There I am, on the 8th floor of a block of flats, a mile or two away from one of the better hospitals in the country. I'm with a 69 year old female who has suddenly developed difficulty in breathing.
This is not the normal “I've had a cough for a bit” difficulty in breathing that I find myself at all the time – no, this women is seriously struggling.
Her pulse is 130 (Not Good), her breathing rate is 40 (Not Good), her oxygen levels when I walk in the room are at 86% (Really Not Good) and she is cold and sweaty (Also Not Good).
I give her oxygen which brings her oxygen levels up to a more respectable 95%, a quick listen to her chest reveals a wheeze and crepitus, so I give her some Salbutamol medication with the oxygen to open up her airways, and she tells me that this has brought some relief.
I'm not happy with the way she looks, nor with the way she is breathing, so I phone up the RRU desk, only to be told that there are no ambulances to send, as they are all busy, and actually they are holding calls all across the sector.
Holding calls means that people want an ambulance, but there is no ambulance to send
The patient is getting some relief from the medicine I've given her, but the proper place for her is a hospital. The way she is sweating suggests that her condition is not getting any better.
Then she tells me she wants to go to the toilet, to open her bowels.
It's now my turn to break out into a cold sweat – as an A&E nurse one of the things you very quickly realise is that when people are ill, and they open their bowels, they have a nasty habit of dropping dead.
I really didn't fancy trying to resuscitate her in the toilet, so I kept persuading her that she really didn't need to go to the toilet, and I kept willing the ambulance to turn up.
Finally, I glanced out of the window of the flat, down onto the street, where I saw the sweet, sweet sight of an ambulance pulling up.
Glancing at my watch I see that I have been waiting with the patient for 35 minutes. I'm unhappy because my patient had to wait so long to get the ambulance that she needed so she could go to hospital for some essential treatment. Then I realise that without me turning up she could have died.
So sometimes it feels nice to be needed, and it is nice to see the RRU doing something more useful than just making sure our response times are up to government standards.
Just one job, during a normal nightshift.