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Refused an ambulance on a 999 call

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Hi I sincerely hope your wife is being treated and that all is well

When my son was diagnosed at 10 years he had 7.8 Ketones we were told his organs were shutting down (It was a very long and scary night) the way we understand it is 2.5 Ketones requires medical attention (Hospital) and, if his reads are on the high side and not showing signs of lowering we always notify his Diabetes Team (They are very supportive) and together we monitor the high reads and the levels of the Ketones. Ketoacidosis is a very serious condition and given your wife is pregnant I feel you did exactly the right thing under the circumstances.
 
My husband is a type 1 who refuses to care for himself and when I do finally get scared enough to involve emergency services, he causes a scene and refuses treatment...

I'm not sure how to handle this behaviour as we just had a son and post partum is kicking my butt. He's 31, I'm 19 and about to suffer a brain injury from all the strain of trying to keep everything together and my son calm as he should be... what do I do? I make sure he has more than the tools he needs to ensure his health and he's showing symptoms of pancreatitis now.

Any advice for an otherwise soon to be single mom?
 
15 years ago I nursed a man age about 32 he'd had high ketones passers by thought he was drunk he will spend the rest of his life retarded I think you we're right to take no chances
 

Jacqulynn ... your husband is 31 years of age and he has T1 diabetes, which is unfortunate. But that's HIS medical condition and HIS responsibility. You're not a Doctor, you're not Superwoman, you're not his Nurse, you're not his Mum and you're not the one who's behaving irresponsibly here. He is. Don't stand for it and by that I don't mean jump in and rescue him every time he flounders I mean ...

Let him sort himself out because you've got better things to do than to engage in his dramas. It's time he faced up to the fact that he has to deal with his T1 Diabetes AND get on with being a husband and father to your child. That's not going to happen if you keep stepping in to take over when he's behaving like a nitwit. Hard as it may be, leave the decisions to him where his diabetes is concerned and leave him to learn the hard way.

You're 19 and have just had a baby, my suggestion would be that you have enough to do looking after yourself and the baby and that that is what you should get on with. Sounds selfish and it IS selfish, but not as selfish as your husband is being towards you and the baby.
 
I totally agree with GraceK.

Maybe you could get your husband to read this thread: viewtopic.php?f=19&t=12551

Sorry to the original poster for hijacking this thread.
 


Grace is right.... it might seem selfish but it may be the only thing that will actually make him start taking care of himself and, in turn, his family. He MUST take responsibility for his condition because nobody else can do it for him.... certainly not you. You can support him and be there for him but he is the one who needs to take charge of his body and his life. You be selfish and think of YOU because he certainly isn't!

I'm so sorry to hear you're struggling with this, especially when you have a new baby and you have your own health to deal with.


And sorry for continuing to hijack this thread.
 
Readin this has actually made me really sad

Firstly, can I jsut say that I hope your wife and baby are doing well.

I'm T1 since childhood and had a very stressful and worrying pregnancy with my 3 yr old daughter, who has, thankfully turned out perfect, until around 2 years old with tantrums etc, but I won't go into that tonight :wink:

I've been working as a Call Handler in NHS24 (the Scottish version of NHSDirect) for just over 2 months and I'm still in my training (with an experienced Call handler plugged into all my calls for guidance, as per our protocols on patient safety). The first thing I want to say about that, is that I have had many jobs in the past and lots of training, but none as intensive as this one! Everyone in my training group either has a degree or has clinical experience (though not qualifications), or both. So I take offence to this comment:
"not to mention anyone that defends them as doing the right thing when they quite clearly hire staff that do little more than complete an nhs symptom checker." Yes we do use algorithms - very complicated ones, which we have had 8 weeks intesive training on, and continued 1-to-1 monitoring for many weeks after. I can assure this poster that he would not be able to assess a patient using the software without a good bit of clinical training, as simply as he would an online symptom checker. These are created my vast teams of consultants with literally thousands of years diagnostic experience between them. It would not be possible for every caller to speak to a diagnostician on every call, so they have used their expertice to create these tools to help Call Handlers do their job, which might I add, is very difficult, and not everyone makes it through the training.

@lightwolfe I would urge you to use the link given to tell the patient liaison in your PCT about your story. If people don't complain, then these systems carry on without change. I dont know how your local service works, so I can't say what happens there, but in our Health Boards, there are teams of people who get every last peice of information and trry to work out a better "patient journey". When they work it out, changes are implented.

In my job, I do get particularly concerned when it's diabetes, I've been there and obviously have a bit more knowledge in that area than some of my collegues.

