Monday, 11 February 2013

Feeling Sick

“48 year old male, nausea”

Yes, you read correctly, nausea, nothing else; no other symptoms, or at least no other symptoms that we were privy to. I hoped there was something else; surely nausea was not something worthy of an EMERGENCY ambulance. After waiting 5 minutes for the recycling lorry to edge down the road we were trying to access, we pulled up outside the house. The garden was overgrown; an old sofa, upside-down, was protruding from the hedge, and various pieces of broken wood and piles of rubbish were scattered up the crazy-paved path. The flaking paint around the rotten doorframe told us all we needed to know about what the house was like inside. There was a porch stopping us from accessing the front door so we rang the bell. Then we rang it again. And again. Eventually our patient, sporting a lovely string vest and trousers held high up his mid-drift, appeared. Using a tissue he opened the door, and then dropped said tissue on the floor. I looked down, carefully stepping over the sea of clean tissues and into the hallway. 

The smell was grim! It was kind of stale with a hint of ammonia and rotten food; nothing new to my senses but unpleasant all the same. Clearly there were social issues at play here as well as medical. We went into the living where our patient had wondered off.

“Take a seat”

I looked around… "I’m OK thank you, been sat down for ages” (massive lie!)

“So, what’s the problem today?”

“I feel really sick”

“How long have you felt sick?”

“Since I woke up”

“And how long ago was that?”

“About an hour ago”

“Have you phoned your GP?” (my tone was already quite short and frustrated!)

“Yes”

"And…"

“There was a queue on the phone so I couldn’t get through”

“So what do you want us to do?”

“I don’t know”

Well if he didn’t know why he called an ambulance, what the hell do we know?! There was no way I was going to take him to hospital. Despite me asking about every symptom I could think of he had none. No vomiting, no pain, no dizziness, no headache, no urinary symptoms, nothing! I saw an old PRF on the sideboard.

“You had an ambulance last night?”

“Yes”

“Why?” I asked whilst I was reading.

“I felt sick”

I decided to phone the GP, there was indeed a queue to talk, and I was 16th in line. There was no way I was going to wait. 

“OK then sir, let's go to the ambulance and we’ll pop you round to the GP, grab your shoes and your keys”

I started scribbling my paperwork to hand to the Doc as we drove off down the road. 100 yards and we turned left, 50 yards and we stopped. Yep… journey time to the GP by ambulance was 42 seconds. It would have taken a whole 2 minutes to walk... Just sayin’.

I sat him in the waiting room and went for chat with the receptionist. After a slight battle to let me see a GP rather than divulge his entire medical history to her, she buzzed me through. I told the Doc that the string vest in the waiting room was feeling sick and had had 2 ambulances because there was no answer on the phone. He rolled his eyes and said a sarcastic thank you! We bid farewell to our time-waster and went grumbling back to our truck.

Seriously… TRIAGE. I know it’s a French word but surely that call could have been downgraded to ‘make your own way’. As much as I want to scream at the people who pick up the phone, dial 999 and say ‘I feel sick’, I equally want to scream at the person who says ‘sure thing, an ambulance is on the way’. What is the problem with saying ‘No’?! This guy didn’t need an ambulance; he didn’t even need the GP. He said what was wrong, he felt sick. So what! We are humans, we feel sick from time to time.  We live in far too much of a nanny-state where the fear of something going wrong far outweighs common sense. One of the drawbacks of a totally free health care system is that it is vulnerable to abuse, and abuse it gets. I think the ambulance service in general needs a new PR department. The Fire Service got it right with their various fire safety campaigns. We need to follow suit with educating people what is and isn’t an emergency.



37 comments:

  1. Completely 100% agree! Sadly hands are tied in control too. I take calls like this all the time and it really annoys me when by get a response by ambulance. There's a whole generation of people that just don't have a clue what constitutes and emergency.

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  2. I don't blame the dispatchers when we get a shit job - I blame the SMT when who prevent them from using their brains when dealing with a call. Until the system becomes less risk averse we'll keep going to shit jobs like that one.

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  3. I really think you need to be reported for the constant personal criticism of people, where they live, how they live, whee they live, what they do or don't do. As a professional I hope there is anyone with a mental health issue or any other vulnerable person is reading your blogs.

