Culture Shock Holby City


Culture Shock

When a management consultant of Sir Fraser's is sent to Holby to shape it up for Foundation Trust status, Hanssen is certain his leadership is being undermined.


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Transcript


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'You have one job, and one job only,

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'and that is to dig us out of this hole.'

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She's dead!

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She left me everything in her will. They think it's about £50,000.

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Wedding cake samples.

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This is a bit of an awkward situation for both us.

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I will assess you just as I would any other nurse.

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I'm going to accept the money and take some more time off.

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I'm going to recommend an extension to your FT status assessment and we'll be back in three months.

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Get out of my way! If I'm going to save this hospital,

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I intend to do so entirely on my own terms.

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I intend to take full and absolute control.

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Until further notice, all allocations of all resources

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and I emphasise all allocations of all resources,

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are to be personally signed off by myself.

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A full and thorough inventory of current medical supplies

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and equipment will be compiled by every department and submitted to my office forthwith.

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Clinical decisions other than emergency surgery

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must be referred to my office for authorisation.

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Theatre schedules and staff rotas will need to be approved daily.

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Everything goes across my desk. Everything.

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BEEPING

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-ET 190.

-Be careful with her.

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BP 70 over 55. Six milligrams of adenosine. Her daughter's with her.

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-She was in an RTA. Sent in from ED.

-Mum's got cancer. Be careful.

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Chest trauma. Prepare a chest drain, OK?

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KNOCK ON DOOR

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Ah, Mr Hanssen?

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-Yes.

-Kris Swann. Shall I use here as a base?

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-Why?

-I understand you have an emergency drill today?

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That's correct and who are you?

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Kris Swann. One of Sir Fraser's management consultants.

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Ah. I assumed you'd been kept in the loop.

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No. I thought I made myself clear to Sir Fraser.

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I'm sure. But he insisted.

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I'm going to be sick.

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BP's stabilising.

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Oh, great, the drill. Just what we need on a ward.

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Thanks, Hanssen. Can you arrange a CT and an Echo?

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-Is there anyone you'd like us to call for you?

-No. It's just me.

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Henrik, with a bit of guidance, a bit of focus,

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this hospital can turn itself around.

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Guidance, from my four years' hands-on experience,

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in health sector strategic planning, is what I'll give you.

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Don't look so nervous. I'm here to observe and advise.

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-You're fully prepared for the drill?

-Yes.

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-Jodie Mullins?

-Yes.

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OK, bed four, please. I'll be with you in a minute.

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Sorry, how long?

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Chrissie, a word, please?

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# Concrete jungle where dreams are made up

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# There's nothing you can't do

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# Now you're in New York... #

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I cannot believe you're flying out tomorrow. I'm so jealous.

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-It's only a week's holiday.

-With your money you could stay.

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One step at a time. I've never even been on a plane before.

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Concentrate, Chantelle. Go right.

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You don't want to be like a lottery winner who's like,

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"I'm not going to let it change me." Let it change you! It'd change me.

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It's hardly a lottery win.

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I'm just saying if it was me, I'd start spending it.

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I am so, so sorry, Mr Griffin.

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Oh, dear. I'll make it up to him somehow.

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I'll see you up there.

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I didn't think I did that badly.

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-Just so you know, it was your diagnostic tests that let you down.

-Really?

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You could be a good nurse practitioner, Chrissie.

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You've just got to prove it.

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-Are these your cases for today?

-Yeah.

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Any chance you could take a look at my RTA?

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Possible internal bleeding from fractured ribs,

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stage two lung cancer patient, due for a lobectomy

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and a heart tumour excision at St James's, in three weeks.

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Electives are out of the question because of this drill,

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but there's a case for performing the cancer surgery here if we're taking her into theatre anyway.

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Very possibly.

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-Let's wait and see what the CT and the Echo show us.

-Sure.

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I can smell booze on the daughter, also in the RTA.

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-Oh, dear.

-Hmm.

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What do you think you're doing?

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Hi, Kris Swann, management consultant.

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So you do have a name?

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Why not use it to introduce yourself? These are private medical files.

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-I'm...

-Look, if you or anyone in management want to poke your nose around here,

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you ask Mr Hope first. You got that?

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That's nice. An evacuation drill, exactly what we need today.

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As evacuation warden...

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I need to attend an evacuation briefing. Why? Fire, we run.

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A drill isn't going to save you.

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-Hanssen's orders.

-Of course.

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How can we live for 30 seconds

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without him inventing a completely new way of ruining our lives.

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So, I hear your preliminary NP exams didn't go as well as we'd hoped.

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She had to tell me.

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She also told me that she thinks you've got it in you to do very well.

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Chrissie?

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Excuse me!

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Could someone...help!

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-What's happening?

-We'll see how the chest drain works,

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but we may need to operate to stem the bleed.

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Increase the oxygen.

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If we do need to operate on the tear,

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it may be beneficial to bring forward the lobectomy

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-and the heart excision that your mother was to have.

-Today?

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Look, your mother is very weak and we wouldn't want to put her

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under the strain of having two operations in one month.

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But let's just wait and see if the chest drain does its job first, OK?

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-Sorry, CT's in.

-Thank you.

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We have to operate today.

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We better call Hanssen first.

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I'm sick of having to run everything past Hanssen.

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It certainly doesn't feel like an economic use of our time.

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How can we run a hospital if they won't allow doctors

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to make basic decisions for their patients?

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Engaged.

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Mum!

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Why didn't you call me?

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Chantelle's really sorry. Is there anything either of us can do?

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I'll sort the car. You concentrate on your job and maybe next time,

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leave the instructing to someone who's paid to do it.

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Mr Quinn, where are you going?

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I'm desperate for a drink.

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-I'll get you a cup of water.

-I'd love some coffee, I need caffeine.

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I need to prep you for a scan.

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You may have sustained internal injuries in the attack.

