Ambulance wait times

[Jon]

I had a horrendous night last night. My mother has degenerative osteoporosis which causes her terrible back pain. She felt back into her chair a couple of days ago and her back got worse. We called the doctor out today and she said it could be a fractured lower back. She prescribed morphine patch painkillers but we were only going to get them today. So about midnight, my father shouts of for help, as I heard screams from the other room. We couldn't get her off the chair and into the wheelchair. Not only that, she started slipping down off the edge of the chair. I managed to put a stool under her, a cushion and some books to get some extra height, to stop her falling to the floor. I recommended to my father to call the ambulance but he was reluctant to do so. He was tired, just wanted to get to bed and the last time we called them, they took 6 hours to arrive, finally getting there at 5am. After multiple attempts to try to get her to stand up, huge amounts of blood curdling screaming and lots of coaxing, he finally relented. We called the ambulance around midnight. They arrived 2 hrs 15 minutes later. They were very good but hopelessly overstretched. We eventually all got to bed at 3:45am.

This is all extremely stressful, drags you down immensely and puts you in a hole.

Have you had bad experiences with waiting for an ambulance, or is it just the UK that is hopelessly underfunded?

 

[Insane_AI]

I live in a rural area and it took less than five minutes for the ambulance to arrive in response to my heart attack in April.

 

[Jon]

I think average wait times for life threatening issues is about 12-14 minutes in my area.

 

[Insane_AI]

We let the ER do triage and the ambulance do the transportation part. I think you are correct to complain about the service.

 

[Jon]

I have realised they don't give a hoot about the pain aspect. It is all about preserving life. When my mother broke her arm last year, she was screaming in pain lying on the floor in agony. I think that took about 3 hours before they arrived.

 

[The_Doc_Man]

When my father had his fatal heart attack, we were told that the "run time" for the ambulance was just over three minutes because they were dispatched from the closest fire station. Can't speak about anyplace else, but in the greater New Orleans area, EMT vans and fire engines share the fire station. According to the E.R. doctor, dad probably wouldn't have survived even if he had the heart attack in the E.R. because of the specific nature of the attack. It wasn't his first such attack and apparently had weakened the heart muscle.

I know that the EMT folks aren't the ones who do first-level triage here. In dad's case, he got priority because he had fallen over in his car seat and was non-responsive. However, if the person appears stable, it is possible that a higher priority would be granted to another call, which means that a more distant but idle unit would be dispatched to the stable individual.

This is not to make excuses for long delays. The real reason is that it is always about how many units a region can afford to keep on staff. When the taxpayers say "no" to increased millage rates for emergency services, that places a limit on the number of units available. I know about this first-hand for another reason. Long before he died, my dad was a firefighter in the neighborhood in which I lived. We understood the effects of budget cuts, which often meant one less person on the fire crew for some shifts.

 

[Bee]

That sounds very stressful, Jon. When I was taken ill suddenly this time last year, they sent an advance paramedic to assess my condition. It took him minutes to get to me and he stayed for an hour trying to get me stable. Then he called an ambulance and they were with me within about 10 minutes.

I don't know if the time of day makes any difference to call out response times - mine was early evening.

 

[Jon]

It was. Most the times I have called the ambulance recently seem to be from 10pm to midnight. I think they probably get busy then with people coming out of the pubs etc. Friday and Saturday night are obviously very busy times but every time seems to be busy now!

They most certainly won't get there in 10 minutes unless they think it is life threatening!

 

[Jon]

My mother had a fall at 2am last night. Had to call the ambulance again. They arrived at 4am and left at 5am, taking my mother to hospital. She banged her head and has bad bruising on her head. This is all very stressful.

My father has been trying to phone through today to find out how she is and was waiting 45 minutes on the phone, after the person basically said, "Hang on, we will check." He gave up waiting in the end. I told him to just leave for the hospital at 6pm so he gets there for 7pm and visiting hours. It's terrible, you can't even get through to find out how your loved ones are. It's all a mess.

That is two ambulance visits during the middle of the night this week. I feel drained.

 

[The_Doc_Man]

I wish I could say I've been there, but for the last several years, we've been OK and my mother-in-law is in a nursing home literally across the street from a hospital emergency entrance. It was an incredible stroke of luck to get her in there and we know it. I can sympathize at least. I remember when my mother had issues, she was in sufficient condition for Dad and I to just transport her ourselves. He had some training and knew her problems weren't life-threatening. It was only about a three-mile run from our house to the hospital so the run was trivial. (That location was by Dad's planning skills.)

I understand issues of trying to get someone to give you feedback, though. Difficult though it might be, actually going there is probably better not only for you but also for your mother to see your smiling face.

 

[Jon]

Essentially, home is a nursing home, with me being a carer, full time job etc etc.

Yes, to get to hospital would be better. I had a commitment this evening for a chess match, playing board one for my local club. My dad said he would go, but he isn't now. He struggles a bit with the mobility and the car park is a bit far for him from the hospital.

