Chapter 1 - Tanked
“Disciplinary Suspension.”
The words jump off the letter that Catherine (Cat) Morris, holds in her trembling hands. “Bastards!” She growls to herself. “God damn, chicken shit, bastards!”
For a brief moment her long fingers twitch as they hover at opposite corners of the letter, preparing to scrunch it in to a ball and throw it across the room. The cheap flimsy recycled paper feels like an added insult to the situation.
With a resigned sigh, she puts the letter down on the kitchen table and leaves it there to fester, accusingly, into the air around the table.
Cat chooses her favourite morning coffee pod, and puts it in her coffee machine and sets her favourite mug under the spout. ‘Nursing is a Work of Heart’ the white text jumps out of the purple glazed mug. Even today it doesn’t fail to make a tiny smile twitch on her full pink lips.
’Swearing, cursing and brooding isn’t going to help; I need a plan; An effective plan. I need to get ahead of the curve on this,’ she thinks to herself. A determined smile starts to form on her lips, the strong coffee has worked it’s magic and kicked Cat’s brain into high gear.
Leaving the letter on the kitchen table, she walks gracefully through to her lounge. Grabbing her laptop and curling her long slim, denim clad legs underneath her on her couch. Cat fires up her laptop and starts to document the events from yesterday’s shift.
Yesterday. …
Danemoor Hospital, 2nd Floor Emergency Operating Theatres: The morning list was so routine it had stalled to the point of being dull. You could count on the fingers of one hand, how many times a month that transcribed to a routine afternoon in emergency theatres.
Cat had been completing paperwork at the admin desk when the red phone rang. Only one department calls the red phone, the Accident and Emergency department.
Cat had felt the usual spike of her heart rate that accompanied the phone’s shrill ring. The surge of adrenaline acting to bring her body to full alertness.
“Emergency theatre. Cat Morris speaking,” she answered calmly.
The calm but brusque tone of Mr Harper, chief emergency surgeon replied, “Cat? Good. Emergency splenectomy. We are just stabilising him in A&E, but we’ll be up in ten.”
Cat checked the status board that logged the readiness of the three emergency operating theatres, on this floor. Operating Room 3 was marked as cleaned, sanitised, restocked and ready for use.
“OR 3 is ready.” She heard a slight sigh.
“Who’s the on-call anaesthetist?”
Cat’s eyes lifted to the board again.
“Mr Mendez,” she kept her tone neutral. There was something about Mr Mendez, the senior consultant anaesthetist that always made Cat feel uncomfortable.
“Page him. I want him down in A&E now.”
Cat depresses the receiver switch with her finger to cut off the call. She releases it and punches a code in via the telephone keypad.
Through speakers mounted in the ceiling a slightly electronic voice rings out, “Paging Mr Mendez. Paging Mr Mendez. A&E consult required immediately.”
Cat and her team had swung into action in the preparation room of OR3. They scrubbed themselves then gowned-up ready to receive the patient and the surgeon.
Cat felt the pressure build in her chest, her body battling to suppress the adrenal response.
The main double doors to OR 3 swung open as the team with the patient on a trolley appeared from the lift hall. The porter handed off to two of Cat’s nurses.
Cat had been taken aback that it was Mr Mendez’s registrar that accompanied the patient with Mr Harper. One minute later Mr Mendez came through the scrub room doors. Followed by Mr Harper and his registrar Jamie Coleman.
Theatre scrub-room protocols are a well rehearsed and choreographed routine; all the players know their roles and responsibilities and gave one hundred percent to the performance. Mr Harper smiled at Cat as he stood with his hands held up in front of him as another nurse dressed him in sterile gown and cap and gloved his cleaned hands.
As Cat pushed the swing door into the operating theatre, open with her hip, Mr Mendez, the consultant anaesthetist, pushed past her. That was the first moment that her nose had wrinkled, just a hint of something. Amongst the smell of sterile air, metallic equipment and hibiscrub she couldn’t be sure. The hairs on the back of her neck had prickled.
Cat had draped the operation field, using clips to keep the sterile drapes from moving. Mr Harper and his registrar went to work.
The clean incision of Mr Harper’s scalpel revealed a paddling pool of blood in the abdominal cavity. Cat didn’t need telling, the suction tube was in place before Mr Harper could ask.
“This is a mess in here. How much blood have we got ready?” Cat replied, “4 units cross-matched and 6 O-Neg.”
“Jo. Call down. See if we can get another 4 cross-matched. Sorry team, if you had plans this evening … … … … We could be in for a rough one.” Mr Harper sighed behind his mask.
The air was heavy in the room, the only sounds, the breathing of the people around the table, the erratic beeps of the monitors, the slurp of suction and instruments clanking metal on metal.
