I’m the one to restart your heart in the back of an ambulance, and I’m exhausted. I wrote those words for this series back in 2015 about paramedics like me who are underpaid and working to the point of exhaustion.

We were at breaking point, and I had hoped something might have been done about it. But since then nothing has improved – in fact, things are drastically worse.

You might hear from this government that NHS spending has increased – all I can tell you is that here on the frontline our vehicles are falling apart because our maintenance budgets have been slashed.

They’ve been cut to the point where ambulances are being sent out with balding tyres, pipes sealed with plumber’s tape, cracked windows, and winches (required to move heavy patients) out of service.

Shoddy maintenance means batteries are going flat during blue-light runs , bringing them to a halt. This happened to me recently and we had to be stood down from the job, waiting for recovery – another ambulance, from further away, had to be sent.

Even the kit we use is being reduced as management is forced to put budgets before what is best for the patient. The drugs we administered previously were prepared for us. Drugs like Narcan, which reverses the effects of heroin and kickstarts breathing, were once sitting in a syringe for quick use. Now, we have to draw them from small ampules, delaying treatment in someone already not breathing.

Experience can be the difference between life and death

When a person goes into cardiac arrest every second is critical. Intravenous (IV) cannulation is a rapid way of delivering drugs and fluids directly into the bloodstream - but driving a needle directly into the bone is much quicker. Gaining access this way is called intraosseous cannulation (IO) and it takes seconds, rather than minutes. But very few of us are issued this kit now, purely because IO needles can cost about £50 each, and IV is much cheaper.

Some might say that we knew what we were signing up for when we took this job, which to an extent is true. But few who say that will have any idea about the mental toll that working in the emergency services takes.

I have felt a child’s ribs break as I deliver CPR, and pulled a new mother out of a bath after she drowned having a seizure. I have closed the eyes of a 92-year-old woman and then had to tell her husband of 70 years that there was nothing we could do for her. I have done all that on the same shift and then had to go home and pretend to my family that everything is fine.

Meanwhile our pensions have changed and this has caused many of our most experienced colleagues to leave in droves. In pre-hospital care, where we don’t have the luxury of CT scanners or blood gas machines, experience counts more than anything. When four or five colleagues leave, it amounts to losing 100 years of experience on the road.

That experience can be the difference between life and death. A colleague of mine was first on the scene at an horrific, major traffic accident in a city a few years ago. That colleague had 20 years’ experience and had to draw upon every bit of it to control herself and the scene in order to triage and manage 20+ casualties, some of whom were in cardiac arrest. Many people owe their lives to the fact that an experienced paramedic was first there.

We know we will never be rich working in the public sector and we really don’t care. We don’t want to be called heroes or wear medals. We want to make enough to cover our bills, eat, and go on holiday. Beyond that, we only want the best equipment to look after you when you’re at your most vulnerable and most in need.



The government vilifies the poor and recent immigrants as drains on the NHS, but actually the most common call-outs we get are to attend to elderly people who have fallen. This is neither the fault of the elderly nor the NHS. But it is certainly not the fault of the poor either.

You may think you never use the NHS, that you have the immortality of youth, but believe me you will need us. For the moment, I am still here. So are my colleagues. For now, we will continue to try to restart your heart. We will do everything we can to get you to hospital alive. On 8 June the public will go to the polls. Let there be no doubt – the very existence of the NHS is at stake.

This series aims to give a voice to the staff behind the public services that are hit by mounting cuts and rising demand, and so often denigrated by the press, politicians and public. If you would like to write an article for the series, contact kirstie.brewer@theguardian.com

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