For any of you who work or the ambulance service, or read blogs about our days at work, you will have come to grips with the phrase "proper" job!

For those of you new to it let me explain: In the ambulance service we go to a vast amount of varying jobs, from the simplest medical problems like a cold to those life threatening problems: heart attacks and the like.

A "proper" job for us is one in which a patient firstly actually needs an emergency ambulance and secondly is actually unwell/ill and we have to treat them for something.

The other day I had a "proper" job, yet with a twist! Working with a trainee EMT we went to a job out in the countryside for an elderly gentleman who had fallen at home (AKA a "Granny down") - sounded like a simple run of the mill job to us, until we got there.

The patients pulse was slightly slow at 54bpm (normally 70-90), but the patient’s wife told us he was suffering with this and was due to see a cardiologist this week so we didn't worry too much about this as his blood pressure was within normal limits.

We got him up off of the floor and in getting him into bed he collapsed and began to have a seizure, only lasting 10 seconds or so. We noted to ourselves at this point that the patient was actually seriously unwell and needed to go to hospital ASAP!

We explained this to the patient (now recovered from the seizure and lying on the floor for where he ended up).

However the patient was adamant he was not going to come to hospital with us as he had a bad experience with our local hospital some time ago in the past.

To cut a very long story short we spent over an hour on scene with the patient trying to convince him to go to hospital with us, getting his GP on the phone who also told him to go to hospital, yet the patient was still adamant was not going to come with us!

Can you see our dilemma – given that the patient had a further 2 seizures and his pulse had slowed again slightly. This job was now becoming imminently dangerous for the patient!

We all tried our best to convince the patient to come with us (my crew mate, the patients wife, 2 doctors on the phone, the patients son and myself!) yet he persisted in his refusal of treatment.

You will appreciate we cannot touch someone, nor take them from their home without their permission – that’s assault and kidnapping! The patient was recovering so quickly after the seizures that he said straight away each time that he wanted to stay at home. The patient on questioning was also sound of mind and so capable of making that decision.

I am all for patient choice and freedom in deciding on treatment that they choose to receive or not to. However here we had a patient who was deteriorating in front of us, and becoming critical, yet wouldn’t come with us. What to do?

My crewmate and I pondered for a few moments and I decided to have one last attempt with the patient. As I said before I am all for patient choice, however the patient was making the decision based on a previous bad experience of the hospital and was not I feel appreciating the severity of his current situation.

I explained to him in a fairly frank (yet understanding and supportive way of course) what the situation was and how seriously ill he had become. With the support of his wife we eventually encouraged him to come to hospital with us!

It’s jobs like this that make our job interesting, difficult, stressful, pleasing and most of all rewarding!

We got the patient to hospital alive (with the help of some drugs from a Paramedic on the way), and he went pretty swiftly for a temporary passing wire in the cardiac care unit, hopefully to have a happy future with his caring wife.

As I said at the start: a “proper” job for us as the patient was actually genuinely ill, yet somewhat of a twist. A good job all round, I actually felt like I had made a difference, which makes me smile! :D