“Cross Clamp!”
Cat moved to pass it across to Jamie, Mr Mendez took a shuffled step back from the anaesthetic systems, then stumbled.
Cat’s eyes snapped to him.
She took a deep breath through her nose as she faced him.
Above all the sterile scents of the OR and the copper tang of blood in the air, she smelled it again. Something that definitely didn’t belong in an emergency operating theatre, any operating theatres.
“Everything okay?” Mr Harper asked. “Everything’s fine. Patient’s just. … He’s being difficult. Won’t hold his pressure,” Mr Mendez huffed.
As the closest person Cat had caught the whiff again something that mouthwash and peppermints couldn’t quite hide.
“Mr Mendez, are you fit to be in an operating theatre?” Cat said quietly but firmly. Everyone in the OR froze. In slow motion all eyes had turned to Cat.
Did a scrub nurse just challenge an eminent anaesthetist in an OR during an emergency procedure?
“I had a rough night. I’m tired. We’re all tired. Focus on the bleeder and leave the vitals to me!” He replied sharply, glaring at Cat over his glasses and mask.
The monitor broke through the tension, a loud, screaming long ‘Beeeeep!’
“Fuck! Don’t you quit on me now kid,” Mr Harper growled. All attention was now on getting this kid stabilised.
“Suction!”
“I can’t see a damn thing in here.”
“Push the fluids!”
“Epi!”
Mr Harper barked out instructions. But he was brutally calm, he knew the process, people don’t die on his table from a splenectomy.
He won’t let them.
His hands were steady but moving rapidly.
A crash from behind Cat, took her attention away from the patient; her eyes snapped from the pool of blood in front of her, to the floor. A syringe and vial on the floor and Mr Mendez reaching for them. He lost his balance, and stumbled again. “Jo take over from me,” she said quietly.
She stepped to the intercom next to the observation window to the scrub room. “Mark, page anaesthetic’s. We need a replacement anaesthetist NOW!”
“Cat?” Mr Harper queried quietly, his eyes never leaving the open abdomen of the patient.
“Mr Harper, I’m sorry, but he’s not fit to be in here. I can smell whiskey on his breath. I won’t let him endanger the patient any longer.”
It seemed to take forever until Cat noticed a figure in burgundy scrubs appear in the scrub room and Mark swung into action to help him ready — the replacement anaesthetist.
Max Williams a good egg. He stepped into the OR and immediately went to the equipment at the patients head. He had quickly read the monitors and reached for the fresh syringe and vial that Suriah had presented to him.
Cat looked at Mr Mendez, “You’re done. Step away from the table!”
Mr Mendez growled, “how dare you. ….”
Mr Harper cut him off, “get out of my OR now!”
Between them, they stabilised the patient. Cat had thanked whatever had prompted Mr Harper to request more blood at the start. Like a sixth sense had told him they would need it.
Without Mr Mendez’ presence, the calm, controlled purpose was restored to the operating theatre. Mr Harper traced the source of the additional bleeding that had caused so much trouble. A small nick in the celiac trunk near its junction with the aorta. “Gotcha!” He murmured behind his mask.
Everything went smoothly from there. With the last suture in place, Mr Harper sighed and rubbed his forearm across his forehead as he stepped away from the table. “Nice work everyone.”
The recovery team began unhooking IV bags from their stands and switching leads on to the portable vitals monitor to move the patient into the recovery room.
Mr Harper looked at Cat, “are you okay?” He murmured quietly.
She nodded with a small smile.
The only problem with evicting someone as prominent as Mr Mendez, is they get the opportunity to plead their case to HR while others are still in the operating theatre trying to save a life.
A missive from Human Resources, on a yellow post-it was sat on her desk when she finally left the scrub room. ’At your earliest convenience, please contact HR’. Cat had called HR immediately, and been summoned to an office on the tenth floor.
The hangover like feeling of a fraught surgery had taken hold by the time the ancient lift wheezed it way up from the second floor. Physically exhausted and mentally drained Cat knocked on the door. “Come,” a voice called from the other side.
Cat had sat in stunned silence as the HR minion laid out the accusations Mr Mendez had made against her. “Combative, disrespectful, over stepping her position, lacking team work, unable to handle the high pressure environment of emergency surgery.”
Cat’s stony silence had continued. She wasn’t going to argue her case without a witness. Then the bombshell dropped, “you are being placed on disciplinary suspension while the matter is investigated.”
Cat had sighed. A twenty-year senior consultant anaesthetist versus a scrub nurse, albeit a senior one. This wasn’t going to end well for Cat. She knew it in her bones.