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All right, I'll behave myself in that case.

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Right, what do you need me to do?

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No nursing the sick for you today.

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Time for you to join your fellow evacuation wardens in a briefing.

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The stupid drill.

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Chantelle's been selected to be evacuation warden?

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Seriously? Come on, even a keeno like you can't be jealous?

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Would have been nice to be considered.

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Chantelle's been put in charge of our safety in the event of a disaster?

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I'm not seeing nearly enough preparation for the drill.

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Electives have been bumped for this trial at great cost.

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The staff are aware of their responsibilities.

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Excuse me. Mr Hanssen!

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I have an RTA with a haemothorax that may well require surgery.

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The patient also has grade two tumours in her heart and lung.

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The CT shows the patient's cancer has increased rapidly

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since her last check-up.

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Mr Hope and I are requesting that we remove both tumours today.

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This patient is from St James's. Send her back to St James's.

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How would the patient feel about their life-changing procedure

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being discussed in a corridor?

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Well, with all due respect, I am consulting my director of surgery.

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Repair the haemothorax.

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But the cancer treatment remains the responsibility of St James's.

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But circumstances have changed. We need to adapt.

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I've made my position clear, Ms Shah.

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Don't let Darwin fail the evacuation drill.

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You're due in a briefing, I believe? Mr Swann?

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-How long have you had stomach pains?

-Since I was about 18.

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It's not usually this bad, though.

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-CT scan ordered by ED.

-Thank you very much.

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I'm meant to be getting a train back up to university tonight.

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I can't afford to miss another term.

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Everything all right?

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Yeah, yeah, fine. That'll be all, thanks.

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-Has the pain relief kicked in yet?

-Yes, thanks.

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Right. We're going to move you to the side room. OK?

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Seven, eight, nine, ten.

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Wow, if that is not a waste of a senior nurse's time,

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I don't know what is. Good thing you can count.

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Yeah. One of my many skills.

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I must go and get briefed on how to direct fake people

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away from fake emergencies. Goodbye.

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-What's wrong with her?

-No diagnosis yet.

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So, go on. Go show the doubters what you can do.

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We're going to monitor her closely over the next couple of hours.

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But you saw the scan and said you wanted to remove the tumour?

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Look, we're still waiting for the Echo results to come back

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which will give us a clearer indication of what's going on.

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But at this stage my director of surgery

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feels it's best St James's deal with the cancer surgery as planned.

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I'm not happy about this. I want it done today.

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Hold on, Mona. If the director of surgery doesn't think operating is a good idea?

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Sorry, I have to be some place else but I will come back, OK?

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I'm going for a fag.

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-Just a fag?

-Just a fag!

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We've looked at your blood tests which confirm you are anaemic.

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Can I help you, Sister Williams?

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-Yeah, I'm taking over Jodie's care. Eddi's a bit busy.

-Right.

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-Unless you would prefer a more senior nurse?

-No, no. It's fine.

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Excuse me. I know I'm anaemic.

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But I read somewhere that can be a symptom of something else?

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Sorry, don't want to sound all pushy.

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The tests don't reveal anything, I'm afraid.

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You should go back to your GP for a referral.

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We could explore some other avenues?

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I can assure you, I've explored every avenue.

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And my best advice is you head back to your GP.

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I eat everything the doctors tell me.

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We believe stress might also be exacerbating the symptoms.

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It's not stress. Something is wrong, has been for a long time

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and I don't know what it is.

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If I can't get back to university this week, that will be it.

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It says in her notes she's taken measures to address stress and diet.

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But still she's exhibiting symptoms.

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-We can't find anything.

-But I'm in pain!

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We'll keep you in until the pain is manageable.

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-If the extreme symptoms persist...

-Speak to my GP again?

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Or visit your local ED, OK, when you're back at university.

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That'll be all, thank you, Nurse Williams.

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'As part of today's evacuation drill, five mock patients,

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'each wearing a blue tabard, have been assigned to each of you.'

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I would like an apology from Ms Shah.

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She was very rude and aggressive towards me earlier.

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I doubt that.

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And her tone when addressing you leaves a lot to be desired.

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'All areas of the hospital.'

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Morning all. I'm Kris Swann, a management consultant from the NHS.

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I see some familiar faces from my rounds today.

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The Trust's eyes are on you, Holby.

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Mr Hanssen and myself want you to do well. But make no mistake.

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The only thing bigger than this, is the real thing.

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'During the evacuation...'

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I have never wanted to burn myself alive, until this moment.

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Yeah, well, I've got patients to treat.

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Somebody should inform Mr Hanssen about that at once.

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PAGER BEEPS

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Echo results are in, give Kris my apologies.

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Please sit down at once, Ms Shah.

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I'll be back in a bit, OK?

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"Thanks, Nurse Williams, that'll be all."

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Yeah, what was all that about?

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It's fine, honestly, it's very straightforward.

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Well, it's very clear you don't want me on the case.

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Thanks for your support. Very touching.

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Chantelle?

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I'm really sorry about your car, Mr Griffin.

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I will sort it, I promise.

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My mum will loan me the money.

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Don't worry about it. I'll sort it.

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I got you a muffin.

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Thank you, there was no need.

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-Aren't you going to eat it?

-A bit rich for me.

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-Would you prefer choc chip?

-I don't really have a sweet tooth.

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What about a fruity one?

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-It's fine.

-Blueberry?

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-You're back.

-These sheets need to go to laundry. And prescription, bay five.

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I just need to get a muffin for Mr Griffin.

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I'd leave it, if I were you.

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I got a quote on getting the scratch fixed.

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That was next on my list. The nail varnish was a disaster.

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It was £500.

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Oh, I don't think my mum can cover that.

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-I'll have to find another way. Leave it with me.

-Chantelle.

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-Let me know when it hurts.

-What's her name?

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Brother, man. She's a nurse, she works here.

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That's all you need to know.

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-Hi.

