Jul 09

Aftermath

Tag: AmbulanceKal @ 3:52 am

Business over, standing about like the father of the bride at the wedding – we’ve handed over our charge.  We were *it* for an hour, everything that the weeping parents in the room held dear rested in our hands and now we’re extra baggage.  We confirm with the team in resus that there’s nothing further we can do, I apologise to one nurse for snapping at her.
 
We sidestep the parents for now.
 
As we walk back to the ambulance there’s a lot of physical contact, shoulders punched and clapped.  We make a laughing show of wiping our damp palms before shaking hands and nodding – “Good job, thankyou.” 
 
The contact unifies us, reinforces the “us-ness” of the team. 
 
We are three, we dealt with something horrible. 
 
It’s still horrible, there is no euphoric victory, no moment to laugh at a little face on the bed, tousle their hair and chide them, grinning, for making us sweat. 
 
The face on the bed in that room has a mask clamped to it, stabbing fingers holding its airway open, a nurse squeezing air into lungs that count their years in single figures.
 
We are three.
 
We sit, one types, the other two chip in with recalled details, debated discrepancies.  It’s almost a debrief.  The job runs and reruns.  We thank the probationer for hurtling, unquestioning, around the scene in the house as we clipped instructions.  Move this. Pass me that. Wire this up. Park my car.  Give me the phone.  Start driving, soft as morning snow but fast as fuck, please. 
 
She smiles – “I was sweating…”
 
We were all sweating.
 
Somebody cracks a joke, it’s a vital part of the system.  Never at the expense of the patient and often directed at a colleague. 
 
The target retaliates and the situation escalates, the jabs are foul, obscene.  You’re a deviant.  She’s a whore.  So’s your Mum.  Aye, but she said you were shite.
 
It’s puerile and offensive and how we tell each other that everything’s ok – “If we thought you were a wank we’d never take the piss out of you.”
 
Paperwork to resus and a quick run-down from the consultant as to the plan, the prognosis.  He has no answers.
 
Our pulses slowed until we’re sure we won’t say anything stupid, we’re able to talk to the parents, reassure them about the skills of the doctors in the room, wish them all the best, try to meet their eyes.
 
Back in the ambulance the crew run me back to my car while I phone Control and update them – “All three of us need a stress break, we’ve worked our arses off.”

They drop me at my RRU, patiently hunkered outside the house. We thank each other a final time, awkward, everyone appreciating the unspoken sentiment. It’s not quite “dodged a bullet”, more that it clipped us and we limped back to safety. 
 
I turn up the tunes on the stereo and sing along,  loud and fierce, my arms tingling and twitching.  There’s no need to sit somewhere and weep, there is nothing to weep for and it would do no good anyway.  This isn’t grief, it’s potential energy.  Unleashed it would manifest as a scream, a shout.
 
If a punter took a swing at me, I think I’d go through them.
 
Stress breaks aren’t there to make you feel better, that takes a lot longer than half an hour in the mess room; they’re there to straighten your head out and ensure the remnants of the last job don’t spill into the next.
 
Your next patient needs you sharp and clear, switched on, not chewing on the details of what-might-have-been.
 
That’s what the break is for, the cup of tea, the filthy humour.
 
It’s how you keep doing what you do, and how you make sure you’re ready to do it all over again once the 30 minutes is up.

11 Responses to “Aftermath”

  1. Metamor4sis says:

    So, so well put… Kal, you must make sure us regular readers have first go at your book.

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  2. Bulk says:

    oh so true Kal!…..black humor and a cuppa is the Ambulance man’s secret weapon.

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  3. Win-Stone says:

    Ah! Jokes so sick and rude that they’d make Chubby Brown blanch, and a cuppa with so much sugar you can virtually stand the spoon up. The universal specific for all!

    Oh, and did you hear the one about ………. :-)

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  4. Sewmouse says:

    Only 30 minutes to put your head on straight? (Resists chance to make “never was on” joke) Is that long enough for all the adrenaline to seep back into wherever it is adrenaline goes when it is done scaring the woohoojus out of you?

    The only time I’ve been even a baby-toe-length into that feeling it took me an hour and 2 hot-fudge sundaes to trust myself to drive home!

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  5. karen says:

    That must be the worst thing about the RRV. You dont have the rest of the shift to talk through, to analyse, to discuss what could have or should have been different. I would end up thinking of everything I did wrong (or thought I had) how I should have done this that way or that this way. A crew mate helps to balance that analysis and makeit less soul destroying.

    I hope the child is ok.

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  6. Jot says:

    Another fine write-up, Kal.
    half hour? to me, not long enough but we’re lucky if we get it. Usually get it under the guise of vehicle cleaning but that’s an hour away from the drop-off hospital as we’re a long way from the DGH.
    Are we not automatoms?… some think we are.
    Keep up the good work :)

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  7. PIZZAMAN. says:

    GREAT STUFF KAL,GLAD YOU’RE ON MY SIDE CAN’T WAIT TILL YOUR NEXT EPISODE KEEP SMILING.

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  8. Utility says:

    Hey Kal,
    bad times, hope the kid is alright, and you and your mates as well, 1/2 hour is not long enough… well done Kal, its not a job I could do.

    I’ve sent you an e-mail on a similar subject, was wondering if you could have a look at it?

    cheers

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  9. Anon says:

    Two of the hardest things about being a first aider are not having a team or a colleague to debrief/de-stress with, and being expected to resume normal functioning as soon as the situation is dealt with.

    I used to work in a deadline-driven, high-pressured work environment with no allowances made for “distractions” from the work process. Never mind that you’ve just had a near-miss with an older colleague who’d succumbed to a combination of shift work, high stress, poor diet, too much caffeine and chain smoking. He’s in the hands of the experts, get back to work—now!

    Never mind that you’ve arrived at work with the shakes because you’ve been up to your elbows, literally, in gore at a horrific crash. Wash your hands, change your shirt to your spare one and get stuck in to the work—now!

    Never mind that you’ve just flown in the door from your lunch break because someone collapsed outside the cafe where you were eating and, to your amazement, your efforts brought them back from the dead just as the ambulance pulled up. You’re late back, so get back to work—now!

    Of course, it’s different if you dealt with an incident that wasn’t at work, on your way to work, or during a break from work. Then, you do what you can, hand over to the experts and retreat to your home where you pace up and down while you debrief yourself. If you try talking to friends, they think you’re weird, too graphic, or seeking hero worship. So, it’s just you, four walls and a lot of muttering, swearing or silence. Either that, or you switch on the TV—and swear at it for the next 40 minutes because some stupid hospital series happens to be on.

    However, things have improved in the past couple of years. I’ve mainly given first aid at incidents close to home, well, on the road right outside my house or just down from it, and that means I’ve been able to debrief with the Other Half. It does make a difference having someone there when you need them—and who knows when to disappear because you need space, loud music and mental white noise.

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  10. RapidResponseDoc says:

    I read this and grimaced; I have just come back from a drowned 2 year old, and it’s all so true, what you say. Keep it up, for all of us.

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  11. Trauma Queen » To speak of it says:

    […] the back of my recent post about stress responses, I found myself the only HCP amongst a host of volunteer first aiders recently. As a team we’d […]

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