Posted by: medicblog999 | February 7, 2010

The Pressures from above!


Here I am sitting on standby at one of my usual spots..Its 08:50 and I am enjoying the wonders of Twitter and how small this world truly is due to social media.

In fact, as I am writing this I am following the imminent birth of @Broshbands new baby (although I am sure his wife isn’t happy with him Tweeting, lol!)

After tweeting with a few of my mates across the Atlantic, a message pops up informing me that one of my favourite writers ,Ben from Insomniac Medic has put up another couple of posts. So, click! and there I am reading his latest thoughts.

The one which got me thinking and I wanted to comment on is his post called ‘positive’.

In it he describes the pressures that are put on him and his colleagues due to government and local targets to ensure ambulances get to patients within certain time frames. We are all subject to these in the UK, and I agree with him, in that I would love to get rid of them and move to a much more results focused way of assessing and comparing ambulance services performance.

But, that is a long way off, if indeed it will ever come about.

Now, if you have read Insomniac medic before (and if not, then it’s about time you added him to you regular reading list!), you will know that he is one of the positive group of paramedics out there. I don’t think I have read an anti-service post from him before, but that isn’t to say that he doesn’t feel that way. What is obvious from this post, is that he isn’t anti – London Ambulance Service, only that he is feeling the pressure of rushing to jobs, feeling that he has to do a rapid assessment and treatment/transport followed by a rapid turnaround at hospital.

Everything is so rushed, that sometimes, caring for your patient feels as though it is getting pushed to the rear of the priority list.

I can really empathise with that feeling!


I have just started my degree conversion programme, and I had my first day last Friday. During that day, we were asked to consider if Government and national targets are resulting in us feeling pressure and stressed.

Do we feel that getting to the patient in 8 minutes pushes us to take risks to try and get there in time?

Do we feel that we are pressured into quick on scene times and quick turnaround times?

My answer, to the surprise of most people there?

No….Absolutely not!

I never feel pressured due to time limits and the reason for that is as follows:

  • I will never put myself or other road users at risk by ‘driving to the clock’. If I get there in 8mins and 30 seconds, that is because that was the fastest and safest that I could physically cover the distance. Don’t get me wrong, I am not a slow driver by any stretch of the imagination, but I have a family to go home to at the end of my shift. My response is governed by the road conditions and the weather, not by a clock in control.
  • Once I am in my Rapid Response car or on my Ambulance, I forget about all of the politics that go on above my head. My one and only purpose in this job is to care for my patients and provide them with the best possible health care and advice that can be given by a UK paramedic. If I am leaving a patient at home, it may take me 30-45 minutes on scene with the patient for me to assess, document and plan a treatment/referral pathway for them. Yes, I could do it in less time, but my patient is more important than that, and at the end of the care episode, they will know that they have had my full attention throughout, and the ‘nice to do`s’ like making a cuppa for them before you go (in certain cases) can go a long way to improving the image of the Ambulance Service.
  • I never take advantage of long turnaround times. That’s doesn’t mean that I am not happy to have a quick chat or let my mate or other crews have a coffee and a little relax. I tend to go with, if I have a walking patient with a quick handover, then let’s make that a quick turnaround. If you do that with those ones, then there is no harm in taking a few minutes more for other jobs. If I were ever to be queried about my turnaround times, I could prove that my ‘average’ is less than 15 minutes. If we all did this, then the pressures for turnaround times would be non-existent.

Sometimes I feel that the biggest pressure is what we put on ourselves.

I don’t know how other services work, but if I miss a Cat A time that the computer and those in control think should have been easily achievable, I may be asked for the reason why I missed it. I have never had any comeback on that, no matter what the reason, whether that is bad weather, heavy traffic, or even ‘I was sitting on the loo when you passed the job to me’

The one thing that I do agree with Ben about is flying through the streets on blues before we even know what the job is (and even sometimes before even the call taker knows). This is all down to ‘Call Connect, or the clock for the 8 minutes starting as soon as the call is connected to the call taker. I pray that I or any of my colleagues are never involved in an accident whilst travelling on blues, before the point that we are informed that it is a “Cat C for a fall with toe injury”.

I do my job to the best of my ability, and I don’t think I will ever find myself in trouble due to times and targets. If I ever do, then you may well read my first every ranting post!

Until then, I will keep smiling and keep saying ‘No Problem’.

It’s not because I am a ‘management man’ it’s just what I do to keep myself focused on my patients and not on things that I cannot change.



  1. I absolutely, wholeheartedly, 100% agree. Great post.Same goes to Insomniac Medic!

  2. […] @UKMedic999: New blog post: The Pressures from above! ^nice post, buddy […]

  3. And thanks for positive paramedics (and other healthcare bloggers) like yourself! It's a breath of fresh air, and it's inspiring to see how you all make this job work for you. Keep it up!

  4. And thanks for positive paramedics (and other healthcare bloggers) like yourself! It's a breath of fresh air, and it's inspiring to see how you all make this job work for you. Keep it up!

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