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    1. Reported for what? Sharing a frustration? I have never said where ANYONE lives nor have I EVER said anything to identify any patient. Like I've said I change ages, sexes, times of day, combine multiple jobs into 1 post to get my point across. If you read my blog you will know I constantly talk about ways to improve care for mental health patients and how the system they are in fails them. Any individuals I think are vulnerable I always to everything in my power to ensure they get help. I'm critical of things that need criticising.

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  4. Agree with the anonymous poster above. This situation is undoubtedly frustrating and I agree with many of your points but the personal criticism of how this person was living was not necessary.

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    1. I think how someone is living is relevant. If I write a post about a hoarder who is ill I can only do that by describing what I see. I'm didn't criticise them for living in this way at all, it merely paints a picture. A picture of social struggle and that's what needs addressing. I referred the patient on because they need social help, NOT an ambulance.

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  5. Oh for heavens sake get a grip!! The relevance of the state of the house and patient is obvious, so many calls come from bored, hard up people with nothing better to do than dial 999. They haven't paid towards it and never will. Get a job, a life and pay your way, then you won't have time to feel sick!

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  6. Baffles me that some people waste the emergency services time in this way... Now you've had a rant shouldn't you be meeting up with the boys (and girls) in blue to be abusing and belittling the fire service??

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  7. Agreed, maybe you are the 'issue' and should look for another job, that will guarantee the 'class' of people you work for & with. I really wouldn't like you to be the person who comes to me if I dialled 999. You speak of People as if they are a bother to you. Your blogs are in fact very discrimanatory & hate filled,

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    1. If you think I have an issue with class you are gravely wrong. You know nothing of my upbringing or who I am. Of the people I see every day at work, some do bother me. I can't hide that. There isn't one person who works on ambulances who could say that there aren't people who bother them. I treat them all patients the same, I could have taken the easy option and just taken him to hospital. Instead I took him to his GP. What would you like me to have done. I don't discriminate against anyone for anything. Not race, sex, religion, sexuality or social standing. I am fed up with the system being abused. I don't like doing CPR on someones mother and waiting for 40 minutes for another ambulance because they are all busy on calls like this. If you hate my blog so much, don't read it.

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    2. What bugs me when I go to a similar job is when people clearly have done nothing to help themselves to deal with what is clearly a minor ailment.

      When someone is feeling sick (as this person was) it is quite clearly inappropriate to call an emergency ambulance - one designed for life/limb threatening emergencies, not for a dicky tummy. I see nothing In Ella's blog that shows she is 'hate filled'; what I see is a professional who clearly cares about her work and the impact that inappropriate calls have on genuine emergencies.

      Yours, a different anon.

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    3. Only one of the anonymous detesters has had the decency to reply to my comments and they explained their point! It appear 15:17 has nothing to add.

      15:53. Thank you!

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  8. It does seem that the ambulance service is being sent to more and more non emergencies. With the introduction of the new 111 service is seems that we are attending even more jobs that are being classified as a red call but are actually not a medical emergency when we arrive, like the story above.

    I personally think it is down to, as you say lack of education of what the ambulance service is for. We are an emergency service, we respond to life threatening emergencies. These triage systems aren't working, and they need reviewing. But another question to ask, is the service covering their arse, by sending crews to these jobs "just in case" it turns out to be more sinister?

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    1. I'm worried about 111 coming into my service! Will cause havoc!

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  9. You clearly care very much about people and the job that you do. That does come across. I wonder sometimes do you write things in the moment before you've had a chance to reflect though? < as we can all be guilty of. When I say the personal criticism of what the house was like, I meant I didn't feel the terms in which you phrased it were necessary. It reads like you're inviting the reader to laugh at the disgusting way this person is living. Referring to him as 'string vest' etc isn't great either. Like I say, the situation is frustrating but like you point out yourself, there are clearly social issues at play. Why would anyone choose to live in those conditions and call upon the services of clearly frustrated paramedics? Just a comment about how your blog can come across. That's all.

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    1. Point taken. I wrote this 3 months ago so have reflected on it. I just describe what I see, when I walk in somewhere. I hadn't intended to make a laughing point, just say what I saw. I did fill out a social services referral for him.

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  10. I love your blog, and really feel for the things you have to cope with on a daily basis. It is terrible the time you are made to waste on situations like the case described above when there could be someone genuinely in need of an ambulance. I only wish that these time wasters could be charged or fined for this behaviour. Maybe it would make people think before picking up the phone and dialling 999.

