- 2 weeks ago
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00:00Are you busy busy?
00:01Fight to save lives
00:03Open your eyes for me
00:04Do you know where you are?
00:05You're in Barnsley A&E department
00:06Charging
00:1024 hours a day
00:11Wow
00:137 days a week
00:14Whoa
00:15Nearly
00:16I feel like a wet dish club
00:20Serving their community
00:22Looks like you have broken it
00:25Mmm
00:26I don't think I'm going to love
00:27I'm dreaming of your gin and tonic
00:30Helping those most in need
00:34Love you
00:35I'm trying
00:36There's nothing to be frightened of
00:38These girls will sort her out
00:39They care for anyone
00:41I think I've lost your hair up, haven't I?
00:43And everyone
00:44Looking more like himself
00:45Thanks to Barnsley
00:48Working together to make people's lives better
00:53You know, I just love to look after people
00:55I love to make a difference
00:57This is Barnsley Casualty 24-7
01:02Must not be entering the beauty contest
01:07On shift tonight
01:09He's driving me mad now
01:11Sister Jane
01:12No worse than a broken shoe, is there?
01:14Dr Sarah Anderson
01:18She's not someone I'd want to rush to send home
01:21Oh dear me
01:23Oh it's you
01:25It is I
01:27And emergency nurse practitioner Claire
01:29There's not anything jumping out at me
01:31Feels like it's been chopped in our hands
01:32So, get ready to share a shift
01:36Sweets everybody, sweets
01:39Come and get your sweets
01:41With the team at Barnsley Casualty
01:43It's the morning shift
01:55And running the hub today
01:57Is Sister Jane
01:59The department's in a good place today
02:02Right now
02:04Saturday we're busy, it was pleasant yesterday
02:05So, it's just set us up good for a nice Monday
02:11No one in Barnsley has awoken yet
02:14So, I'm sure it'll get a little busier later
02:17Paediatric triage
02:27The emergency alarm has been activated in the paediatric ward
02:33Four-year-old Owen is having a seizure
02:37Hey, do you see your money?
02:39Hi, see you
02:44Dr Helen Merson must work quickly
02:46To stabilize Owen
02:50Yeah, it's like
02:51It's difficult to know whether he stopped seizing at all
02:55The seizure he had here was his butt
02:58Getting an ulcer
03:04Paediatric registrar, Dr Ann Babalola
03:07Takes over Owen's care
03:10Not documented but he has felt warm
03:13His chest sounds nice and clear
03:14He's had a little bit of a cough for the last few days
03:17According to Mum
03:19Yeah
03:21No known bugs going round there
03:23Owen's come in with seizures
03:25And it's something that he's never had before
03:27It's very, very important for us to identify the source of the seizures
03:31And nip it in the bud
03:32Mom, is this rush?
03:34Is this rush?
03:35Is this rush?
03:36Is this rush?
03:37Yeah, that's it
03:38Oh, okay
03:39Are you foxing any more rushing was foxing this properly?
03:41Yeah
03:43I'm in my building, I'm going to shine some bright lights in your eyes, okay, sweetheart
03:46It's okay, sweetheart
03:47I know, I'm so sorry
03:49It's only going to be for a little short time, okay
03:53I know
03:55All right, that's it, that's it
03:57Well done
03:58Oh, gosh, I think I've messed your hair up, haven't I?
04:01Oh, sweetie pie
04:02Your mummy's right there
04:04Your mummy's right there
04:07She's right there
04:08She's right there
04:11It's food, it's medicine, what makes people fancy
04:14What we've also done is we're going to get some antibiotics
04:17To try and cover from the fracture
04:21He's going to need to be with us, but he needs to be with us
04:24I'm really sorry, making me cry
04:25We always have to take time to make sure that parents are following us along the way
04:31They need to know exactly what we're doing and why we're doing it
04:35What we're worried about
04:36Because, you know, after all, it is their child
04:38And we need to make sure that they are happy with what we're doing
04:40And they understand everything that we're doing
04:43And why we're doing it, it's very, very important
04:48What sort of a bit of care for me is
04:51I mean, it's...
04:52It's the idea that our guy wants to stop the seizures and then we'll still try and...
05:00Try and prevent it, kind of
05:02It's too...
05:04Yes
05:08We've explored, we've taken a lot of avenues
05:11To try and prevent them
05:13Of course, that would be helpful
05:15Mum Beth faces an anxious wait to learn what's behind Owen's seizures
05:22Lisa, is there any more cubicles?
05:26In the hub, Sister Jane is trying to stay on top of the growing number of patients arriving at casualty
05:33Morning, love
05:35One, two, three, four, five, six, seven
05:38But it's not just the patients in need of urgent care
05:42The chute's broke
05:44No worse than a broken chute, is there?
