"Every night is different"
When patients ring NHS 111 at night, a trained advisor takes them through a set of questions to assess which course of action would best help their healthcare need. One outcome may be that they have a consultation with a healthcare professional over the phone. They could also be booked in for an appointment in the Out of Hours treatment centre if they need to be seen face-to-face. In some specific cases, a home visit could be necessary, for example if it is a palliative patient or someone who is quite frail.
“Every night is different. I think people don’t realise how much goes on through the night in the Out of Hours service. We see a lot of people between three and five in the morning, but sometimes it can be all through the night. For the very urgent cases, an ambulance is dispatched but sometimes we also need to go and see them at home,” explains Julian.
“Some nights, you can actually go and see the same patient two or three times and particularly if they need a lot of help for whatever reason — they’ve just come out of hospital, their life is coming to an end, or they have mental issues — there’s a lot that goes on,” says Julian. “At the same time, at the treatment centre, we tend to get a lot of young children being brought in to be seen that are quite poorly. When we’re not out on the road, I’m a Receptionist at the treatment centre and need to handle those cases, “he continues.
The night shift begins at 10.30pm when the Driver/Receptionists log in and go through the day with the colleague they take over from to check how busy it has been. There is no typical shift. But as part of routine, the Drivers are mostly at the centre till about 1 or 2am and have visits come up after that. “The bookings depend on the nature of the emergency whether it’s a home visit or at a base,” says Julian. “There have been times I’ve gone out to a visit at 11 pm and didn’t get back until 8am. These are rare cases, but we have to be prepared for them.”
“On the flip side, some nights are very slow, and you have fewer people coming into the base, or you don’t have to go out at all. Or, on some nights you might be sent out at the very end of your shift to go to somebody who’s very ill and requires very urgent attention. You never can tell what you will do that night.”
Julian is proud of what he does. “There have been some truly memorable moments, when I’ve felt I’ve really achieved something here – when patients and families thank the doctor and me for helping them. One of the times that comes to mind was when a doctor and I revisited a patient as the wife was concerned about her husband. He was suffering from cancer and was in a lot of pain. A friend of the wife came out to the car after the visit and asked me to ring into work to let them know we were going to be late and offered us some toast and tea. We had been there three times that night to administer the painkillers and she said that the last few nights had been incredibly difficult and without us being there she would not have known what do to. When you have someone acknowledge your hard work, that just feels great.”
Would you recommend this job to others? “Oh yes! Certainly,” he exclaims, adding, “Most people think you’re completely mad to work at night. But it’s just different and the doctors will say the same. We are a close-knit team and work together very well. We know each other extremely well like the shift managers, the doctors, the drivers, the whole team. And HUC is a great place to work in. It’s very structured and people are very caring — not just for the patients but for all colleagues too. There is a great deal of support out there and you never feel alone or unsure who to go to and I really enjoy being part of that,” he says.
