St. John Ambulance

My last posts have been variations on a theme. To prove I am capable of more than rambling rants I thought now would be a good time to write something positive. Hence I am going to write about something which gives me great pleasure and I am genuinely proud to be a part of; St. John Ambulance.

I joined SJA a couple of years ago when I moved down to London. This was done for a variety of reasons; firstly, I have been first aid qualified since I was around 14. Initially it was the boy scout badge followed by a programme at school. At University I joined the lifesaving club which combined first aid with water rescue. It seemed an ideal way to combine my enjoyment of swimming with my love of doing something a bit different (yes Baywatch did play a part as the fact that a girl I fancied was joining). I spent five amazing years in the club and got the opportunity to participate in loads of things I never thought I would do from going at full speed in a power boat in Bournemouth to training in the North Sea... in September!

When I moved down to London I did look around for other clubs to join but a large part of me knew my time with lifesaving was at an end. I didn't want to run the risk of constantly comparing whichever club I joined to Uni and after years of doing it, pool swimming was becoming boring. By this time my pool lifeguard qualification was coming to an end. I knew from experience that the water rescue side of lifesaving would be very unlikely to change (whereas the first aid side got updated regularly) and water confidence combined with common sense are the most important factors when conducting a rescue. Therefore I decided to join an organisation solely focused on first aid (a qualification I wanted to maintain if nothing else, to ensure I would be covered by the insurance of my training organisation should I ever be required to deliver treatment). I passionately believe everyone should have at least a basic grasp of first aid since the skills are not hard to learn and ultimately a small intervention can save someone's life. It seems stupid for people not to learn this when they can make such a difference.

I settled on St. John for several reasons. Firstly, I liked the fact that defibrillator training came as standard rather than the exception. Having delivered seminars on treatment of cardiac arrest as part of my degree, I knew what a difference this bit of equipment made. I also liked the fact that it was possible to reach a higher level of skill than I had previously attained. Currently I have done my advanced first aid with supplemental gas therapy. I also liked the fact that they have a fleet of vehicles which are constantly in use. Although I have yet to attain my ambulance qualification, it remains an ambition and when I do, I think it would be extremely satisfying to provide backup to the London Ambulance Service both routinely and in exceptional circumstances. Finally, I wanted the opportunity to use my first aid skills. Up until that point the majority of stuff I had done was give out plasters and ice packs. While I in no way wish suffering, pain and life threatening illnesses on people, I realise that it will inevitably happen and should it do so, I can offer extremely competent intervention that will increase the chances of a positive outcome. Since joining I have had the opportunity to do this. I can still count on the fingers of one hand the number of times I have had to call on my more advanced skills but the fact remains that I have had to do it and risen to the challenge when needed. Most of the time however, I spend the majority of time on duty directing people to the loo/tube (I'm wearing a high-visibility jacket... of course I know!) Ultimately my membership is fuelled by a desire to have the knowledge and training to help those around me in need.

Now that I'm in, I can honestly say that I love it. I have been very lucky with the division I have joined. The demographic in there is as varied as you care to imagine; from pensioners to teenagers and everyone in between. It is headed up by a brilliant woman who made it perfectly clear when I first phoned her that, in her view, the division was there to support members and not the other way round. She does a wonderful job of making stuff happen. Upon joining I was immediately made to feel at home. There was never any hint of being the "new boy", I was just part of the team. This attitude has continued on duty and means that within a fairly short space of time I have progressed from an exclusively treatment role to a more strategic role on larger duties. Although I like interacting with people and delivering treatment (that's why I joined after all), doing this presents a host of new challenges and has been extremely rewarding. In addition to this, the list of cool events I get to go to (for free) is extensive. They range from Notting Hill Carnival to Proms in the Park via the Royal Opera House and London Marathon.

Admittedly it's not all high-profile stuff. I spend more than my fair share of time standing at the corners of football pitches getting cold (and to add insult to injury, I don't even like football). Lots of the duties also involve obscenely early mornings or extremely late nights. Sometimes both. I wont pretend that this aspect is always great fun but this is where the other members come in. Shared adversity creates a bond, whether it is with people one has just met all converging on a treatment centre or established members of one's own division. The time can be used to get to know new people or relive past mishaps and silliness with old friends. Afterwards we can then look back from the warmth of the pub and have a bit of a laugh about it.

People who are not members have asked me if I mind giving up my free time to do this. As a girl in my division said, it's not a huge deal because it's spending time with your mates as well. I couldn't agree more. I count several people in the division as among my closest friends. One of them has gone from being a complete stranger when I joined to my flatmate and one of my best mates. I can't think of anyone in division who I wouldn't happily go for a beer with. Friends have been made outside division as well. They are people I would not normally have met but I am extremely glad I have. I jokingly say that St. John saves me a fortune since going on duty means I spend time with friends without defaulting to the pub/cafe/cinema.

