"59 year old male. Abdo pain, shortness of breath"
Every now and again, you get a job you are literally right on top of. Our radios went off and the sat nav started directing us where to go. My crew mate suddenly swerved violently in to the road on the left and stopped. We were there already; dispatch time to on-scene time was 13 seconds. Someone in control was now grinning like a Cheshire cat, patting themselves on the back for a job well done! It was about 12:30 in the afternoon on a sunny spring day. As we had arrived so quickly, the call was still in progress so we waited back a few doors down in case it updated that our patient had a large kitchen knife and wasn't afraid to use it! (see 'Retreat') After a minute or so we got the update that the patient was short of breath with abdominal pain. The call had come from a GP surgery and had been booked as an 'Urgent within an hour'. We grabbed our bags, walked up the path and pressed the buzzer for flat A.
I heard the bell ring and echo through the hallway. No answer. I rang again, this time hammering the brass knocker 4 times. No answer. I peered through the old Victorian sash windows and could make out the living room / diner but no sign of life. My crew mate shouted through the letter box a number of times but there was no response. We called control and asked them to do a ring back. After a minute or so they got back to us:
"We tried the number where the call originated from but it was the GP surgery. There was a recorded message saying they were closed for lunch. We'll try the number listed to the address. Standby."
We waited at the door, knocking, ringing and shouting. No response at all. We then heard the phone ringing. It rang and rang. No sooner as it stopped, our radios started ringing again.
"No answer at the patient's address, we'll have to treat it as a collapsed behind closed doors. Standby for police"
I gave the door a shove but there was little movement, so I decided not to make a fool out of myself and wait for the big red key to arrive! There is nothing worse than trying to kick a door in, only to bounce off with a sore knee! The fact I was considering putting the door in shows the concern I had for this patient; short of breath and with abdominal pain followed by being incommunicado in a matter of minutes was a concern.
After 5 minutes of frustrated waiting, the police came screeching into the road. They made short work of the front door! One well-placed hit and the door came crashing open. As it did, I heard the following voice:
"What the hell are you doing?"
Standing at the end of the path was a man of about 60, wearing a shirt and trousers with a tweed trilby hat on. We all just stared at him for a moment. He was breathing very heavily and didn't look too good.
"Do you live here?!"
"Yes!" he said in an astonished, confused tone.
"An ambulance was called for you and there was no answer, we thought you had collapsed. Where have you been?"
"Walking back from the GP surgery. I was told to go home and wait for an ambulance as the surgery was closing. They said you wouldn't be here for an hour!"
He was very breathless. We assured him his door would be fixed and we got him on the truck. His oxygen levels were very low indeed. We put him on oxygen and started checking him over. His heart was racing and his blood pressure was a little low. Having walked nearly a mile, in pain and struggling to catch his breath, the findings were of no surprise. We took him into hospital and left the police to sort out the mess of the front door.
The likelihood is that he would be absolutely fine; there would be various tests done and his symptoms would be treated, but why on earth was he made to walk home?! Surely, if someone is ill enough that the GP feels an ambulance is necessary then walking a mile when already short of breath probably isn't appropriate? Especially as it was only being done so the surgery can be shut for lunch! This isn't a GP issue; it's a general issue of professional conduct. This patient was unwell and needed treatment, not a walk. If we are on a cardiac arrest we don't all stop and say 'sorry, gotta go, our shift has finished'. You don't arrive at an A & E department to find a sign on the sliding doors saying 'Gone Fishing'. Sacrifices sometimes have to be made. It's part of the medical profession; you miss breaks, eat at crap times, do long hours and finish late. If a lunch break is more important than a patient's well-being then you're in the wrong job. I bet the GP in question a) disagrees & b) doesn't get charged for the broken door. Why would you not tell the call taker that the patient isn't actually at the address in question? 'Within an hour' doesn't mean 'In an hour'. Just sayin'!