Episode 4 Getting On

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- Oh, I hope Dave mum's OK. - Hmm.

Still, at least she's in the right place, i.e. not here.

I mean, I hope they keep her in for a few days.

Couldn't cope with another non-paying guest.

Kim, is it really the right day for you to give up smoking?

The day your mother-in-law's been rushed to A & E?

Not really, Den.

Kim! Put that out now!

What? It's an electronic one.

Look. Hmmm!

It can't do you any good, Kim, that.

Not having electricity running round your mouth.

Haven't you got to go for your scan?

Oh...yeah.

Look, if you're worried, I'll get Pam from Everest to cover. I'll come with you.

No, no, no, no. It's fine.

- Sure? - Yeah. Won't be long.

- Hello. - Oh, hello.

- How are you? - Yeah, I'm good. Denise Flixter.

- Good. Yeah. - I just wanted to cancel my scan.

Oh. Would you like to rebook or anything?

Um...Sister Flixter, isn't it? Would you like to come in?

Oh, sorry, I was going to cancel or rebook.

Well, of course, it's up to you, but we've got it all set up, so...

OK, yes, fine.

- OK. - Thank you. I won't cancel.

- Brilliant. Come in. - Thank you. Yes.

Right. My name's Dr Oxford, and you're here to have your 12-week full scan.

Yeah.

I'll deal with this, Kim.

Good chance for you gen up on modern nursing techniques. Good for your module.

Watch this. Good morning! I'm Modern Matron Damaris.

You must be Mrs Dingsdale. Do you want to come through this way?

- Yeah. There you go. - Take that for you. Hi, Donald.

Is this a private ward? No, this is the main ward,

but we're all on the same step of the Strategic Stairway as our clients.

Er, only my son told me that I must see that they put me on a private ward.

Right, well, I'm going to see if I can escalate that with Admissions.

OK? Kim, could you help Mrs Dingsdale into bed and ask her for a lunch order?

- OK. - Thanks, Donald.

All right.

Do you want to just help Mrs Dingsdale into the chair

and I'll just do the curtain. Thanks, Donald.

All right. Let me get your feet out the way there.

All right?

There you go.

All right. Pop your nightie on.

And have you had some bleeding?

No, I haven't had any bleeding.

I'm just going to get another pair of eyes to have a little look. OK?

Is there something wrong?

I'm just going to get one of my colleagues to have a little look.

Won't be a minute. OK?

Oh, hello, John. Er, it's Tatty.

I just wonder if you could come down and have a look at one of my patients.

OK. Thanks very much. Thank you.

(PEN SCRATCHING ON PAPER)

(SIGHS)

(PEN SCRATCHING)

Can I just borrow your pen for a sec, please?

Oh, Um...if it's all the same to you, I'd rather not.

It's got a specially weighted nib.

Yes, I actually found it as I was rooting through a box of Philip's old things,

and it was an old anniversary present.

I'm not going to lean my whole weight on it, am I?

No, no! Good Lord, no. I wasn't suggesting you were going to do that.

Dr Moore, I don't know if I'm speaking out of turn here,

but if I got a present from someone I was splitting up with,

I wouldn't particularly want to be walking around with it and keeping it. I mean,

I chucked Dave's last anniversary present out the window

when he was a bit leery with some woman in the pub.

I hope the nursing staff aren't indulging in conversations about my private affairs.

In a hospital? Wouldn't have thought so for a minute.

- Right, where is Den? - She's at her 12-week scan.

All right. Well, I'll be back in ten minutes.

If you see Den, could you tell her

I want to start ward round pretty promptly this morning, please?

I will.

- Den! Hi, Den. - Hiya, Hils.

Hold on a second. I just need to speak to you.

I've been asked to give a talk about reorganisation services.

Oh, congratulations, that's...

No, I thought it'd be fantastic if you could input into it.

Yeah, sure, whatever, you know, if I can help at all.

That'd be brilliant.

I'm looking at a 62% gain in streamline efficiencies,

and that's just in the first 18 months.

It's all about progress, Den.

- Good. Yeah. - The future.

Senior stakeholders are being invited to put forward their recommendations.

- Good. - I can protect you.

- Congratulations. - Den!

- Den, I can protect the three of us. - Great. OK.

Call me, babe, yeah? Den!

I think your trousers are just in your socks there.

Call me.

(KNOCK AT DOOR)

Hi, Tatty, have you got a moment?

- Yes, of course, Pippa. - I'm hoping to pick your brains

at some point about postpartum prolapses.

