I’m on the Caledonian sleeper train to Aviemore in Scotland with my friends Amy and Emily. I talk to Amy about what she does for a living for Conversations on the Train on the way.
“What do you do?”
“I work for the ambulance service in Bristol”
“The normal ambulance?”
“The nee-naw ambulance.”
“Do you say that often when you’re there?”
“I never say that! I work for the emergency ambulance service. So I do all the driving. I’m not a paramedic.”
“I don’t get that, if you’re not a paramedic how can you drive? I mean, don’t they need to be paramedics… because on Casualty right…” I wink.
“Cutting costs… the NHS can’t afford too many paramedics, so I assist them. I’m an emergency care assistant.”
“So what can you do?”
“Not a lot. I can drive, I can give oxygen and I can give gas and air, but I can’t actually administer any drugs. I’m just there for support.”
“So there’s only one paramedic?”
“A crew would usually go out as a paramedic and an ECA, occasionally you might get two paramedics, but it’s very rare.”
“You don’t need two?”
“No, often we have paramedics that go out in a car as well, a rapid response vehicle, and they’ll get to the scene first because the cars can get there a lot quicker than ambulances. The paramedic will assess the scene and then the crew can transport the patient. So you quite often have three people on the scene.”
“What’s the most common reason you’re called out?”
“Chest pain.”
“Really?” I say.
“Yep, people often think chest pain is a heart attack. It’s not, you can get a call for chest pain in someone who’s 25 years old. That chest pain is probably indigestion, strain from having a cough over a long period of time, or they’ve got a cold with chest pain and freak out.”
“I think my dad called an ambulance once because he had a migraine…” I say.
“Actually migraines are pretty bad…” she laughs, “some people do need an injection for that… but yeah chest pain and respiratory are the most common.”
“Respiratory like in old people, or like I’m choking on a donut?” I ask.
She laughs again, “I’ve never seen anyone choke on a donut. Yeah I suppose any breathing problems like asthma or emphysema, bronchitis…”
“Do you go out Fridays and Saturdays?”
“Yeah.”
“Do you get loads of drunk people?”
“Fridays and Saturdays you do, yeah definitely. I do a shift from five in the evening till three in the morning and that’s predominantly drink-related calls. But we do have St. John’s Ambulance to help out. On Fridays and Saturdays they have a sort of army, if you like, so that whenever there’s a call comes in and it’s within walking distance of the centre they’ll send a couple of St, John’s out to it, find out what’s going on, and if they need paramedic backup then they’ll request it. A lot of the time it’s just young girls and young lads that have drunk too much and just need to sober up. They’ll put them on the booze bus…”
“The booze bus?” I say.
“Yep, then they can take them down to A&E. I believe they just sit in the waiting room until they sober up.”
“Do you get drugs as well?”
“Yeah, we have a lot of regulars. Drug users who have had problems maybe when they’ve been taking heroin, for instance, and they’ve got abscess’ that are out of control.”
I grimace, “are they hostel dwellers?”
“Yeah, a lot of them live in supported living places.”
“But drug-related calls are not a Friday thing?”
“No, that’s an anytime thing.”
“What’s the worst thing you’ve ever seen?”
“I suppose a hanging is the worst thing. It was when I’d just started out. That’s a horrible thing to see.”
“Was the person dead?”
“No… they’d been cut down by their partner. There were quite nasty injuries to the neck.”
“That’s horrific,” I say, “were they young?”
“40s, 50s…”
I talk about how people jump in front of London Underground train quite frequently and how blasé the delayed train announcements are about it as a result of the frequency. But that they offer drivers counselling, which makes me ask, “Do they offer you counselling?”
“Yeah, when we’ve had a bad job they do a debrief session and offer you counselling as well.”
I change the subject, “do you have a special driving test to drive an ambulance?”
“You have to have a category one license to drive the ambulances. It’s to do with the amount of seats and weight. The A&E vehicle is about 3.5 tons.”
“What makes up the weight?”
“Two cylinders of oxygen, a life-pack for monitoring heartbeats and shocking patients who go into cardiac arrest. Then there are drugs… a scoop to scoop people from the floor to the stretcher, chairs… a special chair for getting people downstairs without having to lift them…”
“Do you want to do it forever?”
“I haven’t made that decision yet. Some days it can be the best job ever, and others it can be quite stressful. It’s a very demanding job and I do worry about my back. There’s a lot of manual work involved and there are so many people in the NHS who have had to retire early because of back problems. It does freak me out, that there could be one day when I lift somebody at the wrong angle or the other person doesn’t lift from the other side properly and all that weight would go on my back and that’d be it. But I’m happy with it for now.”
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