I am exhausted.
When I first joined the ambulance service as a paramedic, 14 years ago, my colleagues and I used to be able to do a job then decompress with a cup of tea.
We would talk to one another and – very occasionally – get back to base for a short rest before the next job.
I was inspired to join as my uncle had been in the ambulance service for 30+ years. And like him, I expected it to be my lifetime career – but it may not go that way for me.
This is no longer a job for life. Today, it’s a conveyor belt of patients.
I am by no means work-shy and neither are my colleagues.
But when you attend a serious road traffic collision or a cardiac arrest – that literally tear lives apart – only to be sent 20 miles, on blue lights, to someone who wants to discuss pain relief for an old shoulder injury when the GP surgery opens in a few hours… You can see where empathy begins to wear thin.
More and more, we are being called to non-emergencies. Just a few days ago I was called for someone who’d had a tooth extraction four days previously and the wound had been bleeding (less than an egg-cup’s worth).
They received a category 2 diagnosis, the second most serious – an example of category 2, would be chest pain or stroke, category 3 a non-injury fall and category 1 is an immediate threat to life such as a cardiac arrest or anaphylaxis.
We checked him over and found he was clinically well. Then this person stated they’d been advised to attend an emergency dentist and called us to convey them – that’s totally unacceptable! In the end, they got a taxi.
I cannot tell you how many times I have been on scene for someone with a minor ailment, simultaneously listening to Control calling over the radio for resources to assist with a cardiac arrest – only there is nobody available.
Being on jobs that can be dealt with by a GP or by visiting a pharmacy means we can’t help those who need us most. It leaves us with a sinking feeling that someone who needs our skills is unable to get the help they need.
The ambulance service itself is partly to blame. Paramedics like me are constantly dispatched to calls on a ‘what if the worst should happen’ basis as the service is very risk-averse – I believe it has to do with a fear of being sued.
But emergency responders need to feel confident and protected to discharge patients, encourage them to seek their own transport to hospital or see an alternative clinician in primary care.
Many of my colleagues don’t, particularly those who, much like doctors and nurses, hold professional registrations – those registered with the Health and Care Professions Council (HCPC) – and could face a panel and having our registration revoked if we mess up.
We are constantly made to fear for our registrations and jobs, but as the ones on the front line, we shouldn’t have to.
To keep paramedics going at this pace – seeing back to back patients, taking fewer breaks – will create more and more incidents where mistakes are made and harm is done, because we are burned out.
You may recall recently that the police announced they would no longer be attending mental health callouts. Other services, including police, fire and end of life services are able to refuse to attend a call when paramedics request their help – but we can’t.
Moreover, we are attending more social care and mental health jobs than ever due to chronic under-funding in these areas. Paramedics have no powers of removal under the mental capacity act – we can’t section, we can’t do anything – yet we are still expected to coax sometimes violent or abusive patients onto an ambulance and bump them off to an already overloaded A&E.
That’s not the answer.
I feel the government is in a position to change this, through funding and greater protection for healthcare workers. But it feels like that they turn a blind eye to these problems or bury their heads in the sand.
The NHS in its current state is unsustainable.
During the COVID-19 pandemic, calls were only ever for genuine emergencies, people that needed immediate intervention either on scene or en-route to hospital.
I didn’t see someone with flu or any of the things we’re unnecessarily called out on for months, because nobody wanted to see us – everybody was scared of going to hospital.
People managed their symptoms for minor ailments at home, and I think this should generally be the case.
I feel there needs to be a huge campaign, aimed at educating the public to make sensible decisions when it comes to personal health – and again, this is where the government must step in.
If I come to you and you tell me you’ve got 10/10 back pain but haven’t taken any pain relief – I’m sorry, I might screw my face up
For instance, people need to understand which conditions do and do not need an emergency response. Do you really need an ambulance? Can you get yourself to A&E or an Urgent Treatment Centre? Can you wait and see your GP? Can you speak to a pharmacist, or deal with your issue with over-the-counter medication?
Of course, if you’re genuinely unwell, we’re happy to help. But if I come to you and you tell me you’ve got 10/10 back pain but haven’t taken any pain relief – I’m sorry, I might screw my face up. If I take you to hospital in an ambulance while you’re happily sitting on a chair, medication-free… The likelihood is you could have made your own way.
People are quick to slate the NHS, response times, privatisation – I would put it to anyone that all of these issues can be dramatically helped by all of us taking more responsibility for our own wellbeing.
Paramedics are leaving the profession in huge numbers, as are nurses and other healthcare professionals because the impact on our mental and physical health is too great.
We’re not robots but I frequently feel that we are treated as such by both the public and the organisations we work for.
We feel disposable.
We will do what’s required with a smile on our face no matter the effect it has on us. We will mop up where other organisations can’t or won’t.
I often feel like I made a mistake when choosing a career.
I enjoy my job on the whole – I love the feeling of making a difference, of helping people in their time of need.
But, I feel let down and undervalued by the system, as do many of my colleagues. This is why we need change and we need it quick.
Personally, I don’t think I will be in this profession much longer, certainly not in my current capacity.
The thing is, we do want to be there for you, we want to help you, we don’t want you to suffer but we need your help to make this achievable and sustainable.
Here’s to your good health.
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