New Surgeon at Ashvale A&E. Joanna Neil
the restriction on agency staff,’ Ruby mused. So he had kept tabs on her while she was working in the observation ward, had he? He obviously had his finger on the pulse of how the department ran, but she could certainly see why the two doctors were feeling under pressure. ‘He didn’t waste any time putting his plans into action, did he? He must be very keen to pull the department into shape.’
‘That’s right. I’m the one who put a stop to the extra staff. It costs way too much to bring in staff from outside.’ A now familiar voice came from behind her, and she swivelled around to see the man himself standing just a couple of feet away. Ruby studied him briefly. He was immaculately dressed, as before, in a dark grey suit and crisply laundered shirt, with a silk tie that was perfect in its understated elegance. ‘What do we have here,’ he asked, ‘a union meeting?’
‘Dr Boyd,’ Ruby acknowledged him. ‘It’s good to see you again…albeit in difficult circumstances.’
‘Call me Sam,’ he said in a brisk tone. ‘No need to stand on ceremony.’ He frowned. ‘As to the circumstances, you should all know from the outset that I don’t believe in letting the grass grow under my feet. It’s important to start as we mean to go on if we’re to have any chance at all of saving the A&E unit. We’re not playing at this. It isn’t a game. It’s for real.’
‘I know. I’m sure we’re all aware of that.’ Ruby made a muted response to his bracing tone. Perhaps he was annoyed because they had been talking about him, and they needed to make allowances for that. She added softly, ‘And I expect the problems that follow will be for real, too. I’ll leave you to deal with the complaints from the patients, shall I, and from the management when we fail to meet targets?’
He acknowledged that with a rueful twist of his mouth. ‘I imagine those will be the least of my worries.’ He gave her an assessing glance, his gaze shimmering downwards over her curves outlined by the soft cotton blouse that clung where it touched and then draped itself loosely over the waistband of her calf-length skirt. ‘Besides, I’m sure I can rely on you to help smooth things over during these difficult times. I hear you’re good at dealing with most problems that come your way. You appear to have a knack for calming troubled waters. Perhaps that’s why the department operated so efficiently while Dr Stanford was winding down for his retirement.’
Ruby’s eyes widened a fraction. Where would he have gleaned that wedge of information? Was it possible that he had been talking to his predecessor? Or maybe one or two of the board members had filled him in on her way of working. They might not have given her the job, but it didn’t necessarily mean they were unaware of her capabilities. Her lips made a wry shape. Perhaps her calm attitude was what had lost her the position. They wanted a lion that would roar and show its teeth.
Sam glanced at James and Olivia. ‘I know this is difficult for all of you, but there’s no point in moping about the situation. What we have to do is prioritise, knuckle down and get on with the job and concentrate on providing the best service we can under the circumstances.’
He turned to James and held out a patient’s file to him, his manner totally businesslike. ‘You examined a man who came in earlier with a broken wrist and suspected head injury after a fall…is that right?’
James nodded. ‘Tony Barton…a young man in his late twenties. I treated him for the wrist fracture and assessed him for brain injury, but his neurological responses were fine. I was getting ready to discharge him.’ He glanced at the file. ‘Are you ready to sign off his notes for me?’
Sam shook his head. ‘His condition has changed, according to the nurse who was following up on him. I’d like you to come with me and take another look at him, please.’
‘Oh…of course.’ James’s colour faded, and Ruby could see that he was wondering if he was in trouble of some sort. He was usually thorough and conscientious in everything that he did, but Sam, being a newcomer, clearly didn’t know that.
Sam nodded towards Ruby and Olivia and then strode off with James in the direction of the treatment room.
Ruby’s gaze met Olivia’s, and the senior house officer rolled her eyes. ‘Does that man ever stop to engage in the niceties of getting to know his colleagues?’ Olivia asked. ‘He’s brisk and businesslike, and his whole attitude is “stop fussing and let’s get on with it”, though I must say he seems half inclined to pass the time of day with you…but as to the rest of us…’ Olivia sucked in a deep breath. ‘He’s only been here five minutes, and I’m already beginning to wish Dr Stanford had delayed his retirement.’
Ruby grinned. ‘I dare say we’ll get used to him, given time. He has a huge task ahead of him, and he’s probably still working on his strategies. I expect he has a heart of gold underneath it all.’
‘We’ll have to dig deep to find it,’ Olivia murmured, moving away in search of her next patient. ‘I have the feeling it’s buried under a ton of steel.’
She could be right in that. Ruby frowned as she riffled through the files in the wire tray. Their new boss didn’t appear to be making any concessions to the fact that he was a stranger in their midst, and that they might have difficulty getting used to this different way of working. It was all or nothing with him.
She glanced through the list of patients waiting to be seen. Her first job was to check on the patients from the traffic accident, and in doing that her time was taken up with a host of complications that had arisen from an assortment of broken bones and punctured blood vessels. Worryingly, one man went into cardiac arrest, and she had to use the defibrillator to shock his heart back into a safe rhythm.
‘He’s back with us,’ she said a few minutes later, addressing the nurse who was monitoring his situation. ‘Give the intensive care unit another call, will you, and see if we can move him over there as soon as possible.’
‘I’ll do that,’ the nurse said.
An hour later things settled down a little, giving her time to attend to a young boy who had been injured during a football match on his local playing field.
‘That was an unlucky game for you, Matt, from the sound of things,’ she said, smiling at the seven-year-old and then inspecting the X-ray film displayed in the light box. ‘When you fell to the ground, you hit it with enough force to break your collarbone. That’s this one, here.’ She pointed out the area of the fracture to the boy and his mother. ‘There’s a line across here that shows the break in the bone.’
She turned to look at Matt once more. ‘The good news is, it should heal up quite well because the two pieces of bone are still in line and touching one another. You’ll need to wear a support sling for a week or two while the bone heals, and we’ll give you some painkillers to help you feel better.’
His mouth made a flat line. ‘If I’d done this in a couple of weeks’ time, when school starts again, I could have had some days off. And I don’t even get a plaster cast for my friends to sign.’ He looked thoroughly disgruntled.
‘Isn’t there any street cred in wearing a sling?’ Ruby lifted a brow. ‘I would have thought you could get some pretty good mileage out of that. And it’s the hand that you write with that’s out of action, isn’t it? I’ll bet you can impress your mates with a left-handed signature.’
His expression brightened. ‘Yeah, maybe.’
His mother smiled as they stood up to leave a few minutes later. ‘I’m sure he’ll milk this for all it’s worth,’ she murmured in an undertone to Ruby. ‘He’ll be playing the part of a wounded secret agent before too long, I’ll be bound.’
Ruby nodded agreement, and gave Matt a bravery certificate as he left the room. It seemed he was already working on his game plan. ‘Tyler didn’t get one of these when he sprained his ankle,’ he said. ‘He only got a badge that was this big.’ His fingers made demonstration of its tiny size.
Ruby laughed and watched them leave before going in search of her next patient. She worked steadily through the morning, dealing with a wide variety of