The night shift, p.12
The Night Shift, page 12
Gus jotted down the last of the girl’s results from the computer screen and stood from the desk. ‘Well,’ he said. ‘I’ll leave you to it. I’m off to have a chat with the family.’
Barney’s mouth formed into a smirk. ‘Surprised they bothered showing up,’ he said, his voice low and conspiratorial. ‘I mean you've got to know when to let go, haven’t you, if your kid’s that fucked up. I suppose they blame themselves. Not wrong if you ask me.’
‘Lucky nobody is asking you then Barney, mate,’ said Gus as cheerfully as he could.
‘Ha! Yeah. That kind of conversation’s much better suited to you.’ Barney punched Gus gently on the shoulder as he took the recently vacated seat. It was a minor power move, the significance not lost on either of them. ‘You always were better at pretending you gave a shit than the rest of us.’
A sharp retort was on the tip of Gus’s tongue but he swallowed it down. The problem with Barney, other than the fact that he made you want to smack him in the face on a semi-regular basis, was that he was, for the most part, completely oblivious to any suggestion that his attitude was inappropriate. He would have laughed off accusations of bigotry, and positively enjoyed being called an arrogant snob. Besides, Gus didn’t have the time to challenge him – although he was aware, even as he was thinking it, just how lame that excuse sounded.
Violet
Violet was rushed off her feet for the next couple of hours, and she barely had a chance to sit down let alone make it as far as the mess for a cup of tea. She saw Gus briefly as they passed each other in the corridor at three in the morning and he mimed a short burst of backstroke which made her laugh all the way to ward ten where she found Cindy settling a new surgical patient into the bed next to Mr Zeller.
‘Violet!’ said Cindy, looking genuinely pleased to see her. ‘Give me a moment to get Mr Adoji sorted out and I’ll be with you.’
Violet could see that in the adjacent bed Mr Zeller was wide awake and tutting at the disruption.
‘Mr Zeller,’ she said, pulling up a chair. ‘Can’t sleep?’
‘Not bloody surprising, is it?’ He pursed his lips together and glared at her. ‘What are you doing here anyway?’
‘I work here, remember?’
‘Yes, yes, I know that,’ he said crossly. ‘I haven’t entirely lost my marbles. I meant what are you doing coming and sitting down next to me? Waiting to badger my new neighbour, is it?’
‘No,’ she said. ‘I don’t think he’s one of mine. I actually wanted to see you. I wanted to give you this.’ She pulled a small parcel out of the pocket of her scrubs and handed it to him. ‘Happy Christmas,’ she said. ‘Happy belated Christmas, anyway.’
Mr Zeller contemplated the parcel silently for a moment. ‘What’s that then?’ he said eventually. ‘A present?’
‘Yes.’ Violet sat on her hands and leaned forward. She didn’t want to look too pleased with herself, but she was actually really pleased with herself. She’d got the idea for the gift after speaking to one of the staff on ward eight the night before and had managed to stop by the shops on the way to visit her gran. ‘Open it,’ she said eagerly. ‘I think it might be useful right about now.’
Mr Zeller frowned. ‘I told you I hated Christmas,’ he said grumpily, prodding the package with a gnarly finger.
‘Well, let’s say it’s not a Christmas present, then.’ Violet was undeterred. ‘Shall I help you open—’
‘I can do it!’ he said, pulling the paper away from the sticky tape with the sudden vigour of a small child playing pass the parcel. He eyed the contents curiously.
‘It’s a sleep kit,’ Violet said. ‘To help you sleep. There’s an eye mask, some ear plugs and a lavender pillow spray. My housemate swears by the spray, he says he likes to imagine he’s in a field in the south of France – although I think the effect is supposed to be calming, and Dev’s memories of his summer in Southern France are fairly tempestuous from what I can gather – anyway, I thought you could try it?’
Mr Zeller positioned his finger on the spray cap and was just about to direct an aerosol of essential oils into his eye before Violet reached out to turn it around. She was surprised to note that he didn’t bark at her for intervening. He managed to spray it onto his pillow successfully after the second attempt and Violet saw him take a deep breath in, closing his eyes for a moment.
