Bunslinger asked:
Those harrowing nasties you mentioned.. how DO you deal with them? What’s your coping strategy..?
In fact, how do you deal with the shouty ones who don’t like being told “no you can’t have an ambulance”?
The “harrowing nasties” are in fact much easier to deal with than the timewasters. While I’m on a call, if the patient is unconscious or suspended, I try not to allow myself to think of the patient as a person at all - they are just a resus Annie and this is a training exercise. Better still, this is an episode of Casualty and we’re making it up as we go along. In my head, no-one is beyond hope until the death certificate is written, so there’s no point in anyone getting upset. There’s a procedure to follow. Two breaths, fifteen pumps. Two breaths, fifteen pumps. Keep going, we’re almost there. You’re doing really well. Two breaths, fifteen pumps…
Road Traffic Accidents and other gory accidents are not as bad to deal with as they sound, even though the events themselves can be quite horrific. For instance, once I took a call about a motorcyclist who had hit a pillar in a tunnel and been separated from his head by several metres. Another time a woman had been caught under the wheels of the lorry and, in the words of the caller “was in pieces all the way down the road”. The reason these aren’t so bad is because the caller is just a bystander, not a hysterical relative, so again it’s easy not to think of the patient as a person. It sounds horrible to say I don’t treat patients like people, but the truth is, if I did, I’d go mad and I’d not be able to do my job. Of course, this only applies to dead/dying/unconscious patients - if they’re reasonably stable then my fabulous interpersonal skills and milk of human kindness come flooding back! (Right up until the moment they tell me they’re calling for a toothache).
After work, the best method I’ve found of dealing with nasties is this blog! Writing things down is a good way of getting them out of your system. Another thing I’ve learned is that you must not under any circumstances torture yourself thinking “what if I did this or that?” There’s been a couple of calls where I did worry - for instance, I thought should have recognised this patient’s agonal breathing quicker, and I still don’t know how this panic attack resulted in a dead body. Talking to the crews helps, or to other people in the room.
The shouty rude timewasters (and the shouty rude people who have a genuine need for an ambulance for that matter, though for some reason these are rarer), on the other hand, still have the capacity to interfere with my sanity despite my best efforts to eradicate them from my brain. You are kind of limited in what you can say to them, because you are of course not allowed to be rude and you are also not allowed to say “you can’t have an ambulance” or point them in the direction of the nearest cab firm/pharmacy etc (a policy I have to say I do not entirely agree with). This means you are so busy biting your tongue that the shouty rude person can take over the conversation a bit and you also end up suffering from esprit d’escalier, in other words, thinking of something you could have said which would have put them in their place without breaking any rules halfway through the next call.
The best way of coping with these calls is making a note of their ticket numbers and checking back in a couple of hours time to find they got a call back from TAS telling them that they were wasting our time and needed to see a GP, or even better, got an ambulance accompanied by a stern looking police officer who proceeded to lecture them on being abusive and threatening towards control room staff. That’ll teach ‘em.
