(a) Fractured wrist – young lad at the Boat Show.
(b) An alcoholic ‘frequent flyer’ who has just been released from prison … We thought we’d got rid of him for good.
(c) A 15-year-old with a runny nose.
(d) Very minor RTA.
(e) Domestic Assault, with no actual injury, but police already on scene.
(f) ‘Facial Injury’ which turned out to mean ‘Some bloke kicked my door.’
(g) Assault with a cut hand – actually a decent injury with tendon involvement (which means surgery and physiotherapy).
(h) Varicose Vein that had burst – plenty of blood everywhere.
(i) A 29-year-old with chest pain, hyperventilating, with very upset relatives.
(j) A suicidal overdose in a house filled with young men with short hair and tight T-shirts (ifyouknowwhatImean).
(k) RTA with a traffic light pole coming off the worse in a two-car collision.
(l) An 8-month pregnant female who had fallen earlier that day.
and …
(m) A fitting 9-year-old; only one parent spoke English, and they decided to stay at home and send the father who doesn’t speak English with us, because ‘The hospital has interpreters …’
Now, out of these thirteen jobs, only five actually went to hospital …
This counts as a ‘good shift’, reasonably interesting jobs, and no-one tried to hit me.
Sorry folks, bit of a rant here … but I last slept 22 hours ago …
We got a call to a patient who was ‘Depressed – not moving’: normally with this type of call it’s some teenager having a strop, but this time it was a little different. Basically, the patient, who suffers from depression, was discharged from the local psychiatric unit 3 weeks ago and recently had her dose of antidepressants reduced. Yesterday, she was crying all night, and tonight she was just sitting staring into space, refusing to make eye contact and not talking at all.
One of the things that we as an ambulance crew cannot do is physically remove someone to hospital if they don’t want to go – that would be kidnapping and is frowned upon by the law. This young girl was not going anywhere despite my best attempts to persuade her – she just wasn’t communicating.
The solution would be simple: call the Community Psychiatric Nursing (CPN) team to come and assess her and, if needed, arrange her compulsory removal to the psychiatric unit (called a ‘Section’ under the Mental Health Act). The problem? It was 10 p.m. …
First off I phoned the psychiatric unit that she had received treatment under. After talking to two idiots who had trouble understanding plain English, I finally managed to get the number of the CPN team. Now, the London Ambulance Service (LAS) is quite smart: when we want to arrange an outside agency we go through our Control because all the telephone conversations are recorded … so if someone says they are going to attend they damn well better. I got onto Control, passed the details to them and waited for them to get back to us.
I’d just like to say that in all my years of medical experience I have never had a simple referral to a psychiatric service: they always seem to try shirking any form of work by ‘forgetting’ you or by being just plain obstructive. Maybe I’m just unlucky and get the idiots every time.
Needless to say we waited … and waited … and waited … from 22:20 until 23:00 we waited; then at 23:02 Control got back to us. Apparently the CPN team all goes home at 23:00 and hadn’t answered the phone until 23:00 on the dot. So they refused to visit the patient. The moral so far is if you are going to have a psychiatric breakdown in Newham don’t do it after 22:00.
So we switched to plan ‘B’, which is to arrange the out-of-hours social worker to come and visit, as they double as Psychiatric Liaison. Again we went through Control and waited … and waited … and waited … Finally we heard back that the social worker would ring the family and would like to talk to me. (Outside agencies try this trick, as they know the patient’s phone isn’t being recorded, and so can say whatever they want, with any disagreement being my word against theirs.) The social worker explained that she was very busy and so would prefer not to come to see the patient and have I tried the out-of-hours GP?
Back to Control I went and got them to try and contact the out-of-hours GP (a GP, for those not in the UK, is the patient’s family doctor). Can you guess what we then did? We waited … and waited … and waited … Finally, Control got back to us and informed us that the out-of-hours GP hadn’t arrived for work yet and that when they did, they would have to see two other patients first.
All through this time the family of the patient were very understanding and were happy when I explained that the GP would call at some point in the night. All I could do was advise them to remove anything that the patient could use to hurt herself, and keep an eye on her, calling us back if they felt the need.
Total amount of time an ambulance was tied up trying to get outside agencies to DO THEIR DAMN JOB – 2 hours and 19 minutes … and not the world’s most satisfactory outcome.
As I mentioned to our Control, sometimes you feel very lonely out there on the mean streets of Newham.
It is still the case that as soon as the sun goes down, various community services disappear and people in trouble need to rely on the ambulance service and the A&E department, even if it isn’t the best place for them.
There is something deeply disturbing about walking on a sticky carpet – especially when the flat is in a complete mess and the punter has called an ambulance 4 times in the last 2 days for a pain in the chest that has lasted 2 years. I’d like the jury to note that the pain hasn’t changed in any way, it’s not worse, or moved around the body, he has no other symptoms. But the patient just seems to like calling ambulances. I wanted to wipe my feet on the way out of the flat.
It also doesn’t help when the patient smells so bad that I want to leap out the side window. We didn’t have any air freshener (and apparently, neither does the hospital).
When we got to the hospital the triage nurse took one look at the patient, muttered ‘Not him again’ and sent him out to the waiting room. I suspect that it may just be a ploy to use biological warfare to empty the waiting room.
I still keep getting called back to him for the exact same ‘problem’.
Once again I know a lot of visitors here are from America, so I’m going to explain how the LAS works on a day-to-day basis. This will either be very boring or immensely interesting – your choice.
Ambulances run out of dedicated stations, we don’t share stations with the Fire Service. In fact, some years ago, when it was suggested the idea was shot down as we would be disturbing the firecrews’ sleep throughout the night. Each station has its own call-sign ‘K1’, ‘J2’, ‘G4’ for example, then each ambo has a suffix that is attached to this, so one ambulance running out of station J2 would be called J201, while another would be J207.
The stations are spaced approximately 5–6 miles apart, and you mainly service the area surrounding the station; however, with interhospital transfers and other irregularities you can quite easily find yourself across the other side of London.
It’s an old joke that when asking if we need to travel so far the