Circles

"45 year old female, abdo pain"

In this job you quickly get to know your regulars. People are frequent callers for a number of reasons. Some have complex medical needs that require frequent intentions, some have medical problems they don't control we'll, some are simply lonely, some are alcoholics who fall asleep in the street and others are addicts addicted to Entonox or Morphine and will try anything to get hold of some!

As soon as the address popped up on the screen we groaned! It was an extremely awkward patient who always insisted on going to a hospital a lob way away and always demanded Entonox for her ongoing pain. The fact is, she does get pain but the reason she calls ambulances is because she wants the Entonox. The hospital she insists we take her too, have said they don't want her brought there anymore and her GP insists she should only be taken to the nearest one. After many discussions a protocol was out in place for her which set out what hospital she had to go to and how much Entonox she was allowed. Neither are favourable to her!

When we arrived she was lying on the usual sofa in the usual position.

"I need Entonox, I can't move without it" was the first thing she said as we entered the room.

No 'hello' or 'thank you for coming'! As per recent visits we reminded her of the new rules. She swore a bit, had her 5 minutes of Entonox and then agreed to come to the local hospital. We drove her up there, handed her over to nurse and promptly received a tongue lashing for refusing to give her more Entonox. The duty Dr then entered the cubicle and lectured her about using an ambulance to get a fix of Entonox and told her she wouldn't be getting any whilst in the department. We left to the sound of her F'ing and blinding at the staff! Living the dream.....

We sat there for 20 minutes, did our paperwork, drank some luke warm coffee and then greened up for the next job. 10 minutes later.....

"45 year old female, abdo pain"

Same address, same info, same patient. Really?! I got straight onto control and they confirmed it was indeed the patient. Unbeknown to us, as soon as we'd left, the patient self discharged and had called a taxi and gone home. As soon as she'd got back she dialled 999 and said the previous ambulance crew and hospital had refused to treat her. Due to the symptoms that were described, she was getting another ambulance. And as luck would have it I would get to enjoy seeing the expression on her face when I walked through the door!

10 minutes later we pulled up outside. As usual, the door was open, and in we went to find her lying on the same sofa in the same position.

"I need Enton......is this some kind of joke?!"

"You tell me, we just took you to hospital, why are you wasting resources?"

"Because they wouldn't treat me up there, I'm not going back there, you can take me somewhere else. I'm also allowed 5 minutes of Entonox."

"I'm afraid the only hospital we will take you to is the local one and you've already had your quota of Entonox."

"We'll f**k off then."

With that we left. I know for a fact that later in the evening she had at least one other ambulance. Whether they knew her I don't know, she may have got her own way, she may have had the same as she got from us. One thing is for sure, and that's the going round in circles will continue.

What can be done? Obviously, we can't charge her. We can't refuse an ambulance for someone in pain with a chronic condition. Equally though, it isn't sustainable to keep pandering to people to are simply abusing the system. It's not the call takers fault, nor the dispatcher. It's not our fault, the hospital can't feed her habit and the GP has tried to help. Now what? Where does the madness stop?!