This is an edited version of an account from a paramedic working for the London Ambulance Service. It was first published by Class War
Having worked in the NHS on the frontline as a medic for nearly 20 years, I’ve been exposed to all sorts of pressures, but nothing quite like the one we’re experiencing now.
In normal circumstances we barely tread water with low morale, underfunding, poor staffing levels and high workloads, so when the covid-19 virus hit, needless to say, we were unprepared.
More than 80 per cent of staff working in the London Ambulance Service NHS Trust have less than two years’ experience. They are very young, very inexperienced, fresh from university, quite often having just left home. A culture of bullying from management, mixed with harsh working environments and poor staff welfare means the working life of a paramedic is about five years, quite often leaving a broken young person with mental health disorders and £30,000 of student debt.
Paramedics have never had any sort of financial support to qualify to do a job that, at the start, pays less than a bus driver.
In London, we have more than one-third of our frontline workers off sick, with coronavirus testing kits only being distributed this week, leaving staff at home worried about health, potentially spreading infections to the people they live with, or wanting to come to work and support their community, but unsure of their covid-19 status.
But our trust isn’t about just about frontline paramedics. The call-takers and dispatchers don’t have the luxury of keeping two metres apart, having to work in close proximity with colleagues who are sick, with management asking retired staff to come back to work.
We rely on a huge amount of non-patient-facing staff to make the ambulance service work. During the norovirus outbreak, staff were sitting at their desks, vomiting into buckets while they worked, frightened to go off sick.
And we have no mechanics to service and repair our vehicles, meaning that we have to call out the AA when the ambulances break down.
When we were first exposed to covid-19, our vehicles were taken for a deep clean after each patient who may have caught the virus, we were wearing masks and gowns – PPE, personal protective equipment – that had to be tested to fit correctly.
But that’s all changed: no more deep-cleaning, a wipe down between patients is enough now.
I failed my mask testing, as we only had large mask sizes left, so technically I can’t go to confirmed cases of covid-19. But as the patient testing is done in hospital, you can see where this leaves me.
We wear surgical masks, one-size-fits-all, and an apron that blows up into your face. This is equipment that previously was only deemed fit for cleaning the vehicles. We joke that people making sandwiches get better protection.
We should be tested for masks every three years and carry them as part of our PPE kit. I’ve never been tested.
The call volume now is so high that our rest breaks have been suspended, meaning we don’t always eat, leaving us more physically vulnerable to the virus. Most shifts are 12 hours plus.
The advanced PPE – including a white boiler suit, FFP3 mask, and goggles – is reserved only for confirmed cases of coronavirus. Paramedics are working in situations where we have to perform invasive procedures such as full CPR. Chest compressions – during which breath is forced from a patient’s body – are not considered invasive enough to warrant advanced PPE is the guidance from our management. And remember, we’re in a pandemic with no testing for the virus in the community, so we are sent out to treat patients who are rarely, if ever, confirmed cases of coronavirus.
WHO, the World Health Organization, says paramedics should wear a full gown, which covers their arms and below their knees, when helping patients who might have the virus into an ambulance and taking them to hospital.
We are so vulnerable, with one London paramedic recently put on a ventilator and others critically ill. The majority of patients we treat are coughing and have all the symptoms of covid-19 but are not “confirmed cases”, as they haven’t been tested, so they are not counted on the government figures.
And now we are walking in on patients who have self-isolated and have been dead for days. These patients are wrapped up in plastic, with a bag over their head and sealed up ready for the undertaker to collect. Horrendous for relative to see.
We are also seeing an increase in suicide in the community, the fear and isolation exacerbating existing conditions.
The unions are moderate and have signed us off to work in these conditions.
I just don’t know what to say about that. I feel they haven’t fought for staff at all.
Nearly everyone I see has covid symptoms, and we wonder what the hell is happening to all our other patients: the elderly who have had a fall, the strokes and the heart attacks, the sick children. Some patients are waiting for hours for treatment at home, with ambulances taking up to 16 hours to arrive.
Children’s A&E departments are quite often empty, with the parents of young patients too frightened to go. Other A&E departments have either critically ill patients waiting for a bed on a ward, or are strangely not busy, with people staying away. The patients we do take have to travel alone unless they are children or vulnerable and that the person is a carer. Patients are dying in hospital without their family nearby. When I’m taking vulnerable patients in and the family is waving them off, I feel that’s probably the last time they will see them.
I don’t think the community is completely aware of how bad this virus is, with the parks full on a sunny weekend. We must self-isolate, that is evidenced-based and not just because the government says so.
But you can’t blame people for going out. The majority of my patients are the poorest people, the most disadvantaged, it’s not uncommon to see a family in temporary housing confined to one room, a single mother and several young children in bunk beds. They won’t have the luxury of other rooms or a garden.
The support from the public is overwhelming, we are really proud to support our communities, but it does all get a bit much. Big companies like Costa have delivered drinks to the ambulance stations, people have brought food, too. It’s all very nice, but we are doing the job we are trained to do, it’s a vocational role and you wouldn’t do it because you “fancy” doing it.
We are all working overtime to cover unmanned shifts. Ironically, we are all earning a half-decent living at the moment when others are not. But most of us would rather these gifts of food and drinks went to the homeless, who are not getting support from passersby.
The first episode of clapping the NHS on a Thursday night coincided with me having to tell a family that our resuscitation attempt on their relative was futile. It was a very uncomfortable situation.
I also wondered how many of the clappers had voted for this government that not so long ago had cheered when they blocked a pay rise for NHS staff. We continue to get a 1per cent per year pay rise, when on April 1 the latest parliamentary pay deal will mean that MPs’ salaries will have risen by 17.7per cent since 2010 – almost exactly in line with the 18per cent increase in the cost of living.
I’m a nonjudgmental person. I have to be. I treat people with kindness and compassion, no matter what they have done.
I see the bigger picture, but when the Prime Minister went to an NHS hospital to be treated, I nearly blew a gasket. The man whose party has waged a vicious war with junior doctors, whose Brexit nonsense has meant nurses have practically stopped coming from Europe to work in the NHS (recruitment has dropped from around 2,000 a month to less than 40), and whose ideology is to underfund the NHS and strip it of its assets.
That Brexit bus lie, promising £350million weekly to the NHS. The same Boris Johson who said in September 2019 that patients should pay for NHS treatment, to stop them abusing it. But when it comes to an emergency, he needs to rely on the NHS as there is nowhere else to go.
Private health care does not provide emergency care. There’s rarely any A&Es in private hospitals, and very few intensive care beds. And when they do have medical emergencies in their Harley Street hospitals, they call for NHS paramedics to sort it out.
I really was so angry. I thought Johnson should have been booted out and taken his chances in the private sector. No doubt he has been sitting in bed at St Thomas’, grinning like an idiot, and being charming to the staff that he and his class have systematically abused.
Working in the community, I’ve seen mutual aid replace charity, friendships in communities growing, supporting each other and proving authority redundant we have all seen that happen and no doubt because you are reading this, that’s what you are doing.
Our hearts go out to our working-class colleagues who are keeping everything afloat: the bus drivers and transport staff, the shopworkers, the binmen… the unsung heroes who get no PPE and who are getting covid-19 and in some cases not surviving.
They are the backbone of our society. I hope at the end of this, their positions will be more appreciated and re-evaluated.
- What a Croydon healthcare worker told Inside Croydon earlier this week:
‘We’re scared. But we’re here for you. Help us – stay indoors’
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Thanks for posting this. Amongst all the speculation and conspiracy theories, the variant opinions of the scientists, the daily propaganda briefings, testimony from the reality of the front line is very welcome.