Saturday 9 February 2013

Despair


“4 year old female, vomiting, DIB”

I see a lot of different people in this job; a lot of people from different backgrounds, different ethnicities, different religions and different sexualities. People come in all shapes and sizes, all ages and each with their own unique medical histories. Some people have nothing wrong with them; some have very complex needs and care packages. Until we arrive at someone’s house and go in, we have no real idea of what to expect.  A 4 year old vomiting with DIB is nothing out of the ordinary and could mean anything from a minor stomach bug to a life threatening condition. The latter is unlikely but always possible. 

On route to a job it is not uncommon to get an update, namely because we are dispatched automatically by a computer as soon as an address or mobile phone co-ordinate is obtained. As more information is received we are updated. 

“UPDATE: Patient has special needs”

This could mean anything but made the job a little more interesting. We arrived at the front door, which was opened by a small child who pointed upstairs. Up we went, bags in hand. In the living  / bedroom was about 8 or 9 members of a family ranging in age. Lying on the bed, on her back was our patient. She was very small for her age, her legs were not properly formed and her face was slightly contorted and swollen. In the corner of the room was a very complex looking wheel chair with head and leg straps and a torso restraint. It was clear her needs were very complex so vomiting could be a serious issue in terms of aspiration.

“What’s the problem tonight?”

“She vomited”

“Anything else?”

“She’s not breathing normally”

“OK, so what medical conditions has she got?”

“She can’t walk or talk”

“OK, but what is specifically is wrong with her, what condition has caused this?”

“She was born like it”

“OK but what condition is it that she has?”

They just looked at me blankly and then the mother passed me a folder. Normally when a folder is passed by a relative, it is a care folder with medical history, medications and patient details. The folder we were given contained financial information relating to the kid, benefit allowances, bank statements and letters requesting more money. A bank statement dated 2 weeks previous showed a balance 4 x my monthly salary.  It also transpired that no one in the house worked for a living. 

“This has nothing about her medical history, what is wrong with her?”

“You tell me, you’re the paramedics.”

“Yes. I know that, but without knowing her history or what she is normally like at 2am it is hard to form an opinion of the cause to the vomiting. What condition does she have that causes her to be in a wheelchair?”

*Shrugs shoulders and kisses teeth*

While I was fighting an uphill battle trying to get any kind of history, my crewmate had been checking her over. She grabbed the oxygen and put on a full flow mask. Very low oxygen levels, a very high respiration rate and a very congested chest suggested she might have aspirated on her vomit. 

“Right, we are going to be going to hospital, can you grab a bag of stuff for her”

The mum passed me a bag.

“Can you carry that? We have our bags to carry”

“Oh, do I have to come with you?”

“YES! She’s your daughter!”

“But we’ll be sat there for ages, can’t someone just call us when she needs to come home?”

“NO! One of you has to come with her.”

A look of sheer annoyance spread across her face. Was I really hearing this?! Do people like this actually exist?! Why is this poor child allowed to live somewhere where she clearly isn’t being given the care she requires? I really do despair at what society has to offer. Lying on the bed in the ambulance was a little girl who has a very poor quality of life at the best of times. Couple that with parents full of apathy and who’s priority appears to be what money they can get as a bi-product of her condition and I was left feeling sick. Sick that there has been no intervention, sick that situations like this exist. I don’t know if this behaviour was a cultural thing but as far as I was concerned it wasn’t something that should be tolerated in any culture or society. I certainly wasn’t going to let it go un-noticed.

In a heavily antiquated system there is too much red tape to cross, things simply take too long to take effect. Protocols need to be in place to enforce the strictest of penalties when the care of a child fall short from what is expected. Not just for the extremes in children with complex medical needs but in children who display anti-social behaviour, truancy and crime. I personally think that parents have to be held accountable for their failings at all levels otherwise their culture and apathy towards parenting will be evident in the next generation. Maybe I am being harsh but I really do despair at what we as a country allow to happen. 

