Testing, Testing Doctors

I'm going to mess this up. I know I am.

Karen, there's nothing TO mess up.

"Areas of review - patient consultations, protocols,

"working methods..." I haven't had time to swot up on this.

You should not need to swot up. It should be second nature.

Vocational.

What do you think we should do?

She's going to be in and out. It's no biggie. You're getting into a panic over nothing.

What? So you think it's all right?

No, of course I don't, but there's nothing we can do.

So just chill out and play the game.

-Mr Richards?

-Yep.

-He doesn't seem bothered that our jobs are on the line.

-Don't be daft.

-Yeah, but Zara...

-Zara was winding you up.

-Can I help you?

-I've got an appointment with Mandy at 12 o'clock.

-Oh, hi, Carl. Another footie match?

-Don't ask...

Do you want to take a seat? I'll be with you in a minute.

I shouldn't be included on this. I should be on reception today.

Thank you so much.

Dr Reid! Thanks for coming. Much appreciated.

Oh, it was a beautiful service, Rory, and a lovely eulogy.

Oh, Lord, was it all right, really?

Did you not hear my knees knocking?

No. You did Oona proud.

-Are you the last?

-I think so, yeah.

Thank God for that!

No, I don't mean it like that. Just...

I'm exhausted.

Time to get out of here.

So...what's next for you, Rory?

Got an appointment with a black bag and a charity shop.

-It never ends!

-Take it slowly - there's no rush.

Best to get it over with. Then I can crack on with life.

Well, you take care of yourself now.

And a huge thanks to you for everything you've done... Did.

In fact, the whole team - you were all wonderful.

Well, I will call in and have a proper catch-up with you soon.

That's very sweet of you, Dr Reid, but I know you're busy.

Well, I will. And it's Emma.

-Bye-bye.

-Bye-bye.

HORN BEEPS

Rory!

It's like...a health check for the practice.

Well, think of it as an MOT if you like.

It's a chance for us to review everything that we do

in line with the current protocols -

taking into account patient feedback, of course.

Now, using an outsider will help us focus on everything that's wrong.

I keep hearing about things going wrong.

And I'm sure it will highlight all the strengths of the nursing team.

Now, Karen, any thoughts on progressing forward

from being a HCA?

Mandy, would you like to...

move forward with your career?

I did ask you to wait.

-Mrs Parks!

-We said 12 on the dot.

Indeed we did. Thank you very much, Mrs Tembe.

Howard Bellamy, practice manager.

Karen Hollins, HCA. Nurse Marquez.

And Nurse Reid has his own clinic at the moment.

Right. Shall we crack on?

Yes, why not?

Oh, Rory! Didn't you see the car?

-Brings a whole new meaning to "kerb crawling".

-HE GROANS

-Where does it hurt?

-My arm!

I didn't see the thing coming.

What a stupid, stupid idiot! It's my own fault.

Well, look, look, it's probably best that we get you checked out.

-Come back with me to work.

-No, I'm fine, honestly.

Rory, come on. Come back with me to The Mill.

We'll have a cup of tea and check you out.

-All right.

-OK, come on.

-All right?

-Yeah, yeah.

Mr Bellamy has brought me here today

to assess the state of patient care at The Mill Health Centre.

I have been made aware that there have been issues expressed by patients which need to be addressed.

With reference to the day's timetable, supplied earlier,

we're going to be looking at patient interaction,

support systems for learning, existing protocols et cetera...

-Ah, Mrs, er...

-Parks.

Parks. Welcome, welcome. We are delighted to have you here

and look forward to showing the very best that The Mill has to offer.

Oh, I won't shake, thanks. I'm short of sanitiser.

Dr Heston Carter. Partner.

As I was saying, existing protocols et cetera,

particularly making sure that everyone is up to speed.

It's no wonder complaints are received

when devolved responsibilities -

say from doctors to nurses, nurses to HCAs - are not checked.

