Page 11 of The Night Shift
‘Mrs Jenson’s asking for something to help her sleep?’ Violet clarified.
‘No. Mrs Jenson is actually asking what time the bus to Lyme Regis is coming and whether I’ve told her mother to pack her sun hat. A mother who doubtless died at least twenty years ago. Trouble is, she’s wandering up and down the ward asking the same question of every other patient here and she’s been doing it for the past five hours. She’s keeping everyone awake.’
Violet grimaced. She could see the quandary. ‘But she’s not distressed?’ she said. ‘Mrs Jenson– she’s confused obviously, but not upset, or unwell?’
‘No, she’s pretty cheerful, all things considered.’ The nurse smiled thinly. ‘She thinks she’s going for a day trip to the seaside. But Mr Arnold was less than cheerful when she got into bed with him a moment ago and asked whether he’d remembered to put boiled eggs in the picnic basket. The poor man’s recovering from his hernia op. The last thing he needs is fourteen stone of confusion trying to sit on his lap. Especially when she can be a bit’—she lowered her voice ominously—‘inappropriate.’
There was a pause.
‘I’m not sure that I’m comfortable sedating someone just to make the ward a bit calmer,’ said Violet pointedly. ‘Particularly when you consider the effect of some of those drugs on the ageing brain. It’s not good medicine. You haven’t got anyone who could, you know, sit with her, calm her down?’
The nurse pursed her lips and gestured to the rest of the ward which was very clearly heavy on occupied beds and light on staff. ‘Christmas night shift,’ she said. ‘Not a chance. I’ve got a healthcare assistant off with flu, a student nurse off with a hangover, and those of us who are sad enough to be available on a day like today, are all bank staff. It’s not good enough. I’d said to HR, I’m not doing another night like that one a few weeks back– but they were desperate. Nobody else available. You know how it is.’ She sighed. ‘Anyway, long and short of it is, no. I haven’t got anyone who could sit with her for more than a moment, and she’s been pretty rude to most of the staff here already, so if I could just leave this here and you write her up for whatever you think’s best?’ She patted the chart definitively and handed Violet a biro.
‘I– erm– as I’ve said, I don’t think I’ll be able to prescr?—’
‘Well, I need to crack on and get the obs done,’ said the nurse, interrupting Violet before she could complete the sentence. ‘Sharon’s doing the drug round and I’ve got to check on two new admissions.’ She inclined her head towards the nearest bed. ‘We’ve got a right old mixture. Some surgical outliers as well as the usual medical long-stayers. Anaesthetics are coming down to review one of theirs in a minute…’
She must mean Gus, Violet thought, as the nurse pushed the trolley away. It wouldn’t be his registrar Dr Stringer unless there was a major problem with a patient, and somehow Gus usually managed to convey the attitude that nothing was a major problem. Anaesthetists were like this in general, Violet had realised. The general public usually assumed that their only role was putting people to sleep before an operation, but in reality they were masters of critical care. When a member of the anaesthetics team turned up at a cardiac arrest or a major incident there was always a palpable sense of relief as if the cavalry had arrived. The general medical team, of which she was a part, were obviously competent in a myriad of scenarios, but anaesthetists knew how to stabilise the sickest of patients, how to gain access into the most collapsible of blood vessels, how to intubate and ventilate and resuscitate, and generally keep people alive. That was probably why she was always so pleased to see him. Gus had a very reassuring presence, and it wasn’t simply that he was four years more senior than her. He just seemed so calm, cheerful, unflappable.
She felt a little flutter of nervous excitement in her throat at the suggestion of his imminent arrival and swallowed it away, cross with herself. Clearly it wasn’t just the thought of Gus’s clinical skill and unflappable demeanour that was making her pulse beat a little faster– the fact that she could happily have spent all night feasting her eyes upon him might have had something to do with it. But at least he was engaged and therefore unobtainable. As Anjali had said, having a bit of eye-candy around the place didn’t do any harm and as long as Violet was merely appreciating the aesthetics (or indeed, the anaesthetics) from afar, she would be safe from any messy romantic complications. That really was the last thing she needed at the moment. Besides, he was far too charismatic for his own good. People who knew exactly what to say, and how to say it, made Violet nervous, and the smooth-talking Romeos of this world could do one, quite frankly. She’d had her fingers burned by cool boys before– which shouldn’t make sense from a thermodynamic point of view, but somehow did. Memories of boys, and later men, who had dropped her without explanation, moving on to more popular girls, ones who didn’t ask awkward questions or share awkward truths. And some, perhaps worse, who had tried to cajole and flatter their way out of an ongoing attachment. Making her feel somehow responsible for their fickle nature and lack of moral fibre.
