This poor man was left, alone and shaking, with a carer who seemed to think that if she ignored this ‘problem’ it would soon go away. So, we did the only thing that we could: we took him to hospital, so that they could sort out his medication for him. Meanwhile I filled in an ‘LA260’ which is a ‘vulnerable adults’ form and allows the LAS to bring situations of abuse, and potential abuse, to the attention of the local social services. They now have the name of the care agency, and this problem can be solved before it repeats itself in a month’s time.
Hopefully, someone will get a bollocking, and our patient will get a carer who actually cares for him.
It often feels that we, and the local A&E departments, are left to do the jobs that other people should be doing, but because we are there, these other agencies don’t seem to care about doing a competent job. I’m aware that there are probably loads of health visitors/social workers/district nurse/CPNs and GPs who do actually give a damn about their patients – it’s just that we never seem to meet them.
I never did get any feedback from the LA260 that I filled in – normally you get a little note sent to you explaining what has been done to resolve the situation.
Our ‘interesting’ call of last night was a Matern-a-taxi. What, I hear you ask could be interesting about taking a pregnant woman 1.2 miles into the local maternity department?
Well, apart from the patient, no-one else knew that she was pregnant – she had been hiding the pregnancy from everyone. She hadn’t seen a doctor; neither had she booked into a maternity department. Her family suspected nothing. It’s not as if she were a ‘large’ woman, who could perhaps hide the tell-tale bump under the pretence of fat. She was actually rather slender, which leads me to ask how she could hide her rather obvious pregnancy from everyone.
When my crewmate spoke to her (I was driving), she told him that she had hoped that the pregnancy would ‘go away’.
We tried to prewarn the maternity department that we were coming (because she was quite close to actually delivering the baby), but they hung up the phone twice on our Control. The problem is that the entrance to the maternity department is locked at night, and we need someone to come down and open it for us. So … we were left standing around outside the department waiting for the midwives to phone for a porter to traipse the length of the hospital to come and open the door for us (as opposed to one of the midwives walking down the stairs and opening the door).
By the time we got in the patient was starting to bleed, and we were getting more irate at the apparent ignorance of the midwives.
So, tonight we are going to put in a ‘clinical incident report’ to highlight the danger that standing outside the maternity department for 10 minutes while they arrange a porter puts the patient in.
One of the people on complex has had to deliver a baby in the back of their ambulance while they were waiting for the doors to be opened, so something needs to be done.
Three of our jobs today had the potential to be upsetting, and while they were all sad, only one seriously upset me, and did so in a way I consider rather out of character for myself.
The first job of the day was to an 86-year-old female in a nursing home with a ‘blocked nose’: we raced around there because … well … it was a Category ‘A’ call and those are the top-priority ‘get there in 8 minutes to please the government target’ calls.
Just as we pulled up outside Control let us know that the patient was upgraded to a ‘Suspended’ (no pulse, no breathing), and sure enough we ran into the home to be greeting by a FRU who was doing CPR. I jumped down and did a round of chest compressions, which cracked her ribs (a recognised side-effect of effective CPR), and then noticed that on the cardiac monitoring machine her heart rhythm had changed. She had a pulse! … People don’t normally get a pulse back from cardiac arrests of her particular type. We rushed her to the hospital, where a full cardiac arrest team was assembled. Her pulse was lost, and then returned. Unfortunately, her prognosis was poor, but she stayed alive long enough for her daughter to reach the hospital. She died with her daughter there, which is a small victory, but one that we are getting more used to.
The second potentially upsetting job was to a 1-year-old boy who had pulled some boiling milk on top of him. We turned up to find about 20 police officers on scene, and the HEMS helicopter circling above. The same FRU responder was there and the child had around 10% partial thickness burns to parts of the neck and chest. While nasty, this wasn’t immediately life-threatening, but the HEMS doctor who turned up decided that it would be best to take the patient to the Paediatric Burns Unit at Chelsea and Westminster Hospital by helicopter. As the helicopter could get the child there in under 20 minutes it seemed like the right plan of action. My job during this call was to (1) hold onto the other two toddlers in the house, (2) mix up some paracetamol for the child, and (3) drive child and doctor to the helicopter, which was around 300 yards away. The job was interesting because she was the type of parent who thought it was a good idea to wedge a settee into the hallway to stop her children from falling down the stairs …
The final job was a lot simpler – we were called to an 18-to 22-year-old female who was ‘unresponsive’ in a bus. The bus had reached the end of its route and the driver couldn’t wake up the patient. (Possibly interesting aside – bus drivers cannot touch any of their customers to wake them up.) We turned up and soon managed to wake up the very sleepy girl. She remained drowsy but agreed to let us take her to the place where she lived, but after talking to her a bit, we soon realised that she was homeless. This, coupled with the way she would fall asleep as soon as we stopped talking to her, made us think that it would not be safe to leave her on the street. We decided instead that we would take her to hospital. When we reached the hospital she refused to go in, and instead pulled out a ‘crack’ pipe and started to light up. We told her that she couldn’t do that … So she jumped up, pushed my crewmate and ran off. As there was nothing physically wrong with her we couldn’t chase after her; instead we returned to our station to fill in the necessary paperwork.
So why was it that this last job was the most upsetting, not only for myself but also for my crewmate? Well it wasn’t because she was pretty (she wasn’t, and she had a remarkably nasal voice), and it wasn’t because she was ill, neither was it because my crewmate got shoved.
With our first job, the woman was at the end of her life, and until she died, had enjoyed fairly good health. She didn’t die a painful, protracted death, and she died with her daughter next to her. With the scalded child, he would forget the pain, and will receive excellent care from the hospital he went to, he would return home to his loving (if ever so slightly dense) mother. With this girl, it was as if she were lost; at some point in her life her potential future had unravelled. Instead of getting an education, holding down a job, finding someone special and living a long and happy life, she is homeless, a drug addict, and her future is probably painful and short. What is so depressing is that no-one was able to turn around this descent, and this is perhaps why I despair at society – that so many people are prevented from reaching their full potential. I understand that she has made her own choices, but how much power did she have to make those choices? I wanted to help her, but there was no way I could do this.
And it’s that which annoyed and upset me.
I keep getting upset and annoyed at the same things – the waste of a life is a terrible thing to see. That, and the knowledge that I am helpless to do anything to change it. I imagine that this is why I dislike alcoholics so much.
We got sent to a job of a 6-month-old