It feels like a lack of ownership of patient care.

So if I have a chat with a selection of patients,

then we can get going with consultations.

Sounds perfect.

-I was thinking it might be good idea if I pop in on one or two.

-Sorry?

-Yes, see my team in action.

It's been a while since I've seen the nuts and bolts of the practice.

-Well, if you don't trust me to report my findings...

-Well, just the odd consultation.

-Not all day, of course.

-Of course.

You still think we've got nothing to worry about?

It's no big deal...

honest!

So, how do you find the services here at The Mill?

-They're all right.

-"All right"

as in "fine", or "all right" as in "needs improvement"?

"All right" as in, it's a doctor's. You come in, get seen and go home.

So if you don't mind me asking, what are you here to see the nurse about?

HE SIGHS

Getting my stitches removed. Appendix.

And the level of treatment you've received here?

Look, is this going to take long? Cos I've got to get back to work.

A bit forthright, isn't she?

A damn good trainer, by all accounts.

And whose accounts have you been listening to?

All right?

-Yeah.

-Oh, there's something on your desk.

-What?

PRINTER WHIRRS

OK, if you just take a little breath in for me. That's it.

All right.

You should feel a slight tug but nothing too uncomfortable.

Car's due its service soon - I'll have to book it in.

Yeah, yeah, bring it down. I'll sort it out.

Right. Perfect.

Done a good job there - not much of a scar.

Foreign hospitals have advanced a lot, haven't they?

Yeah. They're not cheap if you don't have insurance.

-Foreign?

-It burst on my honeymoon.

Oh, nightmare.

Weren't that much fun, no.

Ended up having to stay on another week. Work weren't too impressed!

-That's awful.

-Yeah.

Are we done?

Yeah. Right. If you experience any pain or tenderness,

you need to come and see us.

You mentioned the last time you were here was back in June,

presenting with groin pain.

Yeah. Where I'd been booted in the, er...

The ollies by my mate in Sunday League.

Also noted by Nurse Marquez that you experienced abdomen pain.

Yeah, I thought he'd kicked 'em right up there.

The same kind of pain you experienced on your honeymoon?

Similar, I suppose.

Yeah, and I remember after I dressed the cut,

I suggested if the pain continued,

you needed to come back and see a doctor.

-Isn't that right?

-Yeah. Yeah.

-And you didn't?

-No, I hate the doctor's.

Only came after the footie cos the missus wanted to check

I wasn't damaged goods before the wedding.

Anyways, I'd better get off, back to work.

Give us a bell about the car.

Yeah, yeah, I will.

Well done. Nice wound attendance.

Right. Well, I'll leave you to it.

Hey. Have you met Nursezilla yet?

-Who?

-The development woman. She's causing riots.

I tell you, it's like seeing Daniel walk into the lion's den

watching Karen go in there.

Daniel?

Yeah, Daniel. Not Daniel as in Daniel,

but Daniel from the Bible - the fabled Daniel.

I'm talking about Karen.

Oh, is there enough in there for another cup?

-Why don't you take this?

-Oh, great. Thanks.

Actually, Emma, do you have a minute?

No, I've got to sort Rory O'Connell out.

He walked in front of a car at his mother's funeral.

-Really?

-Yeah. Poor fella. He's had a tough six months.

-But maybe later.

-Yeah, sure.

Lovely to see you. Bye!

Are you going to change that blue paper?

Oh, yeah, I would normally.

I just thought you wanted to say something to me... Right, yeah.

Standard consult - nothing too taxing.

No, she's a... She's a regular to, er...

We have to test her sugars. Lovely lady.

You seem to know a lot about her.

Er, well, you know, er,

we like to form a bond with our, er,

multiple service users.

Some of that chat bordering on gossip, I thought.

Gossip? No.

No, it was just passing time with a lonely old lady

who probably doesn't have much contact with people.

-But there's a difference between compassion and nosiness.

-Ooh. Er...

