Is this a British thing or does it happen worldwide?
I have lost count of the amount of times I have arrived on scene whilst working on the full ambulance (not the rapid response car…..someone would have to be really rather challenged in the neurone area to say that to a single responder who turns up in a car!), to hear the patients relative or carer call out
“You`ll need your chair”
As we continue to walk to the house we get further tit bits of information such as
“he cant walk”
“he hasnt been out of his chair for weeks”
“Ooohhh, youll never get him up”
etc, etc, etc.
My response is always the same.
M999: “We will just pop in and see him and then decide how best to get him out to the ambulance”
Now, here is my disclaimer straight off the bat, in case someone reading this things I am neglectful to my patients. I will ALWAYS move my patients out of the house with a carry chair or a stretcher if there is a clinical need for it.
If on the other hand the patient has taken on the sick role, (or what I like to call Pyjama induced paralysis) whilst they have been feeling unwell with a heavy cold, and has got their family run round ragged after them, and there is no concern in my mind, what so ever, that walking will in any way worsen a condition, or prove painful, or risk exacerbating a pre-existing condition…..they will be walking out to the ambulance.
This is not uncaring behaviour, it is not neglectful, it does not demonstrate poor standards of care. It does however, show a process of clincal assessment, risk assessment, and maximising the patients independance in a safe and supportive environment (wow, that sounds good, i’ll have to remember that)
If I arrive on scene and walk in to find a perfectly healthy looking patient who appears to have a minor medical problem, and the initial assessment shows no significant problems, I will casually ask the patient if they are okay to walk out to the ambulance. Most patients will say that they are happy to walk out, however, many of their family members have different ideas and often jump in by saying:
‘Dont be silly Dad, you cant walk out, your poorly, the lads will get a chair and carry you down the stairs and out to the ambulance”
I understand that relatives and loved ones care deeply about the patient, but sometimes it would be nice for them to think that this may be the 7th or 8th heavy lift that me and my mate have done during this shift, and if there is no need to lift the patient, then we need to think of our own health, and backs, and assist the patient to the ambulance rather than carry someone who doesn’t need it.
Mind you, there have also been plenty of times when we walk in with the family telling us that we need a chair, and then as soon as I set eyes on the patient, I turn around to my mate and say “Chair!”
Its all an risk assessment process and I will always come down on the side of carrying the patient if I have any concerns to their well being. If you are a 40 yr old fit and healthy man who is a good colour with normal obs and a normal ECG, but you are describing cardiac sounding chest pain, you are getting a chair, even if you offer to walk. If you say you feel fine and the family are just fussing over you by calling 999, but you look like crap, you are getting a chair. If you want to walk to the ambulance, and have a minor medical condition, but you seem to be struggling a bit, you are getting a chair.
However, if you look fine, obs are fine, are sitting in a clean and tidy house, and have managed to get up to go the toliet (upstairs) throughout the day, then you will be getting asked to ‘have a try’ and walk out to the ambulance.
I think thats fair enough…….do you?