Monday, 11 April 2011

Monday Mornings

Monday morning. A curse for many, a blessing for some. The day breaks on the horizon as I head towards what will almost certainly be the last call of the weekend, with the car sounding almost as tired as I am. Thirty six hours over three night shifts, almost seventy activations, with over thirty patients attended. It's been a busy weekend. 

Henry, well into his eighties, is woken by a crushing pain in his chest and his jaw. 

"Call an ambulance, love. I think my heart's playing up again." He tries to stay calm, putting on a facade for Lena's benefit, but after more than fifty years together, she sees straight through it. Once she's called the ambulance, she wakes up her neighbours and asks them to come in. 

"Just to help me keep an eye on him. You don't mind, do you?" 

Their neighbours are young, and always willing to help. I meet them first as I pull up outside, barely five minutes after the call has started. 

"Thanks for coming so quick. I've hardly even put the phone down! Henry's upstairs." Lena's calm exterior  as she watches me climb the stairs does little to hide her anxiety, and as I step in to the room, I ask her to take a seat next to her husband so she can see and hear everything that's going on. 

Craig, the neighbour, gives me a quick rundown of Henry's history, a heart attack nearly twenty years ago leading to a series of another four over the years. 

"I think I'm running out of lives!" Henry says, only half joking. "I guess I'm lucky to get this far. I think it's Lena's fault that I'm still going. Who else is she going to nag to take out the rubbish?" 

She glares at him and tells him to keep quiet. 

Henry's pulse is irregular, a rate of anything from the low thirties up to nearly one hundred. The ECG shows that the heart's struggling, not getting enough oxygen to where it needs to be. Another heart attack seems just around the corner, and as the second ECG strip prints, I hear the crew arrive. 

"Bring a carry-chair up with you please!" I call down. One set of footsteps keeps heading up the stairs whilst the other heads back out to the truck to get the chair. 

"Meet Henry," I say to the attendant. "He's eighty-five years young, and has a habit of causing Lena stress by having had five heart attacks in the last few years, and his heart isn't particularly happy at the moment." I show the attendant the ECG strip, and he concurs. 

The pain had eased a little since I'd given Henry a lemon-flavoured aspirin and spray of GTN under his tongue. That should help open up the blood vessels that feed the heart, easing the problem at least temporarily, if not solving it altogether. The ECG remained unchanged after we had loaded Henry into the ambulance. His heart was sick, and so was he. Lena wasn't far behind, worrying about her husband. 

Once we had reassessed Henry, cannulated him, taken some of his blood, and given him some more medications, I stepped out of the back of the ambulance and headed back to my car, closely followed out of the treatment area of the ambulance by one of the crew. As she was about take her seat behind the wheel, Craig approached her. 

"Make sure you take good care of both of them, won't you?" 

Loading the luggage into the boot of my car, and with my back to them both, I couldn't believe as I overheard her answer. 

"I'll do what I can. But it's late, it's Monday morning, I've worked all weekend, I'm tired, and I just want to go home." She got in the cab, and within seconds was driving away. 

I left half my kit on the road, and went back to speak to Craig. I don't know why I felt the need to apologise for somebody else's behaviour, but I just felt it was inexcusable. 

"I'm sorry about that. I don't really know what to say!" 

"Don't worry about it. It's not you who needs to say anything. Anyway, thanks for your help. I hope Henry'll be OK." 

"They're taking him to the best hospital in the area for cardiac care, and I'm sure they'll do all they can for him.  If you wait an hour or so and then give them a call, the hospital might be able to give you some details on how he's doing." 

"Hope so. I suppose I'd better go get ready for work now. Back into the real world again after the weekend." 

"Ah. Yes. Forgot about that. It's Monday morning for you normal people." 

"Yup. For normal people and grumpy ambulance drivers." 


We meet dozens of people every week, be they patients, relatives, friends, or neighbours. They all blur into one after a while. For us, these calls become routine, emotions become dull, and we feel disconnected. For us, it's a coping mechanism. There's no way we could feel what they all feel, and still be able to do our job.

