Thursday, 17 May 2012


I can't believe I can say this after only a few years in the ambulance service - but - I remember when... 

I remember when the calls were manually dispatched, each call either rolling off a printer followed by a phone call to confirm which crew was going, or given out over the radio requiring details to be taken with pen and paper. 

I remember when the only radios we had were vehicle based, no personal radios at all.

I remember when vehicles weren't tracked, the all-seeing eye up in control flying blind as a bat and relying on the good will and honesty of the crews. 

I remember when you could guarantee that Wednesdays would be the quietest day of the week. To this day I have no idea why. 

I remember when pushing the accelerator pedal on the old ambulances used to make a hell of a lot of noise, but the speed remained exactly the same. 

I remember when the GPS, or sat-nav, or Doris, or whatever else you want to call your guidance system was nothing but a hardcover book called the London A-Z. 

Ten years later, calls are dispatched to a computer screen, each member of a crew has a personal radio on shift and every vehicle is followed to within an inch of the crew's life. 

There's no such thing as a quietest day any more. 

Pushing the noise pedal still makes noise, but there's a little bit of improvement in the speed, and now, the GPS is a GPS. 

Having started when no such thing existed, on ambulances at least, it meant that learning the streets, or at least the general area, was a necessity. Around where I worked it was fairly simple, almost grid like. An area surrounded by four main roads, with another two criss-crossing the centre. However, as the times changed and technology controlled the ambulances more than the humans did, we started to be dispatched further and further afield. In an area the size of London, with it's thousands of miles of streets, hundreds of train, tube and bus stations and almost ten million residents, local knowledge had to spread a little. Eventually, the sat-nav came in and made that job a little easier, but local knowledge was still local knowledge.

Today, however, the newer generation of EMS staff in London rely on Doris from the start. It means that as soon as a call is dispatched, rather than heading in the right direction, there's a need to wait for the technology to kick in, pick a route and suggest turning either right or left out of the station. The skill of map-reading seems almost lost forever. 

Maybe it's because I learnt to read a map early on. Maybe it's because I don't trust technology. Maybe it's because I'm just awkward like that - but if I'm going to rely on the GPS, I'll check the map first, just to give me an idea. Having that vague idea without having to open a map book is all the better. Doris has a habit of not being up to date with new roads, or changes to one-way streets, or even trying to send you to the wrong Station Road. Do you have any idea how many Station Roads there are in London? Me neither, and not for lack of trying. 

My advice, particularly to the new people? Stop relying on Doris. She has her faults. I dare not say anything about asking for directions from a woman at this point. One of these days Doris will fail - either the screen won't work, the roads she's sending you down have been closed, or she's just having one of those days where she seems to be three streets across from where you know you are, and you most certainly know that you aren't driving through that reservoir or along those railway tracks. 

Learn your area - learn the important points - the places that give you your navigating markers, your wayfarers stars. Learn that from your favourite coffee shop to your favourite take away is a rat-run of streets where you'll do fifty percent of your calls. Travel and take notes, be they written notes or mental ones. If you get some down time as you leave the hospital, go for a tour of the area. 

And for the sake of all that is holy, learn to read a map. 


Anonymous said...

Excellent reading, I too remember the above mentioned and laughed at Wednesdays and the loudness of the vehicle increasing but gettin passed by cars you had already passed before the hill . I also think with new recruits that don't get road experience before starting the job they tend to be speaking out of a phrase book instead of relaxing showing compassion and using common sense in treating the patient therefore putting the patient at ease and more trusting in your judgement . Great post ..

Aaron said...

We had a 'map book' in our county. It was compiled by the engineers that worked on the streets, roads, and highways. It listed every road along with where and what it "T'd" in to.

If you were dispatched to SomeStreet, you'd go look it up and see that is intersected SomeOtherStreet at milepost 1.4. If you didn't know where SomeOtherStreet was, you'd look it up and find that maybe it interesected with the main highway that ran through the county.

It was a ridiculously good system that required you to only know a few of the main roads.