Friendships aside, being out on duty has afforded me to see a lot of things that, in my normal life, I wouldn't get anywhere close to. Some have been sad, some have been funny, some have been scary and some have been heart warming. Tales of these are for another post. I have also had the opportunity to meet some wonderful people; not just other members but patients, their families, members of the professional emergency services and random members of the public.

Taking the rose-tinted glasses off for a moment the organisation is not perfect. Fundamentally it is a volunteering organisation and as such is run largely by volunteers. This combined with it's size means that things can happen infuriatingly slowly. Most of the time this is largely administrative so does not affect our operational ability but it's frustrating none the less. There is also the prevailing attitude in training that because people are prepared to give up their time, they should automatically be allowed to. As a result I have seen one or two people pass assessments where they probably shouldn't. THESE CASES ARE EXTREMELY RARE. The beauty of first aid is that, unless one does something manifestly stupid, it's very hard to make a situation worse. That said, I think the organisation needs to tighten up it's assessments to ensure the highest level of skill in all it's members. If that means extra training for some then so be it. Similarly, others that persistently are unable to achieve the required level of skill should be encouraged into other roles within the organisation. These roles do not prevent being operationally active on duty, they just don't require first aid to be able to do them.

Another problem the organisation has is one of perception both amongst the public and other services. This largely is a result of people being unsure about our precise role and skill level. To clear this up let me give you a rough guide. Most first aiders will spend most of their time giving out plasters. Like it or not, that's the bulk of our work. For serious injuries, we can minimise discomfort. We are trained to stabilise and splint broken limbs but rarely do so as these will usually require hospital treatment (and hence usually ambulance transport). Therefore ambulance crews in attendance will rightly remove our splints and dressings to assess the injury themselves. Most of the duties we do are in urban areas so sod's law dictates that the ambulance will rock up just as we have finished splinting. It's heartbreaking to see one's intricate handiwork fall victim to a pair of tuffcuts so unless we know an ambulance is going to be quite some time, we usually confine ourselves to reassuring the patient, minimizing pain and spontaneous movement and getting a decent history. In emergency situations where life is at threat we are trained to make sure the person doesn't die while more advanced help makes it's way to us.We are not mobile GPs (so if something has been bothering you for the last week, chances are it won't kill you in the taxi to A&E/on your way to your local surgery) and we are not Boots (sorry but despite the fact we look sexy in our clumpy boots and yellow jackets we don't keep condoms on station).

More confusion arises with our ambulance crews. They are trained to a higher level than first aiders in the organisation. The best way to describe it is that they are roughly of the same skill level as London Ambulance Service technicians. This difference is of little consequence to the people we treat but heightened awareness would be useful amongst professional ambulance services not least because, in London at least, we routinely back up the London Ambulance Service. Most Friday and Saturday nights will see St. John vehicles deployed alongside LAS. Our involvement is therefore not limited to providing ambulance cover for our own events and major incidents/national emergencies. While deployed like this, our vehicles and crews are under direct LAS control. However, it seems there can be confusion with the people on the front line. I have read in paramedic blogs that I follow of solo responders requesting an ambulance and being confused when a SJA vehicle turns up. Rightly, they are wary of transferring their patient at this point since they bare sole responsibility for the patient's welfare until they reach hospital. However, hopefully they would be less so if they were more fully aware of what we can offer (including a lift back to your car if your advanced skills are required) and as a result, pressure on LAS would be relieved slightly. (Let's leave aside the political aspect of using volunteers and charity resources to provide backup to a service which should be wholly government funded.)

That said, I have nothing but praise for the LAS personnel I have encountered on duty. They have been uniformly polite, professional and courteous towards us, taking time to listen to our handover while they assess the patient. At times our involvement has ended there however it is not unusual for whoever is attending to allow us to continue to observe while they are assessing and treating all the while explaining what they are doing. Some will even suggest we stay "hands on" delegating parts of the treatment that fall within our skill level. All this is greatly appreciated. Part of our training is knowing our own limits however most members are curious what happens next. In addition, understanding of a subject aids memory so we appreciate you explaining what you're doing. Even if our involvement with the patient ends with the handover we appreciate you treating us with respect and courtesy. Given the nature of volunteering, individual volunteers won't treat all that many patients over the course of any given time period and even fewer serious ones. Therefore when we do encounter something serious we are (understandably) more than a little apprehensive. The professionals taking us seriously and thanking us for our efforts is a welcome confidence boost. That said, if I'm doing CPR, get the bloody ALS kit 'coz my arms are getting tired!

In conclusion; if you are thinking about volunteering I would urge you to consider SJA. If you are considering SJA, I would urge you to join. The opportunities available to you on joining are amazing, not just to do fun things but also to make a difference to people (and I genuinely believe we do even if it is just in the form of reassurance). It doesn't require much of your free time and as I've said, it really won't seem like you are giving anything up at all.

JR