Knock Three Times

The boiler in my place is knackered, so I'm typing this wrapped up and hoping that the laptop heat will warm my legs. Once I get going it'll be fine (for I am completely cleaning and rejigging my flat). Any typos are due to me not being able to feel my fingers.

On our data terminals we have a 'special information' section, often this causes more problems than it solves.

“Elderly woman, unwell, called by relative not on scene, ring three times so she thinks it's her relative calling or she won't open the door”.


Now, we don't have extended contact with patients, but what we do is try to form some sort of relationship with them. Sometimes I take on a parent role while the patient is the child, sometimes it's a partnership and sometimes I'm the child and the patient is the parent. It all depends on what works with the patient. It's one of the skills that we ambulance people develop – to quickly determine the best way to approach the patient.*

What we don't do is start off with a deceit. It's never going to go well if the first contact that you have with the patient is to trick them.

Things tend to go downhill from there.

We were cancelled for a higher priority call (probably a twenty year old with the sniffles, so it goes) but I wondered what I would have done had I arrived on scene only to be greeted by a closed street door.

The options are simple assuming that the relative isn't nearby.

  1. Knock normally and hope that the patient opens the door. It's unlikely that she would. Then shout through the letterbox that we are an ambulance who've been called by her relative. Lots of elderly people try to avoid going to hospital (they aren't daft – people die in hospital), so that wouldn't guarantee success.
  2. Knock three times. The patient then opens the door expecting to see her relative and instead there is a 6'1″ tall stranger in green asking if her can remove her from the house. I can't see anything possibly going wrong with that.
  3. Knock normally, give up and wait for the relative to make their own way down to the house. This may take some time depending on how far away the relative is.
  4. Knock normally and when she doesn't answer get the police to kick down her door. Hmmm I suspect (quite rightly) that the police might refuse to do this.
  5. Be grateful I'm cancelled off the job and am on my way to do something far less stressful.

My job is simple – most folks could do it with the right bit of training – but it can get very complicated over the strangest detail.

*I used to know all the special names for this sort of thing, and much, much more. Now it's so soaked into the very fibre of my being and I've forgotten the 'proper' terminology because I use it unconsciously. I'll leave it to the experts to use the long and impressive words.

23 thoughts on “Knock Three Times”

  1. I imagine having your door 'kicked in' would be enough to induce a medical emergency in a little old lady, that or she would be behind the door with an old cricket bat, ready for you.

  2. The old girl probably had no bloody idea the relation had called an amb. I find that – half the time – the relation simply can't be arsed to go round and visit Auntie Flo, as they've got something far more interesting to do, like watching some reality crap on the TV!!!

  3. Having met a fair few old ladies, she'd probably be more than happy to have a 6'1″ stranger appear on her doorstep offering to whisk her away rather than her relatives…

  4. more likely “knock three times, because you always do”the old dear doesn't know the family told you to do this.

  5. many times we've had this situation with the relative not on scene and many a times requested for police or us sometimes to kick the door in to find that the patient has gone away or decided to have a lie in

  6. Hope you get warmth soon Tom. we cant have you going cold on us, we need your blogs to keep us going !!Best of luck and here is hoping it isnt an expensive fix !!

    Weirdly I have had a VERY long distance ambulance call for me once !!

    “I was actually on MSN voice to a friend who is a dispatcher in the USA when I had a bad brittle asthma attack and no-one else was here and I couldn't get one word out let alone call help!”

    Luckily for me when my mate called over here for me – they believed him and I was rushed to hospital around 12 minutes after the FRU had got here !

    Cant get more long distance help than that !!

  7. If you can put up living on a site full of students, you're welcome to my room… it's never anything less than very hot (no access to a thermostat and the janitors obviously don't know how to work them) – I could do with some time in the cold!Hope the boilder gets fixed soon.

  8. tom after reading your blog for years i bought the book and its fab…on the heating front we had no heating for 7 months 10 years back ( i was a wee nipper of 11) i remember the snow in the febuary and the boiler died in the march! typical… it was warmer out side than in i am sure!

    Get warm soon tom…

  9. *I used to know all the special names for this sort of thing, and much, much more. Now it's so soaked into the very fibre of my being and I've forgotten the 'proper' terminology because I use it unconsciously. I'll leave it to the experts to use the long and impressive words.Erm…”unconditional positive regard”…”building therapeutic relationships”…”working collaboratively”…

    Though if you're not really into the likes of Carl Rogers and other slightly rubbish humanistic psychologists, one could just refer to it as “being nice”.

  10. You can just see the headlines, can't you… “Paramedic needed ambulance after being rescued from maddened Nan” :DThe thought occurs to me, too.. what if the long-distance relative gave you the wrong address, like a couple of doors down, by mistake? “Oh, she lives on Long Road, it's number 34, or was it 38? Something like that.” Could make for all kinds of awkward conversations…

  11. I think it can be summed up as 'being nice' or 'being sensitive' too. I seem to remember the name for the type of method you adopt is Transactional Analysis.

  12. Search parameters: “Eric Berne” “Transactional Analysis”I remember the Parent / Adult / Child model with fondness from my Drama student days. It proves very useful when evaluating my interpersonal communication with work colleagues. How many times I am expected to be the child but insist on being an adult. You've got to laugh! *grins*

  13. Actually, there is probably a simpler explanation: She was waiting for Tony Orlando to come and sing to her, ergo the “knock three times.” password…….

  14. Just a quick question for anybody who can answer this!I need to find a college that offers a course in paramedical science etc for my visit to a college nest month.

    Does anybody know any good colleges or universities offering paramedic courses?

    Preferably in scotland or east anglia but anywhere really……………………..please!

  15. Having spent many years in flower shops, I assure you loads of people do not know their mothers address, it never gets flagged up as being wrong, because the postie, has 'the knowledge', they just know (in rural areas at any rate) that Mrs Violet Sweetsmell lives @ number 39 and not 89, as it said on the envelope and slot the letter in the right place in their delivery run.All fine and dandy till you need a bouquet of flowers delivering or an ambulance, that's called by a third party; by which time a wreath might be more appropriate.

    If you query the address with the customer, they just tell you 'Ask in the village, everyone knows her.' Time consuming for florists and I don't imagine ambulances can go looking for patients by broadcasting the patients name around the village.

    (It's best not get me going on a rant about houses with no numbers or names on them)

  16. Know the feeling mate! Although we get plenty of time in the cold thanks to the fire alarms going off! ๐Ÿ˜‰

  17. At least you are getting info on your data head. The standard down here in Dorset is currently bugger all beyond the address. No patient info re condition or flag file status.

  18. I am not sure why this would be such a dilema for you? I would always suspect the worst case scenario as a way of covering my behind. You were given an instruction by control for a way for gaining access to a person who may genuinley need your help/want it or not. This 'coded' access info must have come from the relative agreed? So if the patient refused to answer the door and deteriorated because you would not follow the instructions surly leaves you open to critisism? (Police would not be interested as you state) advice from control would probably not help either, leaving you with no option but sit there for hours waiting for relative/further instructions etc.Now if you did follow the instructions, gained access (even an open door) – saw that the patient was not suffering life threatening inj/illness and deemed capable of making thier own decision not to travel – then you could leave and your concious would be clear that not only have you followed instructions (No sacking today) and you havent left a patient in genuine need? To me that is a win/win situation? By following that specific instruction – I don't think is beaking the trust with the patient as you do not enter the property unless invited?

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