-Sian Cadogan's Echo.

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The tumour is far bigger than the CT showed.

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We need to perform a lobectomy and excise the heart tumour today

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-or it could become inoperable.

-Mmm-hmm.

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Hanssen has to agree to this now.

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Any luck, Poirot?

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Maybe the patient is just anaemic, like the notes say.

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Could be.

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That's my super-sleuthing done. Back to stock taking.

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Looked a lot more than anaemia earlier, though?

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I know but Sacha's notes are so vague. I mean 'abdominal pain'.

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That could be anything from gynae to bowel problems.

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You'd have a much better chance

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of diagnosing the patient if you were with her.

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I don't think I'd be very welcome.

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But this is your career at stake.

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Do you want to throw away the chance to be a nurse practitioner

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because you can't work with your ex?

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-Sacha's not my ex.

-So what's your problem?

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He doesn't think I'm up to it

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because I failed my NP module. Remember?

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57, 58, 59.

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There you go. Is there anything else I can help with?

0:18:190:18:23

One, two....

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What about patient in bed three?

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He's fine. He's waiting for his scan results.

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Can I twist your arm?

0:18:320:18:33

Do you fancy him?

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No. I just feel sorry for him, he's been beaten up.

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I'm not saying he's not cute, but I'm a professional.

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OK. Go on then.

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Hi. I'm Chantelle, I'll be looking after you today.

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Lucky me. Nice to meet you, Chantelle.

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Mr Hanssen, the patient we discussed earlier, I have her Echo results.

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PAGER BEEPS

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-Thank you.

-The Echo makes the case more than compelling.

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The tumour has spread into the left atrium.

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To have any chance of extending life, we need to remove

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the tumour from both the heart and the lung as soon as possible.

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In three weeks' time the tumour may be inoperable.

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Well, I consulted St James's since our previous conversation

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and in light of the scan you can perform the lung lobectomy.

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-Thank you!

-The patient can then continue radiotherapy treatment

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on the heart tumour at St James's.

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-I don't understand.

-Well, how can I say more clearly?

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Why are you being like this?

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I get it.

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There is a higher chance of the patient dying

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on the table with the heart surgery.

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So, we're just going to wash our hands of the risk.

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Let St James's take the hit. I'm right, aren't I?

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You just want to keep our mortality rates down?

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-I cannot believe that the great Henrik Hanssen...

-Shut up!

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You're a good surgeon, but you need to know your limitations

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and resist getting involved in matters of which you have no understanding.

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-This case...

-If you cannot carry out a simple instruction

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then I'll have to ask Mr Hope to oversee your operations for the foreseeable future.

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And apologise to Mr Swann for your inappropriate behaviour earlier.

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No chance.

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DOOR SLAMS

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Was mum happy this morning?

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No, she wasn't. She's got lung cancer.

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How was your cigarette?

0:20:550:20:57

I'm going to have to call Paul,

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let the family know what's happening.

0:21:000:21:02

Paul is not her family.

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He would be if I hadn't been called away from my own wedding.

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This doesn't just affect you.

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Do what you want. Invite them in. Have a party around her bedside.

0:21:110:21:15

-Is everything all right?

-Yes, sorry.

0:21:150:21:19

Oh, for God's sake, Mona.

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Tell you what, I'll make this easier for everyone

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and go and wait somewhere else.

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We're chasing up your scan. It's been a bit slow this last week.

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I'm sure you're wanting to get on away.

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I'm happy to stay here. As long as it takes.

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MOBILE RINGS

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That cut's going to need a couple of stitches, I reckon.

0:21:450:21:48

I'll just get my needle and thread and check the treatment room's free.

0:21:480:21:51

MOBILE RINGS

0:21:510:21:52

I shouldn't have this on here, should I? Let me take it outside.

0:21:520:21:57

Hello?

0:22:000:22:02

Yeah, I'm fine, I'm just at work. All right. Calm down.

0:22:020:22:07

Sit down. Take it easy.

0:22:070:22:10

Sacha, do you know where Jodie Mullins' scan is?

0:22:160:22:20

It's not in her notes or on the system.

0:22:200:22:23

-What do you need it for?

-Where is it?

0:22:230:22:26

I don't know, but you don't need it, I've told you, I've sorted her care.

0:22:260:22:32

Hi there, it's Chrissie Williams.

0:22:470:22:49

Could I have a copy of Jodie Mullins' scan, please?

0:22:490:22:53

There you are. We're about to take your mum into theatre.

0:23:120:23:16

-If you'd like to come back upstairs?

-Is she having her operation?

-Yes.

0:23:160:23:19

Where have you been? I need to do those stitches. You'll get me into trouble.

0:23:240:23:28

For you.

0:23:280:23:29

Flowers aren't allowed on the ward. According to your X-ray you don't have any broken ribs.

0:23:300:23:35

We'll wait to see if you've any internal bleeding.

0:23:350:23:37

-Meanwhile, don't leave the ward until discharged.

-Sorry.

0:23:370:23:40

If you collapse while you're picking flowers we can't help you, can we?

0:23:400:23:46

-Let's hope the treatment room is still free.

-Don't forget the drill.

0:23:480:23:52

-The what?

-The drill?

-Oh, yeah, sure.

0:23:520:23:55

I don't understand, why can't you just do it all today?

0:23:580:24:01

They know what they're doing.

0:24:010:24:03

She's already said the tumour is bigger than initially thought.

0:24:030:24:07

Mona, if they don't think removing the tumour...

0:24:070:24:10

Tell me why you can't do it.

0:24:100:24:12

-I'm sorry, she's gets upset easily.

-This is our mum's life.

0:24:120:24:16

Your sister is asking a valid question.

0:24:160:24:19

There's a first time for everything.

0:24:190:24:22

Just promise me you are doing what's best for her.

0:24:240:24:28

We are.

0:24:290:24:31

I'm sorry you had to down tools to be here.