‘Smells a little like my Magda,’ he said, fixing his eyes on Violet once more. ‘Not sure it’ll help me sleep but – it smells nice, I’ll grant you. A lot better than the gravy and piss this ward usually smells of.’
‘Well, I’ll take that as a ringing endorsement,’ said Violet, laughing. ‘Shall I feed that back to the manufacturer? “Smells better than gravy and piss.”’
He chuckled along with her as he fished around in the rest of the paper wrapping for the foam ear plugs. Violet didn’t interfere as he pushed them into his ears – even though it looked like a struggle with his arthritic fingers – and eventually he gave her one of his cracked teeth smiles.
‘Bliss!’ he said under his breath as he registered the relative silence. He then allowed Violet to help him unwrap the eye mask and position the elastic at the back of his head before pinging it down over the bridge of his nose and breathing out contentedly. Violet even thought she might have heard him mutter something about a Happy Christmas to you too, Dr Winters as she moved away from his bed, but she couldn’t have been sure of it.
It was only on the way back to the nurses’ station that she remembered that she had been intending to check his obs chart and make sure that his Do Not Resuscitate status was coded but there was no hurry and besides, Cindy wanted to speak to her about John’s Campaign.
‘I’ve spoken to one of the nurse managers, Mark. He’s going to add the campaign to the agenda for the next clinical board meeting,’ she said breathlessly, returning to the desk after she’d finally managed to wrestle Mr Adoji into his pyjamas. ‘He thought it was a good idea – especially when I said it would reduce the burden on the nursing staff and likely improve clinical outcomes. And he was very impressed when I told him the idea had come from one of the junior medical team. He wanted to know which doctor it was. I told him, Dr Winters, my foundation doc on nights this week.’
‘But it was you who made me think of it,’ said Violet, smiling slightly at Cindy’s taking ownership of her in such a way. ‘What with Mrs Jenson and her train trips down to the Dorset coast. How is she by the way? I haven’t seen her on the ward.’
‘Well,’ said Cindy conspiratorially, ‘I managed to get her a side room and although it’s not official policy yet, I figure if they’re happy to discuss this campaign at the board meeting, it’s only a matter of time, so I thought I’d bend the rules a little. Son was able to stay until she went to sleep a few hours ago. She’ll be fine now – sleep right through, no wandering off to the bus-stop worrying about boiled eggs and whether she’s packed her sun hat. It’s all good.’
‘Excellent,’ said Violet, genuinely pleased that their plan had worked. ‘Now all we need to do is find a side room and a relative willing to stay with every single one of our confused patients!’
‘Pfft.’ Cindy made an indeterminate noise of derision. ‘That’s highly unlikely as well you know, but it’s a start. And while we’re waiting for Christmas miracles there are a few jobs to be getting on with here for you as well as me.’ She consulted her list. ‘Have you got time to re-site Mrs Chambers’ cannula? It’s blocked. And the new chap in four needs blood cultures doing. And we need a fresh drug chart for Mrs Carmichael. I’ve written everything out, I know you’ve been busy, so you just need to sign it.’
‘Sure,’ said Violet, pulling the chart across the desk and checking through the drug names and doses. She signed them off with a flourish. ‘Thanks, Cindy, that’s saved me a lot of time. I’ll do the cultures now, build up to Mrs Chambers’ venflon – I suspect her veins are shot.’
Cindy looked sympathetic. ‘They are pretty flimsy. And she’s on warfarin so she’s got bruises all the way up both arms, poor love, looks like she’s been thrown down the stairs. If you can just get a pink in that would be brilliant.’
Violet grimaced. ‘I’ll see what I can do.’
Thirty minutes later and Violet had successfully taken Mr Grant’s blood cultures, reviewed eleven sets of pathology results and written up two new fluid charts, but she was no further forward with getting intravenous access into Mrs Chambers despite numerous attempts, the patient wincing delicately every time Violet tried. After the fifth unsuccessful go Violet mumbled her apologies, returned to the desk and put her head in her hands. Her tea had gone cold but Cindy immediately slid a fresh mug into her hands and Violet was so touched that she didn’t even complain about the shade of it.
‘No joy?’ Cindy inclined her head towards the mess of bloody cotton wool and spent needles in Violet’s tray.