Sorry, butterfingers.

Still, you are fairly new to this.

Maybe you should take a leaf out of the more experienced staff's books.

I mean, there must be some qualities in your colleagues you aspire to.

Of course, there must be some qualities you don't.

That's feeling better already.

At least it's not broken. I reckon that's a pulled muscle.

Maybe lay off the house-clearing for a couple of days.

Sorry.

I feel such a fool, I really do.

Don't be silly. You've had a traumatic time.

Right, let's get your blood pressure checked.

Should have got a buy one, get one free on funerals.

First Dad, then Mum.

Still...all over now.

Well, with all the time you've devoted to their care,

when was the last time you had a proper health check-up?

When have I had time?

Your blood pressure's a bit high.

How were you feeling earlier?

A little light-headed, maybe, but that's because I hadn't eaten.

Did you see those sandwiches?

Well, that's probably it.

But look, since you're here, why don't we give you the once-over?

No! I'm fit as a flea.

-KNOCK AT DOOR

-Come in.

I'm so sorry to interrupt, Dr Reid,

but your first patient has been waiting for quite some time now.

Oh, of course. Mrs Tembe, could you ask one of the nurses

to see Rory for me? I need a blood test.

-Blood?

-Indulge me.

Your mother would never forgive me if I didn't look after her boy!

This isn't supportive development.

You know, there's only so much lip biting I can do

before I draw blood - and I don't mean mine.

Howard has to be seen to be addressing patient concerns -

I'm sure that's all it is.

-KAREN GRUMBLES

-That woman!

How does it make me feel

to be on the lowest rung of the ladder at my age?

Oh, how did that come out?!

Oh...when I was asked to speak frankly about colleagues.

-About your colleagues?

-What did you say?

I can't remember, but I did not call you a whippersnapper, Mand -

-that was her word.

-See, Heston?

You think there's nothing sinister behind this?

Does Howard want us out?

I think you're blowing it out of all proportion.

Ah, well, that's just about the right response,

according to whatsherface - typical lack of support from doctors.

-Excuse me?

-You want to hear what she says about YOU.

"Doctors offering no support or training to the nurses,

"leading to system failure and poor patient care."

-She may have a point.

-She hasn't even seen our work.

Well, maybe some of her annoying ways are a simple ploy

-to flush out our problems.

-Or make them worse.

-Is there anything else?

-Well, isn't that enough?

Ridiculous!

Are you complaining about the lunatic?

-Sorry?

-This creature that's been lurking about today.

The development woman. She's got everyone in an absolute state.

It's marvellous!

-Oh...

-So what's she done to you?

-Er, nothing.

-Mind you, it's quite good to ruffle a few feathers -

keeps everyone on their toes and keeps Howard busy!

Maybe I'll come back later. It's...not important.

Suit yourself.

If she's stepped foot on a proper ward

or worked in a practice full-time, then I'm Shirley Temple.

Oh, is that right, Shirley?

Has it been properly sterilised?

Yes, of course, according to current protocols.

-Seems OK.

-Thank you!

But those - they'll have to come off.

But that's ridiculous - they're my rings.

I mean, they're covered most of the time.

No jewellery, in line with current infection control policy.

And that necklace - that's going to have to come off, too.

There have been complaints.

Well, that's off the website -

-stupid petty complaints.

-Just a bit of charm, mate, that's all.

She'll be eating out of the palm of my hand.

-Everything all right?

-SHE GASPS

Wonderful.

Shouldn't you two be in there?

Yeah, just going in now.

..demonstrate effective hand-cleansing techniques and...

Ah, Nurse Reid, I've been waiting to see you.

Sorry, I've, er... I've been with patients.

Oh, don't keep me in suspense. What other outcomes will I have learned?

Is it going to be much longer?

No, it should not be long, I'm sure.

You do know I buried my mother this morning?

Oh, I... Well, I am very sorry to hear that.

