Not much to do today, two chest pains – of which one was more of an abdominal pain. However he had had a heart attack and angioplasty a couple of weeks ago and his elderly wife was seriously fretting. When we told her that the nearest hospital that would see her husband was the Royal London she was mortified. Apparently the Royal London has had some increased number of Hepatitis cases (hardly surprising given the area which it services). We managed to calm her down until we got her to the hospital where she started to panic again.
We left her in the capable hands of the nurses…
Another job was opposite where I live – these jobs tend to make me paranoid for the safety of my flat. Given the area in which I live, if people know when I'm working I might find myself burgled. The job itself was a simple 18 month child who'd hit his head on a door frame.
The last job we had was the most “interesting”. We got the call as “Male fitting”, when we turned up he wasn't fitting but he was acting very strangely (this is normal after epileptic fits and is called “post ictal”). He was shouting, waving his hands around a threatening to shoot people if they called him a “whore”.
We were a bit concerned for our safety as this fella looked as if he could handle himself and there were several tell-tale marks that led us to believe he had been in more than one street fight.
We managed to get him in the ambulance and got him seat-belted (in the UK we are not allowed to put anyone in restraints) and I drove us through a couple of red lights to get us to hospital before he turned even nastier.
The nurse who took handover was a “development” nurse – which means that she doesn't get to see patients but that she has sat some exams in “time/motion studies” and “implementing change” – all those wishy-washy nursing courses that drove me away from the nursing profession.
She then proceeded to insist that the patient had an altered GCS.
GCS is a measure of consciousness – you score the patient out of 15 depending on how orientated they are, how they open their eyes and how they respond to commands/painful stimuli. It's more complicated than that but this is an “idiots guide”.
Our patient had a GCS score of 15 out of 15, he wasn't confused (he knew where he was, what date/time it was and what was happening to him) and his other markers were fine. But she insisted that it was altered.
She doesn't know I was an A&E nurse and therefore not scared of her, so I took her step by step through the scale throwing in such gems as “Inappropriate mental processes”, “Maintains eye contact” and “bargaining during the scenario” (these are all buzzwords I learnt doing my psychiatry studies). I think she was a bit surprised that a “mere” Ambulance driver could do such a thorough mental assessment on a violent patient.
And she finally agreed his GCS was indeed 15.