No Smoke Without Fire Doctors

Busy?

Summer school party last night. No self-control.

Oh, good morning. How can I help you?

-I wondered if I could see a doctor?

-Yes, of course. What is your name?

Liz Sharples. I keep being sick.

Oh, dear. Well, I'm afraid you will have to wait with the students,

-we are very busy.

-I am a student... well, mature student.

Yes, well. Obviously not that mature...

Will it be long? It's just I've got so much work to...

Oh, my goodness! You could have given me some notice!

Sorry... I can't seem to stop.

Dr Carter, can you take Miss Sharples...?

Well, I'm expecting a phone call, actually.

Dr Khella, would you oblige?

Dr Khella?

I have a lot of phone calls between patients... Jas?

JAS SIGHS

Erm, Miss Sharples, if you'd like to come through.

Sorry. So, who's next?

There is a girl in sick bay.

OK, so I'll be back.

Be careful of this! I will get a mop.

So...if you'd like to lie down here.

When did the vomiting start?

About...midnight.

It sort of stopped after I got up,

but I was still really nauseous until...just now.

Dodgy kebab? Too much to drink?

I'm vegetarian and teetotal.

OK. Any pain in the stomach, under the ribs?

My throat's a bit sore from the acid, but...

Right. Doesn't feel like gallstones or ulcers.

-Any chance you could be pregnant?

-No. Haven't even got a boyfriend.

I'm not here to party, I'm here to study.

I've got a really important paper to hand in for my course on Friday

and I can't concentrate.

Essay crisis.

-Can't you give me some anti...erm...

-Anti-emetics?

It's probably the norovirus or something you've eaten

in which case, better out than in, I'm afraid.

-My brain's so tired.

-Are you finding it hard to sleep?

I suppose I do go to bed quite late.

Well, try to go bed every day BEFORE midnight

and get up religiously eight hours later and the body will soon adapt.

OK. But what about the anti-emetics?

Well, keep re-hydrating and...

Sorry, I really have to get this.

Yep.

Oh, hi!

If you'd sign the register and collect your name badges. Thank you.

-Talk about nursery school.

-Ooh! Grab the choccy ones!

Here y'are. Look at them three - eager little robo-nurses.

-Probably spying for Howard.

-Yeah.

At least Howard admitted Leona was a waste of space.

Yeah, well, if he thinks we're so wonderful,

-what's he sending us on a course for?

-Ah!

"One-day course in team-bonding and compassion"?!

Oh, is that all? I may be crap at phlebotomy,

but I have got BUCKET LOADS of compassion!

-You what?

-Yeah!

Anybody who's endured a four-week slog of double-dose chicken pox,

deserves a medal in compassion.

That's chicken feed compared to what I've had to put up with.

Not the same as 24/7 when it's your own kids.

That does NOT give you the monopoly on compassion, Karen!

Does it, Chris? It's in a nurse's blood.

Yes, it's the nature of the vocation.

And doing an HCA course isn't the same.

Just cos I started late, doesn't mean I haven't got a vocation.

OK, hi, everybody. I am Sandy, your course leader.

Now, firstly I want to thank you for coming.

Like we had a choice.

A few of you may be a little bit resistant to the course, initially,

maybe you think you've covered this ground before, push on through.

It's surprising what a few exercises

and being slightly out of your comfort zone can throw up.

-It's like Blue Peter!

-But before we do too much talking,

I'd like you to fill out these psychometric tests.

-Here we go.

-Lovely.

-One for you, here we go.

It must be here somewhere!

Right. Be methodical.

SHE RETCHES AND VOMITS

WATER RUNS

OK. We'll talk about these after lunch.

Now, for the first exercise, I want you to stay in your workplace teams.

You're going to be building a bridge using balloons,

drinking straws and paperclips!

You'll find everything you need in the boxes.

Whoopee.

Right, you blow up balloons and I'll start planning the structure.

Oh, can't we all plan while we blow?

-Speaking of blowing!

-Ha-ha.

Very mature.

Man, they're taking it seriously, aren't they?

It's a very serious business!

Do you think we'll get extra points for the world's first farting bridge?