Violet shook her head miserably. ‘No, and she’s going to need her antibiotics soon, isn’t she? I’d better call Anjali, ask her to do it – I just feel so bad getting her up here to tidy up after me. She’s got a mountain of people to clerk in down on MAU.’
Cindy raised her eyebrows and nodded. ‘Ahhh, yes. The granny-dum—’
‘Granny-dumpers,’ Violet finished for her. ‘Yes, I heard about that. Seems like they’re all being dumped as we speak.’
‘I wouldn’t assume Anjali could do it easily anyway,’ said Cindy soothingly. ‘Mrs C’s got hellish veins. What you want is an anaesthetist. Is that Gus still on nights? Give him a bleep.’
‘Oh, no, I couldn’t,’ said Violet quickly. ‘He’s not on my on-call team. I’d just be throwing extra work at him.’
Cindy smiled fondly. ‘He’s a lovely one though. He won’t mind. Some of them do, I grant you, but not Gus. You ask any of the nurses. He’s an absolute sweetheart. Never shouts, never throws his weight around. Never says he’s too busy or important. Here, I’ll bleep him for you.’
‘No – I…’
But Cindy had already picked up the phone and tapped in his number.
A minute later and the phone rang, Violet went to grab it but Cindy beat her to it. ‘Hi, Gus,’ she said. ‘Cindy here on ward ten. Wondered if you might be able to help us with a cannula for Mrs Chambers. I know it’s a bit below your pay grade, but our lovely Dr Winters has had a good go and she’s losing the will to live. Dr Winters I mean, not Mrs Chambers, although the same might be applicable.’
There was a pause and then Cindy laughed appreciatively. ‘Excellent,’ she said. ‘Thank you.’ She replaced the receiver with a beaming smile and shook her head indulgently. ‘Such a lovely boy,’ she muttered to herself.
She turned to Violet. ‘Cavalry’s on its way,’ she said. ‘Come on, let’s get a fresh tray and get rid of that crime scene.’ She indicated Violet’s current steri-tray with a smile.
Gus arrived within minutes, strolling onto the ward with his usual air of relaxed calm. Violet was just leaving the supply cupboard, concentrating on the tray of needles in front of her and before she knew it she’d bumped right into him.
‘Oh, sorry – gosh,’ she said. ‘Are you alright?’ She checked to make sure nothing had fallen off her tray and impaled him.
‘Don’t worry – no penetrating injuries,’ he said with an easy laugh. Violet was glad he couldn’t see her flush in the dark of the corridor when he said ‘penetrating’. Really, how ridiculous.
‘I’m really sorry we had to call you,’ Violet said, her voice still a little unsteady.
‘Are you?’ His tone was teasing. ‘I don’t mind being called, and anyway, it’s been at least an hour since I’ve seen you. Maybe I’ve missed you.’
‘Right.’ Violet looked down again. Was he flirting with her? He really shouldn’t be, not if he was engaged – but maybe that was just his way, maybe his fiancée didn’t mind. She knew that she would mind but maybe that wasn’t especially relevant. ‘Uhm,’ she said, eyeing him with more suspicion, ‘it’s just I’ve had no luck with the…’ She gestured to her tray just as Gus reached out to touch her gently on the arm.
‘Honestly, Violet, it’s fine. Getting IV access takes practice. Anaesthetists are only good at it because we do it so often. Here…’ He took the tray from her. ‘Do you want me to show you? I’m not trying to be patronising and if you’ve got other jobs to be getting on with it’s fine, but if I talk you through my technique, it might make it easier to do on someone else, help your confidence.’
‘I’m not sure as anyone’s going to be able to make me feel more confident about procedures,’ said Violet gloomily. ‘I just seem to be completely incapable.’
‘Rubbish,’ said Gus. ‘There’s no skill involved – just practice, like I said. And when you’re halfway through your first ever week of nights in your first ever acute medical job, and you feel utterly knackered, and the medical admissions are piling in, and every patient on the wards has new and exciting problems to attend to, getting a line in, or doing blood gases or whatever, it feels impossible – like someone’s asked you to perform lifesaving cardiac surgery blindfold with your hands tied behind your back.’
