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Are ambulances exempt from normal road rules?

Working Conditions For Paramedics

John Donaghy (Paramedic) gives expert video advice on: Are ambulances exempt from normal road rules?; How much does a paramedic earn?; What hours do you work? and more...

Are ambulances exempt from normal road rules?

They are exempt, but there's limited rules that they are exempt from. There's not that many, and people do think we're exempt from every rule. In fact, there's very few that we are exempt from, but we are exempt from several. We're not so much exempt from red lights, and often people see ambulances and police going through red lights. All that we can exempt that for is treating a red light as a 'give way'. We are to stop, give way, and if clear we can then proceed, but it doesn't give us the right of way to just go through a junction at high speed. The other exemptions are normally just small exemptions such as parking on yellow lines. We do still have to abide by most of the rules and regulations. We're also exempt from the speed limit, but only within reason.

How much does a paramedic earn?

Pay scale is around, and it varies with service, but I think a new paramedic coming out now is probably on something like, twenty-three thousand starting pay and upwards. I believe that's the pay, I'm not absolutely sure. It does vary, obviously London rates . . . in London, waiting allowance is different from other trusts at least I think it's around that margin.

What hours do you work?

The shift varies. There are some eight hour shift, usually, it will be eight hours. Now there's lots of twelve hours, so there is a variation. Predominately they are twelve hour shifts. But we are in the router system, and every station has a different router that meets the command of the local area. There may be some eight hour shifts. There may be some ten hour shifts. But there will definitely be twelve hour shifts. There are normally twelve hour shifts. Seven in the morning until nineteen hundred. And then nineteen hundred to seven. That is the night shift. You would be doing what would equate to three days in a week. But after saying that, it might be that you would do four or five days one week. And then the following week you are completely off for the week. So what normally happens, providing it meets the demands of the service in the area, the road system negotiations it between management and state side. So there is a fairly happy sort of arrangement.

What holidays do you get?

It depends on the length of service. It's done by the hour, so it could be 200 hours a year, or 120 hours a year. It's normally about a month off.

How dangerous is being a paramedic?

It is more dangerous now, I'd say, than what it was. The violence and aggression has become more intense, and we have had some pretty serious assaults on staff. Fortunately, the service has identified this and we have addressed a lot of the issues. We do have training now in breakaway techniques and calming situations down. We have personal mobile phones, emergency call systems, so we can get out, radio systems, so we can get out to people pretty quickly if we need help. In London, we've all got our own stab vests, they issue stab vests. So I think, in time, as time's gone on, there's no question, and I don't know what the answer of why this is happening but violence has increased and aggression against ambulance crews has increased.

How do you prepare for arriving at a dangerous situation?

The situations that we often find ourselves in often are drink related. The patient's often had too much to drink. There is an aggressive sort of atmosphere when we arrive. It may be a pub. It may be a party. So most of us, when we arrive on the scene, we're always being updated all the time. It may be that there's such information coming through to us en route to the call that the police would be sent automatically anyway. So we liaise with the police, just because our 999 call takers are getting abuse from the caller. So there's a picture being painted already to what we may be going in to. So what will happen is the police will be dispatched at the same time, and we'd meet en route. But we could arrive on scene, and it's just, people are often distressed because something has happened. And we appreciate that, and we're here to help them. And that's not so easy when maybe there's drugs involved, or there's drink, or just high emotions, or language problems and all the issues that happen in society. So we have to try and just calm the situation down first and foremost. Most people are pretty reasonable. They know we're there to help, and then we can get on. But there are some people that just will not accept that. It seems like they'd waited a long while for the ambulance. Often that's a perception. They haven't. We've been very quick. Time drags when you're waiting and someone's injured. So that sort of aggression that we can get, and that's sometimes difficult to manage. Sometimes it's fairly easy. Equally, we often deal with people falling in building sites, road traffic accidents where there are motorways involved. They're dangerous situations, but there's a risk assessment being done constantly, so there is a dynamic risk assessments being done by us from the minute we're en route. So as we're driving to the call, we can see the type of incident. We're approaching. We already know when we pull up where we want to park. We want to park to protect the scene or the accident. Often, we've got our high visibility jackets. We've got hardhats. We've got protective footwear on. So we're fairly in control of the situation. Equally so on building sites. Most building sites, we work with the site manager. So if somebody's fallen, it's dangerous where they've fallen. Often we need assistance of the fire rescue service. So they would come out. And we would travel with them and go down. Again, risk assessments would be done on us to make sure we've got the right PPE, person protective equipment, and secondly, that it's safe for us to proceed. So, in some ways, there is more to manage, because they're a controlled environment. Helping out somebody that we just don't know and they become aggressive, often they're dynamic and they're changing all the time, and they're sometimes very, very difficult to manage.

What precautions do you take as you enter a dangerous situation?

Every paramedic would know the way out, because when you're walking into the house or flat or premises you do know where you've come from to get out again. You get into people's houses, and some areas that we cover are quite open to violence and to crime, from the minute we walk in. Some people just lock the front door, so they've unlocked it to let us in and they shut the door and lock it again. If that happens, we would probably ask them to unlock it. We wouldn't want to be locked in the house before we go any further. We'd have some time to unlock the gate to the flat, so we know we could get out again, and then we'd proceed with caution. We're normally fairly streetwise people, especially in London where we've been doing it for a few years. If somebody's maybe had too much to drink and they are maybe staggering or collapsed on the floor in the kitchen, if there's things falling on the floor or off around them, such as if there's knives and things around them, we'd move them. We'd be very much aware of them and we'd be moving them out of the way before we start trying to wake the patient up or making contact because we know it may be that they're diabetic and they just won't have control at that point in time. We don't want things like knives in reach and things like that. We're fairly streetwise and we do know when we go in what we may come up against, and we know our exit out. We have also got good communications to get help.

What age do paramedics retire?

Age 65. You can retire early. I think from about age 55, you've probably got the option of maybe retiring. But predominantly its 65. Retirement age is 65 at the moment.

How often do you get called out to an emergency?

Often. I'll give you an example of last Friday about a week or so ago at night shift on a response call in Eastland in the area that I serve as a paramedic. That's a 12 hour night shift start at 1900 to 7 in the morning. My shift started at 1900 I was probably out of the station by about 1905 and then 13 calls later my shift ended. So I did about 13 calls during that time that's just one night. So that's a busy station in London.

What's the busiest day of the week?

The statistics show, strangely enough, that it's a Monday. Monday day, I don't why that should be. I think that's one of the statistics. Not really certain on that. I think it is. However, saying that obviously, Friday nights and Saturday nights are busy. People do go out and… out on the town… Friday night, Saturday night. I think Friday night and Saturday nights are busy. But I think generally in the service, there seems to be, basically Monday seems to be a busy day.

Are there busier times of the year?

There definitely used to be. We used to have, with Christmas time it'd be busy, and winter where we used to get the very cold weather. A lot of the elderly and frail people would suffer more so, a lot of social depravation, poor housing, poor heating, so a lot of our calls would be target to that. I think now, I wouldn't like to say there is a busier time. We have winter pressures, where the service comes under pressure, we have a plan, a strategic plan to deal with that. Equally now, we have a summer pressure because of the heat that we seem to be experiencing in London. So outside now all year round, I believe New Year's Eve is our busiest night ever for the call rate. Generally we average maybe 4,000 actual calls a day coming into the London Ambulance Service control room. I think New Year's Eve would be sort of, you know, up in the 5,000s.