A bit of a moan this one – I know, I know, I almost never moan…
Our job was to a middle aged man with sudden severe back pain. We arrived and soon determined that it was simple sciatic back pain. Our patient didn't speak much English but his wife was fluent (and given her East end accent she was probably born in England).
The thing about sciatic back pain is that gentle movement often helps it – so what we, as an ambulance service, do is fill the patient up with painkillers and walk them gently out to the ambulance. Then we transport them to hospital.
The thing about sciatic back pain is that we tend to see only the people with the severe version of it. They are often lying on the floor clutching their back, unable to move. Part of our treatment is explaining what is happening to the patient and building up a relationship so that they can trust us. It also helps with the pain.
We spent an hour on scene with the patient – giving him blasts of nitrous oxide (laughing gas) and slowly persuading him to get to his feet, and then, with more analgesia, getting him to walk out to the ambulance. Luckily he was pretty good with just the gas – it's not unheard of for us to give morphine in order to get the patient moving.
By the time we reached the ambulance we were all having a joke about it, with his wife explaining to him that this is what it is like to squeeze out a baby…
Then, as carefully as possible, we drove to the hospital.
Once at the hospital we put our patient in a wheelchair, the reasoning behind this is that sometimes you'll get trollies, or patients, that need to be moved around at speed and it's not good to have a slow moving patient blocking the corridor.
We think ahead like that. For us ambulance people are not dumb, we is smart!
The problem that I had was that of the attitude of two of the senior nurses (the type of nurse who, half the time, doesn't wear a nurse's uniform). There was a general rolling of the eyes that we were giving the patient pain relief.
“Why are you giving him nitrous oxide?”, one said.
(Here is a clue – if I write on my report form that a patient is in severe pain, but don't do anything about it then one of my managers has a damn good reason for calling me into the office for a chat. Plus it's also the human thing to do).
“Why did you bring him here? All we can do is give him pain relief”, one asked.
Well – I generally thought that this is the point of hospitals.
Patient in pain = patient needing painkillers.
The patient had already been taking regular painkillers for a grumbling back pain – so it wasn't as if he hadn't tried self treating.
Out of earshot of the patient these two nurses tutted and grumbled about him. They actually treated him well, but it was the attitude that I found incredibly annoying.
I'm more than happy to have nurses unhappy when I bring them the umpteenth drunk of the shift – heaven knows I used to get fed up with that when I was an A&E nurse. Also nurses, like the rest of us, can have 'bad days', but two of them? At the same time? In this case the patient had a genuine medical need, primarily for pain relief and secondly so that a doctor could assess him properly to determine the cause of the pain.
What annoys me, a few days later, is that I didn't challenge the nurses. I was feeling really rather grotty with (yet another) bout of man-flu, so I just let it slide. Nothing happened that would warrant a formal complaint as the patient was treated as he should have been and the nurse (in a proper nurses uniform) who actually looked after him was her usual excellent self – but the attitude of the senior nurses just rubbed me up the wrong way. If I'd been feeling more myself I might have asked when the NMC/RCN guidelines on pain management had changed, or why they thought that he deserved to be in excruciating pain.
I don't know, maybe I'm getting soft in my old age. Or maybe it's because I'd spent an hour getting to know him and his wife, and didn't see them as 'just another face blocking up the department, causing a breach'.