Blood, Sweat Tea | Page 8

a 'good shift', reasonably interesting jobs and no-one
tried to hit me.
I Hate Psychiatric 'Services'
Sorry folks, bit of a rant here... but I last slept 22hours ago...
We got a call to a patient who was 'Depressed - not moving', normally
with this type of call it's some teenager having a strop, but this time it
was a little different. Basically, the patient, who suffers from
depression, was discharged from the local psychiatric unit 3weeks ago
and recently had her dose of antidepressants reduced. Yesterday, she
was crying all night, and tonight she was just sitting staring into space,

refusing to make eye contact and not talking at all.
One of the things that we as an ambulance crew cannot do is physically
remove someone to hospital if they don't want to go - that would be
kidnapping and is frowned up by the law. This young girl was not
going anywhere despite my best attempts to persuade her - she just
wasn't communicating.
The solution would be simple: call the Community Psychiatric Nursing
(CPN) Team to come and assess her and, if needed, arrange her
compulsory removal to the psychiatric unit (called a 'Section' under the
Mental Health Act). The problem? It was 10p.m....
First off I phoned the psychiatric unit that she had received treatment
under. After talking to two idiots who had trouble understanding plain
English, I finally managed to get the number of the CPN team. Now,
the London Ambulance Service (LAS) is quite smart; when we want to
arrange an outside agency we go through our Control because all the
telephone conversations are recorded... so if someone says they are
going to attend they damn well better. I got onto Control, passed the
details to them and waited for them to get back to us.
I'd just like to say that in all my years of medical experience I have
never had a simple referral to a psychiatric service; they always seem to
try shirking any form of work by 'forgetting' you or by being just plain
obstructive. Maybe I'm just lucky and get the idiots every time.
Needless to say we waited... and waited... and waited... from 22:20
until 23:00 we waited; then at 23:02 Control got back to us. Apparently
the CPN team all goes home at 23:00 and hadn't answered the phone
until 23:00 on the dot. So they refused to visit the patient. The moral so
far is if you are going to have a psychiatric breakdown in Newham
don't do it after 22:00.
So we switched to plan 'B' which is to arrange the out-of-hours Social
Worker to come and visit, as they double as Psychiatric Liaison. Again
we went through Control and waited... and waited... and waited...
Finally we heard back that the social worker would ring the family and

would like to talk to me. (Outside agencies try this trick, as they know
the patient's phone isn't being recorded, and so can say whatever they
want, with any disagreement being my word against theirs) The social
worker explained that she was very busy and so would prefer not to
come to see the patient and have I tried the out-of-hours GP?
Back to Control I went and got them to try and contact the out-of-hours
GP (A GP, for those not in the UK, is the patients family doctor) Can
you guess what we then did? We waited... and waited... and waited...
Finally, Control got back to us and informed us that the out-of-hours
GP hadn't arrived for work yet and that when they did, they would have
to see two other patients first.
All through this time the family of the patient were very understanding
and were happy when I explained that the GP would call at some point
in the night. All I could do was advise them to remove anything that the
patient could use to hurt herself, and keep an eye on her, calling us
back if they felt the need.
Total amount of time an Ambulance was tied up trying to get outside
agencies to DO THEIR DAMN JOB - 2hours and 19minutes... and not
the worlds most satisfactory outcome.
As I mentioned to our Control - sometimes you feel very lonely out
there on the mean streets of Newham.
It is still the case that as soon as the sun goes down, various community
services disappear and people in trouble need to rely on the ambulance
service and the A&E department, even if it isn't the best place for them.
Sticky Feet
There is something deeply disturbing about walking on a sticky carpet -
especially when the flat is in a complete mess and the punter has called
an ambulance four times in the last 2days for a pain in the chest