Please don't start throwing rotten tomatoes at me here, but I'm going to tell you the protocol form the little I know.

Firstly 999 is for emergency, when the public call, what people call an emergency varies from person to person. Your wife's symptoms were picked up by a clinician (DSN?) who said she had to be admitted ( I don't know, did she said urgently / emergency)
If she deemed it "immediately life threatening" then she has a way of contacting ambulance service directly, without 999 or "which service please?" operators. She has 2 sentences to speak and your address & name. Ambulance will then be dispatched immediately, without even needing to speak to you or your wife. This is only for people who are UNCONSCIOUS OR NOT BREATHING.

the next catagory is for URGENT, which is second behind the Immediately life threatening, and covers things like cardiac symptoms and breathing difficulties (among other things) and if an EMERGENCY 1 as above comes in before this has been dispatched, then this would have to wait (it rarely happens). again, the dsn can arrange this

The categories start to descend from here in order of seriousness. Then it becomes issues of mobility and transport, which as classed as non urgent - that is not to say they aren't urgent, its just the category!

In your wife's situation, there were many serious factors, including ketones, pregnancy etc and she did need to be admitted, but it would be a NON URGENT ambulance, as her life wasn't immediately in danger. If she had developed new symptoms or the existing symptoms got worse, she would be regraded, but they can only go on the symptoms presenting at the point of the call, not what might happen if she doesnt get help, if that makes sense??

Now everyone on here knows how serious DKA is, so that feels a bit like banging your head of a brick wall, cos you know what can happen! very frustrating!! :evil:

because you couldn't afford the trip to hospital, nhs direct should have arranged patient transport - whatever that is i your pct, but its not arranged through the ambulance service, even if its them who come and get you. Some PCTs have a taxi service as its way cheaper than ambulances for non urgent / transport / mobility.

As for the time she was in A&E hypo and given insulin, that gross misconduct! Did you make a complaint? I would have because that is not on! Something like that cannot happen on a phone service, as every word and key stroke is recorded and scrutinised constantly, and if patient safety issues arise, things are changed - quickly!

And it's **** that in this country drunks are treated quickly enough, but the A&E etc are not there to judge who has self inficted illness/injury, they treat symptoms by severity and nothing more. they are a patching up service, and the public who get themselves into that state are completely to blame, not healthcare workers who can't pick and choose which patients deserve treatment.

I really hope you do decide to speak to the patient thingymabob, only good can come of it

Sorry for the War & Peace and the typos - I was only reading in passing, but got quite upset at someone presuming to know that we were all call centre brainless folk with no qualifications. I work with nurses, dental nurses, a&e dr's and all sorts, and I'm highly trained and skilled in my job :crazy: and have a rough week at work, so it's nice to know there are so many out there who can do my job better than me.... btw, Recruitment is open again - would be nice to see how many of you pass the application process and 1st 2 interviews - gruelling doesn't cover it. !,500 applied for 150 posts, they only took 44 on, and have reopened the application rather than going back thruogh the old applicants, that must suggest something surely?
 
All i will say to this post is i was told by a complaints manager of the Yorkshire ambulance service that a version of the NHS symptom checker was used for incoming 999 calls.
it took almost 2 hours for NHS direct to call to even look at transport, bearing in mind that when my wife got to hospital they estimated that without treatment both her and the unborn baby had 2-3 hours before coma.
Don't get me wrong I appreciate the job the emergency services do but in this instance i feel really let down.
I'm not pointing fingers at the whole service and saying your all useless because your not if it wasn't for the highly trained staff that are in place lots of people wouldn't be with us now.
The main issue i have and I'm sure 99% of the users here have is although diabetes is one of the most common diseases that there is nobody seems to have a clue what it is or how serious it is. if you asked 100 random people you would probably get the same answer thanks to TV ect. that diabetes is cause by being fat and not looking after yourself. Diabetics aren't allowed sugar and finally if you come across a diabetic that's in trouble a shot of "magic" insulin will cure them.
 


Lightwolfe ... there were three words that I automatically linked together when you first told your story and they were 'diabetic, ketones, pregnant'. That was enough for me to err on the side of caution and say you were right to call and expect and ambulance for your wife and unborn baby.

And like yourself I am also not pointing fingers at the whole service when I say my very many pieces (yes I know I'm a prolific poster and moaner) about the clinicians, employees and services that DON'T come up to scratch. We're pointing the finger ONLY at those particular groups and rightly so. Because if we don't point things out, nothing changes and I certainly don't want to go on moaning and groaning forever, I want things put right within the NHS because I think it deserves better.

