* She couldn’t reach her TV remote control.
* She wanted someone to turn her electric fan on.
* She wanted the position of her bed adjusting.
* She wanted the crew to give her her medication, even though she’d already had it.
* Her incontinence pad needed changing.
* Her inflatable mattress needed pumping up.

If I had been writing this post a few days ago, I would probably have said something about how it is a shame that Enid is so lonely and has no one else to care for her but it is getting to the stage when Enid is actually driving me insane, and every time I see her address pop up on the screen, I want to throw the computer out of the window. Enid isn’t stupid, she knows that we won’t come out for any of these things, so she always tells the call taker she has difficulty in breathing. We can’t argue with that; we have to send an ambulance. The thing is that Enid IS elderly and DOES have serious health problems (including a previous stroke and heart attack) so we can’t take the risk that there is actually something wrong with her this time. But so far, there hasn’t been.

As an allocator, it presents me with a dilemma, because when I have only one ambulance and two calls – a Red for Enid and, for instance, an Amber for someone who’s having a diabetic hypo, which do I send to? If I send to Enid, and the diabetic dies, then I’ve contributed to that by wasting my last ambulance on someone I know to be a persistent timewaster who rings us when nothing is wrong. If I send to the diabetic and Enid really is ill and dies as a result, then I have broken protocol and sent on an amber before a red and could be held accountable for Enid’s death. The ambulance service make it quite clear they will support you in legal proceedings so long as you have followed protocol – but in this case, I wouldn’t have, so would I be on my own?

I have taken to speaking to every crew that gets sent to Enid. Most need no introduction to her, they have been out to her many times before. It is up to the crews what they do when they get there, but my view is that they shouldn’t be doing ANYTHING non-medical for Enid. I know some of them are big softies and think “Oh, she’s a poor sick lonely old woman, it won’t hurt to turn her fan on now I am here” but the trouble is, the more she does that, the more she learns that she DOES get what she wants by calling 999, and the more she calls us. And one day, someone will die waiting for an ambulance whilst a crew is out fluffing Enid’s pillows.

I live for the day when Enid gets a place in a care home or a live-in carer and stops ringing. But of course, there will always be another regular to take her place…

Published Mar 23, 2009 - 18 Comments and counting

18 Comments on “Reasons Enid Whiner Has Called 999 This Week”
  1. Arwen Says:

    What a difficult situation. She must be costing the Ambulance Service vast loads of money, too..
    Is it not possible to develop a line of handling for such cases, within a sector? Something where the crew and calltakes all follow an agreed-upon course? I agree with your suggestion that they don’t do anything non-medical for her, though that may well cause her to call more often (at least at first).
    I also wonder what other care she is receiving, and if the sort of issues she calls for could not be solved via other means… but then I guess that just calling an ambulance is quicker and more convenient if she wants to catch Eastenders and the remote is out of reach..

  2. Elliott Says:

    That’s why I could never do your job… I’d find it to difficult to resist giving someone like Enid a very blunt opinion. Although I understand that Enid is a very lonely old woman with emotional/dependency issues which she is currently inflicting on the LAS.

    Could you not send the police in with the crews and see if that doesn’t shock her into rethinking? Maybe send an LAS officer round with Police to explain that one day she’ll call and that because the crew is there they aren’t saving someone else’s life?

  3. M Says:

    Is there any way for anyone to recommend or require that she gets a live-in carer?

  4. Suzi Brent Says:

    To answer everyone’s questions so far…

    Enid’s case is being dealt with by PALS/Patient Experiences/whatever they’re called at the moment. They have a department who specialise in dealing with regular callers and misuse of the service. We’re not told exactly what they are doing, though. I hope they are trying to get Enid round the clock care though, because that’s clearly what she needs.

    I know she does have a visiting carer, and her GP is also involved. We actually have an agreement to ring them if she calls within GP opening hours. Of course, it’s not the GP’s job to turn her fan on either and I suspect she misuses the GP as much as she misuses us. (When we call the GP and say “Hello, it’s London Ambulance” they instantly say “Has Enid called you AGAIN?”)