Violet nodded and felt her throat go tight. She did feel like that. She was tired, and overwhelmed, and saddened by the stories of old people abandoned over Christmas, and anxious about whether Mr Zeller had really liked his present or not. Gus’s deep sonorous voice, gravelly with lack of sleep but gentle with its inflections, soothed her frayed nerves. What he said made sense. He’d been through it himself. Maybe she wasn’t hopeless, maybe it was normal to feel utterly incompetent from time to time.
‘Thanks,’ she said, hoping that he could hear the depth of gratitude packaged up in that little word. ‘If you could show me, that would be really helpful.’
He took her by the elbow and steered her gently along the corridor. ‘Right, where is she? Let the archer see the target.’
‘Let the hunter see the hare,’ said Violet, giggling along as she did a dreadful Lancashire accent to impersonate Paddy McGuiness from the television show Take Me Out.
‘Let the harpooner see the whale.’ Gus’s accent was even worse and they both laughed.
‘Bit harsh,’ said Violet, relieved that they were back to their usual silliness. ‘Mrs Chambers is quite slim.’
Violet introduced Gus as ‘the best cannula-siter in the hospital, if not the world’, and Mrs Chambers smiled with the weary wisdom of one who has been subjected to multiple attempts at venesection over the years.
‘My veins are a mess, sweetheart,’ she said confidentially to Gus as he leaned over to look at her arms. ‘They weren’t good before but the chemo’s completely rogered them and now I’m on warfarin I bruise if I so much as walk past a needle. But you’re welcome to give it a try.’
Violet watched as Gus put Mrs Chambers completely at ease, talking her through everything he was doing and treating her as if she was the most important person in the universe. He asked questions about how her Christmas had been, what she and the grandchildren were hoping to do once she got out of hospital, what she’d thought of the pantomime she’d been to the night before she was admitted. He seemed to know instinctively that this was a woman who often felt defined by her multiple medical conditions, and who resented it. She was somebody who wanted to talk about anything other than medication and treatment regimens – and getting her to do just that while he tightened the tourniquet and tapped the back of her hand with his fingers was the perfect distraction. Violet was aware that she was in the presence of a master.
‘Right.’ Gus turned his caramel eyes to Violet and gave her a reassuring smile. ‘I’ve found somewhere we can try, but I’m going to get you to do it, okay? I’ll be right here, I’ll guide you through it.’ He turned back to the bed. ‘Is that okay, Mrs Chambers? Dr Winters is an extremely competent clinician and I’ll be assisting her. We’ll make sure that we get a line in.’
‘You do whatever you need to do,’ she said kindly as she offered up her arm to Violet.
‘You need to make sure you’re comfortable, as well as the patient,’ said Gus, manoeuvring Violet gently into position on the side of Mrs Chambers’ bed so that she could reach the tray as well as her patient’s arm. She could feel the presence of his warm palms on her shoulders long after he’d removed them. He then moved the angle-poise lamp so that it was shining directly on the back of Mrs Chambers’ hand, casting the rest of them in shadow, and crouched alongside Violet, so close that she could feel the heat of his body through his scrubs.
‘Feel just around here,’ he said, pointing towards the patient’s wrist. His voice was soft, the instruction just for her, and she was suddenly acutely aware of the bizarre intimacy of the situation, the two of them in the darkness, bodies separated only by the thin cotton of their scrubs.
She obeyed him wordlessly but after a few seconds of ineffectual prodding she threw him an anxious look over the beam of lamplight.
‘Can’t feel it,’ she whispered, feeling hopeless.
He brought his face close to hers so that they both had the same line of sight and then he brought Violet’s hand over to the patient’s wrist. ‘Here,’ he said gently. ‘Can you feel a slight give? A sort of springiness, just there?’ He pressed her fingertip down where his had been and she half-nodded.
‘I guess,’ she said doubtfully.
‘There’s one there, I promise,’ he said. ‘Trust me?’ His breath was warm against her ear and it tickled the fine hairs on her neck.
She nodded and gave a nervous laugh, her voice suddenly squeaky. He tore open the swab wrapper and gave her the square piece of gauze, the tang of its alcohol sharp in her nostrils.
‘Use the corner of the swab as a marker,’ he said once she’d cleaned the back of Mrs Chambers’ hand.