OK. How's it going?

PHONE RINGS

Hey, Tina. How's it going?

Me too. At least I've stopped hurling. Yaay!

Might actually be able to get this essay in by Friday...

What?

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

What is wrong with me? I completely changed it to Friday in my head.

I'll never get it done by tomorrow.

I have to go.

Idiot!

Look. We need a firmer base.

Three balloons tied together - like a tripod?

Yeah, yeah, yeah, brilliant. A bouncing bridge.

So? She said think outside the box.

What's balloons got to do with nursing anyway?

I mean, like Howard said, "Those who can do..."

Oh, you're making good progress!

Now I'd like you to work with one hand behind your backs...

-But it's going to ping everywhere.

-So you'll have to....?

-Work together!

-Precisely.

Erm, Mandy?

Would you mind ever so much clipping that paperclip

to that drinking straw and on to the balloon thank you very much?

Ah, no, it's too fiddly. Chris, can you hold that straw?

-OK...

-Amazing how awkward it can feel

just giving a few basic instructions, isn't it?

Open it with your fingernail!

Leona made me cut them!

-Bend it round your finger, mate.

-I don't know what you mean?

-Oh, I'll do it. Give it here.

-No, no, no, no! Give me a chance.

Ah, genius!

-That's too loose now, isn't it?

-Here y'are. Give it here.

MANDY AND KAREN: No!

Brilliant.

CHRIS SIGHS

MUSIC PLAYS THROUGH HEADPHONES

You seem to be having a slight structural problem.

-He designed it.

-Yes, all right.

-It just needs a few cross-braces, that's all.

-What?

-Just like the London Eye.

-Adapting your strategy. Good.

-Yeah!

-All right you can stop working with your hands behind your backs.

-Only one person will carry on building...

-Yes! About time.

-Oi!

-Blindfolded...

Eh? We'll never finish it!

Well, not with that attitude, perhaps. OK?

Here y'are, you can do it. Go on!

Oh, my goodness! You are soaked!

It's raining. I need to see Dr Carter.

-Well, he is very busy.

-I've been throwing my guts up.

Oh, right, well... I will see if he can see you.

Come into the sick bay.

That's it, that's it. Attach that straw to the end brace.

-This?

-Yes.

-It's a pipe cleaner..?

Oh, Karen, it's in your right hand!

Hurry up, the robo-nurses are nearly finished!

This is my left hand! Give me the Sellotape!

-Here y'are. Here y'are.

-Come on!

-You might have flipping opened it!

-Arrrgh!

-Karen!

-Well, you do it!

-All right, shove off then! Right.

Ah! Quick!

-Yes!

-Woo-hoo!

-Brunel, eat your heart out!

Leaving your colleague to wander round the room unattended

is hardly caring or responsible team behaviour.

Um, we got distracted.

Oh, magnificent!

But as it wasn't completed with team co-operation,

I'm afraid we'll have to discount it.

-What?

-Hmmm.

-Excuse me...?

-Have you been sick?

No. It's just I've been waiting for over an hour.

Well, I'm very sorry, but both our doctors are very busy...

I haven't been sick.

It is not sick, it is...

-Are there any more prescription forms, Mrs Tembe?

-Er, yes...

She doesn't look very busy to me.

Sorry?

Miss Sharples has been waiting for quite some time.

So if you could see her before she starts projectile vomiting.

Dr Khella, will you please refrain

from social networking during office hours?

Yes. Sorry. I'll take Miss Sharples.

It's probably better if I see her. So, if you...

I haven't got time to sit waiting for snotty doctors

to condescend to see me. I've got a paper to get in.

I'm sorry to keep you waiting, but we are...

If I fail, it's down to you - messing me about, patronising me,

-refusing treatment.

-That is no way to speak to Dr Carter.

Besides, I haven't been sick for ages.

Psychosomatic. She's clearly the repressive, controlling type.

Diagnosis by personality type. Not very helpful.

Well, she's anxious and her symptoms are intermittent.

-It's not an unreasonable hypothesis.

-You can't judge by appearances!

-Well, I know. But...