“You’ll have a letter confirming our decision and outlining the next steps in the process.”
Cat sighed again to herself, HR speak for how big a broom do we need to sweep this under the carpet.
Cat returned to the second floor and changed from her scrubs, then emptied the contents of her locker into a bag. As she stepped out of the changing room in her street clothes Mr Harper was waiting. “Cat?”
She looked up at him, “I’ve been suspended.”
“Cat, I’m sorry for what it’s worth. You did the right thing for our patient.”
Cat smiled sadly at him, “doesn’t feel like it right now.”
He patted her shoulder, “I’ll do what I can. But I.. … My attention wasn’t on Mendez.”
Cat nodded slowly, “I know. Makes it his word against mine, and he got to HR first.”
Today. . ...
Cat reread her notes, satisfied that she had covered all the events in OR that led to her decision to remove Mr Mendez to the operating theatre. With another sigh, she attached the file to an email and sent it to her union representative.
Now all she could do was wait. Her future, her career now in the hands of the HR robots. Their job more to protect the image of the hospital, the board, and the trust.
Four weeks later. … …
Cat discovered how far HR were prepared to go to protect that image, the reputation of the hospital.
Cat had an opportunity with her union representative to present her defence. It didn’t take long for Cat to recognise the looks on faces that told her that their decision had already been made.
Hearing Cat’s defence wasn’t going to change anything.
Even her union representative was shaking her head softly.
It didn’t soften the shock when the decision came. A quiet resignation, accompanied by a generous severance payout. The only condition, Cat’s signature on a Non Disclosure Agreement. A promise never to discuss the events in the OR that day.
Non Disclosure Agreements are poisonous to a medical career. Cat had seen it first hand, the leading question in interview; “why did you leave the previous hospital?” Answer – “I can’t talk about it.” Interviewer: “Thank you for your time.”
It was like a brand on your forehead, ‘troublemaker’ or ‘whistle-blower’. Hospital trusts and boards don’t like either.
Cat’s union representative asked, “And Mr Mendez? What is happening to him?”
That question had burned in Cat’s mouth, she was glad that Mary had asked.
There were nervous glances exchanged between the three HR people and the trust lawyer that sat at the end of the line, watching Cat with the same level of intensity as a lion that spots a limping zebra. He gave the tiniest nod of his head.
“Mr Mendez has retired on medical grounds.”
Cat mentally sighed in her head; medical grounds = drunk at work. Nice sidestep. He would get a full pension and be able to continue living his consultant lifestyle. He would not have to sacrifice his golf swing to pay his bills.
“I think I should take time to speak to my union rep in private,” Cat finally said. They stepped outside. “If I sign that it’s like admitting I Was wrong.” She dragged her hand down her neck. “I wasn’t wrong. Damn it I’d do it again if I had to.”
“I’ll never get a job with the National Health Service again. I’ll struggle to get one in a private hospital. What do I do now?”
“You can say no. They can try and performance manage you out. Make your life difficult, cancel or refuse leave. Split shifts, quick changeovers. If they want you gone, they’ll find a way.” Karen said with anger bubbling under the surface.
“At least this way, you get some money to tide you over until you find another job. Cat you’re a damn good nurse, someone will take a gamble on you.”
Cat looked at the paperwork again, “is it worth asking for more money. I don’t want to sound like a mercenary, but if my nursing career is being tanked . . . .”
Karen nodded. “Let us see; We can always threaten that we will go to the press.”
With that in mind, Cat sat quietly watching the four faces in front of her, as Karen made the pitch. “The severance pay. You can do better. This could tank my member’s career. Double this …” Karen flicked her fingers dismissively at the paperwork.
More anxious glances were exchanged and finally a slow nod. Karen sat back in her chair. “We will wait for the revised paperwork.”
More anxious glances. “Now?”
Karen grinned. “We have nowhere better to be, unless you want me to call a press conference?”
Thirty minutes later, Cat’s hand hovered over the signature line of the NDA. Gritting her teeth and closing her eyes she scribbled on the line. With that her time as senior OR emergency nurse at Danemoor Hospital was over.
Four weeks later . . .. . . .
Cat sat in the bar of a small hotel on the Isle of Wight; she had sold her flat in London, between that and her severance deal, she had money to give her time to think, to plan her next move.
A discarded newspaper open at the recruitment page caught her eye.
Help Required
Live-in full-time carer required
Current First Aid and Extended DBS checks.
Medical experience desirable but not essential.
Generous salary and benefits package.
Contact: Piers Jones Solicitors
Magna Carta House
Castle Hill
Lincoln
Cat grabbed her phone from her pocket and took a photo of the advert.