    It seems as if there is a great deal of inconsistency with how calls are dealt with. I know from experience that when my mother was deathly ill I had to practically beg over the phone to have an ambulance sent out (she was admitted and ended up with a lengthy stay in hospital), yet some people seem to manage to get an ambulance at the drop of a hat.

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  11. I read your blog alot and constantly wonder at why people call an ambulance at all in cases like this...education (and improved mental health provision which I know from reading you have raised the need for) seem essential but so is common sense. I was raised with the mantra of 'get some sleep and give it 24 hours before contacting the GP' and wish more were!

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    1. I was also brought up on that mantra!

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  12. This posting aptly describes the utter frustration felt by the vast majority of frontline staff at the abuse of the 999 system and 'anonymous' falls into the trap of commenting from an uninformed point of view.
    I'm sorry but this blog posting paints a picture of the situation Ella was going into very well and I can concur with the sentiment that when you turn up at a house with all the detritus in the garden, peeling paint etc, that is a good indicator of what it's like inside. It's not a class issue or any sort of bigotry, it's a bloody fact whether it's liked or not.

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  13. Don't change a thing!! Your blogs are interesting, and accurately portray what many other front line crews see every day! Its life, in all its technicolor glory!

    I have to agree with 20:39. I had a similar experience battling for hours to get an ambulance for my Step Father, my Sister in Law was with me, she's a District Nurse and her opinion was dismissed too. He was eventually admitted, with Sepsis and had a lengthy stay in hospital. What frustrated me most was the very next day, with the same ambulance service, my mate went to someone with itchy teeth. That apparently was deserving of an ambulance....... go figure?

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  14. Trolls trolls trolls. When they started selling off bits of the NHS to the lowest bidder, it opened the flood gates to a poor service. The cradle to the grave ethos of holistic, symbiotic care went right out of the window. Centralized call centres took local tied in services and blew it apart. In its heyday, even without the technology we have now, people with a clear social need would have been well known to the locally run ambulance service. A GP or a Vicar might have popped round and had a quiet chat (assessment) instead. Now people are very much stuck in an isolated world, where nausea becomes cancer, a cough is death, standing up too quick is an aneurysm. Ella does a fine job presenting her point of view and reflecting the result of the disastrous decisions and social progression we all have to deal with. I don't find her blog NEARLY as judgemental as the commenters.

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    1. Thank you! Youre a legend! Got to love a troll!

      Delete
  15. Ella, you do a great job, please don't stop. You are only reporting things as you see them, in other words 'honestly'! Many a time have I gone to a job and thought the same things as above, also declining the seat even though I haven't stopped all day. And as for inappropriate calls how's a stubbed toe!?

    MAK!

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  16. Before you walked through the individual's door you had made lots of presumptions about the person who lived there. I've read many of your blogs, and as someone who works trying to improve integrated health and social care services, i cannot see what you could possibly add to a team and the future of our working? Your blogs are pre occupied with 'poking fun' at more vulnerable people's expense. I hope none of your patients ever has the misfortune of reading your blogs and discovering your true attitude and mind set. Instead of complaining, did it ever occur to you to try and do something about it? Make a positive change!!!

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    1. Oh please lay off and go somewhere else for your trolling

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    2. 22:45: It's human nature to presume. It doesn't effect how I talk to someone or treat them. If that's how you feel that's your opinion. I wasn't poking fun an anyones expense. I'm bored of having to explain myself to people like you. If you think im stupid enough to describe a single job in such detail you my friend are in the wrong job and are adding little to integrated services. Did it occur to me to make a change? Yes. It it.
      1) Took patient to Gp
      2) Told GP about living situation, all documented.
      3) Referred to socai services via a vulnerable adult form explaining patients living standard and what I thought was needed.
      4) Followed up referral with email giving further details when requested.
      What else would you like me to have done?
      Go troll somewhere else.

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    3. A totally correct assumption. Ella has been doing the job long enough to know what is going to be inside. How likely do you think it is that the inside was going to be any better? Ella did everything she could so that this person got appropriate treatment and follow up. I work in mental health and face the same kind of houses day in and day out. Do you really think that the inside was going to be all clean and plush? Not judgemental just realistic. Now troll off.

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