The patients, however, their friends and family too, may only ever meet one ambulance crew. If the impression they're left with is one of "grumpy ambulance drivers", somewhere along the line, not only do they fail their patient, but we all do.

In amongst all the skills we use, and the knowledge we possess, showing that we care, even if sometimes we struggle to do so, may be the most important thing that we do.

Especially on Monday mornings. 


chris said...

I hope this is a one off lapse from the ambulance person. Mondays suck even for those starting their run of shifts but the PT has to be treated as they are all that matters irrelevant of if its the middle of the afternoon or 30 minutes past finishing. Its our profession!

TLindNY said...

What an ass, about sums it up for me.

Deborah said...

Dear me! Very grumpy lady!

joan said...

I know this diff thing, but i remember few years ago we had an accident on the motorway, the car was smashed up (luckily we wasnt!) we had to wait over hour in a little lane, close to the field we end in! for breakdown, i was still shaking and in tears, the breakdown chap arrived, said " ohh great im going to be late getting home! im having a really bad day!!! ermmm we not actually having a good one!!
ps lemon asprin? do they do them in dispersal? better than the ones i take yuk!
all the best joan

Anonymous said...

Absolutely shocking behaviour, I occassionally let people know how tired I am (normally when I have to stifle a yawn!), but I never, ever let them feel like they are anything but my number one priority at that very moment.

Impressions are everything in our line of work, just a few days ago I had trouble with a crew I requested to take the sick sibling of a very sick kid that I was taking care of. They not only blocked us in, but they went in wearing some very unneccesary ppe and were then extremely rude and uncaring with the relatives of the two sick children. I'm just glad I was there to give a better first impression than they did!

PJ Geraghty said...

When I trained EMS newbies, I always tried to impress upon them that while it's always just another run for us, the patients and families would remember this day for the rest of their lives.

Another friend of mine was even more direct about it: "For these people [patients and families], this is their September 11th."

Hope Henry was OK. How lucky for him to have such caring neighbors!

NightShiftMedic said...

I would have been sorely tempted to follow them to the hospital and give her what for. There's no excuse for that.

burned-out medic said...

tsk tsk tsk

Anonymous said...

It happens. its unfortunate ,no-ones at their best at 0500hrs, but its not something I would dream of saying to anyone.Henry is doing fine, the chain of survival worked!and hopefully I can pop next door and have a cuppa soon.

job well done oh sleepless one.

Anonymous said...

as many have said, the early hours of the morning is not the best time for most (especially me), but like you I am on the car and feel that sometimes after all my hard work calming patients easing anxiety of relatives starting courses of treatments (all on our own may I add) to then have some arrogant (and that is what it is) collegue come up and undo all this hard work through 1 comment is so frustrating. recently the favorite of some crews up here is WHY HAVE YOU NOT RANG THE GP when having being told by ME this HAS been redirected by the gp, thus leaving the person who rang feeling they have wasted our time. People if you are genuinly concerned and dont know what to do ring 999

Eileen said...

Was it a paramedic/tech???? With the addition of APs it might not have been as it was the driver. Nevertheless - that was rude and uncalled for. You know the rules when you join about the hours - the paramedic in our family regularly works up to 1 to 2 hours over on her 12 hour shifts. It's pre-programmed when it is a minimum of 3/4 hour from base to the proper hospital and more than 2 if you get sent south on a call and then you go to the other proper hospital. All on wonderful dales roads! But her view is that she always looks forward to going to work and it's the best job in the world.

Epijunky said...

I realize I'm reading this a little late, but I'm behind, forgive me.

I know what that kind of tired feels like, when one is a bit more less conscious of what one says.

This was inexcusable. Plain and simple. This wasn't just someone being grumpy and tired, this was cruel and just wrong on several levels.

I hope everything ended up okay for Henry. And as for whoever spoke so wrecklessly... I hope she considers another career.