0:24:360:24:40

It's always good to see another great surgeon at work.

0:24:400:24:44

You argued your case. It's out of your hands.

0:24:440:24:48

If there's one thing I never thought Hanssen would be, is weak.

0:24:480:24:52

This is wrong.

0:24:520:24:53

I think there are probably things going on here that we know nothing about.

0:24:530:24:57

Nor would we want to.

0:24:570:24:59

We probably shouldn't be too judgemental. Shall we get on?

0:24:590:25:04

-Hi.

-Hi.

0:25:150:25:16

Jodie Mullins is free to go.

0:25:170:25:19

Fine.

0:25:210:25:23

Could you arrange this prescription for her, please?

0:25:230:25:27

Yeah, sure. Pain killers.

0:25:270:25:30

I'm a bit busy, so...

0:25:320:25:35

Sure. Me too.

0:25:350:25:38

Cut.

0:25:590:26:01

-Bronchial tube not leaking air.

-Good.

0:26:060:26:10

This new regime is out of control.

0:26:100:26:12

This could be the first patient to die because of it.

0:26:120:26:15

That's not very fair.

0:26:150:26:17

If this was your mother on the table, what would you want me to do?

0:26:170:26:20

Saline.

0:26:200:26:22

Ms Shah, we've done as much as we're allowed to do.

0:26:220:26:25

We need to stop here now. Miss Shah.

0:26:250:26:29

Sahira.

0:26:330:26:35

Look. We can't close a patient with that inside them.

0:26:370:26:42

I don't care how inconvenient it is to Hanssen's figures.

0:26:420:26:47

You close her up. I can't. This is wrong.

0:26:490:26:51

OK. We'll proceed with the excision.

0:26:530:26:56

Scissors.

0:26:590:27:00

Are you sure you don't want to go for a fag? Or sort yourself out?

0:27:160:27:20

Thank you.

0:27:270:27:28

BP's falling.

0:27:280:27:30

-Fluids and cross match, please.

-Suction.

0:27:300:27:33

Keep at 100% oxygen.

0:27:330:27:35

-We need to get on top of this.

-More suction. I can't see.

0:27:350:27:38

She's bleeding out quicker than we can get in.

0:27:380:27:40

She's losing output.

0:27:400:27:42

Let me know if this hurts, Mr Quinn.

0:27:470:27:49

-Don't worry, I'll live. Ouch!

-Sorry.

-You trying to rush me out?

0:27:490:27:53

I'm sorry. I've got an emergency evacuation to lead.

0:27:530:27:57

Didn't realise you were a girl scout.

0:27:570:27:59

I have to do it right so they don't think I'm useless.

0:27:590:28:01

You seem pretty useful to me.

0:28:010:28:04

MOBILE RINGS

0:28:040:28:06

You fancy coming out for a drink when I'm back on my feet?

0:28:070:28:12

Well, you're my patient at the moment.

0:28:120:28:17

At the moment, yeah.

0:28:170:28:19

Paddles standing by, please. 4-0 prolene.

0:28:210:28:23

Swab and pressure. There it is.

0:28:280:28:31

Easy. Nice, wide purse strings.

0:28:350:28:39

Good and cut.

0:28:390:28:43

And tie it up.

0:28:430:28:46

BEEPING

0:28:530:28:56

-BP's rising.

-Well done.

0:29:110:29:15

I thought I was going nuts!

0:29:170:29:19

I think you might be right.

0:29:190:29:20

It's not very clear but there's definitely something there.

0:29:200:29:23

Well, you wanted to diagnose and this is a lot of brownie points.

0:29:230:29:28

How could Sacha miss a tumour?

0:29:280:29:30

You need to share your theory. Fast.

0:29:320:29:35

Can I have a word with you about the Jodie Mullins case?

0:29:440:29:48

I would rather you spend your time keeping across Hanssen's stock take.

0:29:480:29:52

And I've dealt with the Jodie Mullins case.

0:29:520:29:55

Of course.

0:29:560:29:59

I'm pleased to say we were able to remove both tumours successfully.

0:30:110:30:16

-She's absolutely fine.

-Both?

-Yes.

0:30:160:30:18

We'll let you know when your mother is being moved back to the ward, OK?

0:30:180:30:23

Thank you so much.

0:30:230:30:26

See, I was right!

0:30:260:30:28

I told you they could do that today. I do know what's best for Mum.

0:30:280:30:32

If you hadn't been drinking or whatever else you've been doing,

0:30:320:30:35

none of this would have happened, Mona.

0:30:350:30:38

Oh, God. I can't find my tabard.

0:30:380:30:41

105, 106.

0:30:420:30:43

Have you seen it anywhere? Elizabeth, have you seen my tabard?

0:30:430:30:47

..110, 111, 112.

0:30:470:30:49

Ah, there it is!

0:30:490:30:51

Is it still Chrissie Williams we send overtime requests through to?

0:30:510:30:55

Mr Griffin's car. I'll work every day for the next year if I have to.

0:30:550:30:59

419, 420, 421...

0:30:590:31:04

You work under a nurse

0:31:270:31:28

-you were previously senior to, are you not?

-Yes, I am.

0:31:280:31:32

You've failed the preliminary examinations

0:31:320:31:34

in the nurse practitioner training, I selected you to undertake?

0:31:340:31:38

I will do better next time.

0:31:380:31:40

Conspiring with me over a patient's symptoms

0:31:400:31:43

to comfort one's bruised pride is not an attitude I welcome.

0:31:430:31:48

Perhaps you could take a look at the CT for me?

0:31:480:31:50

Who failed to look at it to necessitate you bringing it to me?

0:31:500:31:53

Mr Levy. He didn't fail to look.

0:31:530:31:56

He simply couldn't see a mass in the abdomen?

0:31:560:32:01

Yes.

0:32:010:32:03

If I'm forced to stop typing, I expect to see a mass.