17 comments:

  1. I am horrified. Having spent yesterday arguing with social services about our reasons for not using respite, and our reasons for me or my mum staying in when my son has a hospital visit, hell arguing about why we care so much when THIS is what they should worry about! My son is more than his DLA, my son is more than his wheelchair. My son is my son, he just happens to have cerebral palsy.

    ReplyDelete
    Replies
    1. That is an excellent comment and you are a wonderful parent for thinking that. I know you were commenting to support Ella but I think you should be recognised too, cos frankly from what I see in far too many 'emergency services' blogs is that too many parents aren't parents at all they're just genetic forebears. I hope that whatever red-tape problems you and your son face you can overcome them with ease and equanimity and enjoy all the times you have together.

      Delete
  2. Just a couple of thoughts:

    If the mother's first language wasn't English (your reference to the behaviour being a cultural thing makes me think the family might not have been English?) perhaps the folder with benefit letters was the easiest way to communicate the disability / condition to you? They do often contain information about the disability.

    Also, whilst it doesn't sound great, you have only seen a brief snapshot of this family's life. I think your judgement that they're more concerned with what money they can get as a result of the child's condition is perhaps premature. You can't know what else is going on.

    You state there has been no intervention. How do you know this? The local SW team might be working with the family to offer supports but this may not be immediately clear. Did you report your concerns to the local SW dept? If not, you should. You're obviously very concerned. This information could fit into a larger picture of information that would prove useful.

    This post isn't meant to sound harsh, but this blog does come across as quite judgemental, tbh. It's always worth baring in mind that as professionals we come into people's lives when they're in crisis. We have no idea what has been going leading up to that crisis that could influence how people come across. We see a snapshot. Put the rest of the pieces into the jigsaw and it can often provide context.

    ReplyDelete
    Replies
    1. Thanks for the comment. The mothers first language wasn't English but the grown up children were. There were no details whatsoever regarding her medical condition from hospitals or previous care. No care equipment other than the chair. It snap judgment may be premature but having seen snap shots of 1000s of patients lives I can quickly tell if something is an isolated problem or more long term. In this case I really don't think this was a crisis. This was just another sad day in the little girls life not getting appropriate care. Obviously I did flag the issue up with social services with our vulnerable child safeguarding referral. I accept that I can be judgemental but to expect an ambulance crew to take away your child and not want to be by their side sickens me, as a parent. For that I most definitely judge them all. I appreciate your points as some aspects of the job were not fully explained.

      Ella x

      Delete
    2. While you make excellent procedural points I think that Ella as the person on the ground could see the facts, to me as a Member Of the Public & parent I was shocked that she wasn't met at the door by a parent, that she wasn't given the kids red book, that she was given a response of "*Shrugs shoulders and kisses teeth*" rather than have something said even if it was in another language with another person, or child, transalting, and that there was no expectation of going to hospital with the poor child.

      For shame Anon to comment so judgementally accusing Ellla of being judgemental, and doubly for shame those parents!

      Delete
    3. Judging people, harshly or otherwise, doesn't actually help anyone.

      It only serves to make us feel better, briefly.

      But...judge away....

      Delete
  3. Good grief you really do see the worst this country has to offer! I cannot believe this kind of thing goes on.

    ReplyDelete
  4. I use to work on a children's ward and unfortunately parents not staying with the, sometimes very young, child is more common than you would think.
    Sometimes it is unavoidable if they have other children at home and no one to care for them, but then sometimes it is just that the parent can't be bothered. I used to find it heartbreaking to see.

    ReplyDelete
  5. I think your judgment was spot on and is reflected in the sad times we live in. People who care more about benefits than the people they're paid out to. Well done as usual!

    ReplyDelete
  6. Another truly excellent blog, as much as others are trying to say that you are not seeing the full picture, I tend to disagree. Are they stupid even when there is a language barrier a carding mother would sccompany her daughter to hospital. Another sad account of money taking presedance.

