I’ve dealt with little kids with quite serious (though not life-threatening) injuries. I’ve treated patients with chest pains and irregular heart rhythms and ones who think they’re going to die and ones that fall asleep and I think they’re going to die. I’ve had arguments with young people, nearly lost youth members in massive crowds, and had a number of other heart racing situations when they’ve been around. Every time, as soon as the adrenaline has worn off, I’ve just shrugged and got on with things. I’ve felt tired, frustrated, irritated, and even downright angry after treating, but nothing that has ever lasted after I’ve signed out and headed home (well, except the tired, but hey, I work hard on duty… well, most of the time).
This happened nearly a year ago now, and I wrote most of this post at least six months ago. It’s been sitting in my drafts box ever since, and now, I feel that it’s about time I brush it off and actually post it. Youth problems always hit me hard. I genuinely care about the young people in my charge, be they patients, members of the organisation, or just that lost boy who came up to me in the street (a story for later, perhaps). (Without trying to sound defensive, don’t take this the wrong way. I care about their welfare, nothing more. And I really dislike that society is such that I feel the need to point this out.) There is a reason I am considering training to be a Paediatric nurse. However, I don’t normally have a problem putting this aside either.
This, however, was a step beyond.
It looked like a simple patient. I was technically off duty (everyone else had gone home, and I was only there because I’d bought some snacks from the local shop) and spotted a woman, with a couple of kids, who was probably just rather drunk. At first assessment it seemed to be a simple case of sitting with the three of them, trying to keep the mother uninjured and the kids occupied, until someone came to pick them all up. Then a report to our Safeguarding Officer to flag a concern, just in case this is a regular occurrence, and I’m done.
Instead, to cut a long story short, it turned in to a walk half way across the city, following this woman as she staggered and weaved home, chucked abuse at me for following her, and a protracted conversation with a police call taker while we walked. Throughout all of this, I believe I maintained a suitably professional image to all concerned (well, everyone sober enough to make a valid judgement), even when she left her kids in the middle of the road to challenge me for following her (I hasten to add that I chose that moment to also stand in the middle of this road, so that cars would at least hit me in my bright yellow hi-vis, before it hit the kids. And before anyone says anything, I know my safety is supposed to come first. There are some things you have to do…).
Much as I would have liked to, I have no power to remove the children from parents, even for their own safety. Following this tottering woman, until the police arrived, was my only option. If the same circumstances came up again, I wouldn’t hesitate to do it all again, even knowing the final result.
So yes, it was a worrying incident, but it was dealt with as swiftly as possible (my goodness! What a run around trying to get me, the police and woman in the same vague location), properly reported, and throughout I was calm, controlled and confident. I even managed to make my verbal Child Protection report without a problem (as the police were involved and I had already spoken to them, an official written report would only be needed if the police needed a statement).
That is, however, until I started walking home. I was taking the long way, mainly to avoid the crowd that I’d attracted during the walk about. Nobody was being threatening (in fact, quite the opposite, they were completely understanding and a couple even a little grateful). I didn’t even get a quarter of the way up my hill before the shakes set in, shortly followed by the tears.
Any driver who happened to be paying attention to the pavement would have seen a man in a medical Hi-Viz, perched on someone’s step, looking in a right state.
Thankfully I have a good group of friends in the Organisation, many of whom are very willing to spend ages with a slightly hysterical guy immediately after a long duty. I must have sat on that step for a good 45 minutes getting everything aired, repeating myself over and over, and taking up this good friend’s precious time.
To this day, I’m still not entirely sure what about this particularly got to me. Yes it was high-stress, but so was the patient probably having a heart attack, or the one on the boat in the harbour. If I’m honest, I’ve never really closely examined the situation in order to work it out. It’s not exactly an experience I want to relive. It’s hardly a moment to be overly proud of.
So I choose not to focus on it. I got over it, eventually. And, when it mattered, I held it together. It might have been only just long enough, but it was long enough. And that I think I can be proud of.
It’s the Sports Association’s Winter Ball. Everyone’s a bit drunk, but mostly well behaved. You’re not that bad, but you’ve had just enough to stumble and knock your head.