0:32:030:32:08

I'll ask you once, shall I stop typing?

0:32:080:32:12

PHONE RINGS

0:32:120:32:14

Yes.

0:32:200:32:21

I hope for Mr Levy's sake you are wrong.

0:32:240:32:26

-I didn't drink and drive.

-I could smell it when I got here.

0:32:280:32:31

-Why don't you believe me?

-Because you're a mess.

0:32:310:32:34

Mum was driving.

0:32:340:32:36

Mum had to drive because you were drunk!

0:32:370:32:39

I think it's time I got a proper carer for Mum.

0:32:390:32:42

I want to care for her.

0:32:420:32:44

You want to care for her?

0:32:440:32:45

Mum cares for you, Mona. We all know it.

0:32:450:32:48

-You think I'm still using, don't you?

-Aren't you?

0:32:480:32:52

Oh, my God. You don't trust me at all, do you?

0:32:520:32:55

It was supposed to be my wedding today and you were half cut.

0:32:550:32:58

You are such a selfish cow.

0:32:580:33:01

Look, I'm sorry I got wasted on your wedding day.

0:33:020:33:07

I just couldn't stand the thought of the family

0:33:070:33:09

looking down their noses at me.

0:33:090:33:12

I will prove to you that you can trust me.

0:33:190:33:22

Scan's are all clear, just some light bruises. You're free to go.

0:33:300:33:35

Henrik, it's time.

0:34:010:34:04

Keep her on 15 minute obs. Full oxygen.

0:34:100:34:13

I'll let Hanssen know about the heart excision.

0:34:130:34:16

No, I'll, I'll tell him.

0:34:160:34:17

I was the consultant present. It's my duty.

0:34:170:34:20

But I pushed for it, I'll take the brunt.

0:34:200:34:22

I'm in enough trouble as it is. One more thing isn't going to hurt.

0:34:220:34:25

EVACUATION SIREN

0:34:250:34:28

Please follow the trail of death and destruction to assembly point two.

0:34:280:34:33

Do not use lifts. Thank you.

0:34:330:34:36

I was right.

0:34:390:34:41

-Wyvern stairs. No running.

-Should I stay till the drill's over?

0:34:420:34:45

No. You've been discharged. You're free to go.

0:34:450:34:48

Can I get your number?

0:34:480:34:50

I've got to concentrate on the drill.

0:34:500:34:52

I'll be in the car park in ten minutes.

0:34:520:34:54

How am I doing?

0:34:540:34:56

Where's our fifth mock patient?

0:34:560:34:58

Don't run. No lift.

0:35:060:35:09

Sian Cadogan's post op CT scan.

0:35:090:35:12

Kate can you take over?

0:35:150:35:17

He would want me to prioritise the patient.

0:35:170:35:19

This is all ridiculous anyway.

0:35:190:35:21

I've looked all over the ward and he's nowhere to be seen.

0:35:260:35:28

I can't go downstairs with four patients.

0:35:280:35:31

-We better go, we're being timed.

-I wanted to do it perfectly.

0:35:310:35:35

We don't want to make it worse by being late.

0:35:350:35:38

I heard you arranging to meet that patient.

0:35:430:35:45

He's not a patient any more.

0:35:450:35:47

It wasn't a criticism. He seemed sweet.

0:35:470:35:49

Really? He asked for my number.

0:35:490:35:52

I haven't been on a date in ages!

0:35:520:35:54

You'll be fine. You've got to take a risk every now and then.

0:35:540:35:58

Are you sulking, because you're proved wrong?

0:35:590:36:02

-I knew Jodie had a GIST tumour.

-Yeah, right.

0:36:020:36:04

I performed an endoscopy.

0:36:040:36:06

There's no endoscopy in her notes?

0:36:060:36:08

I did it when I transferred her to the side room.

0:36:080:36:11

Fortunately the biopsy revealed the tumour's benign.

0:36:110:36:13

You performed a secret endoscopy?

0:36:130:36:16

What is the best course of treatment for a GIST?

0:36:160:36:19

-To take it out.

-How?

0:36:190:36:20

Laproscopically. In most cases, better recovery time.

0:36:200:36:24

Upper GI laparoscopic surgery has been assigned to St James's,

0:36:240:36:27

Holby will not get paid to do it. Hanssen's as good as banned it.

0:36:270:36:32

He can't do that?

0:36:320:36:33

The only procedure we can offer here is open surgery.

0:36:330:36:36

I was trying to discharge her so she could be treated elsewhere.

0:36:360:36:39

Get her back to university in time and not jeopardise her degree.

0:36:390:36:43

I hope no-one died in this massive disaster.

0:37:060:37:11

One day there could be an absolute disaster

0:37:110:37:14

and you will be glad of this.

0:37:140:37:16

Thank heavens. You made it out alive.

0:37:180:37:20

I'm still caught up. Sit tight. You'll be fine.

0:37:200:37:25

I'm up to my eyes. I'll be there soon.

0:37:250:37:28

He waited for you. That's quite sweet.

0:37:310:37:34

-You should talk to him.

-Do you think?

0:37:340:37:38

If you like him, of course!

0:37:380:37:40

Here, hold my tabard.

0:37:420:37:45

Wait. Where are you off to? When can we get back in?

0:37:480:37:51

I'll just find out.

0:37:510:37:53

Yes, I'm listening.

0:37:530:37:56

Babe, I'm afraid I'm going to be here for a couple of hours yet.

0:37:560:37:59

Yes, I love you too.

0:37:590:38:02

I'll be there as soon as I can.

0:38:020:38:05

Failure.

0:38:060:38:08

Your staff failed to find the mock patient in the toilet, I understand.

0:38:080:38:13

Darwin did turn up, but Ms Shah was notable by her absence,

0:38:130:38:17

which makes me question how seriously you took the drill, Mr Hanssen.

0:38:170:38:22

I took it very seriously indeed.

