There are rules about the telephone in emergency departments...
(1)it will only ring when its very very busy
(2)it will only ring when there is at least a 2 hour wait for a patient to see a staff member
(3)it will only ring during lunchtime when staff numbers are low
(4)no good will come from answering the phone particularly if you give a complete stranger your name
(5)if the phone is answered by a triage nurse or health care support worker they will stand doing nothing at the desk listening to the caller for at least 10 minutes before coming and calling an RN anyway...and then still stand at the desk looking at their nails
(6) 90% of calls will start with the word "Obviously"
So...Thursday morning...and 2 nurses at work with a 2 hour wait already built up by 0900 as it seems to be 'take-your-confused-relative-to-hospital' day.
And the phone rings...
...and rings...
...and rings...
...and rings...
...then stops for the minute it takes to bounce back to the automated switchboard...
...and rings...
...and rings...
Apologising to my patient I grab the phone...
"Good morning...Minor Injuries Unit...how can I help you?"
Is that Bill?
"No...he's not at work today...its Lucien speaking...can I help you?"
Umhh...well I wanted some advice....I was really hoping to talk to Bill...
"Well...he's not here...can I help you!?!"
Well...what it is...obviously...I'm Gillian...
"Uh huh..."
I'm a Community Pharmacist in at the Rigor Mortis pharmacy in Little Armpit...
(the next town along...about 12 miles from us and only 1 mile from St Vulvas Hospital)
...and I wanted some advice about a patient I have here with me this morning...
"Uh huh..."
Well...he's about 65 and he came in and asked us to check his blood pressure because he isn't feeling very well...
"Uh huh..."
And we did it...and its about 80/40...and I think that's a little low...?
"Jah....that's low...does he take any medication of any sort for any reason,medical or otherwise?"
I don't know...
"Can you ask him please..."
Silence
Hello...?...No he says he doesn't take any medication...
"Okay....can you ask him if he has any chest pain of any sort please..."
Silence
Hello...?...He says he doesn't have any chest pain...but he has a 'fluttering' feeling in his chest...and it feels like there is a weight pressing down on his chest...oh...and he is finding it difficult to catch his breath...
"Ok...does he look or feel sweaty or cold and clammy to you?"
Silence
Hello...?...yes he is cold and clammy...
"Okay...I want you to immediately phone '999' and call an emergency ambulance...and whilst you're doing that I want someone else to give him 300mgs of aspirin to chew on if you have it available...
Sorry...?...You want me to call an ambulance...?
"JAH!....I want you to stop talking to me and call an ambulance...it sounds like your guy is having a heart attack..."
Oh...can't I just ask him to drive down to you?
"NO...please just call an ambulance immediately!!"
But I'm worried that you're wrong...and that the paramedics will be cross with me...I don't want to have to deal with that...
"Okay...three things...one...I really don't care what you think...and...two...I certainly don't care what the paramedics will think...because...three...your patient is about to die!"
But what if the paramedics shout at me!?!?
"Then get them to phone me!!"
What's your phone number?
"Well...its either the number that you've just phoned and which we're talking on NOW!!"
"Or...its 0-800-YOUR PATIENT IS DYING!!!"
Oh...
Click.
Pharmacists...really just bartenders with a larger inventory.
sorry had no other way of contacting you, hope that our favorite HCA got away okay and that you are not too sad, it must be hard, i can only imagine how you are feeling, just wanted to let you know i was thinking of you
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