-Doesn't look the type to read saucy chic lit

or smoke roll-ups either, does she?

I'm aware it could be a number of things. I did examine her...

Oh, Dr Khella! Don't let me drag you away from your social life

with the niceties of diagnostic etiquette.

All I'm saying is, you can't always tell

what's going on in other people's lives. Who's next?

-Steve Evans?

-Yes.

-This way.

These summer students are a disgrace.

If they are not being insulting or projectile vomiting,

they are smoking everywhere!

Watch it, idiot!

OK. For the last part of the afternoon,

I want YOU to devise some role play.

Some patient/nurse scenarios that will really test

-the skills of your colleagues.

-Like acting?

Don't worry, we're not judging your dramatic prowess,

it's just listening and responding to what your colleague gives you

with professionalism and, of course, compassion.

-It can be a lot of fun.

-Well, I'll be the patient.

-No, no. I'll do it.

You'll get us disqualified again.

-It's better than being teacher's pet.

-I am not teacher's pet!

-All right. Whatever. Come on.

-I'll do it. You can be my husband.

-Bit young, isn't he?

-All right! Toyboy, then.

KAREN CLEARS HER THROAT

Karen! You don't get extra points for the Long John Silver impression.

-Right, well, shut up.

-It's my leg.

-Oh, obviously.

-Right, where does it hurt?

It's a really big cut.

It probably needs some steri-strips and a dressing.

-You're not supposed to dictate the treatment.

-Oi, stay in character!

Aargh!

All right! I only touched it!

Ah, but it's really sore! It's probably gone sceptic!

Hmmm. Doesn't look too bad, I'll have to do a swab...

No, it's bad. I mean, it's...

I mean, it's probably an ulcer.

-I thought you said it was a cut?

-No, it's an ulcer.

-Oh, OK.

Well, I think that you didn't examine it properly

and clearly you can see that she's in a lot of pain.

Right, I'll just get some sterile dressings.

Aaaarrghgh!

Will you stop over-acting!

Look, I think there's a secondary infection,

because you didn't dress it properly.

I think I know how to change a dressing, thank you!

Well, clearly you don't, because it's fallen off

-and that's why we've had to come back.

-Hardly a compression, is it?

What do you know? You've only been an HCA five minutes!

I'll have you know, I've done loads of compression dressings.

Good afternoon, I'm the senior nurse.

Now, we understand your concerns - ulcers can be very demoralising.

Can't they, Nurse Marquez?

-Yeah.

-So, what are we going to do to reassure Mrs Hollins?

Get the swab results back, ASAP, speak to the doctor about pain

-and a revised treatment plan.

-Excellent.

Right. Just get it cleaned up, shall we?

-Pop a compression bandage on.

-They hardly "pop on", do they?

-They're a right bugger.

-KAREN?

I'm in character! I'd have seen her do loads of compression dressings.

-Wouldn't I?

-Let's just make a good job of the dressing this afternoon.

-Aaaaaarrrggghhh!

-Oh, I was dead gentle with you, then.

No! It's really sore here, look, swollen and red, and at the ankle.

Obviously a thrombosis.

You cannot escalate your symptoms.

This is a training exercise, it's not a disaster movie.

-Oh! You be the patient, then.

-OK.

I know it can be a little tricky getting the hang of role play...

although it can be somewhat revealing.

I'll give you other scenarios once I've explained

the parameters a little more clearly. Right, Mandy.

You can be the next patient.

Liz Sharples is on campus, isn't she? Have you got her address?

Er, yes.

Room six, Pullens House.

Pullens House. Excellent. I'll be back before surgery starts.

Right, Miss Marquez, just going to give you some medication

-before you go down to theatre.

-Finally. I've been here hours.

It's difficult to predict the length of operations

-because sometimes there are complications.

-Oh, great.

-So what you're saying is my surgeon's crap?

-No, not at all.

-You're in the best possible hands.

-Hmmm. I'm starving!

I'm afraid you're nil by mouth in case you're sick during your op.

I'll have to eat something otherwise I'm definitely going to be sick.

-Please don't eat that, Miss Marquez.

-It's only a bit of chocolate!