    I would very much like to agree something with the crews but it’s not my place to tell them how to do their jobs and any official directive would have to come from above. I would also feel very mean sending the police though I see the point, it might teach her a lesson. Although of course she might just ask the nice policeman to pass the remote control. We did send a DSO (ambulance manager) over the other day, hopefully he had some stern words.

  5. Dullahan_999 Says:

    every service has a few of these and Enid makes a good example.

    Hopefully an agreement will get written up between LAS and the GP surgery that any call from Enid presenting with her usual modus operandi (eg:difficulty breathing)will be passed to a clinical supervisor/paramedic in Control to decide what to do . . . but if she calls with another complaint (eg: chest pains) then you run on red.

    We have a few of these for our regulars. they take ages to set up, and once in place everything improves for a while, but the smart ones out there quickly change their story and we start going again.

    At the end of the day there will always be “Enids” and the dark frustrated side of me wishes timewasters of all varieties could be held accountable for the suffering they cause to other people.

  6. Lanes Says:

    Would it not be simple to create a single FRU unit especially allocated for such timewasters?
    Fully loaded incase it IS an emergency – and they can give medical assistance until ambulance arrives.
    If not an emergency, they could have authority to refuse to assist unless it’s medical as somebody else said.
    Surely that beats 2-3 people in an ambulance coming to help some old lady ‘fluff pillows’.

  7. Suzi Brent Says:

    It wouldn’t be practical to have a special “timewaster FRU” because the timewasters are spread out all over London, so it could potentially take half an hour or more to reach the patient. I also can’t imagine a lot of paramedics/EMTs volunteering to man it! Nice idea though.

    We do send an FRU rather than a normal ambulance if one is available and closest, but the same issues apply – if Enid needs transport to hospital and I’ve delayed sending an ambulance she could still die as a result. Ambulances can’t provide the advanced hospital care needed for a stroke or heart attack, after all. And someone else could still be in need of that FRU while it is dealing with Enid. FRUs move a lot quicker than ambulances so they are really useful in time critical calls like cardiac arrests.

    I can’t tell crews that they should refuse to assist Enid with non medical things – my job is to send them out, not to tell them what to do when they get there. When I speak to crews I do tell them her history and give them my opinion, though.

  8. Claire Says:

    I know this type of woman all too well from working at a careline. Trouble is, if she gets put into a carehome with an emergency call system, she’ll just call us saying she’s got breathing problems instead, and we’ll have to call you. Or she just won’t speak, since most housing authorities stipulate we must call ambulances for welfare checks these days. The only solution is to chop her bloomin’ fingers off. But of course, we’re in a caring profession, so we’ve no choice but to get help for people like this who don’t need it, while others queue with genuine problems. Bloody frustrating.

  9. GeekChic Says:

    Charge her a fee every time she abuses the 999 service. Now understand that I’m not recommending a fee for *all* potential time wasters – just the most egregious.

    Example: I used to work on ski patrol and search and rescue in Western Canada. Policy was then (and is now) that we normally would not charge for a rescue.

    However, if the rescue was caused due to extreme negligence or undue risk taking on the part of the “victim” we were authorized to levy fines up to the complete cost of the entire recovery effort (sometimes tens of thousands of dollars). When fines were levied (and it was rare) it was usually $400-$800.

  10. David Precious Says:

    I really don’t understand how timewasters like this are allowed to continually abuse our overstretched emergency services.

    For anyone who continues to abuse them, personally I think they should be given a written warning that continuing to abuse the services will result in them being blacklisted and no longer being entitled to use of the services; if they continue, then their address and phone number is added to a blacklist, and dispatchers can rightfully hang up (or the call can be automatically dropped, whatever).

    It’s not far that idiots like this can abuse valuable services in such a way, potentially even wilfully endangering the lives of other real patients in desperate need of the ambulance which is tied up dealing with pointless calls.

