Ambulance Blues

IMG0060A_edited-1_25Waiting is no fun.  Waiting when you’re a sick patient confined to a wheelchair is insufferable.  The current media obsession with A&E waiting times has obscured an equally challenging issue: that of departure waiting times for those reliant on ambulances.  This narrative conveys the firsthand experience of one such patient: an experience which typifies many for whom the benefits of a hospital visit is undone by the trauma of waiting to return home.I have now broken loose from my umbilical cord in ward C3. The cord which for the last two hours has innervated my body: the drip feed of an elixir that keeps me alive and vital. Now I am making a mad dash from the ward, in my power chair, to the ambulance waiting room. Having travelled through a carbuncle of mile-long corridors I eventually arrive at the waiting-room. What presents itself to me is a battlefield of war weary soldiers, both men and women, who are confined to wheelchairs like me. My initial optimism has obviously been misplaced. This is going to be a long wait.  I turn to the receptionist.

“Name”.

I think perhaps I have misheard her; was she talking to me?

“Name”

…the receptionist repeats in a perfunctory manner. I feel like I’m being asked to give my identity number at a detention centre.  Somehow, I have now moved into a new social status that is undeserving of human pleasantries. I have now become one of the voiceless underclass, unworthy of courtesies.  Having given my details I manoeuvre into an unassuming spot in the corner of the waiting-room.  There above me I see a declaration:

“Average waiting times – 1 ½ hours”

Clearly a statement designed to manage expectations.

The other patients around me look beaten and weary. Many appear to have been there for some time. The collective pain and discomfort in the room is palpable. The urgency of transporting us out as quickly as possible would seem to be self-evident.  What is needed is some Dunkirk spirit to evacuate the wounded.  Many are already traumatised by the hospital visit: a long wait for the ambulance is yet another ordeal. One other fact I learn on overhearing another desperate patient asking the whereabouts of his appointed ambulance: the receptionist can only radio for the whereabouts of an ambulance after a patient has waited one and a half hours or more.  Clearly the lines have been drawn in the sand. I can’t help feeling sorry for the receptionist who clearly does battle from dusk till dawn.

One hour has now passed.  The novelty of the situation has begun to recede. I become more aware of the television, the banal banter from the Jeremy Kyle show succeeded by other afternoon TV chat shows which pervades the whole room.  I had come prepared with a book to read but the uninvited distraction was too great. Clearly we were in the wasteland of mediocrity.  Few people were watching. It didn’t appear to have the effect of making time pass.  The noise only seemed to accentuate our stress, reminding me of an assertion by Florence Nightingale (Notes on Nursing)

“Unnecessary noise, then, is the most cruel absence of care which can be inflicted either on sick or well.”

This does not seem to be a caring environment. The contrast with the hospital ward and the attention of nursing staff is all too apparent.  So much effort, resource and human devotion has been expended to put us right. Now, it seems that all of that is slowly being undone.  We are baggage.  We know all too well that sitting in a wheelchair for any length of time is injurious to us.  The spine becomes compressed.  The bowels become dormant. Without a carer, the temptation is to avoid drinks.  This avoids having to make frequent trips to the lavatory.  However, the long term consequence is that the bladder becomes an acid bath.  All of this will require several days of recovery.

Two hours have passed now. I’ve taken the liberty of asking about the whereabouts of my ambulance.  It appears that it’s now on its way – from a distant location.  Perhaps not surprisingly, given that is now rush-hour, it is stuck in traffic.  My suspected slipped disc (on top of my multiple sclerosis) is starting to be intensely painful.  I feel that I am about to drop from the wheelchair. I look around and see another notice.  It tells me that:

‘Zero tolerance: Any conduct of annoyance… will not be tolerated and may lead to police involvement’

So much for freedom of speech.   It seems that we are no longer entitled to express ourselves. However, there is no risk of me and my fellow sufferers expressing annoyance.  We are well beyond that point.  We no longer have the energy to protest.

IMG0059A_edited-1_25Eventually, after two and three-quarter hours, just before I drop from the chair, I see a guardian angel dressed in green. My ambulance had arrived.

It would be another two weeks before I recovered from this visit.  At this point I am again reminded of a saying from Florence Nightingale’s notes:

“The very first requirement in a hospital is that it should do the sick no harm”.

So who is to blame for all of this damage?  Certainly not the staff on the ground, fighting an un-winnable battle.  Their emotional labour is immeasurable, having to defend the indefensible.  Is it a question of economics?  Well, certainly it’s a very efficient ambulance operation, with peaks and troughs levelled flat at the expense of waiting patients.  But a holistic view of cost savings would highlight the madness of it all: a ‘Rolls-Royce’ care package in the hospital followed by a neglectful money-saving operation at the back door.  By anyone’s calculations this is not even good economics.

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