It's tricky taking out a gall bladder when your diaphragm's convulsing.

It's a minor op. They only say stuff like that to make...

Oi, oi, oi, oi, oi! That's assault, that!

-I want to speak your managers.

-Oh, classic. Calling for Miss.

No, I wasn't. I was improvising.

Still, as she says, mate, it's very revealing.

You're hardly Nurse of the Year material, are you?

-People in glass houses...

-Oh, give over!

HCA's. Noddy nurses.

I'm more up to date with my training than you two jaded slackers.

Whoa! Better than a being a hyperactive healing-freak

that frightens the patients. Here y'are, mate!

KNOCK AT DOOR

Go away!

KNOCK AT DOOR

What?

What do YOU want?

Hi, Liz, I was a bit worried how you left the campus earlier.

-Can I come in for a couple of minutes?

-S'pose.

So you've been sick again?

Duh!

So the pattern is you vomit constantly, and then it just stops?

-For a bit.

-Any idea why it stops?

No. Obviously. Or I'd be doing that now.

Are you smoking marijuana, Liz?

Who do you think you are coming in here accusing me of smoking?

-I'm not judging you.

-This is harassment.

You're showing signs of heavy skunk abuse.

Poor memory, depression, paranoia...

-I could get you struck off.

-..and aggression.

Do you not think you've changed recently?

Maybe. I don't know.

-Cannabinoid hypermesis.

-What?

An allergic reaction to heavy skunk use which, bizarrely,

is only alleviated when you have a shower or a bath.

Does it get better when you bathe?

Yeah. Yeah, it does.

-We need to take a blood sample before you go down.

-Don't touch me!

Oi! That's not very nice! The nurse is just trying to help!

Would you prefer a woman? Shall I do it?

No. I've had enough. I'm discharging myself.

You're perfectly free to go, but you would be wasting

-a theatre full of medical staff.

-They've got plenty of other patients.

And you'd be discharged back to your GP.

And you really need this operation.

I'm fine.

My handbag? I can't find my handbag.

It's OK, it's here.

Listen, you're perfectly free to go,

but wouldn't it be great not to be in any pain any more?

Get your normal life back again? Come on!

Sit back down on the bed

and tell me any concerns that you've got about this operation.

It's nothing. I just don't want it.

-This one or any operation?

-Don't be daft.

It's not daft.

I am TERRIFIED of spiders... and goats.

See? I mean, to some people that's bonkers, but I can't help it.

And I would completely understand if you were anxious.

Well, maybe a bit.

A bit or a lot?

-It's the anaesthetic.

-The needles?

-The darkness.

-Right. Did something happen?

-I got locked in a cupboard when I was little. I hate it.

-Oh!

And you think that something bad's going to happen.

But you got out OK, didn't you? You know, you're all right!

-Yeah. My dad found me.

-Oh!

I promise you that you are going to be as safe as you can be.

It's a very short operation, the anaesthetists are very skilled.

I mean, when I had my appendix out, I didn't even know I'd been under

until I came round. And I felt quite high and I wanted to party,

I kept shouting for my lippy...

Tell you what.

I will come down with you and I will stay with you

until they put you under and if you feel at any time

that you really can't go through with it, I'll pull you out.

Is that a deal?

Deal.

My tutor made a deal that if I did the summer course

it would go towards my degree.

I wasn't doing too badly, but with the being sick and the...

getting the submission date wrong...

If I flunk this, I'm out.

And I worked so hard to get here.

And I've got so much debt.

It just... It makes me want to smoke more.

OK, I'm going to prescribe some anti-emetics,

just to get you through the deadline but after that...

-Cold turkey.

-OK.

Now, it's going to be two tablets, no more than three times a day.

-Thank you.

-You're more than welcome.

Sandy, we just wanted to say thank you for today. It was great.

-Em, sorry if we seemed a bit hostile this morning.

-Just a tad.

We had this...assessment thing with...Leona woman

and she really put our backs up.

-Leona Parks. She can be a bit...

-Uncompassionate?

Well, at least you know what it's like to be on the receiving end.

Yeah, but if you identified, right, with every patient's pain

and, what with your own, you'd never get up in the morning.

