0:00:34 > 0:00:36Competency forms.
0:00:36 > 0:00:39"These are to be used as a self-assessment tool to indicate a level
0:00:39 > 0:00:45"of perceived competence and also to record all of your training needs."
0:00:45 > 0:00:48Whatever all that means. Bit of a mouthful, isn't it?
0:01:01 > 0:01:05Er, Harry Timms. Er... the new teaching assistant. I was told to...
0:01:15 > 0:01:20Now don't get me wrong. Of course, we want you to be proficient in high-level ED care.
0:01:20 > 0:01:23But never forget what you're here to do. It's quite simple -
0:01:23 > 0:01:25it's called nursing.
0:01:25 > 0:01:28That means caring for people and using these.
0:01:28 > 0:01:32Who's frightened? Who's uncomfortable? Who's alone?
0:01:48 > 0:01:50Excuse me...
0:01:52 > 0:01:56- Sorry, excuse me. - Miss said I could wait here.- No... - I'm not doing anything wrong!
0:01:56 > 0:02:00- You don't understand, I'm not saying...- Then leave me alone!- Lee!
0:02:02 > 0:02:07I catch you talking to a member of staff like that again and you're back to Mrs Khan's office!
0:02:09 > 0:02:12- Yes, Miss.- Now, get to class.
0:02:17 > 0:02:20Sorry, it's Harry, isn't it? Come in.
0:02:20 > 0:02:26Someone call an anaesthetist, please. I have no intention of trying to intubate this man.
0:02:26 > 0:02:30You'll see many more of these in your time here. It's nothing to worry about.
0:02:30 > 0:02:33No shouting. No panic.
0:02:33 > 0:02:35It's an organised environment.
0:02:35 > 0:02:37Quiet and controlled.
0:02:37 > 0:02:40- Thank you, Jay.- You're welcome.
0:02:40 > 0:02:44Lloyd Asike and Scarlett Conway, I presume. Welcome.
0:02:44 > 0:02:47- Which one of you's going to take over?- Now?
0:02:47 > 0:02:49You mean now!
0:02:49 > 0:02:52- No, please...- I'll do it. I did an ED placement at St James'.
0:02:52 > 0:02:55I've seen the drill in Resus hundreds of times.
0:02:56 > 0:03:01- Tens of times.- Another milligram of adrenaline, please, Tess.
0:03:03 > 0:03:05OK, that's two minutes. Stop for a moment.
0:03:07 > 0:03:11No. Still in VF. OK, charge to 150 joules, please, Dr Lyons.
0:03:11 > 0:03:14- Oxygen away.- Ah-ah.
0:03:14 > 0:03:16- Everyone clear?- All clear.
0:03:16 > 0:03:18Shocking.
0:03:21 > 0:03:24Wait. No. OK, let's go.
0:03:25 > 0:03:26A little bit further down.
0:03:26 > 0:03:29That's it.
0:03:29 > 0:03:32He was in mainstream education till he broke his teacher's ankle.
0:03:32 > 0:03:38Is there a best way of...dealing... you know, er, managing him?
0:03:38 > 0:03:40Be firm. Be clear. Be direct.
0:03:40 > 0:03:43You're a teaching assistant not his friend.
0:03:43 > 0:03:46So no hesitations, no sign of weakness.
0:03:46 > 0:03:48- And the others, are they...? - Present.
0:03:50 > 0:03:53System was installed at vast expense last summer.
0:03:53 > 0:03:56- Pity about the rest of the place. - Are any of the others...
0:03:56 > 0:04:00dangerous? I've only worked in mainstream before.
0:04:00 > 0:04:02And you're terrified?
0:04:02 > 0:04:09Look, I've been doing this a long time. Just follow my lead. If you do as I tell you, you should be fine.
0:04:09 > 0:04:11Right!
0:04:11 > 0:04:13Good. Effective compressions.
0:04:15 > 0:04:18- Happy to carry on? - You sure, or are you getting tired?
0:04:18 > 0:04:20No, I'm good. I'm good.
0:04:21 > 0:04:25OK, that's two minutes. Stop for a moment.
0:04:25 > 0:04:28No, still in VF. Oxygen away.
0:04:28 > 0:04:32OK, everyone clear. Shocking.
0:04:34 > 0:04:36No, still in VF.
0:04:41 > 0:04:45- Have we considered therapeutic hypothermia?- Sorry?
0:04:45 > 0:04:49I was just wondering, have we considered therapeutic hypothermia?
0:04:49 > 0:04:53- You're going to have your hands full, Charlie.- I hope I'm not speaking out of turn.
0:04:53 > 0:04:56We looked at the research and ALS guidelines at college.
0:04:56 > 0:04:59I know some of you guys have a different take on things,
0:04:59 > 0:05:02but I just wondered is it something you'd consider?
0:05:02 > 0:05:06Good. Strong pulse, decent rhythm.
0:05:06 > 0:05:10Well done, Mr Asike. You just managed to save your first life at Holby City. Your turn next.
0:05:23 > 0:05:25- Stuck? - That's five more minutes everyone.
0:05:26 > 0:05:30Was it that you didn't understand Miss Davies' explanation?
0:05:30 > 0:05:32Was it that you're thick, lee?
0:05:33 > 0:05:37- Are you filming me?- Thicko. - Shut up, Ryan.
0:05:37 > 0:05:41- You both need to be quiet now! - Thank you, Ryan.
0:05:46 > 0:05:51I said...thank you, Ryan.
0:05:56 > 0:06:00- I will not have this behaviour. - But it wasn't me.- Am I clear?
0:06:00 > 0:06:04- I wasn't doing anything.- Lee! - It was Ryan!- I'm counting to three.
0:06:04 > 0:06:06- One.- It wasn't me.
0:06:06 > 0:06:09Two.
0:06:09 > 0:06:11Three.
0:06:25 > 0:06:28Thank you.
0:06:48 > 0:06:52Cardiac compressions. Tick, tick, boom!
0:06:52 > 0:06:55- There he is! - There he is!
0:06:55 > 0:06:58- Ah, yes, the man of the hour. Nice one, mate.- Oh, it was nothing.
