Tea

I've mentioned before in passing my call where I was told that 'Patient wants a cup of tea'.

An 'amber' call – lights and sirens if you please. Drive down the wrong side of the road as well.

Our 'patient' was an eighty year old woman who got up and opened the front door when we arrived. Trying to be as polite as possible I asked her what the problem was.

'My carer hasn't arrived, I need a cup of tea'.

My immediate thought was that this patient wouldn't have much problem making her own cup of tea, but I'm not paid to be an occupational therapist, so I kept my opinion to myself. I tried to feel as much sympathy towards this patient as possible.

I enquired as to how many times a day she would have a carer, what they did for her, and when the carer was expected.

All in all it seemed like a pretty light care package – someone to make sure that she was awake in the morning and someone to put her to bed in the night, meals on wheels and help taking her medicines. Nothing too serious.

But… I know full well what some of the 'carers' on my patch are like, so I looked around for the care notes and rang their office.

'Hello there – London Ambulance Service, I'm with a Mr's Smith and I'm ringing to find out about her carers'.

There was an apologetic cough down the phone, 'Hello ambulance. She's wondering where her carer is isn't she? Sorry about this but she does this all the time – we are a bit short handed at the moment because I've lots of people off with the 'flu – I called her this morning to say that the carer would be half an hour late, but she calls you, the police or the fire service if the carer is more than five minutes late. I'm terribly sorry she's wasted your time.'

The nice lady on the other end of the phone let me know that the carer was on her way there now.

So we watched our 'patient' get up and make herself a cup of tea, and just as she finished the carer arrived, looking somewhat overworked.

I don't know if she was 'mad' or 'bad', but she had caused an A&E emergency ambulance to rush to her aid – for nothing more than a cup of tea.

—–

What annoys me is that the people up in our Control aren't allowed to use any sort of common sense in triaging calls – for example if someone rings up and says they are the patient then say they have 'difficulty in breathing' despite talking constantly and without apparent difficulty to the calltaker, we are still sent on blue lights and sirens to this 'high priority' call.

Meanwhile the granny who has been laying on the floor in her own urine for eight hours is still a 'low priority' call.

I don't blame the calltakers, they are forced to work to a system that simply does not work – if it worked then I wouldn't find myself rushing to twenty year olds with runny noses on sirens while being cancelled from people who have had strokes.

The solution, while simple, would cost money – as you'd have to train and pay people to have some clinical skills rather than the poor unfortunates who have to robotically read questions and answers from a computer screen while being watched over by officers who have never worked on the road or as calltakers themselves.

But then, little Doris with her broken hip isn't as important as saving money, is she?

10 thoughts on “Tea”

  1. I agree, there's no shortage of problems in my area which need sorting but wont; nobody wants to take responsibility because it would cost them money. Yet there is no shortage of roadworks and the like by the end of the financial year, very strange…I agree with the other bit too, my college was recently inspected by HMI, so what did they do? They put up a few new signs (that even light up at night), all that means that they cant actually afford to pay bursaries and EMI anymore. Its all rather sad

  2. Maybe add another category?Red, amber, green, cobblers?

    The cobblers ones still get an ambluance, but with a film crew tagging along, then they have to justify the call on camera. Every night, their footage is broadcast on TV, along with a laugh track and wacky music. And at the end of the week, we get to vote in to choose the most pathetic, and they get their electricity cut off.

    Democracy in action, people!

  3. Having spent my working life building systems of one sort or another, there has been an underlying problem that is never addressed.We meet high-level managers, have high-level meetings, make high-level decisions and only show the result to anyone at a high level before it goes live. Then we dump it on those who will use it on an everyday basis. That's where it all starts to go bum skywards. That's when we find it's not want the customer really wanted because we never allowed to consult the end users because the management claimed to know exactly what is wanted.If the frontline people were involved in developing new strategies, then problems would be minimal. But as long as senior management lives in a world of power crazed ego trips, this situation will prevail ad infinitum.

  4. So the key would be to turn the call takers something akin to the NHS direct where they decide which course of action would be most appropriate? Although in my experience NHS direct always calls an ambulance anyway. But the two systems working more closely in tandem might alleviate some of the runny nosed calls?

  5. The obvious issue is one of targets. If you have targets for different categories of call, then allowing people to exercise discretion to recategorize is effectively giving carte blanche to manipulate figures and the entire system of targets collapses. (Or, worse, the system of targets encourages inappropriate discretionary downgrading of calls.)How to solve this problem? That's rather more difficult. In an ideal world, the aim of targets would be to reduce excess mortality/morbidity that results from increased response times, and this would have to be judged against the negative effects such as inappropriate triage, dangers of emergency driving and indeed issues such as impact upon morale and its consequences. Even in an ideal world, I suspect the negative effects would on a day-to-day basis be far more obvious to the observer than the positive effects. And of course we don't live in an ideal world.

  6. You passed up an opportunity to make tea for her, yourself and yourpartner? (if any on that particular call.)

    But seriously…

    Was the Carer service practically shut down due to flu,

    or merely running at reduced capacity?

    Also…

    Is “Tea” on the checklist?

    If not, I don't see how you were called at all.

  7. Isn't the reason the Ambulance service has a universal triage system to remove an element of 'human error' which happens when people start to make decisions? The problem with a system which has to prioritise calls in a nano-second is surely that there just isn't time to ask lots of questions? However, I am wondering why a call such as this would be prioritised as being 'Amber'.

  8. I can see this from your point of view and why it is so frustrating for you.But to me this is also an example of a deeper issue in society. Your “patient” is obviuosly a very lonely old woman. She probably watches the clock all day waiting for her carer to arrive to have some company.I agree that the answer is not for her to call 999 but I find it very sad that she does not have human contact all day. In the past she would have had family or neighbours calling in every day. Very sad situation.

  9. “The solution, while simple, would cost money”Another solution might be to make sure that time wasting call outs cost money from the people who made them. Except of course that little old ladies would be the first to decide to lie there rather than risk a bill for help while the 'twenty year olds with runny noses' would be the first to argue that they legitimately needed emergency care…

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