She did as he’d asked, hoping that she was right and that she’d marked the correct place, because suddenly Mrs Chambers’ hand just looked like a mass of uniform bruising with no distinguishing features. Gus seemed to sense her faltering confidence.
Barney’s mouth formed into a smirk. ‘Surprised they bothered showing up,’ he said, his voice low and conspiratorial. ‘I mean you've got to know when to let go, haven’t you, if your kid’s that fucked up. I suppose they blame themselves. Not wrong if you ask me.’
‘Lucky nobody is asking you then Barney, mate,’ said Gus as cheerfully as he could.
‘Ha! Yeah. That kind of conversation’s much better suited to you.’ Barney punched Gus gently on the shoulder as he took the recently vacated seat. It was a minor power move, the significance not lost on either of them. ‘You always were better at pretending you gave a shit than the rest of us.’
A sharp retort was on the tip of Gus’s tongue but he swallowed it down. The problem with Barney, other than the fact that he made you want to smack him in the face on a semi-regular basis, was that he was, for the most part, completely oblivious to any suggestion that his attitude was inappropriate. He would have laughed off accusations of bigotry, and positively enjoyed being called an arrogant snob. Besides, Gus didn’t have the time to challenge him – although he was aware, even as he was thinking it, just how lame that excuse sounded.
Violet
Violet was rushed off her feet for the next couple of hours, and she barely had a chance to sit down let alone make it as far as the mess for a cup of tea. She saw Gus briefly as they passed each other in the corridor at three in the morning and he mimed a short burst of backstroke which made her laugh all the way to ward ten where she found Cindy settling a new surgical patient into the bed next to Mr Zeller.
‘Violet!’ said Cindy, looking genuinely pleased to see her. ‘Give me a moment to get Mr Adoji sorted out and I’ll be with you.’
Violet could see that in the adjacent bed Mr Zeller was wide awake and tutting at the disruption.
‘Mr Zeller,’ she said, pulling up a chair. ‘Can’t sleep?’
‘Not bloody surprising, is it?’ He pursed his lips together and glared at her. ‘What are you doing here anyway?’
‘I work here, remember?’
‘Yes, yes, I know that,’ he said crossly. ‘I haven’t entirely lost my marbles. I meant what are you doing coming and sitting down next to me? Waiting to badger my new neighbour, is it?’
‘No,’ she said. ‘I don’t think he’s one of mine. I actually wanted to see you. I wanted to give you this.’ She pulled a small parcel out of the pocket of her scrubs and handed it to him. ‘Happy Christmas,’ she said. ‘Happy belated Christmas, anyway.’
Mr Zeller contemplated the parcel silently for a moment. ‘What’s that then?’ he said eventually. ‘A present?’
‘Yes.’ Violet sat on her hands and leaned forward. She didn’t want to look too pleased with herself, but she was actually really pleased with herself. She’d got the idea for the gift after speaking to one of the staff on ward eight the night before and had managed to stop by the shops on the way to visit her gran. ‘Open it,’ she said eagerly. ‘I think it might be useful right about now.’
Mr Zeller frowned. ‘I told you I hated Christmas,’ he said grumpily, prodding the package with a gnarly finger.
‘Well, let’s say it’s not a Christmas present, then.’ Violet was undeterred. ‘Shall I help you open—’
‘I can do it!’ he said, pulling the paper away from the sticky tape with the sudden vigour of a small child playing pass the parcel. He eyed the contents curiously.
‘It’s a sleep kit,’ Violet said. ‘To help you sleep. There’s an eye mask, some ear plugs and a lavender pillow spray. My housemate swears by the spray, he says he likes to imagine he’s in a field in the south of France – although I think the effect is supposed to be calming, and Dev’s memories of his summer in Southern France are fairly tempestuous from what I can gather – anyway, I thought you could try it?’
Mr Zeller positioned his finger on the spray cap and was just about to direct an aerosol of essential oils into his eye before Violet reached out to turn it around. She was surprised to note that he didn’t bark at her for intervening. He managed to spray it onto his pillow successfully after the second attempt and Violet saw him take a deep breath in, closing his eyes for a moment.
‘Smells a little like my Magda,’ he said, fixing his eyes on Violet once more. ‘Not sure it’ll help me sleep but – it smells nice, I’ll grant you. A lot better than the gravy and piss this ward usually smells of.’
