I never did get to hand in my notice because I began to enjoy nursing. At the end of my training, I spent time in the Emergency Department and found ‘nursing’ as I’d imagined it to be: busy, exciting and unpredictable. In emergency, every day is different. Just my cup of tea.
During my stint in emergency, I had to spend a day observing the work of the ambulance service. Some of the other girls had already warned me about the ambulance men.
‘They’re a bunch of womanisers,’ said one.
‘They’re all sexist pigs,’ said another. ‘Be careful or they’ll have you running around making tea for them all day long.’
So by the time I got to the ambulance station, I was terrified. Acutely conscious of my nurse’s uniform, I felt so nervous, sitting in the mess room with all the other ambulance staff, almost too scared to speak. It was so different from the predominantly female environment I’d been used to at the hospital. And the conversation was a bit near the mark at times.
Then one of the paramedics offered me a cup of tea. Is this a trick? I thought as I nervously said, ‘Yes, please.’ It wasn’t. He just handed me a horribly strong cup of tea. Sitting there, nervously pulling my skirt over my knees as we waited for the first emergency call to come in, I burned my mouth on the hot tea as I sipped it. It really was too strong. But I was too nervous to say a word.
Then a call came through. Two ambulance crew strode over. ‘Are you coming with us then?’ said Steve and Nigel. Little did we know that day that one of them, Steve, was destined to be my husband.
We made our way to the location of the incident, lights flashing, sirens blaring.
It was what we call ‘a proper job’. A woman in cardiac arrest. Right there in the street, I watched Steve, a paramedic, pass a tube into her throat to allow the oxygen to be pushed into her lungs. This is called intubation. Then he put a needle into her vein to provide a route for fluids and drugs to try to restart her heart, a process called cannulation. In the meantime, I tried to help a little by working on the chest with some cardiac, or heart, massage. Then we lifted the woman onto the trolley bed and got her into the ambulance. A priority call went out to the local hospital and Nigel drove us there with the lights and sirens going. In the back of the ambulance, Steve and I tried to resuscitate the woman all the way to hospital. I hadn’t known anything like this before. I was on an adrenalin high all the way.
When we got to the hospital, I was shaking like a kitten. Bits of my hair had fallen out from my pony tail; I was hot and sweating from the exertion of resuscitation during the six-mile journey. Even my stockings had holes and I had grazes on my knee from the pavement. I looked a complete wreck. But I was buzzing.
To me, the job had been amazing. Sadly, as is often the case in such situations, the woman did not survive. But I knew, there and then, that this was the type of challenge I enjoyed. This was the environment I really wanted to work in.
I finished my nursing studies and became a registered general nurse. But back in the early 90s, getting a job in the Emergency Department wasn’t that easy. There were no vacancies. I had to put my name on a waiting list for the ED and start work as a nurse on a medical ward. Even as I started my first post as a staff nurse on the ward, I was hoping to get a chance to transfer to an emergency setting. And then, hedging my bets, I also quietly applied to join the ambulance service. Within six months I was accepted into the service. At last I’d be going back to life on the road. But this time it wasn’t with a diamante bikini in a travelling circus. I’d be wearing steel-toecapped boots in the London Ambulance Service.
I started working as an Emergency Medical Technician (EMT) with the service in April 1994. EMTs form the majority of our frontline staff, responding to all types of 999 calls and providing basic treatments for resuscitation and defibrillation – bringing arrhythmic heart contractions under control – and administering many emergency drugs and other treatments.
After two years I opted to train as a paramedic and in 2003 I undertook additional university education to become one of London’s first Emergency Care Practitioners (ECP). We respond to all types of 999 calls too, but in the London Ambulance Service often work in cars or on our own. Because all ECPs are also paramedics they will be sent to high-priority calls, like cardiac arrest or trauma, in an attempt to get someone to the ED as quickly as possible.
An ECP in a car can manoeuvre through the traffic that bit easier and start to help a patient while waiting for the ambulance to arrive. High-priority calls might also need the skills of a paramedic who can intubate and cannulate patients and offer more options for pain relief and emergency drugs.
At the other end of the scale, an ECP may also go out on lower-priority calls, like minor injuries or illnesses. In these situations many patients may not actually need to go to hospital. An ECP can carry out a full examination and assessment on the spot and frequently will then carry out the care or treatment that traditionally could only be provided in hospital. We carry additional testing equipment and can administer various medications, including antibiotics, on the spot.
Many ECPs also work in minor-injury units, walk-in centres and EDs, as well as with the ambulance service. This means we can work alongside other healthcare professionals and have the opportunity to learn more from them. So the skills we learn in these other settings can then be applied when we’re back out on the road. Elderly or housebound people in particular are often very grateful for this – because it means they may not have to go to hospital at all. An ECP can also refer someone back to their GP, community team or other treatment centre for continuing care. Which is why the work can be so rewarding: it’s incredibly satisfying to help someone and leave them at home, happy and smiling afterwards.
There are two reasons why I wanted to write this book. First, there’s no doubt that this kind of job seems to capture people’s imagination. In a social setting, people I’ve never met before always seem very keen to know more about our work. Quite often I’ll be badgered by someone to tell them the worst thing I’ve ever seen in my years in the ambulance service. Experience has taught me, however, not to indulge such requests too readily. Not everyone is ready to hear a story involving gallons of blood or human carnage. So usually I make a joke about someone weeing on my boots or something similar.
The other reason for writing this book is more serious. I was recently asked to write a monologue for a charity called Working With Men, whose Uncut Project aims to address the reasons and motivations behind knife crime by talking to young people in schools and organising outreach work. I wrote my monologue straight from the heart, as I reflected on a fatal stabbing that I’d attended, talking about the thoughts and feelings it provoked in me. And afterwards family and friends who read it suggested it might become the basis for a book of all kinds of stories, the more memorable call-outs I’ve witnessed of the thousands I’ve been out on over the years.
I’d like to add here that any thoughts or feelings voiced in these stories are mine and mine alone. I’d never suggest that I represent all my colleagues in that respect. But it has to be said that the stories you will read are stories any one of us could tell. We’ve all been to sad, traumatic, scary, funny or ridiculous call-outs. I don’t have any monopoly on that!
Most jobs change over the years and the ambulance service is no exception. Nowadays, for instance, we spend less time on the ambulance station. There used to be more opportunity to sit around and chat with colleagues between jobs – an unofficial form of debriefing or stress relief. Now, it’s much busier. As soon as we’ve finished with one patient we usually go straight to the next call. But technology has improved our speed of response. In my early days we used to take the details of the call-outs on the landline, then handwrite the details on a patient report form. Now the details come to us electronically via the mobile data terminal in the cab of the vehicle,