0:38:220:38:24

You assured me your staff were aware of their responsibilities.

0:38:240:38:27

When I report back to Sir Fraser, I can only sugar coat it so far.

0:38:270:38:31

I am very happy to listen to any recommendations you're willing to impart.

0:38:310:38:35

Do the drill again.

0:38:350:38:38

You can't be serious?

0:38:380:38:40

I am. Are you?

0:38:400:38:45

I have a level of seriousness

0:38:450:38:46

beyond your four years hands-on experience

0:38:460:38:49

in health sector strategic planning

0:38:490:38:51

and your diploma in hospitality management.

0:38:510:38:55

I deal with your type all the time.

0:38:550:38:58

The type who think medical training is equivalent

0:38:580:39:01

to managerial skill in a competitive health service.

0:39:010:39:04

You might get pats on the back from your pals over at the GMC,

0:39:040:39:08

but now, where it matters, your name's dirt.

0:39:080:39:10

A peculiar use of the word matters.

0:39:100:39:13

If you feel out of touch with the needs

0:39:130:39:15

of a modern health service then step down.

0:39:150:39:18

I want my apology from Ms Shah and I want a re-run of the drill.

0:39:180:39:24

KNOCK ON DOOR

0:39:270:39:28

Come in!

0:39:280:39:29

Excuse me, Mr Hope, could I ask you a favour?

0:39:320:39:37

Ah, Mr Quinn. Now, either you have forgotten something

0:39:410:39:44

or you didn't understand when I said, you have been discharged.

0:39:440:39:49

-It's started again. Right in here.

-Really?

-Hmm.

0:39:490:39:54

I know I messed up today,

0:39:560:39:58

but I followed the drill to the letter.

0:39:580:40:00

You followed simple instructions. Do you want a medal?

0:40:000:40:03

I'm more concerned with where my car keys are.

0:40:030:40:06

Since your tidying up this morning, they appear to have gone missing.

0:40:060:40:09

Missing? I never even saw them, Mr Griffin, I swear.

0:40:090:40:14

-I can help you look though.

-It's fine. It's fine.

0:40:140:40:17

Leave it!

0:40:170:40:19

You failed. Who was the staff member in charge?

0:40:190:40:23

Me, Mr Hanssen.

0:40:230:40:26

There was a mock patient left in the Keller toilet and I distinctly

0:40:260:40:29

remember the drill briefing stated all areas were to be evacuated.

0:40:290:40:33

Nobody checked the toilet.

0:40:330:40:35

I want a full account of this ward's failure to comply.

0:40:350:40:38

That's so unfair.

0:40:390:40:42

I just can't believe I'm finally being treated. Thank you!

0:40:420:40:47

Unfortunately, this procedure involves quite a lengthy recovery.

0:40:470:40:51

So, you won't be able to go back to university for quite a few weeks.

0:40:510:40:55

Right.

0:40:570:40:59

I'm sorry.

0:40:590:41:01

I'm really grateful to just be treated, thank you.

0:41:040:41:08

We're going to get you prepped for theatre. OK?

0:41:100:41:13

Sacha, I should have kept my mouth shut.

0:41:160:41:20

It's not your fault, it's Hanssen's.

0:41:200:41:23

Let's just get her into theatre.

0:41:230:41:25

You OK?

0:41:320:41:34

No, I really don't know what happened.

0:41:340:41:38

I've been trying so hard today.

0:41:380:41:40

And now Mr Griffin's car keys are missing

0:41:400:41:43

and I think he's blaming me for that as well.

0:41:430:41:46

Could this day get any worse?

0:41:460:41:48

I tell you what, why don't you get yourself back on the ward and

0:41:480:41:52

I promise there will be something there that'll make your day better.

0:41:520:41:56

Mr Griffin, please, don't worry about your keys. I will find them.

0:42:050:42:09

Keep an eye on fluid output.

0:42:160:42:18

Hi, Sian. I'm Ms Shah.

0:42:200:42:23

You were in an accident.

0:42:230:42:28

Can you locate the daughters please?

0:42:280:42:30

-Sure.

-Thank you.

0:42:300:42:31

I'll be back.

0:42:310:42:33

You were missed at the drill.

0:42:350:42:38

Yes, I had more urgent matters to deal with.

0:42:380:42:40

Look, this is a very busy hospital.

0:42:400:42:43

We've had to bump elective patients for a drill that isn't even a full scale evacuation.

0:42:430:42:48

Everything in good time, Ms Shah.

0:42:480:42:49

Your micromanagement regime is just ridiculous.

0:42:490:42:53

If you don't like my 'regime'. Then you don't have to stay.

0:42:530:42:56

You should know, I decided it was in my patient's best interest to perform the heart excision.

0:43:000:43:04

It was completely my decision. Not Mr Hope's.

0:43:040:43:08

Although he did agree that the patient would have died without that intervention.

0:43:080:43:13

MONITOR BEEPS

0:43:130:43:15

Crash team!

0:43:150:43:18

She's gone into VF.

0:43:180:43:21

No output.

0:43:210:43:23

Bag her.

0:43:230:43:24

This is highly irregular. You're lucky the toxicology team were able to conduct a test.

0:43:310:43:35

See! Told you I was clean.

0:43:430:43:47

I'm going to go and sit with Mum.

0:43:480:43:51

I'm sorry.

0:43:510:43:54

No, I mean it.

0:43:550:43:57

I'm sorry I screwed up your day.

0:43:590:44:01

You kind of surpassed yourself on that one.

0:44:020:44:04

I always try my best!

0:44:070:44:08

Charging to 200. Clear!

0:44:110:44:14

Again. 200. Clear!

0:44:150:44:17

We've got sinus rhythm. Thank God.

0:44:210:44:24

Mr Swann.

0:44:290:44:30

Oh, my God. I can't believe he came back.

0:44:390:44:42

He really must be interested.