‘Well, I’ll take that as a ringing endorsement,’ said Violet, laughing. ‘Shall I feed that back to the manufacturer? “Smells better than gravy and piss.”’
He chuckled along with her as he fished around in the rest of the paper wrapping for the foam ear plugs. Violet didn’t interfere as he pushed them into his ears – even though it looked like a struggle with his arthritic fingers – and eventually he gave her one of his cracked teeth smiles.
‘Bliss!’ he said under his breath as he registered the relative silence. He then allowed Violet to help him unwrap the eye mask and position the elastic at the back of his head before pinging it down over the bridge of his nose and breathing out contentedly. Violet even thought she might have heard him mutter something about a Happy Christmas to you too, Dr Winters as she moved away from his bed, but she couldn’t have been sure of it.
It was only on the way back to the nurses’ station that she remembered that she had been intending to check his obs chart and make sure that his Do Not Resuscitate status was coded but there was no hurry and besides, Cindy wanted to speak to her about John’s Campaign.
‘I’ve spoken to one of the nurse managers, Mark. He’s going to add the campaign to the agenda for the next clinical board meeting,’ she said breathlessly, returning to the desk after she’d finally managed to wrestle Mr Adoji into his pyjamas. ‘He thought it was a good idea – especially when I said it would reduce the burden on the nursing staff and likely improve clinical outcomes. And he was very impressed when I told him the idea had come from one of the junior medical team. He wanted to know which doctor it was. I told him, Dr Winters, my foundation doc on nights this week.’
‘But it was you who made me think of it,’ said Violet, smiling slightly at Cindy’s taking ownership of her in such a way. ‘What with Mrs Jenson and her train trips down to the Dorset coast. How is she by the way? I haven’t seen her on the ward.’
‘Well,’ said Cindy conspiratorially, ‘I managed to get her a side room and although it’s not official policy yet, I figure if they’re happy to discuss this campaign at the board meeting, it’s only a matter of time, so I thought I’d bend the rules a little. Son was able to stay until she went to sleep a few hours ago. She’ll be fine now – sleep right through, no wandering off to the bus-stop worrying about boiled eggs and whether she’s packed her sun hat. It’s all good.’
‘Excellent,’ said Violet, genuinely pleased that their plan had worked. ‘Now all we need to do is find a side room and a relative willing to stay with every single one of our confused patients!’
‘Pfft.’ Cindy made an indeterminate noise of derision. ‘That’s highly unlikely as well you know, but it’s a start. And while we’re waiting for Christmas miracles there are a few jobs to be getting on with here for you as well as me.’ She consulted her list. ‘Have you got time to re-site Mrs Chambers’ cannula? It’s blocked. And the new chap in four needs blood cultures doing. And we need a fresh drug chart for Mrs Carmichael. I’ve written everything out, I know you’ve been busy, so you just need to sign it.’
‘Sure,’ said Violet, pulling the chart across the desk and checking through the drug names and doses. She signed them off with a flourish. ‘Thanks, Cindy, that’s saved me a lot of time. I’ll do the cultures now, build up to Mrs Chambers’ venflon – I suspect her veins are shot.’
Cindy looked sympathetic. ‘They are pretty flimsy. And she’s on warfarin so she’s got bruises all the way up both arms, poor love, looks like she’s been thrown down the stairs. If you can just get a pink in that would be brilliant.’
Violet grimaced. ‘I’ll see what I can do.’
Thirty minutes later and Violet had successfully taken Mr Grant’s blood cultures, reviewed eleven sets of pathology results and written up two new fluid charts, but she was no further forward with getting intravenous access into Mrs Chambers despite numerous attempts, the patient wincing delicately every time Violet tried. After the fifth unsuccessful go Violet mumbled her apologies, returned to the desk and put her head in her hands. Her tea had gone cold but Cindy immediately slid a fresh mug into her hands and Violet was so touched that she didn’t even complain about the shade of it.
‘No joy?’ Cindy inclined her head towards the mess of bloody cotton wool and spent needles in Violet’s tray.
Violet shook her head miserably. ‘No, and she’s going to need her antibiotics soon, isn’t she? I’d better call Anjali, ask her to do it – I just feel so bad getting her up here to tidy up after me. She’s got a mountain of people to clerk in down on MAU.’
