On Monday I posted about what was apparently ‘bullying’ behaviour on my part in order to get a patient the best care that I could give. As I was writing this post I realised that I’ve done it again.
I used to swim. I used to swim alot and so it was a nice surprise to be called back to one of the swimming pools that I used to spend so much time in. Unfortunately it was for a drowning.
Rather obviously we raced around to the pool. A member of staff kindly ran us to the first aid room where we would find our patient. During this run, carrying pretty much the entire contents of our ambulance with us, I was going through my mind about everything I knew about drowning – I was expecting a lot of work on this job.
We entered the first aid room, and the patient, a young lad, was wrapped in a space blanket, sitting up chatting with his friends. My crewmate and I both breathed a sigh of relief.
We spoke to the patient, his friends and the two lifeguards who’d pulled him out of the water. The patient had been unconscious on the bottom of the pool for around 30 seconds, after the lifeguards had pulled him out the patient had started breathing on his own. A short period of time after looking ‘shocked’, and ‘shaking’ the patient had made an apparent full recovery.
“I don’t want to go to hospital”, he told me, “I’m alright”.
My crewmate and I looked at each other.
I turned back to the patient, “You haven’t got a choice mate – you are going to hospital”.
As I looked at the patient the thing that was foremost in my mind (and the mind of my crewmate) was ‘Secondary Drowning’. In secondary drowning there can be damage to the lungs caused by the inhalation of a fluid. The patient will then die a couple of hours after being pulled from the water.
He was going to hospital. I just had to persuade him. So I tried all the nice ways, the ways that won’t worry the patient, the ways that maintain respect and autonomy and all those other hippy words that are apparently so important even if the patient is bleeding to death in front of you.
None of it worked.
Time for the big guns.
“Ok mate”, I said, “the reason why we are taking you to hospital is because of a thing called secondary drowning – you are alright now, but it can cause you to drop dead in a couple of hours, and there would be nothing we could do about it. So you are coming to the hospital with us – you have no choice in the matter”.
He agreed to come to hospital with us. He was a pleasant young man, and he was given the all clear a bit later that day.
My point is – despite the cries of the ‘respect brigade’ (and I don’t mean any of you dear readers – all the comments in the previous post were good points), sometimes you have to become a patriarchal bully in the best interests of the patient. Sometime it’s the only way to get the patient the care that you know they need. I don’t like bullying people, but sometimes it’s the only way to protect both the patient – and my job.
So, sod it, sometimes I’m a bully.