Ambulance Paramedic Bureaucracy Stories

Anyone who has ever worked for an Ambulance Service will understand the deranged incompetence of the Bureaucratic system. Here are some of the ultimate highlights of my experiences trying to improve a Bureaucratic Ambulance system as a Paramedic:

I used to work at a small, outback, country Ambulance Paramedic Station – most Paramedic Stations are stocked based on their Average Monthly Item Use (AMIU) numbers, and this is particularly regulated in small country Paramedic station that does a limited amount of cases per month and therefore more likely to have stock go out of date. At my Paramedic Station, our AMIU for cervical collars has been set at 5 of each size per month, and has been for the past 30 years. Now, as anyone who’s actually worked as a Paramedic would know, everyone, tall short, skinny, fat, will either take a No-Neck Cervical Collar or a Short Cervical Collar (even if they’re 7 foot tall, they still don’t seem to fit a Regular or Tall Cervical Collar!). So, as you can imagine, if we get 5 of each every month, but we only ever use Short or No-Neck, we’re going to always end up without and Short or No-Neck and we’re going to have about a million of the other sizes. So, after about 2 years of accepting there’s no chance of changing this, I find myself working as an Acting Station Manager, and decide (naively), that I will fix this problem, and order 20 of the Short and No-Neck Collars – and no Regular or Tall. This is how the conversation unfolded with both the Stores Manager, and then Eventually the Senior Paramedic Managers.

Paramedic: “Thanks, we’ve ordered 20 No-Neck Collars and 20 Short Collars, but have been sent 5 of each, and then 5 Regular and 5 Tall, which we didn’t even order…”

Stores Manager: “Yes, that’s correct.”

Paramedic: “If we send the excess Regular and Tall Collars back to you, will you exchange them for No-Neck and Short Collars?”

Stores Manager: “No, your AMIU is 5 of each.”

Paramedic: “I understand that, but, you see… we only use the two small collars, and we need more than 5 per month for those… and we already have an excess of the larger ones, so we don’t need anymore of those.”

Stores Manager: “Hmm… it says here that you get 5 of each… so you get 5 of each… good bye.”

I approach Senior Ambulance Management about the problem via mail, carbon copied to the Stores Manager. 4 weeks later, I contact Senior Ambulance Management to see if this has been resolved.

Paramedic: “Any luck with the issue of ordering more cervical collars?”

Senior Ambulance Management: “Yes, I resolved the problem.”

Paramedic: “Great, thanks for that… so we can now order more than 5 collars per month?”

Senior Ambulance Management: “No, you can order 5 of each size per month…”

Paramedic: “But you just said you resolved the problem.”

Senior Ambulance Management: “I did… I reviewed the orders for the past 20 years to determine if your AMIU numbers have changed at all – and over the last 20 years, you have ordered 5 of each size collars…”