You’re fine. You’ve got a bit of a sore head, but all the rest of our checks are clear. You’ve not even got a lump. I’m just finished off the checks, and you’re a little fed up. “I’m fine.”
“Yes, we know. This is just routine, just in case.”
I potter about a bit more with pen torches and other gadgets.
“I know, I’m nearly finished.”
I start writing up, and have to ask for a load of details from you.
“Look, Jane. We now you’re fine.” LittlePara (my partner for this expedition in the world of the drunk) interjects. “But if you keep saying your fine like that, we’re going to start getting worried. Please, just shut up, let us finish the paperwork, and you can be on your way.”
I give LittlePara a look. I don’t really approve of telling patients to shut up, but I suppose if it works, I can’t complain too much. I finish my questions, hand her a copy of the paperwork, and her friend a copy of our head injury instructions (just in case she isn’t fine). “You’re fine. I suggest you go home, get some sleep, and you’ll feel better in the morning.”
“I’m…” She starts
“I know. That’s what I just said.” Her friend grins.
“I think they got the message, Jane.”
You are an important person in the University, a Sabbatical Officer in fact. It’s Freshers’ Week, you were involved in organising it, and you are pretty used to mostly getting your own way. You’re also drunk, and have been issued an AAA Pass (AAA stands for Access All Areas). This already is a bad combination.
I’m trying to treat one of the Freshers’ Crew (who are responsible for looking after the freshers in a specific area of campus accommodation). He’s drunk, needs to sleep it all off, and I’m trying to gather enough information to arrange for him to get home. He’s in his brightly coloured Crew top, so it’s fairly obvious that he’s a crew member, and I’m in my green and yellow hi-vis, so it’s pretty obvious I’m a medic. It’s also very obvious that I’m treating you (or should be, to anyone vaguely sober).
“Is he alright?” You come swaggering up. “Bob? You okay?” (Yes, I know Bob is a very bad fake name!)
“He’ll be fine. Are you his friend?” I reply.
“Mmmwwaaa?” Adds Bob.
“Are you okay Bob?”
“He’ll be fine. He’s just drunk.” I try to get your attention back to me. “Do you know him?”
“He’s one of the crew members. [As if the big words Freshers Crew on his T-Shirt wasn’t obvious enough]. What’s wrong?”
“He’s just drunk. Are you friends?”
“No. No. He’s a crew member.”
I’m definitely getting the idea that you’re drunk now. “Okay, in that case I need you to leave us some room, please go stand over there.” I know there’s no point telling you to go away, but I hope I can send you far enough away that you leave out of boredom. You standing right next to me is hardly good for patient confidentiality, particularly as you strike me the type to want to take photos, and anyway, I’ve always found that drunk + crowd = trouble.
“No, no. That’s okay. I want to make sure he’s okay.”
“Really, he’s going to be fine. We’re just going to get him home, and he’ll sleep it off. All he’ll have is a hangover tomorrow morning. Please, just give us some space.”
“No, no. I want to make sure he’s okay.”
“Look. There’s nothing you can do here. Please, go away, you’re now getting in my way and preventing me from treating him.”
“I’m not going away. I want to make sure he’s okay.”
I’m getting rather irritated now. “Please. Go away. You are not helping, and I will have you removed if I have to.”
“Do you know who I am? [I’m not making this up!] I am a Sabb! I have a triple-A!”
I’m now seething. “Right. And I have two. [I do. One as a First Aider, one as backstage crew.] But that makes no difference. I need you to go. Now, before I call for security.”
“I can go where I like. I’m a Sabb and I have a triple-A.”
“Right.” I’ve had enough. You have now held me up for too many minutes. I might have had Bob on his way home by now, if you hadn’t turned up with your triple-A. I turn my back on you, ensuring I’m standing between you and Bob, and get out my radio. “Control, from 444 over.”
“Yeah, go ahead 444, over”
“Hi Control. Can you send someone from security out to me. I have a Sabb with a pass I need removing, over.”
“Err, say again 444, over.”
“I have a Sabb I need Security to remove for me please, over.”
“Err… All received 444. They’ll be over in a minute, over.”
“Many thanks, 444 standing by.”
You haven’t heard what Control had to say, but what you get the gist from my side. “How dare you! I’m a Sabb! I have a pass! You can’t do this.”
