Page 3 of The Night Shift
‘I know he’s like a total snack; we were all in love with him at medical school, but he's properly off the market. Got engaged last year to his long-term girlfriend, broke about a billion hearts.’
‘Oh,’ Violet tried out a casual shrug. ‘That’s nice. For him I mean. And her. His girlfriend. Another doctor, is she?’
Anjali narrowed her eyes a tiny fraction which must have meant she was suspicious. Clearly the shrug hadn’t been as casual as Violet hoped– maybe she’d overdone it– maybe Anjali thought she had some kind of muscular neck spasm.
‘No, I think she works in television,’ Anjali said. ‘Something glamorous, or more glamorous than hospital anyway.’ She smiled at Violet. ‘Look, there’s no harm in having a bit of eye-candy around when you’re working the wards on nights,’ she said. ‘But he’s a proper charmer. Not deliberate, it’s just his manner. He makes people feel special. I just don’t want to see you get sucked in.’
‘I won’t,’ said Violet, a little annoyed by both Anjali’s assumptions and the fact that she herself had been so obvious in her interest. ‘I don’t like charming men. Or handsome ones. And I especially don’t like men who are charmingandhandsome. I don’t trust them.’
‘Very wise,’ said Anjali who now seemed to be struggling to keep her own facial muscles under control. ‘Forget I said anything. Have you managed to get the blood gases done on Mrs Anderson yet?’
‘No,’ said Violet, relaxing now that they’d changed the subject back to more clinical issues. ‘I was on ward twelve looking at Mr Newton’s swollen ankles before the crash bleep went off. The staff nurse wanted me to write him up for a massive dose of diuretic to shift the fluid, said he’s complaining about his socks digging in.’ She didn’t want to add that she was putting off seeing Mrs Anderson because she hated checking blood gases. The procedure involved sticking a needle into the soft underside of a patient’s wrist which was painful for all concerned. The practical skills of ward work just didn’t come naturally to Violet and no matter how diligently she followed the advice about needle positioning she always ended up with arterial blood everywhere and a bruised, disgruntled patient sat amidst the gory crime scene.
‘Anyway,’ she continued. ‘Mr Newton’s kidney function was all over the place so I told the staff nurse that a high dose of the medication she was suggesting could potentially kill him.’ She paused. ‘Actually, I think Imighthave upset her– the staff nurse– she told me there was no need to be quite so rude and patronising. And then, well, she didn’t speak to me again.’
‘Oh, Violet. Not again.’ Anjali sighed and looked for a moment as though she wanted to say something else but thought better of it. ‘Look, don’t worry too much about Mr Newton’s ankles, they’ve been swollen for years. But I could do with some help with a new chap who’s just been transferred onto ward four. He’s stable but he’ll need clerking properly. It’s been hours since he was triaged down in A&E.’ She looked at her own list. ‘Mr Zeller. Eighty-four. Jaundice, weight loss and shortness of breath. Doesn’t sound like an ideal combination.’ She grimaced. ‘Anyway, I’ll head off to medical admissions and finish reviewing the woman with the abdominal pain and then I’ll do Mrs Anderson’s blood gases if you like?’
‘Thank you. I really hate doing blood gases.’
‘I know you do.’ Anjali laughed, and then she frowned. ‘Take a look at Mr Zeller’s notes, Violet, before you go and speak to him, okay? From what the team in A&E said, I don’t think he has any idea of what’s about to hit him. And they didn’t have the time to drop any hints. Too busy dealing with the steady stream of festive drunks. You might need to be a bit– uhm–delicate.’
Violet’s insides turned over in alarm. ‘I don’t reallydodelicacy,’ she said. ‘You remember what that patient said about me last month, that I had the bedside manner of Dr Crippen.’
‘The man with the liver disease?’ Anjali seemed to be stifling a laugh as she recalled the incident. ‘Oh, he was just upset about the diagnosis. I’ve seen him before. He blames everyone else for what’s happened to him. I think he was just a bit surprised that you gave it to him both barrels.’
‘I only told him he had to stop drinking or he’d die of hepatic failure,’ said Violet. ‘It was the truth after all.’
‘Yes but you know what they say about patients,’ said Anjali, putting on a strange American accent. ‘They can’t handle the truth.’
‘What?’
‘Sorry, I was trying to be Jack Nicholson inA Few Good Men,’ Anjali said. ‘But I guess it’s a bit before your time. Anyway, I’m sure you’re perfectly capable of being sensitive and diplomatic. Just have those skills in the forefront of your mind when you’re seeing Mr Zeller, yes?’
Violet nodded but pulled a sceptical face as she pocketed her phone and Anjali clearly felt compelled to speak again. ‘And, while we’re talking about diplomacy,’ she said.
‘Ye-es.’
‘Don’t worry, this isn’t a telling off. It’s just…’ Anjali’s next words came out in a rush. ‘Do you think you could be a bit more tactful with some of your ward colleagues?’
Violet’s heart sank. ‘Tactful?’
‘Like, the discussion you just mentioned, about Mr Newton’s kidney function and telling the nurse that her suggestion might kill him.’
‘But…’ Violet was confused. ‘You don’t think Ishouldhave prescribed a high-dose diuretic, do you?’
‘No, I don’t. But maybe you could have handled the situation a little better?’
Violet paused, trying to pick apart the detail of what Anjali had said. ‘But– it’s a binary choice. I either prescribe the drug and mess up his kidney function further, potentially causing a lot of damage– or I don’t.’ She looked up at Anjali, trying to gauge her expression. ‘I made the right clinical decision– didn’t I?’
‘Well, yes but…’
‘So– what did I do wrong?’
‘Well, you’ve clearly upset one of the nurses by speaking to her in a…’ Anjali now seemed to be struggling to find the right word. (Welcome to my world, thought Violet.) ‘In a…’
‘Factually correct manner?’ she offered.
‘I was going to say, adismissivemanner.’ Anjali paused. ‘It just might make your life a bit easier if you were more, uhm,thoughtfulin how you approach your colleagues.’
