Sunday, September 21, 2008

Change

There will always be change in one form or another.

I've changed from being an EMT to being a Paramedic, which means a change in crewmate, and a change in rota - twice in a month, but that is only to be expected when you start working in a new role.

Our ambulances are in the process of change - we're finally starting to see the back of the old LDVs, and the service are buying more Mercedes ambulances.

The Orcon start time has been changed from the time the address and chief complaint were established to being from the moment the call is answered in our control room.

Our standby arrangements have faced change to try and shave a few seconds off us going mobile to a call. This is now known as Active Area Cover, Tom Reynolds has already posted about this. It has been and remains a rather controversial change.

Staff morale has changed from being really quite good when I joined the service to being lower than any other job I've done.

Another change that is contributing to this drop in morale is the pressure being placed on our EOC colleagues and crews by management. It seems to me that we're apparently not allowed to take our time and actually care for our patients anymore. A couple of weeks ago we were attending to a poor lady who'd been visited by her GP who'd arranged for her to be admitted into hospital for being "off her legs". According to the family, the GP had been rather abrupt with her to say the least and it had left her quite upset, so we were taking our time, ensuring that we explained everything we were doing, putting her at ease, whilst making sure she received all the treatment she needed. Because this took just over an hour, we got a message on our MDT asking us what the delay was. I told them the delay was I was treating my patient.

This just seemed to confirm to me that targets are the be all and end all for management now, and that patient care is now second. Of course they'll deny it til they're blue in the face, but it is clear to roadstaff.

I know that Beaker is planning a post about the extra pressure being placed on our control staff by management to hassle crews, with the threat of disciplinary action if they don't. I'll let her explain when she has the time to write the post.

The LAS is not a happy place to work at the moment.

*Update: Beaker's split her post into two parts. Part one here and part two here

6 Comments:

Blogger AJ said...

This does seem to be yet another example of arbitrary targets being given more importance than actually doing the job. I think this is a problem that effects all public services these days, not just the ambulence service. I think the problem is this governments love of easy to measure and monitor statistics. Response time, number of jobs attended an hour or whatever are all things that are very easy to measure and type into excel spreadsheets. Quality of care is of far more importance to the people using the servie but unfortunately that is not so easy to measure so is largely ignored.

10:32 am  
Anonymous Anonymous said...

Its a shame that we have to worry about numbers instead of patient care.

I work in a control room and I hate having to keep up chasing crews out of hospitals when I have hundreds of other things but if we dont we wouldnt hear the end of it.

Bring back patient care

11:07 am  
Anonymous Anonymous said...

I work for a service that "inherited" two ex-Kent Ambulance Service managers... and Blind Freddy can see that we'll soon be a version of the KAS/LAS - though they're calling it "Dynamic Deployment" over here. Luckily our union is strong and it's not roadside... yet.
All the UK blogs I read make me wonder if I've really made the right career choice - if I didn't love the job so much I'd probably be looking elsewhere.

11:48 am  
OpenID thegreenghost said...

I the service I work for it's only the cars they're sending to sit for hours. Fortunately for me, I work on an ambulance, so it doesn't affect me - most of the time. However, when there are cars sitting on station unmanned, they've started splitting crews as response time is more important than time to definitive care (the government don't measure that, apparently).

Still, with the lack of calls cars get sent to most of the time, you do get some reading/watching DVD's/etc done. The reason cars aren't being sent? Then there wouldn't be anyone to cover the hotspot!

There was a similar discussion on the radio the other day (I ran out of book) about the fact that our kids can't use maths anymore. They're taught how to pass exams - because the number of A-C's at GCSE can be easily measured. The number of people who can compare the prices of different products in the supermarket so they pay the least for their groceries is harder to measure, I guess.

Ghostie

2:57 pm  
Blogger Beaker said...

I've now posted about AAC and Delays - it's not a happy post!!

4:39 pm  
Anonymous Anonymous said...

I think area cover is a good idea in theory but the implementation is just hacking everybody off. 3 crews on stion? Fine spread them out to cover other areas. Couldn't agree more. last crew on station? don't send em out for the hell of it, it achieves nothing as you don't know if your moving them further from the next job and it just winds them up.

11:30 am  

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