...but newbies would constantly flip to the back of the book where the rough hand-drawn sketches of the main roads were and would attempt to find the dispatched address that way. No matter how many times I would remind them the hand-drawn maps only contained about 20% of the roads, they would insist on looking there first...and always draw a blank.

Now-a-days they just pull out their GPS, but I always smile when suddenly their data service is out and they have no clue how to get to the call. Thank God I had memorized most of the roads.


michael said...

Ever the tech-phobe, I was put in my place last night, as I sat around the table with the guys from Engin7 7 and Ladder 4. A still box came in (report of a house fire)in the other side of Providence and within seconds one of the guys had his I-Pad out, had the address on the screen, Google earth showed the way in, the exposures, everything they needed to know before the second alarm was hit. They had things figured out before they left the station.

I have to get on board, I think. Great to read one of your posts, as always.

bobball said...

We made the leap not all that many years ago. I gotta agree with you completely.

GPS is a tool...fancier than a map-book, but a tool all the same. When we had only map-books (we still carry them as a back-up), sometimes a page would be missing (popular areas, the pages would wear out).

Map, GPS, what-have-you...learning the area is important. In a command role, I'm often by myself, so I don't have a "navigator" riding shotgun. I use GPS a lot to get to the end of my planned destination...especially out in the suburbs where new streets come up with little warning. But I can get to any general area of the county simply by using the basic main routes that have been ingrained in my head over nearly 30 years.

Good one Insomniac.

Anonymous said...

What a great post, you can't beat the old "if it ain't broke - don't fix it"
Technology is brilliant when it's working!
Best wishes

The Girl said...

There was a feature on map reading on Radio 4 yesterday. My (rare) day off spent fixing my car...
They were with the staff at Plas Y Brenin who teach people how to read maps for walking.
the mountain rescue staff told the tale of a couple who wandered off the (well) beaten track in a local forest by about 20 feet then realising they were 'lost' hit three nines on their mobile phone. 'luckily' for the mountain rescue one of their members was local to the call and walked up to the forest, stepped off the path, found the couple and 'lead them to safety'. The Mountain rescue guy said that if they'd had a map and been able to use it they wouldn't have had to WASTE A VALUABLE RESOURCE for something as trivial as OMG I can't see the path and I'm 'lost'.
It was, IMHO, the equivalent of calling 999 for an ambulance to fix your ingrowing toenail...Grrrr.

theSmurse said...

Map books? No personal radios? MDT? Whats that??

Sound just like Irish EMS

Anonymous said...

We have a Satnav on our vehicle, but I still look up our destination in a map book.
Satnavs don't really tell you how narrow the road is, or that there's a better way in, or (in one case) that the road ends (I mean just STOPS) at the river, and you'd be better to reverse into the road rather than driving in forwards...

Uwe said...

I enjoy reading your posts.

I volunteer for the State service, Metro, in South Africa and our vehicles seldom come equipped with GPS. We must use our own if we have one when we come on shift.

We also still use pen and paper when we are dispatched to calls, and I would not survive without our map book!

I get very jealous watching paramedics in the UK and US working in modern ambulances. It must make life a LITTLE easier with technology?
Thanks for a great post!

Anonymous said...

Doris has another name on our truck - Pythagorus. It only has a theory about your destination. Great blog, keep it up.

Anonymous said...

As one of the new(er) generation of EMS in London I heartily agree, local knowledge makes a hell of a lot of difference. On my first placement starting out, one of the first things my supervisor told me to do was check the map (on the MDT) before running on every call, and I have done ever since for the past 3 years. It meant I learnt my area (and most of the rest of West and North London) very quickly and now I hardly ever look at the GPS (half the time I find a quicker route anyway).

However, something that really frustrates me is when I am working with someone more experienced than me (who definitely knows a better route) chooses to follow Doris blindly and without question, either out of laziness or out of a misguided paranoia that they will somehow get in trouble if they don't follow it. I know it is only a minority of staff but the lack of initiative gets frustrating at times.

Anonymous said...

In Melbourne, Aus, we don't have GPS yet, only the local map. And they've just added map-reading as a skill that they test during the interview process!