Cindy raised her eyebrows and nodded. ‘Ahhh, yes. The granny-dum—’
‘Granny-dumpers,’ Violet finished for her. ‘Yes, I heard about that. Seems like they’re all being dumped as we speak.’
‘I wouldn’t assume Anjali could do it easily anyway,’ said Cindy soothingly. ‘Mrs C’s got hellish veins. What you want is an anaesthetist. Is that Gus still on nights? Give him a bleep.’
‘Oh, no, I couldn’t,’ said Violet quickly. ‘He’s not on my on-call team. I’d just be throwing extra work at him.’
Cindy smiled fondly. ‘He’s a lovely one though. He won’t mind. Some of them do, I grant you, but not Gus. You ask any of the nurses. He’s an absolute sweetheart. Never shouts, never throws his weight around. Never says he’s too busy or important. Here, I’ll bleep him for you.’
‘No – I…’
But Cindy had already picked up the phone and tapped in his number.
A minute later and the phone rang, Violet went to grab it but Cindy beat her to it. ‘Hi, Gus,’ she said. ‘Cindy here on ward ten. Wondered if you might be able to help us with a cannula for Mrs Chambers. I know it’s a bit below your pay grade, but our lovely Dr Winters has had a good go and she’s losing the will to live. Dr Winters I mean, not Mrs Chambers, although the same might be applicable.’
There was a pause and then Cindy laughed appreciatively. ‘Excellent,’ she said. ‘Thank you.’ She replaced the receiver with a beaming smile and shook her head indulgently. ‘Such a lovely boy,’ she muttered to herself.
She turned to Violet. ‘Cavalry’s on its way,’ she said. ‘Come on, let’s get a fresh tray and get rid of that crime scene.’ She indicated Violet’s current steri-tray with a smile.
Gus arrived within minutes, strolling onto the ward with his usual air of relaxed calm. Violet was just leaving the supply cupboard, concentrating on the tray of needles in front of her and before she knew it she’d bumped right into him.
‘Oh, sorry – gosh,’ she said. ‘Are you alright?’ She checked to make sure nothing had fallen off her tray and impaled him.
‘Don’t worry – no penetrating injuries,’ he said with an easy laugh. Violet was glad he couldn’t see her flush in the dark of the corridor when he said ‘penetrating’. Really, how ridiculous.
‘I’m really sorry we had to call you,’ Violet said, her voice still a little unsteady.
‘Are you?’ His tone was teasing. ‘I don’t mind being called, and anyway, it’s been at least an hour since I’ve seen you. Maybe I’ve missed you.’
‘Right.’ Violet looked down again. Was he flirting with her? He really shouldn’t be, not if he was engaged – but maybe that was just his way, maybe his fiancée didn’t mind. She knew that she would mind but maybe that wasn’t especially relevant. ‘Uhm,’ she said, eyeing him with more suspicion, ‘it’s just I’ve had no luck with the…’ She gestured to her tray just as Gus reached out to touch her gently on the arm.
‘Honestly, Violet, it’s fine. Getting IV access takes practice. Anaesthetists are only good at it because we do it so often. Here…’ He took the tray from her. ‘Do you want me to show you? I’m not trying to be patronising and if you’ve got other jobs to be getting on with it’s fine, but if I talk you through my technique, it might make it easier to do on someone else, help your confidence.’
‘I’m not sure as anyone’s going to be able to make me feel more confident about procedures,’ said Violet gloomily. ‘I just seem to be completely incapable.’
‘Rubbish,’ said Gus. ‘There’s no skill involved – just practice, like I said. And when you’re halfway through your first ever week of nights in your first ever acute medical job, and you feel utterly knackered, and the medical admissions are piling in, and every patient on the wards has new and exciting problems to attend to, getting a line in, or doing blood gases or whatever, it feels impossible – like someone’s asked you to perform lifesaving cardiac surgery blindfold with your hands tied behind your back.’
Violet nodded and felt her throat go tight. She did feel like that. She was tired, and overwhelmed, and saddened by the stories of old people abandoned over Christmas, and anxious about whether Mr Zeller had really liked his present or not. Gus’s deep sonorous voice, gravelly with lack of sleep but gentle with its inflections, soothed her frayed nerves. What he said made sense. He’d been through it himself. Maybe she wasn’t hopeless, maybe it was normal to feel utterly incompetent from time to time.