- You mean in the over-65s? - Yes, yes.

I'm looking at long-term impairment of vaginal functionality, so...

Ah, there's a brilliant paper - Finnish paper - on it.

- I'll e-mail you the link. - Ah! Absolutely great. Thank you.

Oh, are you including anything about the atrophic penis?

Yes, I'm popping it in as an addendum.

- Oh, good. - Hmm.

Coarseness of texture, rubbery-like quality, prominent veins,

not to mention loss of sensation.

You know, all that chaffing can't be doing the poor old vulva any favours.

Well, perhaps we could have a chat about it over a skinny latte sometime.

- Yes, absolutely great, love to. - OK.

- Super. Thanks, Tatty. - OK. Bye-bye.

- What are you doing, Kim? - I'm looking for a present for Dave.

Well, I know you're broke, but...

- Look at that. - That's nice!

Dr Moore binned it.

- Can I have it? - No!

Ah! Den, how did your scan go?

- Fantastic. Yeah. - Oh, jolly good!

I must say you're doing very well for an elderly primigravida.

- Thank you. - So, gents, primigravida?

Is it an old woman having a baby?

Er, yes, not so much old. Sorry, Den!

Sorry?

Just an unfortunate choice of words -

an "old woman" having a baby, rather than...

So it's a lady over the age of 35 having her first child.

Primi - first. Gravida - pregnancy. Obviously from the Latin.

It's handy, Latin, isn't it,

cos it means the patient's got no idea what you're saying.

Yes, I think if you're planning on being a doctor, which you are, aren't you,

you will need to know a little bit of Latin, so...

You've all done Latin, presumably, have you?

- Yes, I did. - Yes, indeed. All righty.

Den, let's have a look at your scan picture.

Yeah. Oh, yeah.

Er...ooh.

Sorry, we do need to get on, actually.

Sorry, Kim, can I show you later?

- All right. - Great.

All right. So, where to first?

Mrs Ellis.

Going this way, actually, gents. Can you keep up, please?

All right, Mrs Ellis. Morning.

- This is the private patient? - No, that's Mrs Dingsdale.

Perhaps we can see Mrs Dingsdale first, then, please.

- OK. Sorry, Mrs Ellis. - All right, see you in a moment.

Just, er... Thank you.

Hello. Hello, Mrs Dingsdale. How do you do? I'm Dr Moore.

- Mrs Dingsdale, this is Dr Moore. - Hello, Dr Moore.

Hello there.

I've promised Professor Portnoy-Noor I'm going to keep a close eye on you,

so you're in good hands.

Yes, Mrs Dingsdale is in for a small...just cyst removal.

She's having a lipoma excised.

She would normally be an outpatient, but she's...

Yes, so normally this would be done in the outpatient...

...not very steady on her feet and she lives alone.

Living alone at the moment, so we want to make sure she's completely recovered

before we send her off home again, so it's just very much

a question of making sure you're absolutely right before we send you off.

Could I have a private room? I am a private patient.

You are. Yes, yes.

I'm sure that Sister will be able to... probably in the process of organising that

- for you right now. - I don't have a room.

I'm sure that somebody will be

- looking into that at the moment. - I don't actually have any rooms.

I have absolutely no beds. I'm sorry, I can't organise anything different.

- We need to sort something out. - Are you prepared to see Mrs Ellis?

Yes.

Good morning. How are you feeling?

Yes, you might remember Mrs Ellis, Dr Moore.

Yes, of course I do.

She came form the Tall Trees residential home with a touch of pneumonia.

You prescribed amoxicillin orally, and dexamethasone.

Why have we done that, gents?

You need to keep up to speed with current research here,

so what's the reason for utilising that alongside your antibiotic course?

Actually, a recent Dutch study showed that steroids can speed recovery

- and cut admission time. - Very good.

Yes, Dutch are brilliant, aren't they?

- Er, yes. - Love Holland. Especially Amsterdam.

- Yes indeed. So... - Some great times there.

So how are you feeling now, Mrs Ellis?

Still got some problems with the breathing,

and I think this is probably

because she's not actually opened her bowels.

I haven't been for five days.

Righto.

So, Den, if you want to organise some, er, Microlax enema, that would be super.

Yes, great, OK. Kim! Sorry, Kim. We need to organise an enema.

You'd like me to do that, then?

Thank you, yes.

All right? Jolly good. And once we've got things shifting through,

I think you're going to feel a lot more comfortable.

She does require something more than just being comfortable, Dr Moore.

