"I Come First"

Comment & Opinion

Brian Booth, RGN

I come first

Some years ago, when I commuted by train between London and Kent, in the days of slam-door carriages (young people - eight-seat compartments, accessed via corridors - check out black and white  British films ) - I heard a strange drumming noise. Something told me to check it out.

I found a man outside the WC in the throes of a severe epileptic fit. Another man came up, wanting to use the toilet, and all he was concerned about was how he could step over this thrashing body, expecting me to move the person to make this easier. I tried to explain why that wasn't a good idea at the time; we nearly came to physical blows, stopped only by my need to get the 'patient' safe until medical aid (if necessary) was needed.

Fortunately, I'm physically large; even more fortunately, the oaf didn't know that I'm soft as butter. So he left in search of another loo, complete with over the shoulder expletives. All the other passengers had (perhaps understandably) decided to stay out of it.

On those old trains, you had to find the 'communication cord', which resulted in the train stopping whilst the guard (sorry, 'train
communications and customer services manager') worked out where the chain had been pulled. When he appeared, I asked that they got to the next station as quickly as possible and arrange an ambulance, because this was starting to look like status epilepticus. (Not many mobile phones at that time.)

I don't know what the result was. All I did was my job, as a registered nurse.

Problem solved, as far as my responsibilities went...

We have a duty of care to help – the NMC has told us so…

15. Always offer help if an emergency arises in your practice setting or anywhere else 

To achieve this, you must: 

15.1 only act in an emergency within the limits of your knowledge and competence 

15.2 arrange, wherever possible, for emergency care to be accessed and provided promptly, and 

15.3 take account of your own safety, the safety of others and the availability of other options for providing care. 


Perhaps the general public – and that includes us when we find ourselves exasperated when someone else’s illness impacts upon us, should have such a code…


I still wonder about how one person, seeing someone obviously ill, thought that their own physical needs came first. What would that man have said, had he had a relation in hospital, to any nurse who claimed there was a priority in meeting needs?

I offer no solutions; but I look forward to readers' answers.