0:44:420:44:44

Mr Malick said something about stomach cramps.

0:44:440:44:47

Now I can get his number. I'll need something to entertain myself whilst you're gone.

0:44:470:44:51

-It's only a week.

-Oh, please!

0:44:510:44:53

-All that inheritance in the bank and you're going to New York for a week?

-I can only take a week's leave,

0:44:530:44:57

which is fine because I've never even been abroad, let alone America. I might not even like it.

0:44:570:45:02

Like it? Trust me, you won't want to leave. With £50K in the bank, you damn well shouldn't.

0:45:020:45:06

Ah, leave it!

0:45:060:45:07

What are you going to do? Buy yourself a flat, put a millstone round your neck?

0:45:070:45:11

It's a big world out there and I'm sure you'd get your job back cos you're brilliant.

0:45:110:45:15

It'd be like the paps waiting for Cheryl to step off the plane.

0:45:150:45:19

Er, that's not the best analogy, Channers.

0:45:190:45:22

You would like to go for longer though, admit it.

0:45:220:45:25

Maybe I'll surprise you both one day.

0:45:250:45:27

Seven days in the week, Elizabeth. Not one of them is called 'one day'.

0:45:270:45:32

Wait!

0:45:380:45:39

I can't find the consent form.

0:45:390:45:41

Right.

0:45:430:45:45

Well, I'm it will turn up somewhere.

0:45:450:45:48

Hanssen's insisted on caution at all costs.

0:45:480:45:52

I think it's our duty to stop this procedure.

0:45:520:45:55

This might be a little bit cold.

0:45:570:45:59

It's fine.

0:46:010:46:02

I reckon you could just cure me with your smile.

0:46:020:46:04

If that were true, my job would be a lot easier.

0:46:040:46:08

I was going to ask you for your number, but I guess I can't if I'm a patient again.

0:46:080:46:12

Absolutely not!

0:46:120:46:13

I'd really like to see you when I'm not a patient.

0:46:130:46:17

Erm, sorry.

0:46:170:46:19

I should sort this out first.

0:46:190:46:22

You won't find anything wrong with me.

0:46:220:46:25

Hey, Mr Quinn, your phone has not stopped ringing.

0:46:270:46:30

Your wife has gone into labour and she's downstairs in Maternity.

0:46:300:46:34

Better get yourself down there, mate.

0:46:340:46:36

MOBILE RINGS

0:46:360:46:39

You're horrible.

0:46:400:46:41

What's happened?

0:46:540:46:56

Your mother had an irregular heart rhythm. Her heart stopped.

0:46:570:47:01

But we managed to bring her back.

0:47:010:47:03

I pushed you to do this operation. Is she suffering because of this?

0:47:030:47:07

No, it's the stress of surgery,

0:47:070:47:10

but she's fine, she won't need any more operations.

0:47:100:47:13

BUZZER SOUNDS

0:47:130:47:14

Excuse me, just stay here.

0:47:140:47:17

When is Hanssen going to start treating this place like a hospital?

0:47:170:47:21

I'll see what's going on.

0:47:210:47:23

I just need to know whether it's a real emergency or another drill?

0:47:230:47:29

Yes. I'll hold.

0:47:290:47:31

So where's Scott gone?

0:47:350:47:37

Oh, he was discharged.

0:47:370:47:39

You can tell me, you know.

0:47:410:47:43

Thank you.

0:47:430:47:44

It's not a real fire, it is a drill, a re-run of this morning.

0:47:440:47:50

Let's get it right this time.

0:47:500:47:52

Wyvern stairs, no running.

0:47:520:47:55

Everyone wants you to succeed Mr Hanssen,

0:47:550:47:57

but if you can't react to the simplest of drills or have your staff behave

0:47:570:48:01

with a certain level of conduct, then there is a significant problem.

0:48:010:48:05

Three month reprieve or not, the Department of Health

0:48:050:48:08

will not allow a hospital of this size to fail.

0:48:080:48:10

If you aren't seen to be making enough progress, you will be removed beforehand.

0:48:100:48:14

There's no safety net here.

0:48:140:48:16

Right, I'm going to see if there has been any improvement on our last attempt.

0:48:190:48:25

ALARM CONTINUES

0:48:250:48:27

Oh, Elizabeth, I've been such an idiot.

0:48:270:48:31

You've got to take a risk or you'll never know.

0:48:310:48:33

Besides, it's all right to be an idiot.

0:48:330:48:36

Sometimes.

0:48:360:48:38

You going to check the toilets this time?

0:48:380:48:43

Stay with us, folks. We're just trying to find out what's happening.

0:48:430:48:46

For those of you not designated skeleton staff,

0:48:460:48:49

-please make your way to staircase two.

-Sahira?

0:48:490:48:53

Hanssen is working around the clock to save this hospital.

0:48:530:48:56

He needs our support. Let's just get on with it.

0:48:560:48:59

-BELL RINGS CONTINUOUSLY

-Get up. Move!

0:48:590:49:01

I cannot suspend my disbelief that far.

0:49:010:49:05

You shouldn't have put yourself in the firing line,

0:49:070:49:10

not with the scrutiny we're under now.

0:49:100:49:12

If I'd known discharging her meant she got the best treatment,

0:49:120:49:15

I'd have been on board from the start. Don't you trust me?

0:49:150:49:18

-Of course I trust you.

-It doesn't feel like it.

0:49:180:49:21

You know I think you're a great nurse.

0:49:210:49:23

I just didn't want you to get involved.

0:49:230:49:25

There's one thing me sticking my neck out for a patient,

0:49:250:49:28

but in the current climate, the fewer people that know about this the better.

0:49:280:49:33

Better late than never.

0:49:410:49:44

There he is. Do it now.

0:49:510:49:53

Mr Griffin?

0:50:000:50:01

Yes.

0:50:010:50:03

Can I have a word, please?

0:50:030:50:05

Yes, of course.

