camera is on that crossing will I get a ticket?

No question but a huge thank you to you and your colleagues for doing what you do

God that’s awful, I’m so sorry

Yeah, I suppose gory or shocking - limbs off, that kind of thing

I know this is AMA but this is in rather poor taste @Pyri

Yeah, I suppose gory or shocking - limbs off, that kind of thing

OP thank you for what you do.

How much violence or aggression do you experience during an average shift/week?

I live 9ish miles away from our nearest hospital. Sometimes on my drive home from work I can be driving at the speed limit of 50 or a tad above (speed cameras. So nothing crazy!) in front of a blue light ambulance and never need to pull over to let the ambulance pass me because it doesn't get close enough....its too heavy a vehicle and too slow. (I'm driving an old lady estate car, not a super car 🤣). It makes me worry that the person needing attention could be beyond help by the time the ambulance/paramedic reaches them. What do you think?

Couple of questions (if I can ask more than one):

1. do you think shows like Ambulance and similar, are in any way realistic?

2. what has been your best call out as a paramedic? Either the one you felt you helped the most, or the happiest story.

3. is there anything we the public could do to better support the ambulance service?

Thank you for the work you do. Your colleagues saved my husband's life in 2020 and I will be eternally grateful.

What’s the point of AMA if you can’t… ask anything?

What do you think of Community First Responders (if you have them in your area)?

Has your job made you change your behaviours at all, or made you worry about certain things more? Like crossing roads or chainsaws?!?!

Just want to say thank you for all that you do

We hear a lot about delays caused by ambulances having to wait outside hospitals to hand patients over. Sometimes whole shifts can be wasted this way. Surely there has to be some solution to this, it's a crazy waste of resources. Do you have any suggestions?

Each and every one of you are amazing 👏

What band are you on, and why is it so low 😔?

No one is preventing you from asking it, but you shouldn’t be surprised if other people think it’s unimpressive that, given the opportunity to ask things of someone who does a difficult, stressful and under-remunerated job, at the business end of emergency healthcare, you just want a tabloid gorefest.

Thank You for doing this. I have a few questions if that's ok.

Do you get many people call for an ambulance when it really isn't necessary and do you judge people who do that?

Do you get many people who think that because they have called an ambulance they won't have to wait in a and e?

My then 12 year old took an overdose of sleeping pills. He was very drowsy but dh just about managed to half carry him to the car and drive him the 10 minutes to hospital. When he got there someone was stood outside a and e making sure people weren't parking in the wrong places and as soon as they saw dh struggling with a half conscious 12 year old he managed to produce a wheelchair out of nowhere and ds was rushed straight to resus. Should we have called an ambulance? I thought driving would be quicker as even if an ambulance was dispatched straight away it would still have taken a while to get to us. The staff in a and e seemed surprised that dh had driven him in but as well as the speed I thought the unwritten rule was that if you can drive to the hospital then you should.