Wednesday 30 January 2013

A Generation Gap

Working for the ambulance service I get the opportunity to see all parts of society at its best and its worst. I see some truly amazing people but also some truly despicable people. Being an ageing population we are seeing more and more of the elderly and that's not going to change. What amazes me most of the time, is how vehemently independent they are, in comparison to how totally unable to cope our younger generation is. Last night I did two jobs that summed this up. Two patients who were both perfectly pleasant but showed exactly what has happened to society in just 60 years and the stark differences in character and ideals that have emerged.

"26 year old male, ? broken ankle"

We were called to a sports hall. When we arrived, the caretaker (who acted like our presence was really putting him out) showed us to the hall. Everyone in there was still playing football, but one paused to point us into the changing room. Inside, lying a the bench, moaning in agony like he had been shot was our patient. He pointed at his ankle and told us it was broken. That information was given to a backdrop of 'bruvs' 'truss' 'ya get me' and 'innit'. That is how people talk now, I didn't hold it against him for a change, the manners were not omitted. What was amusing is that it clearly wasn't broken.

It was slightly swollen but no bruising or abrasions and certainly not at a funny angle! He had full sensation and full movement (despite the tears) and the way he described the injury, it was most likely a sprain. Still, an x-ray would confirm! The charade of being shot continued and for this I blame the footballers: the play-acting wimps that throw themselves on the floor and cry at the hint of being touched. These are the role models that kids are growing up learning from. You only have to have seen 'BallBoygate' to know what I mean! There is no pain threshold, there is huge overreaction and absolutely no sense of shame in doing so. His first thought was to call an ambulance, not a relative or taxi. This is because that's what you do these days, innit!

We got him onto the bed, because when I tried to get him of hobble with my assistance he wailed! Once on the ambulance I cannulated him because the Entonox didn't agree with him. I gave him morphine, mainly to give me some peace and quiet, but also because he gave a pain score of 10/10. He stuck to this despite me asking if it was the worst pain imaginable. He said it was and even said it was worse than my suggestion of having his arm ripped off by a bear. I refuse to believe any pain score of 10/10 because we all know there is no worse pain than stubbing your toe! Anyway, once the morphine was given we got on our way. 

En route to hospital I was doing paperwork and our patient was regaling his tales of heroism to what appeared to be everyone he has ever met. And he was really hamming it up. 'Bruvs' this and 'bruvs' that. He was telling everyone he'd broken his ankle and may need an operation. He made it clear he wouldn't be allowed to work for at least 6 weeks and was basically going to be crippled. It was also the end of his footballing career! Apparently his body couldn't take it anymore. Just for the record, he was an estate agent and this 'football career' was an indoor 5-a-side kick about on Friday evenings! Soooo melodramatic! 

We got to hospital and the play acting continued. His entire family, extended family and friends were waiting for him. He thanked us for helping him with a well placed 'Safe yeah', which I understand is a gesture of appreciation and we left him to it! 

Three hours later, and back at the same hospital and there he was limping around having got zero sympathy from the nurses!

"Is it broken?"

"Nah, just a sprain, a lucky lucky escape innit."

"96 year old female, fall, head injury"

In stark contrast to our footballing hero, this patient met us at the door....ish! Well, she was lying on floor but had crawled from the stairs and been able to lift herself up enough to let us in. There she was, beaming smile, lying on the floor. The was blood in her hair and she was holding her arm. It turns out it wasn't just a fall, it was a fall down the stairs. Top to bottom with a somersault and half twist on the way down. The first thing she said to us was 'so sorry to have to bothered you'.

Under normal circumstances she would have been collared and boarded and fully immobilised. Unfortunately, we couldn't because a) should had severe spinal curvature and b) she wouldn't let us. In fact, she was quite insistent that we got her up off the floor immediately. I checked her neck before letting her get up and there wasn't any pain or obvious injury. Once up, we dressed the injury on her head and put her broken arm in a sling. My crew mate got the chair. 

"What's that for?"

"You need to go to hospital my dear!"

"Do I have to?"

"I'm afraid so, you've had a big fall and you've broken your arm."

"Ok, but I need to go to the loo and pack a bag."

With that, she shot off up the stairs despite all my attempts to stop her! She packed a bag without any difficulty despite only having one arm at her disposal. All the while, she was apologising for being an inconvenience. She spoke very eloquently, no use of 'bruvs' or 'innit'. It was the way I was raised to speak too. I simply don't understand this new language that people speak. It really does leave me in despair when I hear the ridiculous voices that the younger generation are using. And what worries me more is that they are breeding now! Where will this lead?! Will the Prime Minister in 2065 address the nation by saying 'Yes yes me rude boyz, safe'?! 

After much fussing and packing she had everything she could possibly have need. Notes were left for her cleaner, her gardener and the milkman. The lights were switched off, as was the heating and we got her to the ambulance. 

"I'm so sorry to be wasting your time."

As we arrived at hospital, the 'footballer' was getting into a car. I thought of the dying swan act he put on and then wondered how he'd have behaved if he'd fallen down the stairs and broken a bone! I dread to think. We wheeled our patient inside, smile still spread across her face, and handed her over to the nurse. We left to a chorus of thanks and appreciation. 

There really is a huge void between generations. I know the elderly generally don't feel pain as much but they are made of stronger stuff. They respect society and society respects them. They hail from the days where respect meant something and where getting help was truly appreciated. The younger generation have been spoon fed throughout childhood, spoilt rotten and taught that services in this country are their right. The first patient wasn't a bad person and in his own way, was polite to us, but the gulf in generations was painfully obvious.


