Emergency Doctor and Cinderella. Melanie Milburne

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СКАЧАТЬ of her way back in medical school. She fought against her human feelings all the time; they kept her awake at night—the sea of faces that floated past like ghosts. ‘Not really,’ she said, her tone chilly. ‘As I said, it’s not my job.’

      ‘You might want to have a rethink about that, Dr Taylor,’ he said. ‘The first trial ward-round begins tomorrow at the end of your shift.’

      Erin forced her gaze to remain connected to his. ‘Well, I can’t see that working. You know as well as anyone that A&E shifts don’t end according to the clock—they end when you finish treating your last patient, or at least get them to the point where you can hand them over to the next shift. You can’t just breeze out to start chatting with folks on the ward.’

      ‘You’re so right. I am quite aware of that,’ he said. ‘If you read the plan properly, you would see that wind-up on your last patient starts an hour before your shift ends—that gives you at least part of the last hour to do ward follow-through.’

      Erin gave him a mutinous look. ‘Oh, so we just walk out an hour before our shift ends then, and I suppose the next shift starts an hour early to fill in the gap? Or maybe we just abandon A&E altogether for an hour. Look, you can hardly force already overworked staff to take on even more responsibility.’

      ‘If you had read the proposal carefully, Dr Taylor, you would see that new arrangements do not mean more responsibility, just different responsibility. And, as far as implementing this plan, I’m not a great believer in using force to achieve anything,’ he said. ‘But I am the director, and I would like those working in my team to actually be a part of that team. The response from everyone else has been very positive, actually. I think you are going to find yourself out of touch with what everyone else is doing if you simply reject the department’s policies.’

      She arched her eyebrows. ‘So, what do you plan to do, Dr Chapman? Hand-hold every A&E doctor until you’re confident they’re doing things your way?’

      Eamon held her pert look, privately enjoying the way her burnt-toffee-brown eyes challenged his. Her defensive stance made him wonder why she was so against change. None of the other doctors he had briefed that morning had expressed any opposition to his proposal. In fact, three of them had cited cases where if such a plan had already been in place patient outcomes would have been better.

      From what he had heard Erin Taylor was not one of the more social members of the department. Apparently she never joined in with regular drinks on Friday evenings at one of the local bars, and as far as he could tell she lived alone, apart from a contraband cat. She was prickly and unfriendly, yet her clinical management of patients was spot-on. She was competent and efficient, although one or two of the nurses had mentioned in passing her bedside manner needed work.

      ‘I have certain goals I would like to achieve during my appointment,’ he said. ‘One of them is to improve overall outcomes for patients coming through A&E in this hospital. What you might not be aware of is how your expert work in A&E can be undone by isolating later management teams from the acute-care team. When was the last time you did a tertiary survey? It’s mentioned in EMST and ATLS, but hardly ever happens. Sometimes injuries and clinical clues get missed in the wards. There is clear evidence that tertiary survey by the doctor who carried out the primary and secondary surveys is more likely to detect missed injuries, and so avoid complications which eat up beds and cost money.’

      She continued to eyeball him in that ‘I don’t give a damn’ way of hers. ‘So, how long do you intend on propping up the public system before you scoot off for far more lucrative returns in the private sector?’

      Eamon cocked an eyebrow at her. ‘I could ask you the very same question.’

      She held his look for a moment before turning to look at the harbour. The sun was low in the sky, casting a pinkish glow over the sails of the Opera House and the towering skyscrapers of the city on the opposite shore. ‘I’ve thought about it plenty of times,’ she said. ‘But so far I haven’t got round to doing anything about it.’

      ‘You don’t like change, do you, Dr Taylor?’ Eamon asked.

      She turned to look at him, her expression like curtains pulled across a window. ‘I can deal with change when I think it’s appropriate,’ she said, and without another word slipped inside her apartment and shut the sliding doors—locking him out in more ways than one, he suspected.

      CHAPTER TWO

      ERIN had not long finished stitching a leg wound on a teenager the following morning when Tammy alerted her to a new admission.

      ‘Forty-five-year-old male complaining of severe back pain,’ Tammy said, reading from the notes she had taken down. ‘His wife found him on the floor of the bathroom. He’s nauseous and vomited prior to arriving in A&E.’

      Erin twitched aside the curtains in bay four and introduced herself. ‘Hello, I’mDr Taylor. The triage nurse tells me you’ve got back pain. Can you describe it exactly?’

      The man pointed to his left loin. ‘Here…’ he said somewhat breathlessly. ‘Every couple of minutes…I…ahh…!’ He writhed and groaned on the bed as his ashen-faced wife clutched one of his hands in hers.

      ‘We’ll give you something for the pain and nausea,’ Erin said, administering morphine, buscopan and stemetil IV, with Tammy assisting.

      ‘Is he going to be all right?’ the man’s wife asked.

      ‘How long have you been unwell, Mr…’ Erin glanced at the notes ‘…Aston?’

      ‘I…I haven’t been sick for years,’ he said, and turned his head to his wife. ‘Have I, love?’

      Mrs Aston nodded. ‘That’s right, Doctor. He’s never even taken a day off work in thirty-odd years. He’s always been—’

      ‘How’s the pain now?’ Erin asked as she clicked her pen open.

      ‘Eased off a bit,’ Mr Aston said, regaining some colour in his face as the pain-relief flooded his system.

      ‘When did you first feel unwell?’ Erin asked, pen poised over her patient-history clipboard.

      ‘First thing this morning,’ he said. ‘I woke up to go to the toilet and then it hit me, didn’t it, love?’

      ‘I found him on the floor of the bathroom,’ his wife put in. ‘I nearly had a heart attack myself.’

      Erin acknowledged the wife’s statement with a movement of her lips that was neither a smile nor a grimace but something in between. ‘I need you to give me a urine sample if you can manage it, Mr Aston,’ she said, addressing the patient once more. ‘I’d also like you to have an abdominal X-ray. The nurse will organise that while I see to another patient. Once we have the results of the urine sample, we’ll know more.’

      ‘Is it cancer?’ Mrs Aston asked hollowly. ‘Jeff used to smoke, didn’t you, dear? He gave it up…what?…ten years ago now, it must be. I remember the day. It was when we went to—’

      ‘We’ll know more once we get the results back from the tests I’ve ordered,’ Erin said briskly.

      Tammy took over the care of the patient as Erin moved to the next bay. She parted the curtains to see Dr Chapman standing СКАЧАТЬ