ACUTE CARE
Acute Care
"So, you care for the patients, do you?"
Angeline was uncharacteristically angry. Angry with this unfeeling, alien being who had entered and disturbed her well-ordered world a month ago. She had managed quite well as Senior Nurse Adviser, thank you, before he came. After all those years of struggle and prejudice, it seemed like it was starting all over again.
She was black, Jamaican, and sensitive. Since last summer, she had been on the threshold of a true management position with the new NHS Trust, when they appointed this...businessman. As Inpatient Services Manager, he was one of the new breed in the modern National Health Service. Competent, calm and cold. That, of course, was on the outside. It fuelled the fires of deep prejudices within a caring culture that felt it was above such stark realities of money, choices, market forces.
On the inside, Paul Wilshire was human - hiding a raft of fears, frustrations and feelings. He had come from the world of industry and commerce - big business, where there were no such things as staff counselling groups. Nor had there been any culture like this. A climate in which fallibility and irrational action were admired; where it was process and procedure which mattered, not outcome. For him, it had only been a year in this crazy world of the public sector. He had believed the hype, bought the message that it was all changing; swinging round behind the winds of reform. He now realised that it was a culture that ran too deep to be so easily lifted or excised. There were so many personal and professional agendas. OK, he knew about politics. GramTech was full of it, but there was, at least, one overriding universal principle: competitive edge and profit. Neither were understood here.
Every one of the thirty or so days since his new appointment, it had been like the last day of school, when you brought games - filled your time with token lessons; when nothing much was expected of you. This was very wrong, he thought. I have skills, motivation, energy, ideas.
As a professional manager, he was always careful about working relationships with his female colleagues. Angeline was his closest peer, a senior nurse who seemed to know what she was doing, but - part of that culture again. She was attractive. It was the first time he had worked so closely with someone so black. It had been necessary to get inside some of her thoughts and cultural influences. Sharing a two hour car ride to a regional meeting the other day had probed beneath the surface of polite, work-related small talk. He had got to know her a little better.
For Angeline, it had been an awkward car journey. He had been polite, charming, even. There seemed to be none of the expected prejudice from a white middle class male. He never spoke much of people, though. More about things and ideas. Some of his thought patterns were quite alien to her. He was certainly intelligent; she respected that, but valued warmth more. He lacked warmth, that was it. All figures and economics - what about real people, people who cared for people. Was there any room left for that anymore?
It was Friday, and it had been a gruesome day on the ward. Fifteen mentally disturbed patients took a lot out of any member of staff. When tensions ran high within the nursing shift, it was worse. When there was that pig of a consultant psychiatrist doing a ward round, it was impossible. At noon, there had been an incident with one of the patients requiring an injection. Dr Nigel Quigley had left all that wet stuff behind some years ago, but today he was the only one on the spot to administer the dose. The tip of the needle repeatedly probed the patient's arm, each painful attempt seeming like an insult. The thirty year old male patient could take no more. He brought up a fist which connected with the consultant's aquiline nose, now red with blood.
The nurses had been blamed, of course. Angeline had stepped in to mediate between the two professions, but with a consultant it was always going to be one-sided. What upset her more than anything was the hurried transfer of the patient to Broadmoor. A violent assault on a doctor was seen as a good enough reason for admission. Ironically, this patient was the mildest of all of them. Just a bad morning and limited patience with a fumbled injection, and now this harsh, vengeful punishment. Wounded pride, that's what it was. At five, Angeline returned to her office, still trying to hold back her feelings and the tears that were forcing their way to the surface.
As she pushed open the door, she saw Paul sitting in the low chair in the corner. Of all the times, she didn't need this. She wanted to be left alone for a while, have a good cry - a mini tantrum, even. Then wipe her cheeks and get home. Home wasn't much of a comfortable refuge these days. Curtis had left a few months ago. Disappeared without trace - probably somewhere up north with his mates and family. Well, that relationship hadn't lasted very long.
Paul looked up and instantly registered that something was wrong. Angeline sat down in her swivel chair and with lips compressed, began to flick through her desk diary, obviously not focusing on the pages.
"I'm here because you said you wanted to meet when you got back." he said.
Damn, she thought. Yes, she had asked him. That seemed like such a long time ago - before all this blew up.
"Look," she began, but her eyes were filling up. Damn!
"Tell me." he said quietly, moving over to sit on the corner of her desk.
She told him, and couldn't stop the tears from flowing. It was the last thing she wanted: to show him that she was just like he suspected - weepy, soft, not in control.
Paul knew she was hurting, understood the pain she felt. He too was not immune to the injustice of it all. They also shared a common bond in their dislike of Dr Nigel Quigley. Through wet eyes, she looked at Paul - trying to see his reaction to her display of emotion. Was it incomprehension, faint contempt or would the mask slip and show any sympathy?
Paul reached across and took both her hands. His thumbs explored her soft, pink palms that contrasted with the chocolate brown skin on the back of her working hands. Unconsciously, his fingers stroked her small hands in a consoling gesture. There was something more than physical touch that connected them in that moment. An understanding, a private bridge between two people from different worlds.
"Let me drive you home." he said, his voice soft - but confident.
"OK, thanks." she smiled.
Why had she accepted that offer? What was she thinking of? Suddenly, she became aware of the pressure of his grip and that he was holding her hands. She hadn't fully realised until now. Strange, disturbing thoughts ran through her mind. For an instant she felt like pulling away, embarrassed at her vulnerability - especially in front of him. Then, a moment later, she felt calm. Why fight this? He was showing and sending out waves that were genuine. Empathy - she knew what it was. He was human, after all. Good looking, too - for a white guy.
For Paul, his feelings were out in the open. Something had triggered their release and they were all over the place, uncontrolled. Angeline was attractive and surprisingly, he felt close to her. There was something special about this moment.
Following the subtle tugging lead from his fingers, she stood up and joined him at the corner of her desk. She was trembling now, unsure of what was happening. His hand slid protectively around her back and he pulled her gently to him. Deep inside, her body won the decision. Her head would have to wait another day. She moulded to him and, as he touched her temple, she looked up. Their eyes and lips were only inches apart. The chemistry was strong and the moment was there. She closed her eyes and felt the tingle as their lips lightly touched.
"Come on, let's get out of here. You can unwind at home. This place gives me the shudders sometimes."
They emerged into the dingy corridor that smelled of disinfectant and floor polish, and closed the door behind them. Paul hesitated then smiled. The budget papers left on the desk could wait. This was people business - the most important kind. A priority activity in the plan.
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