On the subject of knowledge of diabetes, you're spot on - it's a common condition but that's about all people know about it, including myself. Before joining this forum after diagnosis I had a rough idea that the pancreas, Islet of Langerhans wasn't working properly and my insulin wasn't doing it's job properly in processing carbs and sugars. That knowledge was dredged up from my school biology classes and medical secretarial course I did in 1972. The experience and results of being unable to process carbs had been noticeably showing itself to me for at least the past 10 years by my body failing to work properly and slowly coming to a grinding halt leading me to feel life wasn't worth living and I'd be better off dead. That's another side effect of undiagnosed diabetes that not many people talk about - but I'm willing to talk about the depression/suicidal side of undiagnosed diabetes because it's definitely linked in my case. There is a lot more to diabetes and how it affects our lives than meets the eye and I think it needs publicising, not to scare people but to ensure we all get the respect and the treatment we deserve instead of being relegated to the "Patient should have gone to WeightWatchers years ago ...", sector.

I think it IS time Diabetics told people what THEIR perspective of diabetes is, and changed public perception and services offered. It's a COMMON but certainly NOT TRIVIAL medical condition and it deserves a lot more publicity from those who have the condition. We always hear from 'the experts' - medical clinicians, pharmaceutical companies, food industries - but THEY ARE NOT EXPERTS - WE ARE. So let US tell THEM what's what, not the other way round.

Lightwolfe ... I know you have your hands full at the moment but please try to go to a post by Bellx15 called NHS ADVICE ON DIET. Some of us are putting some ideas together there to approach TV channels with.
 
@ lightwoolfe
V.sorry to hear this. Next time take note of date, time, name of operator, control location etc. Ambulance Controls are remote, detached and "protocol obsessed". Protocols are written to guide under-trained, inexperienced call-takers....that's right...they are NOT paramedics manning the phones!! I expect the whole job to be outsourced to Bangalore ..... then there will be fireworks and button pressing?? GP's are having serious problems with UK Ambulance Services now. There was a time when a GP was known by name and highly respected by Ambulance Controllers, but these tin gods with tin pips in their shoulders are a bureaucracy now.

A paramedic attending your wife would do everything to care for her including (as I have) standing firm by my patient in A&E until someone has grasped total responsibility for MY patient...this may take some time if the dept is busy....but no matter....your wife would by my ONLY concern. There are forces at play now destroying and depleting the Ambulance Service. Did you know that BUS companies now run PTS...the out patient and hospital discharge service...dealing with sick people...without adequate training. The whole thing is pushing the experienced staff who care into an impossibly difficult job.

My advice is to pass the responsibility for caring for your wife's health back to the NHS YOU pay for. COMPLAIN to everyone incl your MP. Join and check out the 38 degrees website who are campaigning to stop the destruction of OUR NHS. That way OUR government will be forced to come clean on the real agenda being played out on us all.

Put together a back up plan for your family....ask your wider family or a neighbour to help with the kids, ask a car owner if they could drive you to hospital if this stupidity occurs again and above all know you aren't alone in this. If I lived near enough I would come out and care for her.

As a footnote, did you know that the NHS, Ambulance Trusts, Trade Unions, and many ambulance staff, nurses and Drs opposed the introduction of the UK Paramedic Service. To bring this service to our patients, 200 of us were trained in our time off by progressive Drs and especially Anaesthetists. These "Gas Men" as they are affectionately known took a chance on us and trained us in their theatres on their patients. We formed our own Association...Paramedic UK and arranged our own insurance and refresher training. Eventually the NHS was shamed into accepting us but not before insisting we re- qualified as a passing insult. Of course the NHS exam was a doddle and we passed out with high grades. Today, the Paramedic will probably have attended Uni but it is unlikely that today's graduate will be able to survive a lifetime of stress induced by blunt targets and ever decreasing workplace rights. The NHS is now basically unworkable and only functions because of the goodwill of many who fear a world without care free at the point of consumption.
 
I thought this was the case when making a 999 call.

An emergency is when:-
Someone’s life is at risk
Someone is injured
There is a fire
Offenders are nearby
Immediate action is required
Your call will go through to an emergency telephone operator. They will ask you,
“Which emergency service do you require?”
Ask for the service you need:-
Police
Ambulance
Fire Service
Coastguard
They will then connect you to the Control Room for the service you have asked for, in whichever area you are phoning from.
The emergency services operator will then ask you a few simple questions:-
“What has happened?”
“What is your name”?
“What is the number of the telephone you are calling from?”
“Where is the incident?”
“Is anyone hurt?”
You might be asked other questions to help the operator assist you more quickly. Whilst they are speaking to you, they will also be giving the information to the officers or paramedics who will be on their way to help.