Thank you, Mrs Ellis. It's more than comfortable.

I mean, she's really struggling with her breathing.

- Well, she's got pneumonia, Den. - Yeah, obviously.

Is there something the matter with you today?

I'm fine, thank you.

- Mrs Lewis. - Hello, Mrs Lewis.

- This is Gwen Lewis. - Yes.

Den, is there no way we can find a private ward for Mrs Dingsdale?

It's just that Dr Kersley referred her to the professor,

and I'd really like to help Benedict out.

I have said, Dr Moore, I do not have any space.

Look, whether we like this or not, this is the way things are heading,

so I think it's quite important

that we support Dr Kersley's initiatives at this stage.

So if you could have perhaps just another look...

Sorry, I've got to... (MOBILE PHONE RINGS)

Excuse me a moment. I'm so sorry. Jenny, hello, yes.

Are we all set for tomorrow? Right. I see.

What if Philip changes his mind? I'm just worried that Michelle might get at him.

Yes, I will do. I will do. All right.

Yes, indeed. Yes. Thanks, Jenny, thanks very much indeed.

All right, then, bye-bye.

Den? Are you all right?

I'm fine, thank you, Kim. Absolutely fine.

- Actually, I was... - Oh, hang on a minute.

- Hello, Donald! - What's this?

- I don't know, but it's for Den. - What is that?

- A pressie from someone? - Oh, let's have a look.

- Well, come on, get excited! - Kim, no, it's for me.

Please can you let me open it?

Thank you.

It's like Darren's sixth birthday party.

He wouldn't let me open them either.

It's my fridge.

It's a very premature fridge, Den.

It's my fridge!

Hey! I'll open these bits.

Oh, that is lovely!

Um... Where are we going to put it?

Oh, that's fantastic! That fits perfectly!

It's completely flush with the drugs trolley.

- Well, I never. - Look, I've got to go.

Look after yourself, then.

All right. See you, Kim. Have a good day.

Yeah, well, I would, except I've given up smoking,

so I'm not in a bloody great mood, to be honest with you.

Oh, bloody hell. Good luck with that!

- Yeah, thanks, mate. - See you later.

See you later.

Oh, look, Kim, look!

It's got an interior light, it's got a drip tray,

it's got an egg thing, it's got a salad crisper.

That'll make it a fridge, then, Den. 'Scuse me.

Ah, is that the fridge for Mrs Dingsdale's Fragmin?

Er, no, it's the one for Den's breast milk.

Oh! And the health service have paid for that, have they?

It's brilliant, isn't it?

As long as she only uses it for breast milk, I suppose.

Do you hear that, Den?

You're going to have to drink your Tennent's Super warm from now on.

Ah! Hansley! Oh, sorry, I don't want to tread on your...

Oh, no, it's OK, please, don't worry.

About, um... Oh, sorry! Lord, I'm messing this up awfully, aren't I?

No, it's OK. It's fine.

I just, er... About this Norris add-back at tomorrow's FDR.

Um, I've been thinking, this French piece that Philip's taken up with,

I just don't trust her. Have we covered all our bases?

- Er... Please. Sit down. - Oh, er, thank you.

Has your solicitor flagged up White versus White?

No. Should she have?

In determining ancillary relief for the spouse,

there is no determined order of priority

and the distribution of assets depends on every case.

- But that could drag on for years. - Costing you millions.

Well, we don't exactly have millions, but...

The only winners are the lawyers.

Lord. So what would you advise?

Minton versus Minton.

Right. Minton versus Minton.

Right.

Thank you.

I'm sorry. I...

Oh, no, thanks, I've given up.

I just come here for the view.

(MOBILE PHONE RINGS)

Oh, excuse me.

Hello?

She's what, Dave?

Shit.

No. Well, I mean, if they're not going to admit her...

Yeah, we're just going to have to find the space.

No. Really shitty.

The patches are useless.

All right. I'll talk to you later. Cheers.

He's got Vijay's nose.

And Hilary's fat arse.

Oh, come on, Kim!

It's only a joke!

- I'm just trying to cheer you up. - I don't need cheering up, Kim.

- It's you who needs cheering up. - Me?!

You've been a real grump since you gave up the fags.

Well, it's not just the fags, Den. It's Dave's mum.

They're going to discharge her, right?

As you know, we've got no room at home at all,

so I'm sorry, but you're going to have to move out for a few days.

Look, I'm not doing it to be nasty, all right?

No, I understand that, Kim, I can see you're not doing it to be nasty.

