Monday, 25 February 2013

Not Again

"84 year old female, fall"

It was the start of the shift and this particular patient had been lying on the floor for about two hours. Not a priority right?! Patient care is the ambulance services number one focus right? Hmmm. Anyway, grumbles about the right and wrongs of making an 84 year old wait on the floor for two hours, off we went! We were let into the house by our patients husband who clearly suffered with dementia. He shuffled up and down the hallway for most of the time we were there. Very sad to see. Our patient was lying on the floor in piano / bedroom. Her bed was now downstairs and placed a few feet away from a wonderful grand piano. She used to be a professional pianist and this way she could still lose herself in her music without the need to struggle with the stairs. 

We assessed her whilst she was on the floor and quickly determined that there were no injuries. The only problem was that she had been incontinent. We got her up and onto the chair. The evening carer hadn't shown up which is what had caused her to venture to the toilet in the first place so we were left doing the carers work. We undressed her, gave her a flannel wash and re-dressed her in her night clothes. She hadn't been wearing an incontinence pad when we found her so I assumed it was because she'd been on the floor so long. She was so thankful and grateful and apologetic, it must be so horrible to lose your dignity in such a way. Hospital wasn't on the agenda because she cared for her husband who was still shuffling up and down the corridor.

Once it was established that she would normally help her husband to bed, we said we'd put him to bed, then come and put her to bed, to save her walking around with her frame too much. So, for the second time we did the work that the carer  that they pay for should have done. We took her husband to his bedroom, undressed him, washed him, re-dressed him, gave him his pills and put him to bed. Job done! Now, back to our patient.

My crew mate had prepared her medication and a glass of water. We gave her all the pills which she took so now it was just a case of bed and goodbyes. We stood her up and immediately noticed the wet patch on the chair. A cursory glanced down made it clear she'd wet herself. Not again! Remember that assumption I made?! They really are the mother of all f**k ups! It was then that I noticed I pile of incontinence pads stacked behind the door! So, we undressed her, washed her, re-dressed her and got her into bed. Again, she couldn't stop thanking us and apologising despite my threat of charging her £5 for of every time she said 'sorry'! We packed up our stuff and said our goodbyes when she said:

"I'm really sorry, but I think I need the toilet."

Bags down, duvet off, swing legs around, help up with frame and usher quickly towards the toilet. Unfortunately, at 84 'quickly' wasn't something that was going to happen. She slowly shuffled, one step at a time towards the toilet. 4 meters, 3 meters, 2 meters, fart, 1.5 meters, fart, 1 meter.....

"Sorry, I didn't make it."

The smell confirmed our fears. Not again! We got her onto the toilet, we undressed her, we extensively cleaned her, we got yet more clothes and redressed her, we got her back into bed and we put a load of washing on. I finished off my paperwork including a vulnerable adult form (she clearly needs more help and commode) and then said our goodbyes. On cue, the front door opened and in walked the carer......


26 comments:

  1. Oh my oh my oh my, you two deserve a medal. If only 'the general public' knew what your job actually entailed!

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  2. It's shocking how some care sectors are able to get away with negligence leaving the ambulance service to clean up the mess they have left behind.

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  3. The management of this case is a credit to your humane professionalism. I can't help feeling that you were dealing with a social problem though.In earlier blogs you a
    dvise that there are constraints on the amount of vehicles available. Should there not be another agency to deal with this? In my opinion these cases need to be managed by social services and there needs to be Social Care Asisstants available 24/7. A flying squad that can come and address social needs in a reasonable time frame. This will allow the Ambulance Service to manage its finite resources and ensure Mrs Bloggs who is having an MI does not suffer because Mrs Smith has the only Ambulance to address her social needs. IMHO

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  4. I agree with anon above.... Wholeheartedly.

    Dips x

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  5. I agree with anon above as well. Makes such sense, but we all know common sense is sadly lacking in the NHS.
    Hats off to you Ella, outstanding care!

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  6. If the companies that should be providing the service were cross charged the cost of the ambulance response plus the cost of the labour they would soon sort out the problem. This situation is a demographic timebomb that needs urgent reveiw. If the care companies continue to provide sub-optimal care with no incentive to improve services and no professional accountability this situation will become all to common. A national social care service run by the ambulance service, funded by the government is what is needed.

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  7. Your an egotistical cunt

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    1. It's 'you're' or 'you are', not 'your'. That should therefor read 'You're an egotistical cunt.' Notice how I also added a full stop to end the sentence. I really have missed you! You never called, you never wrote, I feel used. Anyway, now you're back fancy that drink and some dinner?

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    2. This comment has been removed by the author.

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    3. How we've missed your inspirational, intelligent contributions! Not to mention the courage you display by remaining anonymous! Welcome back!

      p.s. please note the correct use of "your"

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    4. Why would you write that as a comment on a blog? If you don't like the blog don't read it, if you don't like the author again don't read the blog, it's not rocket science, is it? Ella your blogs are great keep up the good work, or should that be you're lol.

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    5. He's a troll foll-deroll -

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    6. Thank you people! Aren't they great!

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  8. Move over Winston Churchill, there's a new master in witty and sarcastic put downs. Oh wait...

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  9. Ella, another great blog, oh the poor dear woman. Frankly it is appalling that she is the carer of her husband when she needs one too, should they not each have a carer? Things are royally effed up in this situation and it is all down to penny-pinching. I reckon that some of the NHS & Ambulance service office staff could be used to do that cross-invoicing that is required to ping the 'priavte' companies doing these 'carer' jobs and that if looked at no doubt someone with more brains than charisma (a non-MP obv.) would work out that the NHS & Social Services doing this stuff is cheaper and more effective.

    Also loved your reply to the critic

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  10. I'm really enjoying reading your blog, and I know this is an old entry, but I really wanted to comment. I am a carer myself and I just wanted to make a point about how care work happens. We are probably just as pressured as you are by mental health issues, timescales, lack of breaks, emotional situations and so on. I'm willing to bet money that the carer who came to that lady was delayed by a previous call. Probably something similar to what you yourselves had to deal with, but ultimately coming down to nothing going to plan. Sadly though, carers do not have time built into their schedule for delays. As a rule, the delays that happen will only be rectified when you have a break. Meaning you don't get a break.

    There are always going to be good carers and bad ones, just as there are good and bad paramedics, police officers, and people. However in my experience the majority are just trying to do their best in difficult situations with inadequate resources. We can pin it on people slipping through the social care net, lack of funding, or simply patients/service users who do not want to accept the help that can be made available, but it is always sad to see someone not getting the care they need.

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  11. I truly admire the compassion you showed here, a friend of mine shared your blogg with me and all i can say it that it is eye opening.
    I've always been grateful to the ambulance service, I've only needed to use then twice (once when i was very young and had a severe Asthma attack and could not breath, the second a year ago, when i was involved in a car accident and had to be stretchered out of my car.)
    The work you do is incredible and i honestly don't think people in your profession get enough credit for everything you put up with.
    I wish there was more that i could say, but i will say Thank you.

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  12. I truly admire the compassion you showed here, a friend of mine shared your blogg with me and all i can say it that it is eye opening.
    I've always been grateful to the ambulance service, I've only needed to use then twice (once when i was very young and had a severe Asthma attack and could not breath, the second a year ago, when i was involved in a car accident and had to be stretchered out of my car.)
    The work you do is incredible and i honestly don't think people in your profession get enough credit for everything you put up with.
    I wish there was more that i could say, but i will say Thank you.

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