    ReplyDelete
  7. Ella how you do this job without falling apart from stress or just losing it with some of these twonks and giving them some medication they'd never forget amazes me. You and your colleagues are real heroes!
    I must say that while the nasty party want to take us back to victorian times and I know this would be very bad for many people, not just the most vulnerable, the idea of people able to get away with horse-whipping some of the effweits you folk have to deal with is very tempting.

    ReplyDelete
  8. It's a wonder you sleep at night Ella, you and your colleagues are absolute heros/heroines for what you have to put up with.

    ReplyDelete
  9. This saddens and sickens me. When our daughter was admitted to childrens hospital there was nothing that would stop me being there. In fact during her third week of admission I was told to go home over night & get some rest, even then I struggled to leave her. Its my opinion (which is probably not popular) that some people should never have children.

    ReplyDelete
  10. As a former health care professional all too often you're called upon to sort out other peoples messes, and it's natural to become judgemental or sharpen instincts. You don't get time to research a background when your job is emergency care, and there are countless other blogs written by SW or HV who do get to see the whole picture. I find it fascinating to have this glimpse into other people's lives, so different at times, and so similar at times to mine.
    I think they ust probably keep all the paperwork they have together and as financial stuff is the most frequently sent out and updated, that's what they had to show. I know I have drawers full of assorted reports and updates about y sons condition, and most of that is financial, as with lot of conditions, once you have the diagnosis, if it's not a progressive or life threatening condition there won't be much more to add by the PCT even with birth defects. We live in a time where there is actually very little support available to parents of children with such illnesses and conditions, and the help available will often go those who fight for it the most. The parents in this case don't strike me as those types of people, but we could be wrong. Hope so.

    ReplyDelete
  11. Ella...I am an EMT-IV in the US and we see the same thing all the time.the worst was being called to the home of a 1 month old not breathing. Got on scene, took about 2 minutes to get him breathing again....then on way out the door the mother stopped us and refused ED treatment. Her words? "He's breathing. No need to waste time."

    ReplyDelete
  12. This has made my blood boil i have 3 children 2 with additional needs one with aspergers and another with a rare chromosome disorder called (16p) when my little boy with 16p gets any kind of cold it always turns into a chest infection and he does aspirate on fluid so we have had many a hospital visits ( only one via ambulance due to a seizure) if they told me i couldn't go with him i would be so annoyed and to think this poor child has a whole range of problems and it seems the parents dont care aslong as someone else is watching there child it doesn't matter . In my eyes if you have children you have to be there for them no matter what yes there is times i sit and cry because both my boys suffer in there own way my youngest the worst as he 3 and cant walk or run like any other 3 yr old but i give them up no would i get rid of there problems yes i would but i wouldn't want to change there personalities because at the end of the day they are my flesh and blood problems or not.

    ReplyDelete
  13. This has made my blood boil i have 3 children 2 with additional needs one with aspergers and another with a rare chromosome disorder called (16p) when my little boy with 16p11.2 microdeletion ( yep thats its name ) gets any kind of cold it always turns into a chest infection and he does aspirate on fluid so we have had many a hospital visits ( only one via ambulance due to a seizure) if they told me i couldn't go with him i would be so annoyed and to think this poor child has a whole range of problems and it seems the parents dont care aslong as someone else is watching there child it doesn't matter . In my eyes if you have children you have to be there for them no matter what yes there is times i sit and cry because both my boys suffer in there own way my youngest the worst as he 3 and cant walk or run like any other 3 yr old but i give them up no would i get rid of there problems yes i would but i wouldn't want to change there personalities because at the end of the day they are my flesh and blood problems or not.

    ReplyDelete

I love comments! All bloggers do! If you have something to say, agree or disagree I would love to hear it! I will reply to all! (or try my very best!) If however, you're a troll, save your breath!

Due to an increase in spam I moderate comments but ALL genuine comments will be posted. See above exclusions!