"HOW WRONG IF YOU LIVE IN YORKSHIRE"

Sorry Lightwolfe for being a tax payer that let you and your family down so badly.

Roy.
 

Be reet ... THANK YOU for making this very honest post, I was beginning to think it was me who was slowly going round the twist. I'm a qualified Medical Secretary who was dismissed from my job because ... wait for it ... I had an asthma attack/pneumonia at the hospital I worked in and ended up ... in hospital ... and because when I was telephoned the day I was home from hospital being pressed for a date when I would return I told them I'd need a week off ... I was dismissed from my post.

And the reason I ended up with pneumonia was because last November when it was freezing and snowing, the woman who sat next to me insisted on opening the window which was right behind me and she also turned on the air conditioning and I was frozen solid for 3 weeks before I eventually became ill. Every time I closed it, she opened it. When I approached the supervisor she said 'It's give and take isn't it?' I was the newbie and that was that. My work, by the way, was given to the remaining permanent staff as overtime, which is what they wanted and why, when I started work my colleagues refused to supply me with work from their pile. There was also another issue which I won't go into here but it came under the category of bullying in the workplace and I reported it to the Chief Exec directly because I was absolutely disgusted with the attitude and unprofessional behaviour of the people I worked with.

The thing is, most of the women I worked with were NOT qualified Medical Secretaries, they came from industry with no medical terminology experience or qualifications. I've been working as a temp because of my own health problems and also because I was my parent's carer and I could work round my home responsibilities better that way. And I can count on one hand the number of qualified Med Secs I've come across and it's not very many. Most of us have left because of the poor working environments and conditions - we're not front of house in clinics where the public can see us so we're often shoved in rooms no bigger than cupboards which are filthy dirty because the NHS Trusts won't pay for cleaners. I've even worked in one hospital which emailed us all asking us to VOLUNTEER to come in and clean some wards because the hospital had failed the Care Quality Commision test for hygiene. Have you ever heard anything so ludicrous? I worked in another hospital where a temp arrived who had no clue whatsoever about working in the medical field. While I was in the sweatshop bashing away at the keyboard for my £8 an hour, she was sitting downstairs in the waiting room reading a book and being paid exactly the same money as me. When she was eventually spotted and given some work she was sat next to me and of course, because I knew what I was doing, it was me she nudged every five minutes when she couldn't understand some medical terminology or didn't know how to perform a certain routine.

The employment agencies are to blame for sending inexperienced people to jobs which really do require qualifications and experience, but the NHS is also guilty of accepting them because they can then pay what they like, they can downgrade salaries and it's horrible to say because it sounds so snotty - but standards have slipped tremendousbly and so has the attitude towards patients, because many such employees aren't in their jobs by choice because it's an area of work they really wanted to work in, they're there simply because it happened to be the next job going so they took it.

I absolutely LOVED my job as a Med Sec, it's what I CHOSE and WANTED to do from the day I started studying for my GCEs and I went straight to college, studied for 2 years got my quals and started work at a University Department of Surgery. At one time my job was something to be proud of but not now, because it's been devalued, my employment rights are zilch and I know the NHS doesn't care a jot whether my working conditions are healthy and safe or whether I drop dead at my desk and that's the part I find really difficult to accept from an employer who prides itself on being a HEALTH SERVICE.

I read your post and was nodding my head all the way through because you come across as someone who takes a pride in your work and are LOYAL to the patients you attend to, and it really is a case of one insult after the other with the NHS as employers and it's a case of how many more insults can we be expected to take? Are they deliberatly trying to get rid of everyone with any empathy for the work? Because that's what it feels like to me. All these flashy new hospitals they're throwing up overnight are being paid for by the likes of you and me as our salaries and working conditions are further and further eroded and we're pushed to our absolute limits to meet targets under great pressure. It's not the work I have a problem with at all, I love my work, but I have a big problem with my human rights being eroded while I watch the Chief Execs being awarded their huge bonuses come Christmas! :x :x :x :x
 
been in this situation myself and having the added complications of neuropathy and epilepsy an ambulance was called on 999 call so when did fast approaching a diabetic coma fail to become an emergency if the emergency services had adopted this attitude where i live.
i would no longer be alive to type this post
 
Lightwolfe and I usually hate calling for ambulances in the best of circumstances (last time 1 attended we were complained at for NOT calling them sooner and not calling them more regular when they found out my history of severe nighttime hypos).
I'm just worried now after this experience we are not going to call and something will happen
 

Same, my fiance and mum never call them unless i'm admittedly really really bad because i both hate using the resources (when i know i should) and because I hate going in to hospital. Thankfully my mum was good with me when I was little so we know the whole high blood sugar/ketone routine now, lots of water, small bites and a whole load of insulin.

