Working permanent night shifts on an FRU means that I often spend a while with the patients before a crew is available to come to my rescue... Or that of the patient's, depending on which way you look at it. Although sometimes that extra time on scene allows me to make a much fuller assessment of the patient's needs, other than the presenting medical emergency.
Jim is in his sixties, with very bad mobility. I've met him a few times before, usually just to help him up off the floor. He normally walks using a Zimmer frame. Last night his frame let him down, literally, and Jim found his head going through a large glass door. When I arrived he'd managed to get himself propped up on a pile of clean laundry. Now not so clean, due to the blood. He was very much conscious and alert, and although he couldn't even see me as I came in to the house, his first comment was "I see you're back again..." .
The lounge is the first room you come to and it's tidy and clean. At the back of the lounge is what I guess was meant as an extension to the house, but has now become Jim's bedroom. The room's a mess, now even more so with all the blood and glass everywhere. It's a complete contrast to the rest of the house and I find it a little difficult to understand why. In his room he has all sorts odds and ends that he's collected over the years, as well as a painting that's only half way done. This seems to be his pride and joy and he tells me how much he's looking forward to finishing it.
In the meantime I've checked Jim's observations, found them on the whole to be OK, and tried to clean the back of his head where the hair is all matted with blood. I've found that he's still covered in shards of glass, there are about four or five cuts to the back of his head, one of which is still oozing. I'm concerned that the cuts still have glass in them, but it's impossible to see without properly cleaning the whole of his head and that's not really possible, so I place a bandage on his head and wait for the crew to turn up.
All the while, Jim's main carer has been there watching and trying to help where possible. The only problem is that Jim's main carer is his Mum. She walks better than Jim, she does his shopping, his laundry, his cooking. But she's in her 90's. 93 to be exact. She's as fiercely independent as she is deaf. I offer to help clean up the glass. I offer to try to get them some extra help. I offer to get social services more involved by filling in what's known as a Vulnerable Adult form. Both for her and Jim. But she's having none of it. All she's concerned about is how Jim's doing, how long Jim's going to be in hospital for and how he's going to get home. She won't let me back into the house to help clear the mess, and she really doesn't want me to fill in any forms. She just wants to continue to look after her home and her child.
She doesn't need help. She just wants to be his mother.
I hope I did the right thing. I went back to station and filled in the forms...