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Birth, death and everything in between: lessons learnt in the back of an ambulance

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In her first blog post, our new Children’s Helath Student Editor, Desiree Deighton, shares her placement experiences after going on the road with the ambulance service. 

Finally, I could live out my ‘999, what’s your emergency?’ dreams as I had successfully gotten a placement with the ambulance service!

The Paramedic’s radio whirred that a call had come in and the blue lights began as we pulled out of the station to the piercing cry of the siren, which split the traffic like a haphazard parting of the ocean. 

The information screen flashed BIRTH, and I had that guilty feeling students have when something exciting happens.

The mum’s water broke over their sofa and wrapped in a blanket, we escorted Gail out to the ambulance. Gasping on the Entenox mouthpiece and squeezing my hand as tight as she needed we made it to the delivery room.

“The information screen flashed BIRTH, and I had that guilty feeling students have when something exciting happens.”

With the baby’s head crowning, amidst convincing Gail that she could actually do this and meet her baby, we got called away to another job. Falls and injuries were common with the Ambulance service, and we also took several individuals who were on end of life care back home, to be with their family to pass away.

The patient that stays with me though, is Steve, who taught me my biggest lessons: about dishonesty and unwise decisions.

We picked him up from a shop car park where we assessed him as being dangerously septic. Steve told us he had been in hospital for sepsis, and had been receiving IV antibiotics and morphine before he self-discharged, against medical advice.

Sepsis can cause agitation and confusion, so the ambulance staff gently but firmly insisted he must go back to hospital as he was at risk of organ failure and death.

Steve tried to negotiate to be dropped home, that his partner wasn’t coping, his front door wasn’t locked, to find his mobile phone, did not remember where his partner worked; yet the paramedics assured him that the priority was him and they would find his partners details somehow.

“I reminded him of his partner, how he would die if he went home, and shared with him how I had nearly lost my husband to sepsis.”

Steve went straight to resuscitation in A&E as his clinical observations were so unstable. Again, he tried to leave and presuming he was confused the nurses reassured him. I reminded him of his partner, how he would die if he went home, and shared with him how I had nearly lost my husband to sepsis.

Steve looked me in the eye and promised me he would stay. One hour later as we returned with another patient, Steve had gone, self-discharging following a passed mental capacity assessment. Why? Alcohol.

The truth was that he had liver failure and this was what had become septic due to chronic alcoholism. The partner he had spoken so fondly of did not exist, and attempts to get home were not delirium but the desperate drive of addiction.

I am not naïve when it comes to addiction. I have seen parents choose drinking or drugs over their children. I have wheeled elderly individuals for a cigarette, despite their COPD, because they have capacity and the unwise decision is theirs to make.

“The warning was not for six years or six months time, it was six hours. I naively expected behaviour like Steve’s to be for hard drug addiction, rather than alcoholism.”

Yet I have never seen the power of alcoholism in such raw form. To have two choices: stay and live, or go home and die in excruciating pain? The warning was not for six years or six months time, it was six hours. I naively expected behaviour like Steve’s to be for hard drug addiction, rather than alcoholism.

I lay awake that night thinking about Steve’s choices and hoped with my heart that he had managed to dull the pain.

In children’s nursing there are laws and rights in place to ensure the child’s best interests are always met, but the paramedic placement opened my eyes to the vulnerable adults who have the capacity to make catastrophic decisions for themselves.

This placement taught me so much but I was relieved to return to child branch, where we can rely on the security of legal safety nets to swaddle the children and keep them safe from harm.

Names have been changed to protect patient anonymity. 

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Readers' comments (1)

  • Thank you very much Desiree for writing this.
    This is brilliantly written!
    You have captured working in an ambulance perfectly.

    Quick I want to read everything you have written
    Love
    Prashant

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