Cruel to be Kind?

Kindness costs nothing.

Being based in a small rural hospital, we were part of the community. That meant patients expected a certain standard of care. We did our best to oblige but it wasn’t always easy. Some tried to take advantage, the majority appreciated it

An example : in the city, if an elderly person fails out of bed the crew take them to hospital, at best they return them to bed, check them over and drive away. In the country, we’d check them over and return them to their bed if they were uninjured. We’d make the patient a cup of tea and call a friend to see if they could come around to sit with the patient for a while.

The powers that be didn’t like this because jobs took longer and the figures on their computer looked bad, but we still did it.

When I first began with the ambulance service I was an Ambulance Care Assistant, a non-emergency transport driver. Even then we had memos saying we were taking too long when dropping patients back home after hospital stays. That’s because we took the time to settle them and make sure they were comfortable. We put the “care” in Care Assistant into practice. Kindness is free, if ambulance crews can’t show that, who can??

I recently called my broadband service provider to upgrade my service. The person who took the call was friendly, caring and kind. They listened and made me feel like I mattered, something that doesn’t happen often with large companies. If that kind of care can happen elsewhere, why were we being told we were wrong to make patients feel valued?

Many years ago I worked for a large mobile phone retailer. The company was based on a number of principles (I may have mentioned this before), the most meaningful one, the one that has stayed with me, being: Treat Everyone the Way You Expect to be Treated Yourself.

There’s nothing cruel about kindness. Now, more than ever, show some everyday and who knows what might come back to you.

Keep the Faith

Recently I was sitting outside a café with some other people. We noticed a bit of a commotion across the other side of the road. Some large seagulls were attacking a young pigeon, quite savagely.

I stood up and walked over to the scene scaring the seagulls away but, as soon as I turned away they were back. The pigeon was in a bad way but alive so I picked it up and walked back towards the café.

As I walked past the café and the others joined me, the pigeon passed away in my hands.

The people in that café must have thought I was a bit nuts, maybe I was, but I wasn’t going to do nothing. It may have been “nature in action” but my instinct was to try.

It reminded me why I joined the ambulance service in the first place – because I’m a rubbish onlooker and I wanted to help. It also reminded me of the many jobs we did that didn’t have the outcome we wanted. Even when we knew the situation was hopeless, we still tried.

Early in my career an older paramedic told me: “If it’s someone’s time to go, there’s nothing and no-one can change that, but we don’t make that decision!”. At that time the figures showed CPR jobs were around 5-8% successful, but everyone we were called to was in the 92-95% group until we had done our job.

Sometimes that was difficult, especially when you knew the relatives were watching. It would have been so easy to do nothing and tell the family it was over, rather than letting them hold onto some hope as we worked, but there was hope in us too, hope that this patient was one of the 5-8%, and we would never give up until
protocols said we had to.

We never beat nature, the lost ones were always lost but, to shake the hand of the survivor, the one who would not be there if we’d lost our faith – there are no words.

Who’s going to drive you home tonight?

Older people. We know they great, we know they come in many flavours – sweet, grumpy, old-fashioned…

With Christmas soon to be upon us again, along with the long nights and cold weather, it’s a time when ambulance crews are often called to elderly people suffering from hypothermia, or dehydration. Sometimes infections set in, chest, urine, kidney. All required a visit to hospital. Other times it was something simple that could be treated with medication at home. When I was in the service, the mentality of most of the city crews seemed to be that everyone went into hospital, that’s ok in a city where there is a good transport system, and non-emergency vehicles, dedicated to returning patients home, readily on hand.Because I worked in a large rural area, it was different. There was quite a long journey into the nearest main city hospital so, whenever possible, we and the decent GPs in the area would try to treat the patient in their own home. This was often the best policy as many had no relatives in the area and, as a result, no way to get home after treatment in the city.

On more than one occasion, and this still makes me angry, family members would push doctors or ambulance crews to take their elderly relative into hospital over Christmas or New Year so that they weren’t a burden on the family celebrations. My opinion was that the relative was probably better off in hospital surrounded by people who actually cared, and nursing staff often pull out all the stops for patients at Christmas.

Our biggest problem was, even if we could see a way to treat the patient at home, if they or a family member expressly asked us to take them to hospital, we were obliged to do so. Once at the Accident and Emergency Department, the staff would examine the patient, deem them to be fit to return home then discharge them. This did not mean they were thrown out into the car park, but often it meant a long wait, sometimes in the waiting room, sometimes on a hospital trolley in a corridor, until a relative or friend could be found to collect them or a nursing home arranged transport. Neither of these solutions were ideal. Sometimes, if the patient required transport on a stretcher, they had to wait until a non-emergency crew became available. That would be the next morning at the earliest.

I believe things have improved slightly since I left the job. Doctors have more ability to treat the patient at home, but still there are a lot of unnecessary calls made to the ambulance service, patients unnessarily transported to hospital, unneseccarily using resources and bed space that hospitals don’t have to spare. Sometimes its the fault of the relatives or care staff, calling an ambulance when it’s not really required, sometimes it’s just a problem with the system.

Wherever the issue lies, should you or a loved one find yourself stuck in an A&E department for hours waiting to get home, please don’t blame the ambulance crew. Part of their job is to take people to hospital, that’s all they did.