I don't think you are. And these seats need cushions.

Hey-hey-hey! No.

No. You are not allowed to drink in here!

I will give it you back when you leave.

Mrs Tembe,

could you sort out a referral at St Phil's for me, please?

Ah, yes, of course.

But, er, first, you need to sort out Mr O'Connell.

Rory, that isn't going to help anything.

This is how it all started with my dad.

High blood pressure. Heart attack. Coronary bypass.

OK. Look, hang on a moment and I'll go and find out what's happening.

KNOCK AT DOOR

Excuse the interruption,

but I had ordered some blood tests for a patient of mine a while ago.

Sorry, Dr Reid, we've been caught up in training.

Right, well, he's getting rather anxious

so could somebody see him now, please?

Well, as we haven't seen Nurse Reid in action,

why don't we take advantage?

Absolutely. Right, I'll go and get him.

Well, if your BP was a little high, we should be able to detect

any underlying causes, if there is any,

and help you get back to normal.

So, what brings Mr O'Connell here today?

An incident with a car.

I was distracted.

He's got raised BP and we're checking bloods.

Emma thinks it's something more sinister, I'm sure.

-Emma?

-Dr Reid.

It's probably something and nothing.

All right? At times like these, your body does strange things.

But whatever it is,

we'll get it sorted.

So what's your next move?

Report back to Dr Reid as requested.

And I would recommend dietary care,

with a follow-up appointment to check the results.

OK. Thanks, Nurse Reid.

Anything else, Mr O'Connell?

HE SOBS

Hey! Hey, mate, it's all right.

It was his mum's funeral today.

Reception deals with follow-up appointments? Yes?

-I know it's hard, mate.

-How did you feel when you lost your dad?

Well...

I wanted the pain gone.

I prayed that Mum would go -

she could join him...

And then I felt selfish.

Well, it's different for everyone.

And now I'm ill for thinking it.

Look, we don't even know if there's anything wrong yet.

Sometimes grief - it makes us do odd things.

Like walk in front of a car?

I don't think so.

Rory! Hang on a minute, mate.

Well done. Another satisfied customer

just within the standard acceptable consultation time...

Yeah. Look, I just...

I'm a bit concerned about his welfare - that's all.

I'd say there's little more you can do in this instance.

For crying out loud! His mum's just died.

And time's a great healer for grief.

My fault. It should be 20mg once a day.

Pretty standard for those antidepressants.

I'm so sorry.

Well, you are going to be if you don't buck your ideas up.

Is something wrong? It's clearly affecting your work.

Can I show you something?

All right.

You are unbelievable!

This guy is dealing with one of the toughest times of his life

and you dismissed him.

Where's your compassion?

There was nothing more to be done for him at this point.

Besides, I've seen his type before - self-absorbed.

I didn't believe that you could possibly be this witch

the others were saying you were, right? But clearly, I was wrong.

I shall, of course,

be reporting your deplorable behaviour to Mr Bellamy.

Well, go on, then!

And if Mr Bellamy backs you, he can have my resignation right now.

-HOWARD:

-I heard that.

I have never been spoken to like this in my life.

Well, you should get out more.

My office. Now.

-What's going on?

-Her.

Why? What's happened?

She hasn't got a compassionate bone in her body.

Rory's not in a good place, right?

And she wouldn't even give him the time of day.

I tried to talk to him, it got a little personal and then

she gave him some mechanical answers and he walked off.

-Well, where is he now?

-I don't know.

But he is really not in a good state.

Mum, was it definitely an accident, him walking in front of that car?

-HOWARD:

-Nurse Reid!

Leave it with me.

What kind of small-minded idiot would send such a pile of...rubbish?

Probably the same person who sent this.

Wow!

Well, if you want my advice,

you need to send a sharply worded response. That'd soon scare 'em off.

You think I should engage with this...nutter?

Once, with a patient of mine,

he mistook my professional care for kindness.

