service like a business.
I know that some people believe that the free market will constantly provide superior service to anything run by the government. Unfortunately healthcare isn’t a ‘market’ and this market view of the NHS leads towards some very silly initiatives. It’s why ‘failing’ hospitals get less money than ‘successful’ hospitals. Who would want to throw money into a failing business?
Why are hospitals so dirty? It’s because of the free-market contracting of cleaning to the cheapest supplier—regardless of the quality.
It’s also why, despite increasing numbers of patients, more calls, very few new staff and all the other reasons why we may not meet our government ORCON target this year, we’ll get less money to be spent on improving our service.
But what do I know—I’m a van driver not an economist.
The thing about wearing a uniform—it really changes your behaviour.
I’m guessing that a lot of you are aware of the Milgram experiment, where members of the public more willingly follow instructions if the giver is wearing a uniform or other symbol of authority. (Go to the internet for a more complete explanation. If you’ve never heard of this experiment, it and the Stanford prison experiment make scary reading.)
So when I am wearing my uniform I am more confident and can order people around. The police, firefighters and members of the public tend to do what I tell them if there is someone sick around. Obviously I only use these powers for the force of good, but without my uniform I am a much shyer person.
I noticed this when I went to a recent gathering of internet people. When I arrived I knew one person there, and once I’d stopped talking to her I became an instant wallflower.
But there is a flip side to wearing an ambulance uniform, you also become more passive.
Out of uniform, if I was in the street and some drunk tried to hit me—I’d punch them on the nose. If I was verbally abused—I’d soon be in their face shouting and ranting along with the best of them.
Yes, I know three paragraphs before I said I was a wallflower, but this is in a social situation. When my temper is roused it is a terrible thing to behold.
But in uniform I’ll gently restrain the drunk trying to hit me and I’ll ignore any verbal abuse that is thrown at me. Unfortunately the anger that I feel is then turned inward, which I am guessing is not a healthy thing to do.
I wonder if it is the uniform, or the risk of having a complaint put in about me, that turns me into such a wimp. It might just be that I spend so much time trying to keep patients calm, that I’m feeling very mellow when people abuse me.
I was racially abused on Friday night, and it meant I spent the rest of my shift gritting my teeth and wanting to punch someone.
We were sent to a ‘standard’ abdominal pain with vomiting. The patient, a black woman, had vomited ten times that day and had lower abdominal pain. As always I treated the patient with respect and compassion (as that is my ‘default setting’). All her observations were within the normal limits. Talking to the patient was a bit tricky as she insisted on having me ask every question at least twice before answering.
So we took her to hospital, where I handed over the patient to the triage nurse. She was happy to have another nurse perform a further assessment (for example, an analysis of the patient’s urine). Unfortunately the place for this assessment was physically full, so we were asked to take the patient into the waiting room until some space could be made. My crewmate did this, while I booked the patient in with the reception staff.
My crewmate told me that when the patient saw she was going to be put in the waiting room, she let out a loud ‘Tut!’
My crewmate then joined me in the reception area which overlooks the waiting room.
The patient then threw herself on the floor and pretended to be unconscious (trust me, when you’ve seen people really pass out in a chair, you can tell when they are faking it).
The waiting room erupted with two people jumping to her aid. The security guards went to get a nurse. Then a lot of the people in the room started shouting at us to come and help. Never mind the half-inch-thick glass between us and them.
We told them that a nurse was on the way.
‘Look at her! Look what’s happened to her!’ shouted one man.
‘Yes mate,’ replied my colleague, ‘there’s nothing wrong with her—all she’s trying to do is get seen before you.’
The patient was loaded onto a trolley and taken into the main area of the A&E.
The crowd in the waiting room then started moaning at us.
Then both my crewmate and I heard the comment that would have us angry for the rest of the shift.
‘You wouldn’t treat her like that if she were white.’
My crewmate stormed out of the department—he was, quite rightly, fuming.
All I could do was laugh loudly at the black teenager who had said this. ‘Well, if you are that stupid, you’ve just opted out of talking to me,’ I said to her.
I left the hospital.
Here is the thing that made my crewmate and me so angry. We like our job—we both like helping people and we’ll help anyone, we don’t care what colour their skin is, which religion they believe in, or if they can speak English or not. I don’t even care if they are an illegal immigrant. We sure as hell don’t do this work for the pay. My crewmate is a trained plumber so he could be earning much more money installing radiators.
We don’t need to work in this area—I could put in for a transfer to a more ‘white’ area tomorrow. But I enjoy working in east London—it’s a challenge—and I enjoy working with all the different cultures that make up our ‘demographic’. For me, a predominantly white area would be incredibly boring.
But that comment: ‘You wouldn’t treat her like that if she were white.’ It made me despair as to how we are seen by the non-white population. Are we all seen as being racist? Does the assumption that I would treat a patient better if they were white sit in the minds of the people I treat? Is this why I get so few thank yous? When I walk into a household, do the people there think ‘I won’t get good treatment from these two, they are both white’?
I wish I’d gone around to the person who had made the comment and challenged her. I wish I’d gone into the waiting room and explained exactly what had happened. But as I’ve mentioned earlier, the uniform that I wear makes me more passive than I would normally be. So I turned the other cheek and walked away.
I’m still fuming.
Imagine that you are 23 years old.
You are also a ‘brittle’ asthmatic. This means that you can have asthma attacks that can rapidly progress to life-threatening status. You have been intubated in ITU a couple of times—this is a last ditch treatment to keep you alive.
So why, whenever you get taken to hospital, would you treat your disease as a mere annoyance?
Also, why would you smoke 20-40 cigarettes a day, knowing that it will make your asthma worse?
And why would you self-discharge yourself from the resuscitation room against medical advice