0:06:58 > 0:06:59Oh, modest, isn't he?
0:07:01 > 0:07:04Hey, listen, don't worry,
0:07:04 > 0:07:07I was terrified about getting my first cardiac arrest when I started.
0:07:07 > 0:07:10I used to run and hide in the loos every time the red phone went off.
0:07:10 > 0:07:14- Thanks, that's really sweet. - It's true, though.
0:07:30 > 0:07:33- You did well.- How do you do it?
0:07:33 > 0:07:35Come on, Lee.
0:07:35 > 0:07:36Experience.
0:07:37 > 0:07:41You'll get used to it. Sometimes, we even get to do some teaching.
0:07:41 > 0:07:43It was nothing to do with me...
0:07:47 > 0:07:49Lee... I... I'm so sorry.
0:07:54 > 0:07:57- Lee!- Leave me alone!- Lee, please!
0:07:58 > 0:08:00It wasn't me!
0:08:01 > 0:08:04I'm very sorry, Lee. I shouldn't have hit you.
0:08:05 > 0:08:08If you let me or Harry come to the door, then we can let you out.
0:08:08 > 0:08:11OK, Lee? You need to calm down.
0:08:15 > 0:08:19- You know what I'm going to do. - Lee, just put it down.
0:08:23 > 0:08:26Argh!
0:08:27 > 0:08:28- Lee!- Shut up!
0:08:28 > 0:08:32- Lee, please.- Shut up! Shut up!
0:08:33 > 0:08:35Lee!
0:08:38 > 0:08:40Lee, please!
0:08:45 > 0:08:47Inhaler...
0:08:47 > 0:08:50Cupboard...
0:08:50 > 0:08:51Inhaler.
0:08:53 > 0:08:56You should be more comfortable now, Mrs Harley.
0:08:58 > 0:09:01Great, so...
0:09:01 > 0:09:07Just let us know if you need anything. OK?
0:09:07 > 0:09:09After you.
0:09:09 > 0:09:13Just so you know, Scarlett, it's absolutely par for the course
0:09:13 > 0:09:17to be a bit apprehensive about a cardiac arrest. OK?
0:09:20 > 0:09:25Scarlett. I just wanted to make sure I didn't tread on your toes in there.
0:09:25 > 0:09:29- I can get a bit carried away sometimes.- Sure. - We're in this together, yeah?
0:09:29 > 0:09:33I wasn't trying to get one over on you. I've just wanted to be on a cardiac arrest
0:09:33 > 0:09:36since the moment I started training and...I got excited.
0:09:36 > 0:09:40- That's all it was, you know that, yeah?- Lloyd, it's fine, really.
0:09:40 > 0:09:44Ah, it was such a rush. The team, Mr Jordan...
0:09:44 > 0:09:46He knew who we were. He was expecting us!
0:09:48 > 0:09:50I think that's brilliant, don't you?
0:09:50 > 0:09:54Sorry, I don't normally do this.
0:09:54 > 0:09:58- Would you be interested in dinner tonight? - You know where to find me.
0:10:01 > 0:10:04- Was he from before? In Resus?- Yeah.
0:10:06 > 0:10:08- You'd not met him before today? - No, Lloyd.
0:10:08 > 0:10:11- Don't you think that's a bit...? - It's fine.
0:10:11 > 0:10:14You've got your strengths and I've got mine.
0:10:18 > 0:10:22You're doing really well, son. All right, good boy.
0:10:22 > 0:10:27I'm going to put this bandage on first, mate and then I'll take a look at the rest of you. OK?
0:10:27 > 0:10:32There we go. Can you just stay with her for a minute. I just need to go to the ambulance and get a trolley.
0:10:32 > 0:10:36You all right, Emma? OK, I'll be one minute.
0:10:39 > 0:10:42- It's my fault.- Try not to worry.
0:10:42 > 0:10:46- To slap Lee, of all people! - Please, you need this.
0:10:49 > 0:10:51- I've never...- Emma...
0:10:51 > 0:10:54You've busted yourself up pretty good there, pal.
0:10:54 > 0:10:58- Might want to try the door next time, eh?- 15 years!
0:10:58 > 0:11:01He touched you first. You were provoked.
0:11:01 > 0:11:04- I can say that when I make a statement.- It's end of career.
0:11:04 > 0:11:08- It was instinct. Self defence, almost.- Doesn't matter.
0:11:08 > 0:11:11He's a child. I'm his teacher.
0:11:15 > 0:11:17Only...one way out...
0:11:17 > 0:11:21Claim...it never happened.
0:11:24 > 0:11:29- You demean yourself.- Excuse me? - Actually you demean us all. Nurses.
0:11:29 > 0:11:34- Clearly I've been underestimating my impact on the world and on the nursing profession.- Exactly.
0:11:34 > 0:11:39We're professionals. And you're telling me all you think you're good for is a bit of flirting?
0:11:39 > 0:11:43Three years at university, training, studying, going on placements.
0:11:43 > 0:11:49All that was in aid of you bagging yourself some rich doctor like it's still 1952? Sad.
0:11:49 > 0:11:51I like to call it realistic.
0:11:51 > 0:11:56Lloyd, you're in Resus with Charlie today, and Scarlett,
0:11:56 > 0:11:58you'll be assisting Dr Winters in CDU.
0:12:03 > 0:12:05You want to be a nurse, yeah? A good nurse?
0:12:05 > 0:12:07Of course I do.
0:12:07 > 0:12:11Try having some self respect. Try having a bit of faith in yourself.
0:12:16 > 0:12:20OK, this is Emma Davies, she's 38. She's had a severe asthma attack.
0:12:20 > 0:12:23We've nebulised her and her breathing's improved en route.
0:12:23 > 0:12:26Sats are of 95. Tachy at 110.
0:12:26 > 0:12:30All right, Emma. Let's put her in cubicle six. I'll send Dr Hanna in.
0:12:30 > 0:12:34Lee Stark, 15, he's got lacerations to his head, face and arms.
0:12:34 > 0:12:38- He's refused pain relief. - Hello 'lacerations', I'm one of the ED doctors.
