Friday 25 May 2012

I Want It Now!

"30 year old female. ?Sepsis"

No one likes getting off late. No one likes getting off late especially when it is because of a GP! With only 45 minutes to go until we were off we got the 'Sepsis' job. I could tell before even arriving that it wasn't sepsis. I'd have been happy to stake my job on it! Besides, it was 17:45; call me a cynic but I'm sure this GP surgery closes shortly! We grabbed our bags and headed in. This GP surgery in particular has provided me with more blogs than any other. They leave more patients in the waiting room with letters and they call more ambulances on Monday mornings than any other. 'GPs: Take Note' and 'Gone Fishing' were the recent posts inspired by this abomination of a surgery. We were directed to the same room as we always are. Inside was our patient lying on the bed with her fiance by her side. In a change from the norm the GP was also still present; probably because we were on scene within two minutes and he didn't have time to palm them off to the waiting room. I listened to his sepsis handover with eager anticipation and it did not fail to deliver:

"This lady has a three day history of feeling unwell complaining of febrile symptoms. She is pyrexic at 38.2 and tachycardic at 101. She is expected by the medics to rule out sepsis"

Sepsis?! 30! A three day history of a cold in someone normally fit and well? I did her obs while she laid, whimpering on the bed. Her temperature was 37.9, her pulse was 84, her blood pressure was good, her oxygen levels 100%, her blood sugar normal and no cough to mention. She did have a 2 day history of urinary symptoms which I'm guessing could be treated by the GP with antibiotics. But what do I know, I'm just a stretcher monkey! I read the sorry excuse for a letter, and as much as every part of me wanted to tell the GP to do his job rather than palm her off to the hospital, I suggested to the patient we go to the ambulance. 

"She can't walk, can you get a stretcher?" her fiance quickly interrupted.

"How did you get here today? She must have got in here somehow"

"We got the bus"

"Right, so she can walk to the ambulance"

"She's been on the bed a while, she is probably feeling weak, I'd advise a chair" said the GP. 

Oh would you? Of course you would. You are not the one who has to carry her. Whilst continuing to bite my tongue I asked my crew mate for a chair. Whilst waiting I continued to try and get some more history. Unfortunately the patient was too ill to answer so her fiance answered for her. 30 years old and she is acting like a 5 year old. It was embarrassing. My crew mate returned with the chair, opened it up and asked her to sit in it. She sat up about 6 inches then dropped back.

"I can't, I'm too dizzy". 

Oh, she can talk after all. Her fiance then tried to dead lift her from the bed to chair. I stopped this attempt quickly in its tracks and respectfully explained she was perfectly capable of getting into the chair. At last the GP agreed and told her to get into the chair.

Once on the ambulance the drama continued and her refusal to talk returned. It was a relatively quiet journey to hospital as she wouldn't speak and her fiance couldn't answer my questions. We wheeled her into A & E as she 'couldn't walk' and joined the other 4 ambulances in the queue to hand over. We were quickly told there were no beds so it would be at least 2 hours to hand over. Her fiance asked what the problem was.

"There are no beds, it will be two hours until we hand over and then 4-6 at least to see a Doctor"

"Let me speak to the doctor, this isn't on, my fiance is sick and needs attention"

"The nurse is over there, she can direct you to a doctor but it won't change anything, there are no beds"

On over-hearing this news, our patient started crying. And I don't me a whimper and a tear, I mean full on balling-eyes-out crying and whaling. Everyone was looking, I was cringing, it was what you would expect from a 3 year old you have removed from a sweet shop without any sweets. She was 30 years old, not Veruca Salt stamping her feet saying 'I want it now'. This went on for 10 minutes until the doctor DID come and see her. Apparently she who shouts  the loudest does get seen. It wasn't the outcome either of them wanted though.

"I am the doctor in charge of the patients in this department, there are 42 people waiting to be seen ahead of you. They will be seen in order of clinical need. That is what 'triage' means. No amount of screaming, shouting and crying will change that. I have seen your letter from the GP and to be quite frank you are not a priority. You will wait like everyone else has to and if you don't like it, the door is over there, now stop this nonsense and act your age."

Silence! Chew on that! Now THAT is what I call a 'bedside manner'. It was exactly what needed to be said and it was exactly what everyone else was thinking. If only we were allowed to say it how it is! Unfortunately we are forced to bow and say 'yeth sir, no sir, thwee bags full sir'. That's just the way the cookie crumbles. 7 years at med school gives you the right to verbally bitch slap people!


  1. Resp rate? Early warning score ? Tut tut Mr GP

  2. Hope you high fived the doc!

    1. I sure did! When the patient was out of sight!

  3. Fantastic. I so want to speak to some of the 'patients' we go to like this. A+E queue out the door yet every one of the people on the beds are laughing, texting and looking quite well. Keep up the good work Ella

  4. I've got that bloody song in my head now from Willy Wonka & Chocolate Factory :)

  5. Well done that doctor! The one in A&E, not the muppetrt from the surgery.

  6. Fantastic we must get more docs at triage it would save the nhs bags of money and time!

    1. I have long said doctors should take the handovers as they have the power to discharge immediately!

  7. Wish that Doc was coming to an A&E near me.

  8. I've been septic 7 times from ages 19-22 and it never felt like a cold and I was never well enough to even go to my GP.


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