It was odd how she and Gus had been bumping into each other in the last twenty-four hours though. She felt certain that their paths hadn’t crossed in the few months she’d been working here, she’d definitely have noticed him for one thing, but now he seemed to be popping up everywhere. She guessed that things were different on nights. During normal working days each specialty would keep very much to their own department, but night shifts meant far fewer doctors roaming the corridors and perhaps the festive week with its reduced outpatient clinics and lower rates of routine surgery exacerbated it further. Seeing the same faces over and over again was probably inevitable. And Gus did have a face that bore regular repeated viewing.
As if she’d voiced the thought out loud she suddenly heard his cheerful whistle coming down the corridor towards the nurses’ station where she was sat with her drug chart dilemma.
‘We have to stop meeting like this, Dr Winters,’ Gus said, smiling his slow confident smile as he pulled up a chair beside her. ‘Have you had any further dealings with middle-class bigotry in the hours since I last saw you?’
She laughed in what she hoped was a natural, unaffected way. ‘No, thankfully,’ she said. ‘I’m just trying to decide what to do about this.’ She gestured to Mrs Jenson’s drug chart and explained the problem, grateful to have something clinical to focus on now that she was acutely aware of Gus’s thigh positioned inches from her own.
‘The thing is,’ she said, ‘I don’t really like feeling bullied into prescribing something that I don’t think is medically appropriate. Mrs Jenson doesn’t need sedating. She doesn’t usually take sleeping tablets and I don’t want to prescribe medication for her just to make someone else’s life easier. It doesn’t feel right.’
Gus looked thoughtful. ‘I get what you’re saying,’ he said. ‘And I imagine it’s not really been put to you as a choice.’
‘No, I’ve very much been told to write something up, the choice of medication is up to me, but refusing to give her anything doesn’t seem to be an option.’
‘And you want to keep everyone happy,’ said Gus nodding knowledgeably.
‘Erm, no. Not really,’ said Violet, confused. ‘Keeping people happy is not top of my agenda.’
‘Oh,’ said Gus, evidently surprised by this admission.
‘I just want to do the right thingmedically,’ Violet continued. ‘I know from the ward point of view, it would be easier if this patient was sedated. It would probably benefit the other patients here too if I’m honest, the staff do seem thin on the ground. There’ll be plenty of people who maybe won’t get the level of care they need if one of the nursing team is constantly occupied with one patient. And it doesn’t seem fair when that patient isn’t medically unwell, she’s just being a nuisance.’
‘Uh-huh.’ Gus nodded.
‘But on the other hand, should I be sedating someone simply because they’re an inconvenience? How would I feel if that was my grandmother being given a medical straitjacket just to give the nursing team an easy life?’
‘I take it you haven’t put it in those terms when discussing it with the actual nursing team?’ Gus looked slightly alarmed.
‘I haven’t gone as far as implying that they’re workshy, if that’s what you’re worried about,’ said Violet. ‘At least, I don’tthinkI have– although, if they were being lazy I would absolutely tell them that. I have done in the past.’ She faltered slightly, recalling incidents when she had said exactly this. Seeing her comments cast in the light of what Anjali had said yesterday, she wondered if perhaps her wordscouldhave been interpreted as a little bit rude and patronising.
Gus had taken a sharp intake of breath, clearly horrified by the very thought of saying such a thing.
‘But that’s part of the problem,’ she continued, trying to ignore the flicker of self-doubt and the troubling thought that she might have shocked him. ‘There’s no correct answer. If someone was in the wrong, then I could put them right. If they were asking me to write this lady up for cardiac drugs that she didn’t need, then I could give a clear answer, and know I was doing the right thing.’
‘But this is a bit of a grey area?’
‘Yes.’ Violet sighed. ‘And I’m not good with those, as a rule. I don’t do nuance.’