0:12:38 > 0:12:43- Can we put him into Paeds?- Assaulted a window at his pupil referral unit. Can't say I blame him.
0:12:43 > 0:12:48Is that hurting, Lee? Give you something to take the pain away if you like. Do you understand me?
0:12:48 > 0:12:50All right, Lee.
0:12:50 > 0:12:53Just shufty over for me, mate, all right? That's it, good boy.
0:12:55 > 0:12:56Thank you.
0:12:56 > 0:13:00Lee. The doctors... they want to know if it's hurting.
0:13:00 > 0:13:02She hit me! Miss hit me.
0:13:02 > 0:13:04Miss hit you?
0:13:04 > 0:13:06D'you know what he's talking about?
0:13:08 > 0:13:11- Sorry.- Looks like your own work to me there, 'lacerations'.
0:13:11 > 0:13:15Can I sit you forward, please? There we go.
0:13:15 > 0:13:18Scissors, please, Charlie.
0:13:18 > 0:13:19Arm up, please.
0:13:24 > 0:13:26You've got an FB there, 'lacerations'.
0:13:26 > 0:13:29It's Lee. My name's Lee.
0:13:29 > 0:13:31Dr Keogh. Very nice to meet you.
0:13:33 > 0:13:36All right, Lee. You've got some glass under your skin.
0:13:36 > 0:13:40That's what the doctor's saying. FB, that means foreign body.
0:13:40 > 0:13:44That's what the glass is. It's nothing to worry about. We'll soon have it sorted.
0:13:44 > 0:13:47X-ray, whip out the FB and stitch him up, thank you.
0:13:50 > 0:13:52- Are you going? - It would appear so, yes.
0:13:52 > 0:13:53Lloyd...
0:13:56 > 0:13:57Bye-bye(!)
0:13:58 > 0:14:00Better?
0:14:03 > 0:14:07- So drunk she bit into the wine glass. - Sounds like a good night!
0:14:07 > 0:14:09OK, I need you to put a cannula in.
0:14:09 > 0:14:12Right, a cannula.
0:14:12 > 0:14:14You are fit, you are.
0:14:14 > 0:14:17- Has anyone ever told you that? - Like I said...
0:14:17 > 0:14:18drunk.
0:14:18 > 0:14:21We need to rehydrate her before we do anything else.
0:14:21 > 0:14:23- Gorgeous.- We haven't got all day.
0:14:23 > 0:14:26Oh, and you need to tie that hair back.
0:14:31 > 0:14:36- D'you want me to call the police? - Why? Has Mr Jordan been at the nurses' custard creams again?
0:14:36 > 0:14:40Never, ever tell a doctor you've got biscuits.
0:14:41 > 0:14:42Right.
0:14:43 > 0:14:45Lunch break. Come on.
0:14:48 > 0:14:52- So you've called them, then?- Who? - The police! About the boy.
0:14:52 > 0:14:56- Lee.- No.- But he said he'd been hit. It's a child protection issue.
0:14:56 > 0:14:58The school have got their own procedures.
0:14:58 > 0:15:02Caring for people who are frightened, alone, uncomfortable.
0:15:02 > 0:15:04- I thought that's what being a nurse was all about.- Lloyd.
0:15:04 > 0:15:08I've seen kids like him before who've been hit so many times they don't feel anything any more!
0:15:08 > 0:15:12With all due respect, we've seen a lot more kids like Lee than you have.
0:15:12 > 0:15:17They're the one who always get brushed aside. It happened earlier. He's not 'lacerations', he's Lee.
0:15:17 > 0:15:21- He's a person.- Lloyd, lunch. Now.
0:15:29 > 0:15:33- OK?- Wait, what's the first thing you need to do?
0:15:33 > 0:15:36Sorry. Warn the patient.
0:15:37 > 0:15:40- Sharp scratch coming up. - Can't wait(!)
0:15:43 > 0:15:44Sharp scratch then.
0:15:50 > 0:15:52First time. Perfect.
0:15:52 > 0:15:55Can you run a litre of saline over two hours? Thanks.
0:15:59 > 0:16:01Beautiful or clever -
0:16:01 > 0:16:03which would you rather be?
0:16:04 > 0:16:05Both I suppose.
0:16:06 > 0:16:09- I wish I was beautiful. - You ARE beautiful.
0:16:10 > 0:16:11No, I'm clever.
0:16:13 > 0:16:18Just got into medical school. Hence last night's...celebrations.
0:16:18 > 0:16:20- Your parents must be thrilled. - Not really.
0:16:22 > 0:16:26Bet being that beautiful means you get whatever you want in your life.
0:16:26 > 0:16:27Not really.
0:16:28 > 0:16:30Sorry, just a minute.
0:16:33 > 0:16:35I don't know what's wrong with it.
0:16:40 > 0:16:41Is everything OK?
0:16:43 > 0:16:45I-I don't understand. I've definitely attached it right.
0:16:45 > 0:16:49It's not tissued, I've waved her arm around. The bag must be faulty.
0:16:49 > 0:16:53- The saline's not going anywhere.- It wouldn't - tourniquet's still on.
0:16:57 > 0:16:59Never mind.
0:16:59 > 0:17:00I'm fit, right?
0:17:02 > 0:17:03Excuse me.
0:17:09 > 0:17:11Scarlett triumphs again!
0:17:11 > 0:17:14What's the stupidest thing you could possibly do
0:17:14 > 0:17:17- when you're trying to flush through a cannula? - Leave the tourniquet on.
0:17:17 > 0:17:21- Got it in one.- Right...
0:17:22 > 0:17:26You seem pretty angry with that chicken.
0:17:26 > 0:17:28Want to talk about it?
0:17:28 > 0:17:33- My chicken?- Whatever it is that's making you look like you're about to explode.- Hey.
0:17:33 > 0:17:35First day of my first ED job.
0:17:35 > 0:17:39Alcoholic, homeless guy come into cubicles, boss asks me to flush through the cannula.
0:17:39 > 0:17:42- What d'you think I did? - You left the tourniquet on.