- Have you done that enema yet? - It's lunch in 20 minutes!

Well, then, that gives you 20 minutes, doesn't it?

Oh, OK.

Eyes down for a full house, Mrs Ellis.

- Morning, Denise. How are you? - Oh! Hi.

So, listen, would it be possible to move Mrs Dingsdale to a private room?

I've had a call from her son, and he's a bit unhappy with the accommodation.

- Normally, it would be fine... - Tom!

- Hello, there! How are you? - Pippa!

Fantastic to see you.

- Mwah! - Mwah!

- To what do we owe the pleasure? - Just had a meeting with Mr Loftus.

- Ah, yes. - I was just rebriefing him.

Yes, provision of services. I hope we're passing muster.

- We're getting there. - Oh, good. Good.

But I was actually just trying to sort out this private referral of mine.

Ah, yes. I had Benedict's secretary on the phone, actually.

Den, sorry, before you disappear,

I've had a call from Professor Portnoy-Noor's secretary

about our private lady. What's the status on that at the moment?

Well, I've only got one side ward,

and unfortunately it has got a patient in there with a stage 13 coma.

So...

Right, I see.

Is that patient a private patient?

Priority, but not private.

- Not private. - No, not...

- Hmm. - So...

Shouldn't she be in ITU anyway, really?

I think they're a bit stacked up up there as well.

Well, um...

So...

Shall we... We'll leave that with the sister.

OK. Yes. I'll make some enquiries.

I have great faith in her to make the right decision.

Jolly good. Do you want to grab a coffee, or...?

You read my mind.

Lovely. How is Tania doing?

- Tania's very well. - Yes.

- Just incredibly busy. - Is she?

Yeah...

Shit.

- Den? - Hmm?

I'm sorry about earlier.

You know, I think it probably was the fags.

And Dave's mum's going to be a nightmare.

It's OK. Honestly, don't worry about it, Kim, it's fine.

Kim!

- Yeah? - Can you keep a secret?

Of course I can.

You've got to keep this totally in confidence, right?

- Ooh, how exciting! Yeah. - It's about Hilary.

Is it his baby?

No, no. It's serious.

He has asked me to make some recommendations.

- Oh. - About the staff cuts.

Right. Look, Den, I honestly haven't got any space at home.

- If I did... - Kim, I wouldn't use that.

Why would I use something like that?

I wouldn't do that just to get back into your house.

You might. All right, I'm kidding.

It's serious, this, Kim.

Jobs are at risk here.

But you know you're leaving anyway to have a baby, aren't you?

Yeah, but... No, no, no, my job's protected.

No, it's you, Kim. I'm going to do my best to look out for you.

Yeah?

Well... OK. Thanks. Thanks, Den.

Um, I've just been reading your essay, Kimberley.

Only weird people call me Kimberley.

Oh. Well, I hope you don't mind. I just thought, as I am your mentor, I could...

Well, I do mind a bit.

OK. OK, Kim.

Well, um, it starts off really well.

It's fluent and articulate and it makes some very pertinent points.

Um, but then, halfway through, it kind of,

er...it kind of turns into something completely different.

Good or bad?

Well...

I don't like to use negative words

like "clumsy" or "adolescent", but...

It's clumsy and adolescent?

It just kind of loses the essence of academic analysis.

If you see what I mean.

Why don't we see if we can turn this into a positive?

I'd rather have a prolapse.

I just want to maximise my job as mentor

and give you the best opportunities as mentee.

So why don't we just have a look at it right now? I'll just grab a chair, OK?

OK.

Right...

Quails' eggs and asparagus not to your taste?

- It was horrible! - Oh, sorry.

Do you think there's any chance that they can find me a private room?

- I'm sorry, I don't think they will. - I'm sure we can do that.

- I'm sure we can. - 'Scuse me.

I'll see if I can push the envelope of care just a bit further for you.

Den! Den!

Damaris says she's going to give Mrs Dingsdale a private room.

Sorry.

Matron.

- Sorry, I just wanted a quick word. - Right.

Yes.

Kim says that you're thinking of moving Mrs Dingsdale

- into the side room. - Yes, yes.

The thing is, I've had to use that room sometimes, you know,

to catch up on admin and paperwork overload.

I mean, it's very, very difficult to work out here with the noise...

Right. I'm going to have to overrule you on this one. Sorry.

Even though I'm pregnant?

I'm terribly sorry, Den, but you know our priority is enhancing care pathways

for all of our patients, including our private guests, so...

- Yeah, I just need the room. - Yes, but so does she.

