Evening clouds

Evening clouds
Sunshine and Clouds

Monday, 16 March 2015

Being a target

Those who follow my tweets and those who access my Facebook page might have seen my posting about my health incident this last weekend. Enjoying a 'self-care' stay at a hotel near mum's prior to the UK Mothers Day, I became unwell during dinner, experiencing severe abdominal pain and feeling feint. Within a few minutes the kind and helpful hotel staff along with Megan decided help was required. The London Ambulance Service crew showed up a few minutes later and took control of the situation. I remained conscious and with my first aid and nursing knowledge realised the possibility of either an aneurysm or heart attack were high on their list of concerns. Dodgy food was  considered though no evidence was seen.

I was soon in the ambulance and wired up to the ECG machine, whilst the crew calmly went about checking me over. Without further discussion we set off for the nearest A & E where after a few minutes wait I was loaded onto a trolley. At this point I'm sure the ambulance reached me inside 8 minutes, and I was dealt with efficiently so the crew were on their way after handover.
It was relatively early on in the Saturday evening so the staff were fresh and not under too much pressure; my vital signs were recorded by a RN who used hello my name is, nice! A cannula was put in my arm and bloods taken; Megan was asking if there'd been anyone in the lab to process them. I was sure there was; some things have changed a lot and I expect there was machinery close by for doing the analysis required; there has to be to aid meeting targets.

I was put into a single room and vitals checked again; different RN and no ' hello my name is ...'. A cheerfully helpful HCA recorded another ECG, and gave me a gown and blanket with an apology for the lack of a pillow. He was another 'hello my names is ...' hero along with the doctor who saw me. The HCA insisted I put the gown on (I kept my trousers and shoes on all through my stay) though I'd have preferred to stay in my T shirt; a curious requirement and no reason from my perspective. Does wearing the gown help differentiate me from visitors and make life easier for staff? Is this a money saving opportunity missed? On a similar point why not have universal ECG stickers so the ambulance ones aren't pulled off and new ones applied at hospital?

My main question I suppose is around the need to transfer me without question to A & E? Would a wait a little longer at the hotel have reassured all concerned it was a one off and that resting in the room would have been ok? Maybe with my insight I would have been ready to take the risk that it was a one off episode and did not need hospital intervention. I suspect though that algorithms and risk averse targets played a part in driving my care rather then patient choice and perhaps an application of experience and common sense.

Treated with warm politeness at the hospital, privacy and dignity were only nearly there. Wearing a gown as one carried a sterile pot to the toilet clearly shouted - "he's a patient off to do his urine sample" - amplified by the evidence visible in my hands on the return journey did dent both privacy and dignity. As a nurse its ok to walk about carrying other people's bodily fluids; as a individual carrying ones own, its a whole different situation. Within about 3.5 hours I was allowed out after some IV fluids and pain killers, clutching my blood results sheet - though not sure why I was given it. We dutifully completed the Friends and family test card. So, I was treated and moved on from A & E inside the 4 hours and the ambulance team did their job too in that regard; I was a target met.

Was I safe, cared for effectively, in a responsive manner by a well-led team? Yes, so CQC-wise I have no faults to mention. I am still left questioning whether the expense of resources for me was a good use of what was available that evening. I asked the senior nurse who helped administer my IV medicines about the coming shift; it was clear that my case was a straight forward one; single episode of nasty tummy pain that passed off quickly and simply. Yet to come for the ambulance and A &E teams was an after midnight rush of drunken fighters and fallers, that required an increasing police presence. That makes those public servants targets of a different kind, and a group of people for whom I have the greatest admiration.

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