0:17:42 > 0:17:45Sure did. Saline ran into the soft tissue, before anyone realised,
0:17:45 > 0:17:49- poor guy's arm had started to swell up.- Thanks.
0:17:49 > 0:17:50You're welcome.
0:17:50 > 0:17:54Oh, and, um, very important game of Charlie Bingo in the pub tonight.
0:17:54 > 0:17:56- And you two are playing.- Excuse me?
0:17:56 > 0:17:59Charlie Bingo, you know! "Quiet, controlled environment".
0:17:59 > 0:18:02Ker-ching. "Don't overstep your experience". Ker-ching.
0:18:02 > 0:18:07"Nursing is very simple. Who's frightened? Who's uncomfortable? Who's alone?"
0:18:07 > 0:18:09It's a full house. Get in!
0:18:11 > 0:18:15It's just a bit of a laugh. Charlie'll probably be there, too.
0:18:15 > 0:18:17He might buy you a pint or something?
0:18:34 > 0:18:37That kid you were with. What was he talking about, "Miss hit me"?
0:18:37 > 0:18:41I'm sorry. I-I haven't worked with him before today.
0:18:41 > 0:18:44- I don't know the boy.- So why did he smash up the classroom?
0:18:44 > 0:18:46He didn't like being told off.
0:18:46 > 0:18:47And that was it?
0:18:48 > 0:18:50What are you saying, he just...
0:18:50 > 0:18:53made it up? Why would he do that?
0:18:53 > 0:18:56- I don't know.- Or could he have been talking about another time,
0:18:56 > 0:18:59or could it have happened when you weren't in the room?
0:18:59 > 0:19:01- It's possible.- So what happens now?
0:19:01 > 0:19:04- What d'you mean? - What do the school do?
0:19:04 > 0:19:07- Investigation, call the police in? - I'm sorry, I don't know!
0:19:07 > 0:19:11- I'm new, it's my first day. - What's that's got to do with it?
0:19:11 > 0:19:14- Only that I don't know what'll happen next! - It's about right and wrong.
0:19:14 > 0:19:18It's got nothing to do with being new. Nothing to do with it.
0:19:25 > 0:19:27Can you feel that? Is that numb?
0:19:36 > 0:19:39Earlier on you said someone hit you.
0:19:40 > 0:19:42You said, "Miss hit me".
0:19:47 > 0:19:50This is normally the part where I ask people to stay
0:19:50 > 0:19:51absolutely still.
0:20:00 > 0:20:02Did you mean your teacher?
0:20:02 > 0:20:04Doesn't matter.
0:20:15 > 0:20:17There we are.
0:20:20 > 0:20:21That's it.
0:20:21 > 0:20:24All done and dusted.
0:20:26 > 0:20:28If she hit you, it does matter.
0:20:28 > 0:20:30I don't want to get into trouble.
0:20:31 > 0:20:33Well, if it's true,
0:20:33 > 0:20:35you won't get into trouble.
0:20:41 > 0:20:44Sorry about earlier.
0:20:44 > 0:20:48- At least the saline didn't get trapped in your soft tissue and make your arm swell up!- OK!
0:20:48 > 0:20:52- Er, Staff Nurse Conway will be assisting me.- Sorry?
0:20:52 > 0:20:55- She'll just be cutting the stitches. - I understand.
0:20:55 > 0:21:00- I wouldn't want me anywhere near my face either.- Aren't you going to refer me to plastics?- No.
0:21:00 > 0:21:03- Are you sure?- If it was beyond my skills I would've referred you,
0:21:03 > 0:21:06but the wound edges should come together very neatly
0:21:06 > 0:21:08- if that's what you're worried about. - I want to go to plastics!
0:21:08 > 0:21:11I can call them, but when I explain the injury to them
0:21:11 > 0:21:14they'll say that I'm wasting their time. They are very busy up there.
0:21:14 > 0:21:18I want you to call them and ask for Professor Fitch.
0:21:18 > 0:21:22- Just tell them his daughter's here. - Professor Fitch?
0:21:22 > 0:21:25If you're his daughter, why didn't you call him?
0:21:25 > 0:21:29He's far too busy with his patients to answer the phone to me.
0:21:29 > 0:21:32Coming here's the quickest way to get through to him.
0:21:36 > 0:21:38Emma!
0:21:40 > 0:21:44Er, I was trying to find you. I've been discharged.
0:21:45 > 0:21:46- How is he?- Yeah, he's...
0:21:46 > 0:21:48he's OK.
0:21:48 > 0:21:49Any problems?
0:21:49 > 0:21:52Emma, I want to help you, I do.
0:21:54 > 0:21:58But.. he could be for excluded for this, couldn't he?
0:22:00 > 0:22:04What'd happen then? Where would he go? He'll end up with no school to go to at all.
0:22:04 > 0:22:09- It's not the first time this sort of thing's happened.- But if nobody knows what provoked him,
0:22:09 > 0:22:10that's not right, is it?
0:22:10 > 0:22:14It's not right that you and I or the other kids have to live with
0:22:14 > 0:22:18- the threat of that level of violence!- But...
0:22:18 > 0:22:20I've been doing this job for 15 years. I've been punched, kicked,
0:22:20 > 0:22:24knives held to my throat, and not once have I retaliated!
0:22:24 > 0:22:28Not once. Until today. And for that I'll be mincemeat.
0:22:33 > 0:22:35Is his mum here yet?
0:22:35 > 0:22:37- No.- Dad?- No. - No, course they're not.
0:22:37 > 0:22:40But the minute they hear I even touched their son,
0:22:40 > 0:22:43their son who's had more time and more attention from me
0:22:43 > 0:22:45than he's ever had from them,
0:22:45 > 0:22:48the minute they find out, they'll be here.
0:22:50 > 0:22:53The poor kid's already got a child protection plan in place
0:22:53 > 0:22:57because of the threat of violence from his dad, real violence.
0:22:57 > 0:22:59- But that's it.- What?
0:22:59 > 0:23:03He's a child, probably has some kind of learning disability.
0:23:03 > 0:23:06He already thinks the world's against him.
0:23:06 > 0:23:07I've gotta tell the truth.