Most times i've been in hospital the care standards have been reasonably good, but going back to an earlier post GraceK mentioned, the world definitely need educating about the real person with diabetes, the knowledge is shocking! I've been teaching everyone in work for months, still on going, about how I live my life and what I have to do just to eat and stay alive. most of them are utterly shocked and they said themselves that they had no idea whatsoever about how serious diabetes is.

I don't mind telling anyone or answering questions about my diabetes any more because I just think at least I've set one person straight about the disease today. It drives me mad when i get the whole 'your diabetic, why are you eating chocolate' scenario - I turn into the hulk!!

GraceK - So sorry to hear you we're dismissed. Did you take it any further, surely that's wrongful dismissal, you've a serious health condition!! Stuff like that doesn't half Pee me off! My mum's getting bullyed at the moment but the unions aren't helping as much as I thought they would! Makes you wonder about the NHS sometimes. I trained as a medical secretary, unfortunately I could never get a permanent job within the NHS and I've now ended up as a co-ordinator but some of the secretaries I've worked with in the past, I must admit, are shocking with there knowledge. Thankfully the girls in our department are good secretaries.

Just realised how much of a rant that was, sorry all, rant over lol
 

Thank you Insanity ... and I'm sorry you've found it difficult to get a permanent job with the NHS too, despite being qualified. It's not only a disgraceful waste of resources but it's absolutely ridiculous to employ inexperienced and unqualified people before those with quals and experience. I believe it's a deliberate move to strip employees of all dignity and pride in their work so that we just become automatons and take whatever pay and conditions are offered to us. Why bother getting an education at all these days? There's no point if it's not rewarded. The unions are of little help when you need them, I get plenty of emails from various unions asking me to sign this petition and that petition but when I needed them, they couldn't help me. Apparently, I'd signed my life away when I signed my employment contract with the agency and I could be dismissed from my job because I wasn't 'available' because I was ill. In my experience the NHS as an employer, absolutely stinks. The Trusts do not care care about the health and safety of their staff and as a medical secretary I've worked in conditions that could only be described as bordering on third world standards. What the public sees is the new hospital that's just been thrown up, which is brand new and shiny and has all the bells and whistles. What they don't see is the old hospital that's falling down, and is riddled with vermin and has holes in the roof (not joking - a hospital I worked in 2 years ago was on 3rd floor, had no lift, and the corridor was strewn with plastic buckets to catch the drips from the leaking roof - and my colleagues just accepted the conditions because they didn't want to lose their jobs.) If the NHS can get away with treating people like that what hope is there? And if the unions won't do anything what hope is there? We're very gradually moving towards slavery in the workplace, not honest employment and the contracts we sign are heavily weighted towards the rights of the employer not the employee. :x
 

I agree, it's a joke, we've got a leaky roof at the moment! And yes there are buckets everywhere!!

I feel that its a shame because we are so lucky to be able to recieve free treatment on NHS, I don't know how we'd survive in the likes of America, I believe insulin is a good few hundred dollars a month. But then the way they treat some patients is just unacceptable.

I don't really know where the solution lies, as far as I can tell we are moving towards a more private care focused country as all the NHS Trusts are being bought by private companies, and then of course you have people who are not medically trained or inclined governing policies about the likes of us lot and others with serious conditions, of which they don't have a clue.
 
I had to call an ambulance after I had a fall, there was blood running down my face. I have type 1 and i suffers with low blood sugar especially when I am stressed or in shock. I explained this to them but I was refused an ambulance eventually they said they would send a taxi for me but I had to fight for it. They wanted me to drive myself or another suggestion was to get my husband to come home from work to take me to hospital.
 

That's absolutely atrocious.

As a last resort I'd bang on a neighbour's door and 'fall over' on the pavement outside their house and get the neighbour to call an ambulance while you were 'unconscious'. Telling you to drive yourself to hospital when you've told them you're T1 and have low blood sugar and in shock is absolutely incredibly STUPID. You could have killed not only yourself but other people on the road if you'd fallen unconscious at the wheel after following THEIR INSTRUCTIONS.

So if I were you I'd have no qualms about having to use 'devious measures' like the one I've described above to get an ambulance. If the NHS is not playing fair with patients, patients shouldn't feel any need to play fair with them in cases of genuine emergency.
 
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