  11. Smo Says:

    I know in Yorkshire they have a regular caller system that enables any of the Enid-types that are on the list to be transferred straight to a nurse/paramedic in the control room regardless of what category AMPDS spews out. It helps no end once a person gets on the list, but it takes absolutely ages for them to make it onto it. Maybe this is something that LAS could take on as well. Worth a shot :-)

  12. Always Tired Says:

    Does LAS have a clinical supervisor scheme (i.e qualified Nurse or Paramedic) in the room?

    We have one which is a great success when it comes to dealing with the regular callers. if a regular has had their one ambulance for the day and there was nothing wrong they can very often prevent a crew going out again.

    saved us a heck of alot of time and money

    In fact I think we pinched the idea from Yorkshire ;)

  13. bgw Says:

    Do what the city of Toronto, Canada does. Every time you use an ambulance it cost $45.00 (25 pounds).

  14. Flora Gardens Says:

    What all of you need to realise is that LAS management are the most useless lot in the NHS. They are only interested in figures and statistics. Patients and staff come a very poor second.

    A mixture of AMPDS – set up in USA because of the notoriously litigious nature of Americans – and this current government’s creation of an “Everyone is a victim” culture has served only to teach the great unwashed that the LAS will roll over backwards to avoid being sued by some twat who “Knows their rights”.

    Until LAS management grow a pair, tell central government to shove their targets, and allow us to tell wasters to Foxtrot Oscar we are stuffed.

  15. Aussie EMD Says:

    Can totally sympathise here, and I understand your frustration!

    Has the PALS/Patient Experiences system you have over there managed to sort out a solution?

    Like everywhere else I expect, we have our own ‘Enids’ (and our worst offender already HAS a full-time carer – who is usually in the room when our Enid calls! – so don’t go holding your breath for THAT to fix the problem!) but our system uses ‘Clinical Dispatch Supervisors’ for well known ‘callers of interest’, (which I assume is pretty much the same as mentioned by Dullahan_999…).

    When our Enid calls, the call-taker passes it straight on to the CDS, who chats with her (or her Carer, sitting there in the background watching her call…) for a while to determine whether the ‘pt’ is actually in legitimate need of medical attention or if she is just presenting with her usual ‘non-emergency’ complaints…

    It doesn’t stop her (or our other regulars) calling all the time, but it does tend to solve 3 problems for us:

    1. It saves the lines being tied up while the call-taker tries (and tries and tries) to get our Enid to follow the system appropriately;

    2. It severely drops the number of times the Dispatchers are faced with the dilemmas you mentioned above; and

    3. A stern reminder for her not to use the Ambulance Service for non-emergencies from the supervisors every time she does it (and in some cases from the Police or OIC attending) or the long wait when she is allocated the lowest priority welfare check, serve as at least some small deterrents!

    Good luck!

  16. kingmagic Says:

    Regular callers…when one eventually dies (or moves to another area) another one steps upto the plate and takes over.

    They are like an alien sub-species…waiting patiently to take over the planet through a war of attrition on the ambulance services.

    we are trained for worse case scenarios…cardiac arrests, gunshot wounds, knife injuries, all manner of RTC related trauma etc. But they dont equip us in training school to deal with the mass of regular callers we get.

    They truely knacker up the system by their selfish demands and people have died as a result of ambulances being diverted from more deserving cases.

    My answer to this problem…? Education, Education, Execution! 3 strikes and your out!

  17. Nee Naw - RIP Enid Whiner Says:

    [...] of the paramedic told me that Enid Whiner, one of our sector’s most frequent callers, passed away in hospital some time in the last few [...]

  18. Rob Says:

    There should be a system for wasting ambulance time, much as there is for fire and police service especially as it is the taxpayer that ultimately pays to service these peoples whims.

    Have they not heard of crying wolf?

    Nee Naw
    Nee Naw was a blog about life in the London Ambulance Service control room. It was written by Suzi Brent from 2005 to 2010. The blog is no longer being updated, but the archives will remain here.
    Buy My Book!

    Pages
    Latest Tweets

    Recent Comments
     
    November 2014
    M T W T F S S
    « Aug    
     12
    3456789
    10111213141516
    17181920212223
    24252627282930
    Archives
    Meta
    Adverts