0:23:07 > 0:23:10You've been teaching for five minutes, Harry!
0:23:10 > 0:23:14I'm trying to think about him, about how he feels, that's our job, isn't it?
0:23:14 > 0:23:18Our job is to be firm, clear, direct. LABOURED BREATHING
0:23:18 > 0:23:23No hesitation. No signs of weakness. That's all we...have time for.
0:23:25 > 0:23:29- We have to stick together.- Emma?
0:23:31 > 0:23:34- Please, Harry.- Emma!
0:23:37 > 0:23:39- Talk to me.- She's acutely short of breath again.
0:23:39 > 0:23:41Unable to speak in full sentences.
0:23:41 > 0:23:46- I've started her on another five of salbutamol.- Let's add 2.5 of Ipratropium to the nebuliser, please.
0:23:46 > 0:23:49We'll look after her from here.
0:23:49 > 0:23:51- Chest x-ray and blood gases. - No, no...!
0:23:51 > 0:23:55- All right, Emma, here come on. - Resps 34, sats 96%, pulse 120.
0:23:55 > 0:23:58Slow your breathing down for us, please.
0:23:59 > 0:24:00No...Harry...
0:24:00 > 0:24:02stick...
0:24:02 > 0:24:03together!
0:24:03 > 0:24:06- Should I...? - Do you want him to stay?
0:24:08 > 0:24:12Just take her hand. Quiet, positive reassurance. We need to keep her calm.
0:24:16 > 0:24:19- You're doing well.- Linda, can we add 200 of IV hydrocortisone, please?
0:24:19 > 0:24:22Come on, Emma. Let's slow down your breathing for us, please.
0:24:22 > 0:24:24Nice and calm.
0:24:25 > 0:24:28Well done, Emma.
0:24:30 > 0:24:32She's getting tired.
0:24:32 > 0:24:36Can we check the state of the ITU bed, please?
0:24:38 > 0:24:42Emma, I'm so sorry. You don't deserve this.
0:24:42 > 0:24:44Please forgive me.
0:24:45 > 0:24:48We stick together.
0:24:49 > 0:24:50You understand?
0:24:50 > 0:24:52No hesitations,
0:24:52 > 0:24:54no weakness.
0:24:55 > 0:24:58- You were right.- Good. That's it.
0:25:02 > 0:25:05Good, yeah, her breathing's improving.
0:25:05 > 0:25:08Monitors show signs of good oxygen absorption.
0:25:08 > 0:25:10- You'll be fine.- Well done.
0:25:18 > 0:25:21Professor Michael Fitch. World-leading plastic surgeon.
0:25:21 > 0:25:26Also a tutor in the European Microsurgical Course in Milan.
0:25:26 > 0:25:28Wife number five's an actress. Which figures.
0:25:28 > 0:25:30He's operated on half of Hollywood!
0:25:30 > 0:25:34Special interests include all aspects of aesthetic surgery, in particular
0:25:34 > 0:25:37face, breast and body contour.
0:25:37 > 0:25:39And he's coming our way.
0:25:43 > 0:25:44Michael Fitch.
0:25:44 > 0:25:48Hi! I'm Dr Winters, this is Staff Nurse Conway.
0:25:48 > 0:25:50Delighted to meet you, Dr Winters.
0:25:52 > 0:25:54So, Professor, shall we...?
0:25:54 > 0:25:58If the wound had crossed the vermillion border, or if there were some skin loss,
0:25:58 > 0:26:01I would have thought about a plastics referral.
0:26:01 > 0:26:03- Dr Winters.- But even then I was... - Dr Winters!
0:26:03 > 0:26:06I have absolute faith in your abilities
0:26:06 > 0:26:08and your decision-making skills.
0:26:09 > 0:26:11Mr Jordan tells me it's your first day.
0:26:13 > 0:26:16- Daddy!- Grace.
0:26:16 > 0:26:19Sorry. I got a bit drunk. More than a bit, actually.
0:26:21 > 0:26:23Never mind my face, you should see the wine glass!
0:26:29 > 0:26:32Dr Winters, your judgement is impeccable.
0:26:32 > 0:26:35Not an appropriate plastics referral.
0:26:35 > 0:26:38It's been a pleasure to meet you both. Good luck with your first day.
0:26:40 > 0:26:43- I look forward to checking your craftsmanship.- But Daddy?!
0:26:43 > 0:26:46You're in the right place, and I have a clinic to get back to.
0:26:53 > 0:26:55Hello, Lee.
0:26:55 > 0:26:58I hear you've been speaking to the nurse about this morning.
0:26:58 > 0:27:02- About what Miss Davies did. - She hit me.
0:27:02 > 0:27:04Yes.
0:27:05 > 0:27:07It's true.
0:27:07 > 0:27:09So I won't get into trouble.
0:27:10 > 0:27:11Lee...
0:27:11 > 0:27:15when I saw you this morning for the first time by the doors at school,
0:27:15 > 0:27:16d'you remember?
0:27:16 > 0:27:19I think you were scared that I was going to tell you off
0:27:19 > 0:27:22and that made you angry. Yes?
0:27:22 > 0:27:24Hm.
0:27:24 > 0:27:27Well, I think it's the same for you and Miss Davies.
0:27:27 > 0:27:30She got scared. When you grabbed her arm, she got angry and hit you.
0:27:30 > 0:27:33When you get angry, you...
0:27:33 > 0:27:35get into trouble.
0:27:35 > 0:27:38Yeah, but the consequences for her could be very serious.
0:27:38 > 0:27:41Because she got angry.
0:27:43 > 0:27:44Lee...
0:27:44 > 0:27:46I didn't see Miss Davies hit you.
0:27:48 > 0:27:50If anyone asks, that's what I'm going to have to say.
0:27:50 > 0:27:52Then I'll get into trouble.
0:27:54 > 0:27:56That's not fair!
0:27:56 > 0:27:58Am I clear?
0:28:06 > 0:28:08What happened last night?
0:28:10 > 0:28:12I told him about medical school.
0:28:13 > 0:28:15"Well done, Grace."
0:28:15 > 0:28:17And that's it, he's gone.