I don't know who Damaris thinks she is. I mean, I really need my office.

What are you going to do?

Well, Hilary's all over me.

Maybe I could get rid of her.

I mean, I'd lose my mentor, but I suppose it'd be worth it.

I think it'd be better for you, Kim. It would keep your job secure.

Well, that would be amazing, Den, cos I'd really owe you one.

I mean, like, a small one.

- Not a big one, like moving in... - I know, Kim.

Don't worry. I'm not going to exploit you.

I know you're under a lot of stress with your mother-in-law.

Den, honestly, if I thought I could help, you know I would, don't you?

Yeah.

Den, any joy with Mrs Ellis's Microlax?

Sorry, no, I don't think so. I think the enema was unsuccessful.

Ah. OK. I think perhaps we'd better move straight to manual evacuation, then.

- Fight you for it. - Oh, thanks, Kim.

Jolly good. Do you want to get consent?

- Great. Thank you very much. - Could I just have a quick word?

- Just very quickly. - I want to ask you a favour.

- Er... - My mother-in-law had a fall

and broke her arm and she went to A & E at St Luke's,

but they're not going to admit her,

and Dave and I can't really cope with her at home,

so I just wondered if I could ask you if you'd mind phoning St Luke's,

if you know a consultant there, and seeing if he could keep...

Nurse, while I understand your difficulties, er...

I doubt it.

Well, I just can't call in too many favours with St Luke's, you know.

And it may be that the best place for her is in the home environment.

- Oh, just forget it, OK? - Righto!

- All right. - Oh, I'm sorry about that, Den.

- Oh, it's OK. - She wouldn't even listen.

I mean, I could maybe put you top-to-toe on one of the bunk beds

with one of the twins.

Yeah... Do you think it's worth me having a word with her?

You won't get anywhere.

Ah, Den, I've just had Benedict on the phone.

He's pretty keen to sort out this private patient.

- Have we got any news on that? - I've got that all in process.

Oh, great! OK. Thank you. I'll let Tom and Benedict know. Thank you.

- Dr Moore, just... - Yes?

Sorry, um...

I just wanted to say sorry, actually,

because I have been very irritable today. I know that.

Er...we've all been a bit, probably...

The thing is, I'm picking up on Kim's stress, because she's given up smoking,

This thing with her mother-in-law...

Right.

..it's really getting her down.

You couldn't just have a word with someone at St Luke's, could you?

I'm sorry, I've already made that very clear to Nurse Wilde.

I'm not prepared to call in favours for staff.

Just on this occasion?

I'm surprised at you asking me, rather, Den.

It's frankly unethical. So, yes.

No is the answer to that.

Dr Moore... I just want to give you a warning, actually.

It's about Tom.

Dr Kersley?

Yeah. Well, I had a relationship with Tom.

It was about five years ago and it wasn't really a relationship,

I suppose, it was more of one night.

It wasn't quite one night...

- But it was just... - Sorry, why are you telling me this?

I just wanted to... I've just heard things.

Apparently, these days he'll shag anything.

I just wanted to let you know, as a favour.

In what way is that a favour?

Well, it...

Mm-hm. Hmm.

I'm really... Yeah, thank you so much. Yeah.

I'll see you in Chatters, yeah. Thanks.

Are you not catching the five to five?

Oh, just, if I hurry, actually.

Not been a great day, has it?

I don't know. You've given up smoking.

- That's a good thing. - Yeah, you got a fridge.

Yeah, that was a very good thing.

- Den? - Hmm?

Look, I've had a thought, right.

Me and Dave have got a big wardrobe with a sliding door in our bedroom.

I could put a little mattress in it, and you could shut...

Look, Kim, honestly, I've sorted something out.

I've got an Encore room, just for tonight.

- Are you sure? - Yeah.

Have you sorted out Mrs Dingsdale?

Yeah. Yeah.

Den. You promised Dr Moore.

I have! No, I have. Popocatepetl have got a sepsis in their side ward.

She's been on high dependency. She's come back. She's much better.

They're putting her onto the main ward,

and I can get Mrs Dingsdale into their side ward just for a couple of days.

That's all she needs.

You couldn't get Dave's mum in there an' all, could you?

- No. - We can try.

- Listen, are you coming with me? - No, no, quick, go!

- I've got to stay with Amma. - All right, I'll see you. Bye.

- Need to hand over, you know. - OK.

# Roll, river

# Keep on rolling

# Ancient lady

# Cold

# Roll, river

# Roll. #