‘Thanks,’ she said, hoping that he could hear the depth of gratitude packaged up in that little word. ‘If you could show me, that would be really helpful.’
He took her by the elbow and steered her gently along the corridor. ‘Right, where is she? Let the archer see the target.’
‘Let the hunter see the hare,’ said Violet, giggling along as she did a dreadful Lancashire accent to impersonate Paddy McGuiness from the television show Take Me Out.
‘Let the harpooner see the whale.’ Gus’s accent was even worse and they both laughed.
‘Bit harsh,’ said Violet, relieved that they were back to their usual silliness. ‘Mrs Chambers is quite slim.’
Violet introduced Gus as ‘the best cannula-siter in the hospital, if not the world’, and Mrs Chambers smiled with the weary wisdom of one who has been subjected to multiple attempts at venesection over the years.
‘My veins are a mess, sweetheart,’ she said confidentially to Gus as he leaned over to look at her arms. ‘They weren’t good before but the chemo’s completely rogered them and now I’m on warfarin I bruise if I so much as walk past a needle. But you’re welcome to give it a try.’
Violet watched as Gus put Mrs Chambers completely at ease, talking her through everything he was doing and treating her as if she was the most important person in the universe. He asked questions about how her Christmas had been, what she and the grandchildren were hoping to do once she got out of hospital, what she’d thought of the pantomime she’d been to the night before she was admitted. He seemed to know instinctively that this was a woman who often felt defined by her multiple medical conditions, and who resented it. She was somebody who wanted to talk about anything other than medication and treatment regimens – and getting her to do just that while he tightened the tourniquet and tapped the back of her hand with his fingers was the perfect distraction. Violet was aware that she was in the presence of a master.
‘Right.’ Gus turned his caramel eyes to Violet and gave her a reassuring smile. ‘I’ve found somewhere we can try, but I’m going to get you to do it, okay? I’ll be right here, I’ll guide you through it.’ He turned back to the bed. ‘Is that okay, Mrs Chambers? Dr Winters is an extremely competent clinician and I’ll be assisting her. We’ll make sure that we get a line in.’
‘You do whatever you need to do,’ she said kindly as she offered up her arm to Violet.
‘You need to make sure you’re comfortable, as well as the patient,’ said Gus, manoeuvring Violet gently into position on the side of Mrs Chambers’ bed so that she could reach the tray as well as her patient’s arm. She could feel the presence of his warm palms on her shoulders long after he’d removed them. He then moved the angle-poise lamp so that it was shining directly on the back of Mrs Chambers’ hand, casting the rest of them in shadow, and crouched alongside Violet, so close that she could feel the heat of his body through his scrubs.
‘Feel just around here,’ he said, pointing towards the patient’s wrist. His voice was soft, the instruction just for her, and she was suddenly acutely aware of the bizarre intimacy of the situation, the two of them in the darkness, bodies separated only by the thin cotton of their scrubs.
She obeyed him wordlessly but after a few seconds of ineffectual prodding she threw him an anxious look over the beam of lamplight.
‘Can’t feel it,’ she whispered, feeling hopeless.
He brought his face close to hers so that they both had the same line of sight and then he brought Violet’s hand over to the patient’s wrist. ‘Here,’ he said gently. ‘Can you feel a slight give? A sort of springiness, just there?’ He pressed her fingertip down where his had been and she half-nodded.
‘I guess,’ she said doubtfully.
‘There’s one there, I promise,’ he said. ‘Trust me?’ His breath was warm against her ear and it tickled the fine hairs on her neck.
She nodded and gave a nervous laugh, her voice suddenly squeaky. He tore open the swab wrapper and gave her the square piece of gauze, the tang of its alcohol sharp in her nostrils.
‘Use the corner of the swab as a marker,’ he said once she’d cleaned the back of Mrs Chambers’ hand.
She did as he’d asked, hoping that she was right and that she’d marked the correct place, because suddenly Mrs Chambers’ hand just looked like a mass of uniform bruising with no distinguishing features. Gus seemed to sense her faltering confidence.