  1. Michelle Fullerton30 January 2013 at 11:15

    spot on as always although I disagree stepping on a lego is the worst pain known to mankind :)

  2. Great post, totally agree! Although I must say that not all of the younger generation (at 24/25 do I still count in that?) are like the guy you mentioned xx

    1. I know they're not! I'm one of them ;-) Ish.......

  3. Ah , the more they're paid , the worse the injury . ;-)

  4. I'm a physio, and I think the 0 to 10 pain scale can be too much of a test of the patient's imagination, so I describe it as from no pain to 'pain so bad you pass out.' So obviously, they either have to give me a 9 (which is more reasonable) or they have to drop to the floor and quit with the noise-making - win either way ;-)
    Of course, if one were to step on an upturned plug whilst in labour, a 9.5 may be required...... :-)

    I also wonder if it may be an age thing rather than a generational thing. Younger people tend to believe that pain (or blood) means something is seriously wrong. Older people have had more time to experience pain and find that you can be in pain and nothing too awful has happened. Younger people get more scared too, and that panic makes them feel pain more. Then there's the whole 'learned helplessness' thing - but don't get me started on that!

    1. 'Too much of a test of the patient's imagination'! I LOVE this!

  5. As someone who is living with (or trying to, anyway) chronic pain, I find the Hyperbole and a half pain scale the most accurate one around.(

    1. Tell me about it! A couple of years ago my legs gave way on the stairs and I ended up with what turned out to be a doozy of a break/dislocation (I just thought it a simple break because I felt the bone go - it wasnt lol). From speaking to me and my partner on the phone with me still able to move (I had fallen blocking the front door I had to get out of the way) the attending crew did not expect quite such a bad injury and both they and the A&E staff thought I was nuts using minimum pain relief - but the injury was no worse than my normal pain and more to the point the relief worked on injury pain far more effectively so after taking it the injury hurt less than the rest of me.
      Now if someone says fibro is just a low pain threshold I laugh at them.

      I wish people would realize how lucky we are to have the ambulance service and to try and think before calling them - and I wish people would realize they can take far more pain than they think they can.

    2. Ouch!

      I wish they'd realise that too!

  6. How true, I'll never forget the elderly 86 year old lady with an open fracture of the ankle in the middle of the park who turned down the helicopter and had to be persuaded to have morphine as she said' it's a lot of fuss about nothing' and 'if you will just help me up I can hop to the ambulance'. Loads of thanks and apologies for troubling us. Contrast with a 30 year old with a headache- not a thunderclap one just one that he had been treated for before but he didn't have any painkillers in the house and of course was too ill to walk to the corner shop!
    He said on the 999 call that he had breathing diffs so got a red response.

  7. I have been in both scenarios (of some degree)
    I used to have to call an ambulance for my daughters seizures as she always stopped breathing and I couldn't get her breathing by myself. I always felt bad for calling ambulance, and after the first 2 seizures I had a go bag by the door but felt bad because I knew there were more severe cases than ours! Each ambulance crew was fantastic and we began to know a few of them over an 18 month period. Every time I thanked them prefusely for their help and (at the time I was 21) I had every respect for the system and actually speak without bruvs just the occasional "like" and "Urm"!!
    When my daughter was even younger I noticed a bruise on her head, I called NHS direct as I didn't know what to do and didn't want to call an ambulance if it wasn't needed, they said we needed to go to hospital by ambulance because of the bruise and her symptoms. I was in a flap! My 4 month old was going to hospital by ambulance!!! The crew were AMAZING! They held my daughter (because her dad refused to) and said take your time, pack a bag, food, bottles and formula. They allowed me to get changed and were brilliant. I was shaking so much as I was scared I asked them to carry her to the ambulance, they got me seated on the bed and handed her to me and wrapped us up warm. Her dad was trying to wriggle out of comin to the hospital but the amublance insisted he came too. I think it was due to the nature of the accident and the investigation that followed. I thanked them to no end and 5 years in the crews behaviour with me has stayed and know what a wonderful Job you do.
    Whilst in a&e for one of my daughters seizures, in the next bay there was a young(ish) lad making a huge fuss over NOTHING it turned out he had just stubbed his toe and had a little cut, but called an ambulance for this!!!
    One other time we was in resus and a gentleman had had a suspected heart attack/stroke and was being assessed. He tried insisting me and my daughter went first and that he could "walk it off" he got chatting to me while they checked him over before going for scans. (me and my bat hearing heard he had had a major heart attack and was lucky)
    I have the utmost respect for ambulance crews, and the nurses and drs at hospital. I wa recently training to be a nurse but due to financial trouble I've had to withdraw. By my dream is to be a midwife, and in 2 years i am looking to save a good amount of money, and return to education to persue my dream. My hat goes off to every one of you, not only for the pain and heartache you see several times a day, but for putting up with idiots calling for headaches and stubbed toes.

  8. Agree utterly with you... Other than the worst pain ever. Treading on Lego wins hands down.


    1. Worse than an upturned plug or toe stubbing?! Never!!

  9. I don't know... My son broke his fingers playing rugby, and I mean fingers pointing the wrong way broken. I had to drag him to A&E and he refused pain relief. But then I got on a bus to A&E when I was run over and broke my leg in a hit and run so maybe under reacting runs in the family :)

    1. Getting run over is more than reason enough to call 999! We'd actively encourage that!

  10. Not 10 years ago a friend ruptured his Achilles tendon (we knew it was ruptured as it had disappeared into his calf muscle)

    We carried him to one of our cars - and drove him to A&E ( we took two people, one to wheel him to A&E reception in one of the wheelchairs - presumably for that purpose and one to park the car in the P&D carpark).

    If there is more than one person and the patient isn't going to die - I still don't get why people call EMERGENCY ambulances so damn often!!


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