Esmee POV... there may be trouble ahead

There may be trouble ahead

There may be trouble ahead,
But while there's moonlight and music and love and romance,
Let's face the music and dance. 

Soon, we'll be without the moon, 
Humming a different tune, 
And then, there may be tear drops to shed. 
So while there's moonlight and music and love and romance, 
Let's face the music and dance. 
Let's face the music and dance, 

Let’s face the music, and dance

Written by Irving Berlin sang by Nat king Cole

It was never a good sign when the office phone went off on the middle of the night. During the day everyone was used to it ringing off the hock but at night it normally always spelt trouble.

“There may be trouble ahead, but while there’s…”  I cracked a smile as Ingrid sang what we were all thinking before picking up a thank you bear that was sat on the desk in front of me and lobbing it over the room towards her. I seemed to turn into a teenager when I was on shift with the very girly Ingrid.

“Hello Apple gate house Children’s ward Esmee speaking how can I help you?”

“Oh hello yes, I was hoping to speak with the nurse in charge please.”

“Yes that’s me. Can I ask whose calling?”

  “Yes of course yes. I am a doctor Ryder and I am currently over at the general hospital. I am in desperate need of a bed for a young lady that I had just seen who is in crisis and needs hospital admission. I was hoping that Apple gate could provide me with one.” I dreaded dealing with calls like this one. It was never easy to deal with the disgruntled psychiatrist in the middle of the night and the truth was most units would have had to give him bad news on the bed front but in a way that would have been easier that what I was going to have to try and explain without sounding rude.

 

“Physically yes, I have two spare beds at the moment but one of them is on the second floor so really unpractical for a new admission so I would have to juggle patient rooms and of course all my kids are now sleeping. The other is an observation bed for new admits but I haven’t got the nurse power to observe it right now. I am a nurse down and barely legal with my ratios as it is. Can’t she be admitted to Skylight ward until the morning? I can arrange a nurse to come over and induct her in there. It would be so much nicer for her. I mean what are we looking at?” I asked replacing the receiver on the stand and turning on the loud speaker so I could get Ingrid’s back up if it was needed. In fairness there was two main ways that this could go now, the psychiatrist could and usually would back down and ask me to look for staff then get back to him or alternatively he could assume I was super woman and magic more nurses out of thin air as he bark on about the physical bed and ignore everything else I had to say. I prayed for the first option. It wasn’t that I was incapable of my job or I wouldn’t have been at work but the bad shifts drained anyone even if they were the most stable in their life. I had to admit that I was feeling wobbly and that was why I switched to the night shift.

“So there is a bed. I can send her over.” Great, just bloody perfect.

“We are short staffed as it is Ingrid said to me under her breath. If one of the others wakes up in trouble we won’t have enough as it is to get everything done.” I nodded to Ingrid silently and did a Crystal eye roll. Getting through to Doctor Ryder was obviously going to be as easy as addressing one of the many walls in the unit.  

“Physically there is a bed but I don’t have the nurses. I can try and find some but it will take some time, as you can understand people are not always that happy about being woken up in the middle of the night. I can get one of my NA’s on the phone now…” I mouthed sorry to Ingrid as I used the term and made it sound like she was somehow unimportant. The truth was without the nursing assistance the staff nurses wouldn’t be able to function at all… “But I will need a few hours at least, more if she has been detained because I will need to make sure I get someone who is confident with C&R. I am assuming that she is under a section five or four.”

“Yes, yes of course. She tried to leave the general hospital about two hours ago after making it clear to a nurse that she was going to take her own life. I was called down and deemed it necessary for her to stay. I believe that it will be transferred to a section three as soon as it can be. The plan was for her to stay on the ward for a few more days with a view to voluntarily admitting her to your unit at the end of her stay after we got some calories into her.  She has a BMI of 13.3 and she is extremely malnourished but is still coherent. She was admitted to the Emergency department with deep six inch vertical cuts to both wrists which severed the vain and acute Paracetamol poisoning. She was treated with pervolex for the poisoning and a surgeon repaired her wrist in theatre, there has been no damage to tendons. There is also a history of chronic self-harm. I have told her that she has been sectioned under the mental health act and she has to stay in the hospital but she keeps trying to abscond and of course it is very easy for her as Skylight isn’t a locked ward.”

I glanced over at Ingrid who was already on the other phone to the agency relating like a pro exactly what I was going to need for such a complicated admission. We had obviously both agreed simultaneously without even speaking to each other that we were not going to just need one more nurse to replace Jacob we were going to need two.  

“OK. You’re going to have to give me to at least an hour and a half get the room set up and enough staff to make this admission safe. You understand what I mean. You cannot send her over here until 2 30 at the earliest or I will turn the ambulance away,” I said firmly down the phone to the very softly spoken doctor.

“but you have the bed…”

“2:30 am the bed becomes free. Send her then good bye Doctor Ryder.