I STARTED a shift with an ambulance crew thinking we would be involved in a Casualty-style heart-stopping drama, but was quickly set straight by the two men I was to spend the day with.

"It's total cobblers," said Mike Belcher, an ambulance worker of nine years who completed his paramedic training last year.

"If we went around like Josh from Casualty saving people and 'taking out' vehicles who were tailgating us, we would get the sack immediately."

Colleague David Hope, an ambulance technician with 28 years' experience, agreed.

"I've given up watching it now - it makes me want to put my foot through the TV," he said.

And to set the record straight, nor do ambulance workers put their sirens on to get home quickly for their tea - I was reliably informed this would also bring a swift P45, as well as a speeding fine.

So fortunately (or unfortunately, depending on how you look at it), the day I spent with the Hereford and Worcester Ambulance Service NHS Trust crew did not involve scaling down quarry faces to rescue helpless children.

Despite, that, the day was not without drama, with various trips across the county, blue lights a-flashing and racing at breakneck speed down country lanes.

Throughout the day, we were called out to three emergencies across Worcestershire.

An elderly Fernhill Heath man had fallen while he was in the bath and needed some help to get out and a Malvern pensioner suffered a hypoglycaemic attack as a result of his diabetes.

In the third emergency at the end of the day, a policeman was rushed to the Worcestershire Royal hospital with a suspected broken ankle after falling down some stairs at Hindlip police HQ.

Even though the nature of the emergencies had stayed the same over the years, both Mike and Dave admitted their jobs had changed a great deal over recent times.

Dave said it had changed most over the past 18 months when new working practices were brought in to make sure strict new response times were adhered to.

Crews now spend most of their time at tactical points throughout the area rather than on station, more drugs can be given out and, by the end of the year, heart patients will be given ECGs which will be sent electronically to hospitals to see if clot-busting drugs are needed.

But both Dave and Mike agreed a less desirable change had been the increase in their training to deal with violent and abusive attacks.

Dave said he had been punched unconscious in one incident and bitten in another, and both have been shouted and sworn at by patients and relatives.

The trust has now introduced a zero tolerance campaign for dealing with abuse, both physical and verbal, and reports are made after each incident and handed to police.

Ambulance workers have also learnt not to turn their backs on patients and their friends and are trained to run from any potential violent attack rather than endanger themselves by standing their ground.

Despite the drawbacks, however, Dave and Mike agreed there was no other job like it.

"We have to wear many heads - social worker as well as ambulance worker - because when we go into a situation it may not seem very serious to us but, for the patient and their family, it's a dramatic crisis," they said.

"Personal skills are almost more important than medical ones as, at the end of the day, if you treat someone badly they will remember you for the rest of your life.

You don't often get any thanks for what you do, but it is the best job in the world.