A day with the Waltham Forest Response Team
Anna works as a Paramedic for NELFT with our Waltham Forest Rapid Response Team. No two days are the same for this busy team and the work is exhausting, but so rewarding.
So that we can understand the role in more detail, Anna kindly agreed to put pen to paper and write about just one of her days as a busy Paramedic at NELFT.
Read on...
"I qualified as a paramedic in 2012, and, my goodness how the last ten years have flown!
After a small stint in the South West with ice creams and beach views, I made my way to the big smoke hoping for the superhero type paramedic life you see on the TV and in magazines. I was introduced to Waltham Forest aged 21 and loved it! Such a diverse area with so many cultures and different age groups to see and treat. A max blue light speed of 12 miles per hour with the stand still traffic, it often would have been faster to walk!
Most of my patients were elderly, falls, suffering with poor mental health and ‘generally unwell’, with a small percentage of my patients suffering the ‘juicier’ conditions you hear about in the news or reported on the TV. I worked a mixture of front-line ambulance, first response cars, and even a push bike response in central London for a period. But it was clear to me even in the early days that my real love and joy of the job was in the community, and working at keeping patients at home when appropriate. I had worked a lot with the Waltham Forest Rapid Response Team before coming to work for them, I loved their ethos, and certainly felt as though the patient’s involvement in their own treatment plan was always considered.
I’m going to tell you about a patient I visited at the end of last year, a 78 year old lady who was found on the floor when the carers arrived one morning."
"The carer rang the Rapid Response Team as well as the ambulance service. I picked up the Razor lifting device from the office and headed down to the patient’s address. My physiotherapist colleague and the ambulance service were already on scene, carrying out an initial assessment and observations.
The patient had fallen the week before, hitting her head. The patient had not received any assessment or treatment post-fall, but had slowly been becoming increasingly confused. Alarm bells were ringing, observations were shown to be in the normal range, and the patient was not showing any new muscular, skeletal or neurological presentations. The patient herself was alert and orientated to time and place. The first thing was to get the patient off the floor. My Physio colleague and I used the Razor to get the patient off the floor to standing, and walked her to the armchair. A quick visit from the manager of the property informed us that the patient was confused before her fall one week ago and it often happened when the patient was not taking her medication. A large tower of medication (I counted 37 boxes of one drug never opened) on her table. And the real issue for this patient was clear.
Previously when working in the ambulance service, I probably would have taken this patient to hospital. She would have been put back on her medication and a CT scan would have quickly shown no cause for alarm bells. However, that patient would have come back to the community, the medication tower still growing on her dining room table, and in a couple of weeks, we would have been back to square one. We waved goodbye to the ambulance service and I set to work with my colleague who was then assessing the patient’s gait:
Phone calls were made:-
- to the GP surgery requesting blister packs
- to the Pharmacy requesting blister packs to start today
- to the care agency to ensure they were happy to start prompting medication, now that it will be in blister packs
- to the social worker (who also works alongside the Rapid Response Team) to increase patients care package as soon as possible
- to the bridging team to cover the patient from her current, one visit a day, to four visits a day until the patient’s own care agency could increase the care package officially
- and finally, to the family who lived nearby to ensure everyone was kept in the loop.
I collected all the medication from the table and took it down to the pharmacy, returning with a blister pack to start for that afternoon, and I ensured the patient had a cup of tea to keep her going until her now next visit from the bridging team in two hours’ time.
The patient stayed on our caseload for four days with a mixture of phone calls and home visits to ensure an improvement in the patient presentation, as well as to ensure the increased care package and blister packs continued. A win for the Rapid Response Team and the patient.
From there, I went on to assess a chest infection of a COPD patient, a possible DVT where bloods were obtained to help rule out a clot, and another fall with a small wound closure required.
If I was still with the ambulance service, I would have taken the possible DVT to hospital, as well as the wound closure to the urgent care department for closure, where these elderly, vulnerable patients would have had long waits and been at greater risk of infection.
Our close work with other allied health professionals within the Rapid Response Team and within NELFT, mean that we can go on to provide patients the best care in the safety and comfort of their own home.
I honestly believe that multiskilled teams able to provide this treatment and care, really is the future of the NHS."