In an update to the great and wonderful new I.T. programme that is being implemented in our local hospital, I have an example into how the providers think...

...They are going to install a palm scanner on the door so the staff can book in and out. Of course, biometrics work wonderfully, and this is an obviously essential system to help patient care. Sarcastic? Moi?

During today's shift I had to pick a patient up at a local Nursing Home, and very nearly became one of those "Under Investigation". The GP had visited this patient, an 88 year old male with Dementia and Parkinson's disease, who had not been eating and drinking. The GP had left the patient in the care of the nursing home, and had arranged a 'non-urgent' ambulance.

A 'Non-Urgent' ambulance is the sort of job where you take a wheelchair bound patient into hospital for his out-patient eye check. There are no blue lights and sirens involved here...

My crewmate and I turned up to take this patient into the nearest hospital and found him in a collapsed state, extremely dehydrated and with a very faint pulse. I asked the staff what the patient was normally like and they looked at each other and shrugged. It seemed that no-one on that floor had any information about the patient, even though he was a long term patient. The staff didn't know his previous medical history, or even what regular medications he took. So I asked for the letter that would be accompanying the patient to the hospital, which is written by the GP. On it the GP had written the patients Blood Pressure as 100/60, which is a bit low - when I checked the blood pressure it was 80/60, a much more worrying result.

We transported him into hospital, where even the medical students, who have recently descended on A&E like over-enthusiastic teddy-bears, spotted that this man was seriously ill. I left the patient, and the escorting nurse in the tender mercies of the triage nurse and a trio of medical students who all agreed that he 'needed access'.

"Needs access" is a shorthand way of saying that the patient needs an intravenous cannulae so that drugs and, more importantly in this case, fluids can be given. In this case, although they were right, I suspect that their main motive may have been to get cannulation practise on an uncomplaining patient.

Perhaps if we had been a bit busier today, and the patient had died, I too would be 'under investigation' for not reaching the patient quickly enough - even though he was supposedly receiving care from a doctor and nursing staff...