0:50:050:50:06

I'm not just going on holiday to New York.

0:50:080:50:11

-I'm going to stay for a while.

-What?

0:50:110:50:14

But... Where's this come from?

0:50:150:50:19

It's something I have to do. I've never done anything like it.

0:50:190:50:23

-It's an opportunity I can't miss.

-What does that mean? How long?

0:50:230:50:26

Six months? A year? I don't have a plan.

0:50:260:50:31

I need something new.

0:50:320:50:34

Fine. Well, put something in writing

0:50:370:50:40

and we can start the process of finding a replacement.

0:50:400:50:44

Elizabeth says she's going to America. Did you put her up to that?

0:50:500:50:53

-She needs it, don't you think?

-She's my best nurse. Thank you very much!

0:50:530:50:58

She needs to do something for herself for once.

0:50:580:51:01

And you've got me, Mr Griffin.

0:51:010:51:03

How long do you reckon she's got left?

0:51:060:51:09

Long enough for her to see you get married.

0:51:090:51:13

Yeah.

0:51:150:51:17

She'll make sure she sticks around for that.

0:51:170:51:20

Maybe I could help this time.

0:51:220:51:24

Mr Swann.

0:51:360:51:37

Hi, I wanted to apologise for my unacceptable behaviour earlier on.

0:51:390:51:45

Thank you, Ms Shah. A big improvement, by the way,

0:51:450:51:49

on Darwin's evacuation time, much closer to what it should be.

0:51:490:51:55

Sahira.

0:51:580:51:59

How did you make a mistake like that?

0:51:590:52:02

-It was my fault.

-Can't we go back?

0:52:020:52:05

I've referred you to St James'. They'll schedule a new operation in.

0:52:050:52:09

-I've told them it's a priority.

-I just want this over with.

0:52:090:52:12

Believe me, they will do it. And they will deal with it quickly and efficiently.

0:52:120:52:17

You should be back at college in no time.

0:52:170:52:19

Thank you.

0:52:200:52:22

-Time to face the music.

-What do you mean?

0:52:250:52:27

Well, Hanssen will want to know what happened.

0:52:270:52:30

-Maybe I should go?

-It's my call, Chrissie.

0:52:300:52:32

Sacha.

0:52:320:52:34

I wish she knew what you've done for her today.

0:52:340:52:37

Well, we got there in the end.

0:52:500:52:53

One job off the list.

0:52:530:52:55

Sir Fraser and I only want to help you.

0:52:590:53:02

In time, you will see we are all on the same team.

0:53:020:53:06

Will you be coming back?

0:53:070:53:09

We will be keeping a close eye on things.

0:53:110:53:14

I am only ever a phone call away if you get stuck.

0:53:140:53:16

Look at the turn around in Doctor Shah's attitude today.

0:53:180:53:22

Just goes to show what can be achieved when you apply yourself.

0:53:220:53:26

I shall bear that pertinent advice in mind.

0:53:260:53:29

That's all we're asking, Henrik. Good evening.

0:53:290:53:33

When you get yourself a sofa, I'll be out to visit.

0:53:420:53:45

Yes, of course and Chantelle.

0:53:450:53:46

She's given me a list of things to do. She was telling me about some few museums.

0:53:460:53:50

Bloomingdales and Macy's.

0:53:500:53:52

Let's get you a Cosmopolitan after this lot.

0:53:520:53:56

Oh, no, it smells like medicine.

0:53:560:53:58

Oh, come on. You need to get some practice for when you're in the Manhattan crowd.

0:53:580:54:02

-Come on Elizabeth, you can't have leaving drinks and not drink.

-No excuses.

0:54:020:54:06

OK.

0:54:060:54:07

Ooh.

0:54:120:54:15

Another round?

0:54:150:54:16

Actually, I'll have to leave you to it.

0:54:160:54:18

Mr Griffin, have a shot.

0:54:180:54:20

No, I have an early start and I still haven't found my car keys.

0:54:200:54:24

There's something waiting for you outside.

0:54:270:54:30

It's as good as new.

0:54:300:54:32

Thank you.

0:54:400:54:42

Travel safe and be sure you split your money up.

0:54:440:54:48

Put it in separate pockets. That's what I do.

0:54:480:54:51

I've left some money behind the bar.

0:54:510:54:53

I'm really going to miss you, Mr Griffin.

0:54:530:54:56

Thank you.

0:54:580:54:59

I know everything you have done for me has been out of kindness.

0:54:590:55:04

Whenever you want to, you can come back to us.

0:55:070:55:10

# Now you're in New York... #

0:55:100:55:12

Enjoy your party.

0:55:190:55:21

(SINGS) Now you're in New York!

0:55:210:55:24

You could have the X Factor, but you don't!

0:55:240:55:27

Right... to Isabel.

0:55:280:55:32

ALL: To Isabel!

0:55:320:55:33

The best nurse ever!

0:55:330:55:35

KNOCKING

0:55:440:55:46

Come in.

0:55:460:55:47

Was just passing. You OK?

0:55:540:55:56

Yes, I'm fine, thank you.

0:55:560:55:58

Subtitles by Red Bee Media Ltd

0:56:290:56:32

E-mail [email protected]

0:56:320:56:35

Sahira is tired of the new micro-management regime Hanssen has employed. But when Kris Swann arrives as Sir Fraser's management consultant, Hanssen is less than pleased and rallies support from the team. But Sahira is determined to treat her patients as best she knows how, until she realises how much pressure Hanssen really is under.

Sacha is forced to block out his team on AAU, and remain secretive about the results of a patient's CT scan, in their best interests. When Chrissie suspects Sacha knows more than he's letting on, she goes behind his back to prove the patient's diagnosis is wrong. Who will be right?

Chantelle doesn't get off to a good start in the day when she crashes into Ric's car. With the help of Elizabeth, can Ric's mood change as the day goes on?


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