Thursday, 15 November 2007

Hips and Poo!

So, I am still somewhat bored, although I have had to use my brains, in conjunction with D's brains to extract some pts from their awkward positions.........

The title of this post really reflects what D and I have been to over the last few days. It all started with a faller. When we walked in I thought there was a strange smell which got worse as we got towards the bedroom. To cut a long story short we picked the pt up off the floor, started doing a few bits and pieces, watched her walk badly, realised she was dirty (unable to clean herself after the toilet) and started asking questions about the diarrheoa and suddenly, oh yes, she had C-Diff in February and the Dr says it hasn't fully cleared. The the pt piped up and said that she had had a sample tested and had that hospital bug........ I then flashed back to a colleague saying that C-Diff smells very distinctive and I thought that'll be it then.

The son who had turned up just after us was very little help, he cleared out her fridge while we were there and none of the food was in date, he said she hadn't asked for any food in a couple of weeks - well what was she eating?? When was the last time he had seen her?? The place was a mess, cold drinks, dirty clothes, feces on cushions, blankets, the carpet. What were the carers doing? She hadn't been to bed for a few days, again why was she left to live in that state??

Due to the surrounding issues I made the decision that the pt needed to be in hospital. She couldn't look after herself and it didn't look like she had the support to stay at home. The son even said, its easier when she's in hospital....... She lived in Wexham's PCT but was normally taken to Frimley so I rang control so they could contact Frimley and let them know I was coming in with a pt with C-Diff. More of a courtesy than a necessity so they could prepare. They were strangely nice when we got there. The staff at Frimley have a habit of looking at us strangely as we are from Berkshire not Surrey, add C-Diff on top and I expected a frosty reception but no, very friendly and accepting!!!

This is a major difficulty with pre-hospital care, especially for the elderly (and mental health problems...) as A&E, or even hospital, is often the wrong place for the pt, yet there is nowhere else for us to take them. Drs tend to be worse than useless (my apologies to the good ones - you are out there I know) and palm people straight back to us when a referral to a respite care centre or such could be the real solution. Admittedly C-Diff or the like will throw a spanner in the works for anyone.

Another two of our pts kept the poo title alive, another acopic pt with diarrheoa, although not C-Diff and a Drs urgent who was generally unwell and had an accident on the way to hospital......

As for the hips, one definite fractured neck of femur (the smack you in the face obvious type) and a couple of falls onto hips which were waiting for replacement. The first of which involved a Paramedic for pain relief (the one who turned up could also be classified as the comedy act!!) and some logical thinking and organisation (hmmmmmmmmmm(!)) to get the pt out comfortably. Good job and the pt was smiling by the end of it!

Next a couple of police stories. The first: I was driving (D not feeling well) and heading out of FPH grounds. A dark car came into the hospital drive followed by a police car on blues. I assumed the car was being pulled for speeding or the police car was on their way to A&E for something. The dark car ended up on my side of the road, I stopped, they stopped as I was in the way and then the driver got out and legged it, followed swiftly by the two cops...... We drove by, close the police cars door and then drove round the roundabout (waiting for another cop car on blues) and went back to have a nose. The driver was on the floor under a cop and a security guy and as we drove out again there were 4 or 5 police cars now parked on the wrong side of the road........wonder what was going on there and wonder whether they noticed the ambulance that drove round twice...!!!

Secondly, as I pulled into a parking space last night at home a car approached me and the window wound down, I assumed they were after directions so I wound down my window (probably silly at 2am...) and suddenly realised they were police in an unmarked car. The woman driving said, was I home, I said yes just got home from work. She said that she thought I had seen them, paused and pulled in so I didn't have to drive past them. I said no just deciding where to park due to the boyfriends parents car being where I normally park. They said goodnight and drove off. Only then did I think, why would I have noticed them they were in a black or dark blue Vauxhall (I think)........ Oh well, my first run in with the police on the road!!

Right, that is the end of war and peace. Me, well, after having migraine after migraine, I am feeling better this week. I have what feel like sun burnt legs (a new rather annoying but not problematic MS symptom, I assume) and am still tired but much better than last week. Was loosing my patience last week..... The OH's parents are here this week. They arrived on Saturday and leave on Saturday, they have been fine, I haven't seen much of them so far due to work so I am happy with that! They have decorated upstairs so that is looking nice and fresh, getting ready to sell next year.

Right I'll stop waffling now, back to bed for a nap before work!


mdmhvonpa said...

That is a HORRIFIC story ... what is with people and caring for those who raised them from babies!?

Anne said...

Oh but does your story remind me of back in the day when I started out as an EMT. By the time I was finally and ER doc, some 15 years had passed, but the patients never changed.

In my twilight years, I worked in a nursing home and C-Diff was rampant, second only to hip fractures.

I guess your nights went by quicker when you were busy, but are usually only welcomed once a week or so.

Give me a cup of tea and a comfy chair anytime.

That burning you are feeling is a typical MS symptom and not much relieves it except cold compresses or a cool bath if you can stand it.

Always glad to read your stories of work life -- makes me feel like I'm still in the loop.

Take care,