0:28:17 > 0:28:19Not even so much as a hug.
0:28:20 > 0:28:22He can't even look me in the eyes.
0:28:22 > 0:28:24I'm just a stupid little girl.
0:28:24 > 0:28:27Grace, you're beautiful.
0:28:27 > 0:28:30I'm clever, and he doesn't care about clever.
0:28:30 > 0:28:32I'm sure he does.
0:28:34 > 0:28:37I don't even know why I thought THIS would make
0:28:37 > 0:28:40- a difference in the first place. - It wasn't an accident, was it?
0:28:48 > 0:28:51Oi! Matey? All right, that's enough.
0:28:51 > 0:28:52All right...
0:28:52 > 0:28:54That's enough!
0:28:54 > 0:28:57- Not fair!- That's an expensive one...
0:28:57 > 0:29:00- IT'S NOT FAIR!- No! All right, hold your ground.
0:29:00 > 0:29:03- Everybody stay back, I'm calling Security.- Lee...
0:29:05 > 0:29:09- ..what's not fair?- Situation in reception, one young male, you need at least two.- Tell me.
0:29:11 > 0:29:12Well, find it!
0:29:25 > 0:29:26- Mr Jordan!- Yeah?
0:29:26 > 0:29:31I just wanted to let you know that I'm going to go ahead and suture Professor Fitch's daughter.
0:29:31 > 0:29:34- Er, thank you, Ruth, yes. - He's been to see her
0:29:34 > 0:29:37and he agrees that it would be appropriate for us to...
0:29:37 > 0:29:41- to treat her here.- Then I'm sure that's the correct form of action.
0:29:41 > 0:29:43Of course, um, I-I mean, I'd understand
0:29:43 > 0:29:46if you wanted to do the sutures yourself.
0:29:46 > 0:29:48He is a world-lead surgeon.
0:29:53 > 0:29:57And I am a highly skilled, experienced
0:29:57 > 0:30:02and confident ED doctor, more than capable of doing an excellent job.
0:30:16 > 0:30:20- Dr Winters, do you have a moment? - Not really.
0:30:20 > 0:30:22- Self harm.- Sorry?
0:30:22 > 0:30:24Grace Fitch. It wasn't an accident½.
0:30:24 > 0:30:28- I think she did it to get her dad's attention.- And?
0:30:28 > 0:30:29Erm, what should I do?
0:30:29 > 0:30:32Nothing - patient confidentiality.
0:30:34 > 0:30:37Cubicles one to six. Basic obs. OK?
0:30:37 > 0:30:39I've put your lad Lee in cubicle three.
0:30:39 > 0:30:43- Would you mind keeping an eye on him for me, please?- Sure.
0:30:43 > 0:30:46- I've called the police. - About the teacher? The slap?
0:30:46 > 0:30:49No, he's a minor and he needs to go home with his next of kin.
0:30:49 > 0:30:53I've asked them to call in there. Mum's not home
0:30:53 > 0:30:55- and she's not answering her phone. - Right.
0:30:55 > 0:31:00I've also called the school just to report the accusation.
0:31:00 > 0:31:03The TA said he'd log it, but, er, I wanted to make sure.
0:31:03 > 0:31:07Not still fussing about 'lacerations', are we?
0:31:08 > 0:31:12I think you'll find that most of the patients in here have given names.
0:31:12 > 0:31:14Tends to help all round if we use them.
0:31:14 > 0:31:18The patients being real people, human beings with feelings
0:31:18 > 0:31:21and emotions, some of them maybe even pet owners,
0:31:21 > 0:31:26not to be reduced coldly to mere diagnoses and so forth.
0:31:26 > 0:31:27Yeah. Indulge me.
0:31:29 > 0:31:31Why not? Why not?
0:31:34 > 0:31:36Thanks.
0:31:36 > 0:31:38Didn't think you cared.
0:31:38 > 0:31:42I don't want to have to say this more than once. This is your first day.
0:31:42 > 0:31:46For everyone's sake, please, try not to overstep your experience.
0:31:54 > 0:31:56Your social worker's on the way.
0:31:57 > 0:31:59Thought you might be hungry.
0:31:59 > 0:32:02We're meant to encourage five a day, but...
0:32:02 > 0:32:04You know?
0:32:04 > 0:32:05Fruit and veg?
0:32:13 > 0:32:15My gran calls it 'the reds'.
0:32:18 > 0:32:20The reds.
0:32:22 > 0:32:24No-one understands,
0:32:24 > 0:32:27there's nothing you can do.
0:32:27 > 0:32:29And it's not fair.
0:32:31 > 0:32:34And it feels so hot...
0:32:36 > 0:32:37..you're so angry,
0:32:37 > 0:32:39and then bang!
0:32:40 > 0:32:42That's it.
0:32:42 > 0:32:43You explode.
0:32:45 > 0:32:48And suddenly, you're the one who's in trouble.
0:32:50 > 0:32:52How's that right?
0:32:52 > 0:32:54You're the one...who's in trouble.
0:32:57 > 0:32:59The reds?
0:33:05 > 0:33:06That's the one.
0:33:08 > 0:33:12Some of us, we're always going to get them, yeah? Can't help it.
0:33:12 > 0:33:14I don't know about you,
0:33:14 > 0:33:17but me...I find it helps if I try and make a plan.
0:33:17 > 0:33:19I sit down...
0:33:19 > 0:33:22and I ask myself, "What can I do to fix this?"
0:33:25 > 0:33:27- A plan?- Yeah, a plan.
0:33:32 > 0:33:34Ah!
0:33:34 > 0:33:37- Staff Nurse Conway, isn't it? - Professor Fitch.
0:33:37 > 0:33:40- I thought you had a clinic to get back to?- It can wait.
0:33:40 > 0:33:42How is she?
0:33:42 > 0:33:44Gracie? Is she...
0:33:44 > 0:33:46- bearing up?- She's fine.
0:33:47 > 0:33:49Actually, she's not fine.
0:33:50 > 0:33:54I think what she really wanted was for you to do the stitches.
