I reckon its important to have fun whilst you work.  It keeps you relaxed.  And a relaxed mind has larger scope for making better decisions.  Anger, aggression and fear as we all know lead to the dark side, and they can make for very bad jobs too.

So, when you end up working with someone you ‘click’ with it not only makes the day go well but benefits the patient also.  You’re relaxed enough to have banter, both with the patients and your crew mate.  Everyone ends up in a better mood, you all have a laugh, the patients release their own pain inhibiting hormones and feel better, inhibitions about hospitals and clinicians are alleviated (more important with the youngsters and the very old) and our stress levels are kept at a minimum.

And sometimes these fun days can end up in giggling fits.  You know the type I mean – anything can set it off and then that’s it, you’re desperately trying to hold it in but can’t.  And then huge belly aching laughter ensues which ends up being more contagious than the Rage virus.

There’s no harm in this – other than perhaps looking a little less professional.   It happens to everyone and I can bet that anyone reading this has had it happen to them at some point in their lives, if not multiple times.  Its great!  So long as the patients do not suffer because of it.

Here’s a few examples of them . . .

Example 1

I remember not being out long, working with a crew mate who fit the description above.  We were having a ball that day but were still going to the same constant “non-entity” stuff that all ambulance services go to – but it didn’t touch us.  Our good mood was too high.

We were at a job where an average woman from an average Eastern European country was having an average belly ache of no particular average description.  My crew mate was rattling through the questions as if ticking off subjects on a list.  Whilst he did so I would do the observations, write them on my gloved hand and hold them up in front of his face (so the patient couldn’t see) so he could make a note to himself and not disrupt his flow.

Crew mate:     “. . . and how long have you had this pain?”
Patient:           “This morning
Binder:            **shows heart rate: “70” **
Crew mate:     “Do you have any medical problems?”
Patient:           “No”
Binder:            **shows Sats: “100” **
Crew mate:     “Do you take any regular medication?”
Patient:           “No”
Binder:            **shows temperature: “36.9” **
Crew mate:     “Do you have any allergies?”
Patient:           “No”
Binder:            **shows BM: “6.2” **
Crew mate:     “On a scale of one to ten, where one is nothing and ten is like having your arm slowly burnt off by a laser attached to a shark’s head – what number would you give the pain?”
Patient:           “Huh?”
Binder:            **shows drawing of penis with hairy balls **

I have no idea why I did that, it was utterly automatic and not premeditated at all – but the effect was instant.  My crew mate turned away doubling up – as if in pain.  Snot began to shoot from his nostrils as he tried to gag an explosion of laughter.  I looked at what I’d drawn and then did the same.  We were now both helplessly in the state of hysterical giggles.  On the way down to the ambulance my crew mate made me go with the patient in the lift so he could compose himself better.  But our childish fits continued on to the hospital where, after handing over the patient to the waiting room, we were finally able to calm down over a cup of tea.

Example 2

These sort of outbursts are not just segregated to us.  The patients can have them too.

Not long ago I was sitting with a patient in a large open plan office in the city.  She was suffering a nose bleed that had been going on for over an hour.  Her blood pressure was through the roof and she was quite stressed and her colleagues and friends were huddled round offering support.  My crew mate had gone back to the ambulance to fetch the chair.  He said afterwards that he couldn’t remember what floor we were on and this was the reason he called my mobile whilst he was at the lifts.  However, I’m pretty sure he did it purposely!

I was giving my best calming voice to the patient when my mobile went off – to the theme tune of the old children’s programme, “Rainbow”.  There was a split seconds silence – I went bright red and the group started sniggling.  But the patient – with her head already bent forward with a large clump of tissue pressed against her face – started crying with laughter.  And the more we tried to get her to stay still and concentrate on her nose the harder she’d laugh and the more she’d bleed.

This continued on to the hospital where the bemused hospital staff were able to receive the nose bleeding giggling woman alive and well.

Example 3

Sometimes though, the giggles can start at the most inappropriate moments . . .

A few weeks back there were three of us working on a woman who was in cardiac arrest.  Her heart had just slipped into [tippy title=”VF” URL=””] VF – Ventricular Fibrillation.  This is when the heart has gone nuts.  Nothing is firing properly and can be best describes as having an epileptic fit.  Whilst it is like this, it is filling with blood but not pumping anything.  The rhythm is shockable and often, shocking the patient will kick start the heart back into a proper rhythm (of sorts).  Unless there are underlying causes of course.  However, it is important that CPR is performed immediately because the more blood there is swelling the heart, the less likely a shock will work. [/tippy] whilst watching TV with a friend.  We all knew and worked well with each other and the job was therefore going smoothly and professionally.  Until I’d gained I/V access.

Getting the line in was not a problem but as I was attempting to attach the bag of fluids the FRU, Jane* (who was at the head end and therefore in charge of shocking) shouted that the the Lifepak was charging for a shock.

I’d almost finished attaching the line when I saw her finger starting to press the ‘shock’ button shouting, “Stand Clear!”.  I pulled my hands back as the shock was administered.  The patient arched their back and their body went rigid for that split second.

Unfortunately, also at that split second, the poorly fitted line sprung free from the patient’s arm like a water bottle jet shooting up to the sky.  And of course yours truly was the recipient of the fluids from both the I/V drip and the patient’s vein!

Jane started first, apologising through snorting chortles.  My crew mate quickly followed and within seconds we were all red faced and laughing through puffed cheeks as the rest of the cardiac arrest went with barely contained laughter.  But believe it or not, we still gained [tippy title=”ROSC” URL=””] ROSC – “Return of Spontaneous Circulation”.  This is the term used when a patient who has been in cardiac arrest suddenly has their heart start beating again . . . and we can all stop and take a quick rest! Before getting the patient ready to go to hospital. [/tippy] and were able to transfer a live patient to hospital.

Example 4

And sometimes these giggling moments don’t even happen with patients.  They can happen anywhere.

I was recently told of a crew who were just leaving their station to go to a job.  The driver, spying his crew mate reaching for his seat belt and with an evil sense of mischievousness, decided to put the ambulance in full left lock and floor the accelerator.

Regrettably however, his crew mate was now thrown across his lap.  Which, under the most unfortunate of circumstances resulted in both the steering wheel becoming jammed and the driver’s leg being unable to lift off the accelerator.

The effect was sensational and the general public watched as the ambulance charged in a full 180 degree arch straight back into the cast iron fenced barrier of the station with an almighty crash.

Several bystanders rushed over to see if the two occupants were ok but were surprised when they found them both splayed out in awkward positions in uncontrollable fits of barrel rolling laughter.

A policeman, who also witnessed it, came over and asked them what had happened.  The two crew members gained a little composure and wiped the tears from their eyes.  They both looked at each other and then smiled at the policeman.

Driver:             “Dark hairy dog story?”
Policeman:      “Oh . . . fair enough, carry on”

So, there you have it.  We all get the giggles from time to time.  And these aren’t isolated stories above.  No matter what you do and whatever the job (or not) it happens to us all and I believe whole heartedly it is essential for maintaining good health.

And if you are a patient that this happens to, please rest assured it is not aimed at you.  And please also rest assured that we can still operate and treat you in this state.  In fact, it might just help.

And as for the dark sides of the force?  Anger, aggression and fear?  Well, when these are used in jobs, not much tends to go right and a very bad feeling can be left in your mouth – unless it is nipped in the butt early . . . as will be explained in the next post.

Binder

*not her real name of course