There were cards and flowers, and other...

unsavoury items, outlandish declarations of intent on a website.

All very freakish.

Leading to a short, sharp and humiliating - for him -

denouncement in front of his colleagues.

-Right...

-So, what are you waiting for? Get typing.

Things here are far worse than I could ever have imagined.

Truculence, aggressiveness, poor patient care.

I recommend a wholesale change of nursing staff

if you are ever to regain patient confidence.

I have never heard of a divide-and-rule system of training.

Strengths and weaknesses of other staff members, my eye.

I'd like to know what your colleagues say about YOU.

See? Their attitude speaks volumes.

The objective of today is to review and consolidate

best working practice and latest protocols.

Correct?

And identify weaknesses and act upon them.

Chris, how do you feel about that?

Well, I think it's been useful in all respects.

I have indeed identified huge gaps in knowledge

and gaps in the ability to demonstrate understanding

of primary patient care needs.

-Well, the day really has been a nightmare.

-Thank you.

Oh, I wasn't talking about these.

You've been divisive and patronising,

and insistent on undermining the excellent work of these nurses.

-Me?!

-Well, thank you for your insight.

I think we'll leave it there for today.

I apologise for putting you through this ridiculous farce today.

Ridiculous? Do you know who I am?

You really want me to answer that?

What kind of outfit are you running here?

-You'll have my invoice by return.

-Lovely!

Rory!

I've been to your house...

Ta-dah!

-I've been worried sick!

-Why?

Because of the accident this morning.

I might as well be dead.

Don't be daft.

Illness is my punishment.

For what?

For relief.

Relief that they've gone.

-Did you see her face?

-Sanitise that!

Suppose I should thank you, really, Chris.

What for?

All charm, was it?! What a crock!

-I am so glad I lost my cool!

-Thank you.

KNOCK AT DOOR

Oh, Howard, we really appreciate your support, you know.

You really had us going in there.

I thought you were going to give us a right mouthful.

Yes, well, Mrs Parks' visit hasn't shaken my faith in training.

I agree she was rather a bad apple.

But the website has raised issues that still need addressing.

So I have enrolled you all on a course for tomorrow -

-a proper course.

-What?

Who's going to look after the patients?

It's all sorted - agency nurses are lined up. Enjoy your day.

"He's a good boy but it's all too much for him."

That's what she said.

-Who?

-Your mum, the last time I saw her.

She loved you.

And she knew what a sacrifice you were making.

And I know that you loved her - and your dad.

I saw it.

But what I don't know is anyone who hasn't felt relief

when the suffering is over.

But to want them gone,

pray for it to be over...

-Another.

-No.

Rory, it isn't helping.

Numbs the guilt.

Is that why you think you're ill?

You think this is karma?

-Explains a lot.

-Oh. I see.

Nothing to do with finding solace in a glass full of Scotch?

And what happens when the test results come back

and they say you need to lay off the drink?

You've had a tough time.

But no-one is going to begrudge you having a life.

I guess you're right.

I do miss them, though.

I know.

But this is your time now.

So...

panic over?

What panic?

SHE CHUCKLES

What do you think?

Maybe change "twisted way of getting off" to "perverse satisfaction".

Oh and change "little".

What to?

How about "diminutive"?

Yeah. That just about hits the mark.

Do you really think this is a good idea?

You've got to be assertive.

You don't want idiots walking all over you, do you?

-No, of course not.

-Right. So send it out into the ether.

Show the little no-mark you mean business.

-COMPUTER CHIMES

-Better?

Yeah.

SHE SIGHS

How about a few after-work bevvies?

I am a stu... Well, mature student.

-Obviously not THAT mature.

-It's like Blue Peter.

No, no, no, it's Friday. I wrote it in my diary.

If they are not being insulting or projectile vomiting,

they are smoking everywhere.

-KAREN YELLS

-Oh, I was dead gentle with you then.

I worked so hard to get here!

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