Before anyone judges, factor in that I have done 180 hospital and nursing home visits in the last couple of years, been in the ambulance about 10 times in the last few years, helping my mother get to bed every night, dealing with screaming due to agony, cleaning excrement off the carpet last night at 4:45am etc etc. I feel utterly worn out!

Also, factor in that my father gets up on average 5 times during the night to help my mother get back into bed after she has used the commode, helps her undress every night, empties the commode, gets all meals and so on.

As a two man team it gets done, but to be frank with it being 365 24/7 with no respite, it is pretty exhausting.

 

[The_Doc_Man]

While it was a hellish decision, I was in more or less that situation with my mother before I finally realized that I did not have the skills she needed and that to keep her at home was just me being selfish and clinging to a past situation that no longer applied. Dad was gone and all of my family was elsewhere. When Dad died in 82, he taught me the true meaning of responsibility. When I had to make the decision, I learned the bitterness that comes with that particular territory.

Fortunately, between her pension, her savings, and her health insurance, we were able to afford a nursing home. I had figured that she had maybe about 80 months worth of residency in the home before I had to start supplementing her monthly expenses out of my own pocket, but she only lasted a little more than 3 years - early July of 84 to late August of 87, so the money didn't run out. Fortunately I had a durable power of attorney and could manage her finances that way. But it was one of the two or three toughest days of my life to drive her to the nursing home and come home alone, knowing she would never be able to come home again. The ultimate irony and pain of that evening was that I visited my friends who had young kids. They were watching the movie Dumbo and there is a scene where Dumbo must leave the circus behind with his mother chained in a cage. To this day I don't know how I didn't run screaming from their house.

The only thing that kept me even close to staying sane was knowing that she needed me even though she was in a nursing home. I still had to get things for her and manage her social security, pension, and savings. But I can look at myself in a mirror without flinching now. I did what I had to do and got through to the end. Jon, there is no end to the things that will crop up. Then suddenly there WILL be an end and you will feel strange. The part that will vex you for a while is the realization that even though you've lost a loved one, you feel relief. And no, it is not a selfish feeling.

Jon, I don't wish ill on you because you already have that in full measure. But it is a measure of your character that you are staying. And those clean-up moments are bad, but you know what is happening and why. Age and illness take their toll from each of us. We don't want to be a burden on others but sometimes that isn't our option. But if we remember the moments of love, we remember why we do what we must and don't look back on the bad times.

 

[Jon]

Thanks for your kind words Doc. Yes, I understand the relief part. My mother stays in hospital for a second night tonight and it gives me a chance to have some space and time out. The one way trip to a nursing home must have been a horrible experience. It is like shedding one life and entering the next and final phase.

Every situation is unique, but I don't think people realise the challenges of it all for the carers unless you have been through it yourself.

 

[The_Doc_Man]

I don't think people realise the challenges of it all for the carers unless you have been through it yourself.

Sadly, I have found that to be true. Some people get it. Sometimes when I mention that part of my life, all I get are blank stares denoting total lack of understanding or appreciation.

 

[Jon]

There is also the difference between intellectual understanding and empathetic understanding. The latter may come from personal experience.

 

[Jon]

Just spoke to the doctor, so at last got an update on my mum. She has a fracture in her pelvis. They couldn't move her to get an xray done before, but managed to get one done today. Supposedly, they take 4 to 6 weeks to heal. They have given her a drug to help with her lower back pain, hip fracture, neuralgia pain and excessive agitation. They took her off morphine as she stopped eating, was constantly sleeping and nauseous all the time. Now we have to liaise with social services for whatever the next step is. I do worry about the social services, because they seem to be a law unto themselves, making decisions on things that may go against what we want as a family.

 

[The_Doc_Man]

Yet another factor that makes USA and UK more similar than some people think. Our government-based social services ALSO operate by rules that we don't always comprehend and with which we don't always concur.

Good luck with your mum, Jon. And your dad, because this can't be easy on him either.

 

[Jon]

Thanks Doc. Yes, stressful times. You know what it's like from first hand experience. However, this new drug she is on is amazing as it tackles 4 of her health conditions in one go.

Now let's see what the over-zealous social services say.

 

[The_Doc_Man]

Takes on 4 issues at once? OBVIOUSLY it won't be on the approved drug coverage list, or it will be schedule D which has the highest co-pay.

(Thus speaks the voice of the cynic.)

 

[Jon]

Actually, it does cover all issues at once. It works on the nerves. So it reduces pain. My mother has nerve pain (neuralgia) from a bout of Shingles. She has lower back pain. She has Fractured hip. Then, it also calms the nerves to stop agitation, which she had a lot on. It is all in the drug description. That is why it seems a miracle drug. We tried all sorts to reduce the neuralgia pain but this seems to be doing something. Maybe it is an expensive drug and so they don't use it much, who knows.