Over your shoulder, I see the head of security (a diminutive Welsh lady best described as a force of nature), and her assistant manager (a bulky man twice her size) heading my way. I nod at you, and they nod back. “I already have.” I turn back to Bob, who should have been the centre of my attention for the last few minutes. Behind me I hear you being removed, and when I chance a look while moving around my patient, I see your AAA go in to one of their pockets. Hopefully that’ll teach you not to but out next time when you are politely asked.
Needless to say, I had a lot of explaining to do once I got back to the First Aid post. I also got an apology from the Sabbs the next day, and even if I hadn’t, the look on your face when you had to hand over your AAA was well worth the aggro.
You’ve volunteered to look after freshers this week, and had a good night out with the house you’ve been allocated. In fact, it was such a good night that they didn’t notice that you didn’t come back from the toilets, and went home without you.
I get called to you twenty minutes after the event closes, while we’re packing up. ‘Patient, unresponsive in toilets.’ Perfect. Grabbing a kit from where it had been put away, I walk swiftly out to find you. I have a bit of confusion when I notice that the route to the toilets is far from obvious, but get to you eventually.
You’re sat on the toilet, your boxers around your ankles, body lying on your knees. When I open the toilet door, which opens towards you, it presses against your head, stopping me getting in. It also stops me lifting your head up to properly assess you.
I bend down to speak in your ear, a far from pleasant prospect considering that this is a chemical toilet block, the floor is covered with vomit, and I don’t think you’ve showered in the last couple of days. Yelling loud enough to make security jump, I try and coax a response out of you. Nothing. Hitting you firmly on the shoulders, in fact very nearly slapping you, I try to reach out to a more basic level of your consciousness. Nope, you are indeed completely unresponsive.
You’re a big lad, and try as I might, I can’t get you sat up, not with the door in the way. With you like this, I can’t open your airway, and I can’t check that you’re breathing. This is a problem. I can’t even slip around the door so that I am in the cubicle with you. I’m just grateful that the door isn’t locked.
I have only one choice. Turning to the biggest member of security I can see, I ask him to break the door down. Indicating which way I need it to come, I stand back, and he takes great pleasure in forcing the door the wrong way. Outside I can see campus security eyeing up the door. They’ll be getting your name, assuming you are sensible enough to give it, and I hope you get sent the bill.
The crash of the door seems enough to wake you up, though you aren’t impressed. Twice you try to swat me away, but you’re moving so slow I can easily dodge. Besides, you don’t seem to be seeing straight, and only stay upright while I hold you. You are definitely in no fit state to go home tonight, and I’m not happy loading you on to the vomit comet for the easy ride to A&E (the vomit comet is an SU run minibus that takes all our minor injuries to hospital, saving on ambulances).
Up comes the local ambulance service, the crew not impressed that they’re having to pick up a drunk. I don’t blame them. I have no sympathy for you either, but we all know that it’s the safest thing to do. The last thing we need is for you to roll over in your sleep, vomit, and then drown in your own stomach contents. Once we’ve got the basic details out of you, we leave you in the care of the ambulance.
You’ll probably get put on fluids, rehydrated, and have no hangover the next day. You may even go for a repeat tomorrow. However, tonight at least you and your liver are safe from further harm. Perhaps you’ll learn. Can’t say I’m too hopeful…
I’ve been responded to a man collapsed in the street, and spot you staggering away. A helpful bystander points at you and tells me that you are the person I’m looking for. You continue your weaving way down the pavement, effing and blinding as you hunt for the person who knocked you down.
Before I can even say a word, you’re friend spots me and my partner approaching. He forcibly grabs and leads you to me. I quickly look you up and down. You’ve obviously been knocked about, have a lovely black eye developing, abrasions on your knuckles, a bad attitude and an electronic tag to match.
In an instant I decide that you aren’t particularly child friendly, and while your friend and I lead you to the First Aid unit, I have my partner call ahead to advise the youth member supervisor on the Unit that she and her charge may wish to go on a patrol. Right now. (The young man must have been at least 14, but that’s not the point. Our officer in charge of youth members on duty would have strung me up if I hadn’t done this. Sorry mate.)