That's where some of our distancing techniques come in really useful.

To be honest, the Government and management

don't really treat us with compassion.

We feel second class to doctors, really.

And I didn't realise, until I became an HCA

how much nurses bridge the gap between doctors and patients

-and how emotionally demanding it is.

-Well, that's true,

but I hope you've got a taste today of how much more rewarding

a consultation can be if it's approached with compassion.

-Were we really that bad?

-No!

You scored really highly on the psychometric tests,

it's just my JOB to put the cat amongst the pigeons.

You are clearly a resourceful, feisty group of people,

that any practice would be proud of.

-Thank you.

-You're welcome.

Sorry, my fault. The district nurse did leave a message, but I...

Yes, of course, but it'll be tomorrow now. Sorry.

I thought the farting bridge idea was pretty good, actually.

But by the way, I didn't mean what I was saying earlier...

-No. Me neither.

-Ah, no. None of us did.

It makes you realise how much this caring lark takes out of you.

You know, the three of us should have a weekly meeting - vent - whatever?

-Discuss our more draining cases.

-Throw a few specimen bottles.

Seriously! You know. Give each other a bit of support.

-Yeah, well, I feel better already.

-I mean, yeah.

This compassion lark - all well and good for the patients,

but I think we should start with ourselves.

Ooh, that makes me sound like Sandy. I could have a sideline career in...

Yeah. I think we should start with the weekly meetings first, mate.

Oi-oi. Good day coasting at the campus?

Kidding me, aren't you? It was mental.

-You all right?

-Fine.

How about a few after-work bevvies?

Jas?

-I said, I'm fine.

-All right. Easy, tiger. It was only a few drinks.

Oh. No, thanks.

-Kevin, hang on.

-What?

Erm, I'm probably overreacting, but...

over the last few days I've been getting these funny texts and e-mails.

Well, not that funny, actually.

-You what?

-I know.

Let's get some fresh air.

This all goes back to that rose on your windscreen.

-Do you think?

-No doubt.

Yeah. There was the rose, then the poem, and the texts,

-then the e-mails...

-All increasingly invasive and aggressive.

I suppose it's quite a lot when you think about it.

-Why didn't you tell me?

-I don't know!

I didn't want to think about it. There was the misunderstanding between me and you...

-Which was dumb.

-Well, my head was all over the place.

And then there was the £8.93 for the phone. It just felt...awkward.

I'm sorry.

All right. I spoke to Zara. Yesterday. After the e-mail.

-OK, good.

-Yeah. She helped me write a real stinger back.

-You actually engaged with him??

-Yeah.

She said to be really fierce, nip it in the bud.

Is she COMPLETELY bonkers? You NEVER, EVER engage with a stalker!

-It's basic psychology!

-Stalker?

I'm not being STALKED! Nah. It's just some idiot messing about.

Jas! This isn't some harmless crush.

This guy knows where you work, what car you drive,

your...your phone number, your e-mail...

He knows where I live.

No wonder I've been feeling really spooked.

-What am I going to do, Kevin?

-Look. Don't you worry, OK?

We will get to the bottom of this. Have you any idea who it might be?

A patient? But I can't think who.

I don't think it's a patient.

Well, I don't know who else it could be...

Can't you?

What about Al?

AL? Don't be daft.

He's been a really good friend lately.

Jas, you know he has a crush on you.

-And he was weird after this whole kiss thing...

-He's got a girlfriend.

Yeah, right!

Have ANY of us so much as seen a photo

of this beautiful, mysterious Jackie?

And it's a bit of a coincidence that this "admirer"

suddenly has your phone number and your e-mail.

And who else has such easy access to your personal details?

Yes! Five-card trick.

-Karen?

-What?

Have you seen my fishing jumper?

-Might help me get Ol' Steve.

-Nobody's ever seen him.

-I have.

-How about drinks tomorrow night?

-Could do.

-Why not?

-Great.

-Your girlfriend's been invited to the drinks.

-Yeah, but she can't go.

How can you do better than dipping a pig?

You might want to think about being just a little bit more sensitive.

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