Monday, 2 February 2009

Snow

All snowed-in with nowhere to go.

Day shift: Four calls; one left on scene; three by ambulance.

Stats: 1 Cardiac arrest; 2 EP fits; 1 Febrile convulsion.
The phrase ‘extreme weather event’ had been used by the media to describe what was coming but still we were ill-prepared for it. A snow storm, lasting all day and laying down up to 40cm in places, left us with very few ambulances and an ORCON nightmare.

I started out at 5.30am and slid, crawled and slithered my way to work on virgin snow and untreated main roads. I saw cars that had been abandoned and some that had simply crashed to a halt before their drivers left them where they rested. Although there was traffic on the road – more than I had expected – the going was very, very slow and I eventually got to my station a little late for my shift.

A handful of my colleagues were there. The usual early morning buzz of people, motorbikes and ambulances was missing. All was relatively quiet and a single on-duty officer busied himself with the task of trying to put crews together. The whole day reminded me of 7/7; not since then have we been forced to tell the public that we would only answer life or death calls, so only Red1 and Red2 emergencies were being passed to us. Everything else was being carefully screened by clinical desks and patients were being told to deal with their own ailments or make their way to the G.P. or hospital. Why we can't do this all the time is beyond belief.

I’ve never seen so many people walking about in such quiet conditions. Even cyclists were attempting to brave the weather, to the cost of many of them as they fell off their rides. I saw no motorcycles today at all. You’d have been a fool to consider it. Neither were there any buses - for the first time in their history, every London bus was out of service.


My first call was a cardiac arrest with no ambulance available to run on it. My FRU colleague, who’d just finished his night shift, offered to stay and help out until we got our manning levels up. He came with me and we ran the four miles on blue lights at no more than 30mph. Even with the snow covers on my tyres, traction was unreliable and the car slid more than once on the way.
When we got on scene we found that no-one at the Nursing Home had attempted CPR on the woman. She wasn’t very old and had no terminal conditions, so something should have been done. Twenty minutes or so had passed without a single one of the ‘registered nurses’ putting their hands to the task of saving her. It meant my hopes of reversing her suspended state were virtually nil.

My colleague and I set to work and the crew arrived soon after we’d started but it was hopeless and I called it after a decent attempt. In my opinion, nobody deserves to use the title ‘nurse’ if they refsue to carry out this basic duty of care. That said, there is much more to this story but I can't get into it here I'm afraid.

What I will say is that the nurses I know and work with are true professionals and not one of them would shy from their responsibilities at work. It is disgusting that we have so-called nurses and carers out there who neither nurse nor care for anyone. It is wrong and has to stop.


A 7 month-old baby having an epileptic fit was attended by a crew as I pulled up at the address, so I wasn’t required. The trip had taken me four minutes but the location was only a few hundred metres away from where I’d set off. The roads were still treacherous to drive on.


Another EP fit, this time a 3 year-old that I’d attended before, was called in as a Red1 ‘cardiac arrest’ but the mother’s screaming and the father’s panic had created confusion. This little girl fits regularly and often eight or nine times in a day, so it was understandable. For a few minutes though I considered that my day might consist of suspended patients of all ages. We really were being used as a genuine emergency service for once.

When I got on scene, a crew was with me and another FRU had already arrived ahead of us. Before that the call had been downgraded to a Red2; the patient was fitting but not in cardiac arrest, thank God.

It took a while to find the address, even though I’d been there before the estate had many access design flaws and reaching the pertinent block proved stupidly difficult. We had to ask a group of teenagers where it was and that delay (if this had been a Red1) may have cost the little girl her life. It’s all very well building security into these places but it makes emergency access slow.

The child was recovering and we swept her up and got her into the ambulance quickly. As I said before, I knew her and I knew that she could fit again at any moment. She has a big-eyed amile for everyone and shows no fear. It's heart-breaking to think that sooner or later her condition may prove too much for her young body. I really don't want to be the one who arrives first when she truly suspends.
She had another seizure in the ambulance, despite being given Diazepam and it took a few minutes before she settled again. The crew blued her into hospital for the nth time in a short period.

Some smart Alex decided to sculpt this onto the roof of my car while I was inside the station. It was a shame to knock it off when I got a call.


Finally, as the snow began to fall again for the evening’s rush hour, I was sent to a 20 month-old girl with a fever who’d just had a convulsion. Febrile convulsions are common and perfectly normal – usually without hazard – but all children suffering them should go to hospital just in case.

The Grandmother was well aware of this and had called because she was concerned that the Calpol she’d given hadn’t worked to reduce the baby’s temperature. I had no way of knowing, apart from palpating the back of her neck (the baby, not the Grandmother) because my thermometer wasn’t working as a result of the cold weather.

There was no big fuss and no screaming relatives; the Grandparents had seen this all before and it made life a lot easier for me and the crew when they arrived to take the child away.

Then off home and into a mini-blizzard. Luckily the traffic was light and most of the main roads had been gritted so, apart from one near-miss when I skidded toward the pavement (containing two nervous pedestrians), I got back in one piece.

Be safe.

7 comments:

Hugh said...

It's quite clear in our code of standards expected of Registered Nurses under the section

"Provide a high standard of practice and care at all times"

This deeply worries me that no attempt was made, as for it to be registered as a Nursing Home, there must have been a RN on duty

Have you reported the Nursing Home?

Xf said...

Hugh

The police were called.

Hugh said...

Oh

Well the NMC will definitely be hearing about it.

Unfortunately in this country the term "nurse" isn't protected, it is only an offence if you use the term to imply that you are a Registered Nurse. As a result anybody can call themselves a "Nurse"

Tom Reynolds said...

The saddest thing about the 'nursing' home is that this is the *usual* sort of care that we ambulance people see provided.

When someone is actually doing CPR you could knock us over with a feather.

Louise said...

"tell the public that we would only answer life or death calls, so only Red1 and Red2 emergencies were being passed to us"

I wish our service had adopted this policy on Monday, conditions north of the border were awful and we were being sent to GP referrel Urgent calls, that the GP hadn't even been out to themselves. 3 of these cases had had the aliment for longer than a week.

Unbelieveable disregard for our safety. As careful as we are as drivers these conditions are still dangerous.

Anonymous said...

As a registered nurse I am appalled to hear that it is quite 'usual' for staff not to attempt resuscitation on patients in Nursing Homes. Why on earth would this be the case? Surely staff are given training on CPR in these establishments. I work on a rehabilitation ward for older patients where arrest situations are rare and I know how scary they can be to deal with when they happen - but to do nothing is unforgiveable. If this is the norm in such places surely somebody should be investigating what is going on.

Xf said...

Louise

Hmm...your Trust has a duty of care to YOU as well as the patients. It was very dangerous on Monday and maybe your bosses should have considered the extra risk you were taking for coughs and colds!

Quite frankly, if patients can be told NOT to call us unless they are in serious trouble on one day, then it can be done EVERY day!

Effectively, we are admitting to everyone that we are nothing more than a taxi service for the lazy and ignorant.