0:33:54 > 0:33:55- Nonsense.- Grace's injury,
0:33:55 > 0:34:00- when you looked at her, did you not wonder how she got it? - What are you talking about?
0:34:00 > 0:34:03Can't you see why she's here? It's because of you she did this!
0:34:03 > 0:34:06Professor Fitch, the injury was deliberate.
0:34:06 > 0:34:10- I barely took my eyes off him. - Can you look in the toilets for me?
0:34:10 > 0:34:14I checked them already. I was doing obs in the other cubicles.
0:34:14 > 0:34:17I know. One last scout round and I'll put a rocket under Security.
0:34:56 > 0:34:57I've spoken to him.
0:34:58 > 0:35:00I don't think he'll say anything.
0:35:02 > 0:35:06- Thank you.- Just try not to worry. Concentrate on getting better.
0:35:14 > 0:35:17- Can I have some help here, please?! - Where is she?
0:35:19 > 0:35:21- Lee? What's happened?- Stop!
0:35:22 > 0:35:25She's the one who got angry. She should get into trouble!
0:35:25 > 0:35:27- Lee!- No, leave him! Leave him.
0:35:27 > 0:35:30Where is she? WHERE IS SHE?!
0:35:34 > 0:35:36- She's has to tell the truth.- Lee!
0:35:38 > 0:35:40All right, Lee.
0:35:40 > 0:35:43She's the one who got angry and now I'm...
0:35:43 > 0:35:47I'm the one who's going to get in trouble. I'm the one who's...
0:35:47 > 0:35:49- I won't let you get into trouble. - Let's get him into resus.
0:35:49 > 0:35:54- All right, we've got you.- She slapped you. Miss Davies slapped you.
0:36:00 > 0:36:04- Resus two.- Mr Jordan! He took the glass out of his back pocket.
0:36:04 > 0:36:06- I think it may have nicked an artery.- Lloyd!
0:36:06 > 0:36:09- No, lie back down! Please. - Two litres of saline.
0:36:09 > 0:36:11Bloods, glucose, FBC, Us&Es, clotting.
0:36:11 > 0:36:15- Come in, come in.- Cross match for six units, I think.
0:36:15 > 0:36:18- I think it's the popliteal artery. - OK. Let's roll him, please.
0:36:18 > 0:36:21Quick as you can, everyone.
0:36:25 > 0:36:27- Anyone got any scissors?- Yes.
0:36:29 > 0:36:33Yep, that looks nasty. Thank you. Right, let's have a little look.
0:36:33 > 0:36:35- OK...- Ooh!
0:36:35 > 0:36:36There we go.
0:36:40 > 0:36:44- Right on the money, Tess. - He only needed to have slipped or crouched down for a moment.
0:36:44 > 0:36:48Can we get a firm pressure dressing on this, please? OK, Lee?
0:36:48 > 0:36:49You OK?
0:36:52 > 0:36:53- He's trying to say something.- What?
0:36:53 > 0:36:57- He's trying to say something and no-one's listening to him! - We're trying to save his life.
0:36:57 > 0:36:59Concentrate on what you're doing.
0:36:59 > 0:37:03Hard as you can, please, I'll call Vascular.
0:37:05 > 0:37:08I...had a plan, I had a plan.
0:37:12 > 0:37:16- I can assure you your daughter is in very capable hands. - I sincerely hope so.
0:37:20 > 0:37:23You can't go around breaching patient confidentiality.
0:37:23 > 0:37:27- He needed to know.- He wants his daughter stitched up and discharged.
0:37:27 > 0:37:31You'd better hope he doesn't take this further.
0:37:32 > 0:37:35- Sorry.- Are you?
0:37:36 > 0:37:40Do you know what, just keep quiet and do what I tell you.
0:37:40 > 0:37:42These sutures have got to be perfect.
0:37:45 > 0:37:47Finally! Quick as you can, please.
0:37:47 > 0:37:49- Get off me!- Oh!
0:37:49 > 0:37:52It's all right, I've got it, I've got it!
0:37:53 > 0:37:56- BP's dropping.- Stay still, please!
0:37:56 > 0:37:58Come on, we need those bloods now!
0:37:58 > 0:38:01- He's in class four shock here. - We're ready.
0:38:02 > 0:38:04- Off...- Stay still!
0:38:04 > 0:38:06Get it through the infuser.
0:38:08 > 0:38:11When I was a kid, my dad used to take me swimming every Saturday.
0:38:13 > 0:38:17- I used to spend all week working out my moves for the diving board.- OK.
0:38:22 > 0:38:27Bit longer next time, it's important to leave enough room to cut them out.
0:38:30 > 0:38:34Saturday would come and... he'd watch and clap and laugh at me.
0:38:34 > 0:38:37And then one week, I was doing my moves
0:38:37 > 0:38:40and I looked down and he wasn't there.
0:38:41 > 0:38:44OK.
0:38:45 > 0:38:47Lower.
0:38:50 > 0:38:54He was in the cafe, having a bag of chips. And that was it.
0:38:54 > 0:38:57It was the same every week from then on.
0:38:57 > 0:39:01- He just wasn't interested any more. - Why?- Try not to speak, please.
0:39:01 > 0:39:04Took me years to realise. He was embarrassed.
0:39:04 > 0:39:10Suddenly I wasn't his little girl any more. He didn't know where to look. Your dad...
0:39:10 > 0:39:13he only knows how to relate to women in one way -
0:39:13 > 0:39:16to charm them, flirt with them.
0:39:16 > 0:39:19But you're his daughter, his beautiful, grown up daughter.
0:39:21 > 0:39:24- He just doesn't know how to be with you.- Staff Nurse Conway!
0:39:25 > 0:39:27Sorry.
0:39:32 > 0:39:34You need to remind him that you're still his little girl.
0:39:39 > 0:39:40OK, I'll get the lift.
0:39:50 > 0:39:53Is he going to be OK?
0:39:53 > 0:39:55He's lost a lot of blood
0:39:55 > 0:39:58and the surgeons will have to repair the artery, but yes...
0:39:58 > 0:40:00should be OK.
0:40:03 > 0:40:04Excuse me, I...