So we get you in to the now empty post, and take a proper look at you. You are still arguing with your friend, because you don’t want to be here. In fact, all you want to do is start another fight. In the confined space, I can now smell the alcohol on your breath, and a quick light shine in your eyes shows the slow reacting pupils of the drunk.
You tell my colleague you’ve drunk two litres of cider. He miss-hears you and starts to right two pints. I point this out to him, and he takes a double-take. Two litres is a stupid amount alcohol, about 11 units. Binge drinking in the UK is defined at about 8 units tops for a male. Oh, and it must only be about 11:00.
I do your pupil response again, because something’s bugging me. I might be imagining it, and it might be because your response is so slow, but they don’t look quite equal to me.
I’ve made my decision. I want you to go in to hospital to get checked out. My partner agrees, and so does the ambulance officer who has just poked his head around the corner. There is no way we can rule out a major head injury in this post.
But you don’t want to know. You just want to go, and the only thing keeping you here is your friend’s hand on your arm. I try to calm you both down, and explain what I want to do. You aren’t listening. Your friend is telling me to ignore you. I’m not allowed to do that, so I keep trying to persuade you. You and your friend are getting louder and louder, and eventually security come in and remove your friend.
In the new peace and quiet, we three medics try to persuade you that you really want to go to hospital. We think we’re getting somewhere, until your friend bursts back in. You immediately continue start protesting about being there, and demanding where the person who hit you is.
Eventually, we give up, get you to sign the decline part of the paperwork, allow security to help you out.
Personally, I think we would have got somewhere, if your friend, who thought he was helping, hadn’t got in the way. I just hope you weren’t seriously injured.
“Hello. My name’s ****, one of ****’s colleagues. I’m just going to shine this light in to your eyes, is that okay?”
“Okay. Just hold still for a moment.” … “No, keep your eyes open for me.” … “Just look straight ahead, that’s it.”
“****, you have very beautiful eyes.”
*Blink* *Blink* *Blink*
“Uh… Thank you.”
It takes a second for me to realise that I’m being chatted up by some bloke, who has not only been hit around the head so hard that he can’t remember the incident, but is also so drunk the alcohol is practically crystallising out of his breath.
I turn to my colleague. His face is carefully blank, but I can see his chest twitching as he tries not to laugh. Over his shoulder I notice the rest of our teams conspicuous absence.
It’s going to be a while before I’m allowed to forget this.
It’s your first year. You’ve just arrived at Uni. You don’t have to explain yourself to Mummy or Daddy any more, and in response, you’ve got yourself completely plastered.
The mats in our First Aid Post aren’t that comfortable, but in your current state they’re just fine. All you want to do is sleep, not worrying about precisely where it is you are.
My plans are different. I only want you here long enough for me to ensure that you’ll probably be okay. As long as you are stable, maintaining your own airway, and we don’t think you’re about to die on us, you can go sleep in your bed. While I’m monitoring you, I try to get some water in to you. Perhaps if I can get you hydrated a little, you might make a bit more sense.
No such luck. I’m almost having to bottle feed you to get water down you, and both my partner and I are getting cross. So cross, in fact, that my partner has just had to walk away, and I have just snapped and called you a four-year-old. You’ll probably be fine, and now we want rid.
You won’t even stand up. All you want to do is sleep. We badger, we pester, we even try tricking you in to getting up. All without success. Again, my partner has to walk out before he starts properly yelling at you.
Then your phone goes off, and you make the final mistake we’ve been waiting for. You sit up, scrambling around for your phone. “Right. That was a bad idea, mate.” A quick shift gets you leant up the wall. Now we’ve got you sat up, anything’s possible.
My friend returns, and together we grab you under the armpits. Before you really know what’s happening, you’re on your feet and heading towards the door.
Together, my partner and I walk you home. The cold air quickly starts to sober you up, and you’re making enough sense to get us in to your place, and dumped on your bed. Just in time for you to vomit once (neatly contaminating all the clothing on your floor), roll over, and fall comfortably asleep. A quick shift to protect your airway, a strict instruction to your housemates to keep an eye on you until morning, and then we’re off.
I hope you enjoyed cleaning up the next day. Perhaps it’ll teach you not to get in such a state again…