0:40:04 > 0:40:08I don't blame you for not wanting to talk to me.
0:40:08 > 0:40:11It was about right and wrong. I was wrong. I should've listened to you.
0:40:12 > 0:40:13No, mate.
0:40:13 > 0:40:15You don't want to listen to me.
0:40:15 > 0:40:18Lee listened to me. Look what happened to him.
0:40:33 > 0:40:34Hmm.
0:40:34 > 0:40:36Beautiful work, Dr Winters.
0:40:36 > 0:40:38Thank you.
0:40:38 > 0:40:42I asked Nick Jordan to make sure the best person in the department did the job. And I can see she has.
0:40:45 > 0:40:49- Dad...- Grace...- ..you remember my old needle and thread?
0:40:49 > 0:40:54Whenever I had a tiny graze on my arm or a scratch on my knee, I'd show you and you'd say...
0:40:54 > 0:40:56"Looks like you need some stitches, Gracie."
0:40:56 > 0:41:00And you'd get that rusty old needle and make me pretend to stitch you up!
0:41:00 > 0:41:02Then when I was stitched up,
0:41:02 > 0:41:05you'd give me a big hug and say...
0:41:05 > 0:41:08"There you go, Gracie. All better now".
0:41:08 > 0:41:10Ah, Gracie.
0:41:10 > 0:41:13You've...grown up so fast.
0:41:27 > 0:41:33And the blood gases and chest x-ray have come back fine. Now we normally recommend a quiet,
0:41:33 > 0:41:36calm environment for a good few days after an attack like that.
0:41:37 > 0:41:39How is he?
0:41:39 > 0:41:42Out of surgery. They think he's going to be fine.
0:41:44 > 0:41:46The Deputy Head's here.
0:41:46 > 0:41:49We'll have to make statements about this morning.
0:41:49 > 0:41:52About you slapping him.
0:41:55 > 0:41:57OK.
0:42:20 > 0:42:22Lee...
0:42:22 > 0:42:25..I-I wanted to say...
0:42:26 > 0:42:29First of all I wanted to say sorry.
0:42:32 > 0:42:35I think you probably feel the whole world's against you.
0:42:37 > 0:42:38What we did was wrong.
0:42:38 > 0:42:41We're the ones who should be in trouble.
0:42:41 > 0:42:44Who made it worse.
0:42:44 > 0:42:48I know this is difficult to believe, Lee...
0:42:50 > 0:42:52..but I'd like to try to be your friend.
0:43:03 > 0:43:07I have it on good authority we're playing a spot of Charlie Bingo in the pub.
0:43:07 > 0:43:11- I told him to make a plan. - You were trying to help him.
0:43:11 > 0:43:13- Yeah, but...- Lloyd.
0:43:13 > 0:43:17You care, and that's a fact. It isn't everything, but it's a hell of a good start.
0:43:30 > 0:43:32- All right?- Yeah, great.
0:43:34 > 0:43:36- You?- Yeah, great.
0:43:36 > 0:43:40- Really?- CDU turned out to be brilliant.
0:43:40 > 0:43:43Stitched up the daughter of a world-class plastic surgeon!
0:43:43 > 0:43:46- World class?- He's a leading tutor in European Microsurgery.
0:43:46 > 0:43:48Well respected in Milan, Italy...
0:43:52 > 0:43:56- How about you, Mr Cardiac Compressions?- Yeah, yeah.
0:43:56 > 0:43:59Er, resus was cool. Saved a kid's life.
0:43:59 > 0:44:03- Me and Charlie just got back from the surgical ward.- So...
0:44:03 > 0:44:05A great first day all round, then?
0:44:06 > 0:44:09Yeah. Couldn't have gone any better.
0:44:12 > 0:44:14Shall we?
0:44:15 > 0:44:18Hello there. Right. Pub. Who's for a pint? Jay?
0:44:18 > 0:44:21- Of course.- Er, Ruth? Pint? - Yeah, I'll come for one.
0:44:23 > 0:44:29OK! Oh, here's the man. Lloyd. First day. Unfortunately that means your first round.
0:44:29 > 0:44:30Ah!
0:44:30 > 0:44:33- Lloyd's done well. - Well, you did pretty well, too.
0:44:33 > 0:44:37- What with my cool, calm, collected response to the cardiac arrest(!)- No.
0:44:37 > 0:44:42- Or my stunning show of clinical expertise with the tourniquet. - I meant your work with Grace Fitch.
0:44:42 > 0:44:45Come on then. Both of you.
0:44:45 > 0:44:47Which gems did you get? Eh?
0:44:47 > 0:44:50Was it, um, "You may feel like fish out of water,
0:44:50 > 0:44:54"but just remember you are key players in the department"?
0:44:54 > 0:44:58Or was it, "Just remember one thing- patients are unknown quantities.
0:44:58 > 0:45:02"Never try and second guess them" Come on! Spill!
0:45:04 > 0:45:06- What's the ma...? Hey!- Hey!
0:45:06 > 0:45:07Charlie!
0:45:07 > 0:45:11I'm glad to see you three are getting along so well.
0:45:11 > 0:45:16- Cos as it turns out Jay here is going to be your official mentor. In fact, you're team leader!- What?
0:45:16 > 0:45:22- Tess and I think that it's appropriate to your professional development.- No, Charlie...
0:45:22 > 0:45:25I wouldn't want to overstep the limits of my experience.
0:45:25 > 0:45:27We think you're ready for it.
0:45:27 > 0:45:30You are, after all, a key player in this department.
0:45:32 > 0:45:34You all are!
0:45:39 > 0:45:42No. No, no, no, no, guys! Seriously...
0:45:42 > 0:45:43Right, pints.
0:45:48 > 0:45:53I may be a nursing disaster of spectacular proportions, but...
0:45:53 > 0:45:55I've still got my self respect, right?
0:46:07 > 0:46:1165-year-old male found collapsed in the street...
0:46:11 > 0:46:13disorientated. Query left side skull fracture...
0:46:33 > 0:46:36Subtitles by Red Bee Media Ltd
0:46:36 > 0:46:39E-mail subtitling@bbc.co.uk