05:47The chute is used to transport bloods through the hospital efficiently
05:51It's too sharp there
05:53Nurses are scratching themselves
05:55That should have, like, a black holder that holds the pod in
05:59And because it's all broken here
06:01There's... the wind doesn't take it
06:04It's a bit of a nightmare
06:06We need a simple foot staff here
06:09Instruction on how to do it
06:11Yep
06:12Press 444 to send pod
06:15Place pod in chute under desk
06:19Yep
06:21OK, love, I'll do it now
06:22Thanks, honey
06:24As Sister Jane troubleshoots her chute, another emergency is on its way
06:32What have you got?
06:3432-year-old sheep
06:36How far are you away?
06:3712 minutes
06:38We'll move straight through to resource
06:40It's fine
06:41Hope late, see you soon
06:42Bye
06:48An ambulance has just arrived with a woman who has a dangerously high heart rate
06:56You alright there, I dug up a bit more?
06:57Oh, that's better
06:58Thank you very much
07:00Yes, thank you very much
07:02Patricia's husband has remained by her side all morning
07:05She looked like a ghost when she got up this morning
07:08So I was sent for an ambulance
07:10And it's the best place to be when you're unwell
07:15Paramedics Helen and Jacob hand over to Dr Sarah Anderson
07:20Right, tell me, what's been going on?
07:23I got up this morning, I felt very lethargic
07:26Yeah
07:27I could hardly stand up, I was so dizzy in my head
07:30And my heart was going bum bum bum bum bum bum bum bum bum bum
07:33So you can feel it in your chest?
07:35I could feel it in my chest
07:36Yeah
07:37And it really frightened me
07:39Because I didn't want another heart attack
07:44When was that?
07:452006
07:46Fine
07:47And nothing since?
07:48Two stents
07:49Two stents?
07:51Now then it's going dizzy
07:53Yeah
07:54That's alright, you take a minute
07:56What's happening is your heart is going too fast
07:59And it's also irregular
08:01It's what we call atrial fibrillation
08:03We'll take an ECG, okay
08:04We'll take some bloods from you
08:06And we'll go from there
08:08There's lots of things that can cause it
08:10Sometimes you're more prone to it
08:11If you've had a heart attack in the past
08:13If we can get your heart rate down
08:14And sort of manage it
08:15It may be that we could later on
08:17We could send you home and get you follow up
08:19But I don't want to jump the gun
08:20Patricia's heartbeat will be closely monitored
08:26Any sudden rise could trigger a stroke
08:43It's now three hours into Sister Jane's shift
08:47Okay, what's your call sign? Lovely
08:51How long are you going to be?
08:53Yeah
08:54Alright, love
08:55Bye
09:01I'm just going to have a little look at your head, sweetie
09:04I know, I know, I know
09:06And in recess, Dr Babalola is caring for four-year-old Owen
09:11Who's suffered several seizures since arriving
09:14To stop the seizures we give something called benzodiazepine
09:17It helps calm down
09:19It also helps with the electrical activity in the brain
09:21That's sort of hyperactive at that moment in time
09:23So he's had that and that has settled the seizures
09:26But he's also had some antibiotics
09:28Because we think it may be caused by an infection
09:30But we're not too sure at the moment
09:32So we've done some blood tests to check for that
09:35And also we're going to get a scan of his head
09:38Because he's had seizures only on one side
09:40And that's not something that we often see in kids
09:41We just need to make sure that nothing else sinister is ongoing
09:48Hello
09:50It's been tough
09:51Please have lots and lots of drinks
09:53It's going to be a long day
09:54Yeah? Yeah
09:56Owen's seizures have stopped
09:59But as a precaution, he's being taken for a CT scan
10:03About to take the pictures now, alright?
10:06Just keep your head still for me, okay?
10:09Owen, are you ready for the pictures?
10:13Good boy, Owen
10:15Well, you're doing well, very well
10:17How's it done now?
10:19He's going to spend some time with us
10:22At least a few days for us to try and see what's going on
10:26Gives time for the investigation to come back
10:28And then also gives a lot of time for us to monitor and see what he does
10:31Good boy
10:33Also to see how he progresses
10:35For us to then manage accordingly
10:37Following the scan, Owen is taken straight to the paediatric unit
10:43Further tests showed that a virus was causing Owen's seizures
10:48He was discharged the following day
10:51And has now made a full recovery
10:57Back in the hub
10:59And Sister Jane has a temporary fix for the broken chute
11:02Friends
11:04Please count
11:06One, place blood in pod
11:08Two, press 444 to send pod
11:11Place pod in chute under desk
11:13Perfect
11:14But I don't know what the meambrolite means, do you?
11:16And why haven't they took that pod?
11:19Is there something coming down?
11:21Because it's gone up?
11:23It's here!
11:25No, that's what I'm trying to send
11:27There should be a green button now, not amber
11:30Green to say it's going?
11:31Yeah
11:32Back in Reesos, 82-year-old Patricia's heart is beating twice as fast as it should be
11:45I could hardly stand up, I was so dizzy in my head
11:49And my heart was going bum bum bum bum bum bum bum bum bum bum bum
11:53She's under the care of Dr Anderson
11:56Shall we have a look and see if we can get some bloods from you and a bit of a cannula
12:01And then we can give you this medicine to try and slow things down
12:04Hopefully it'll make you feel a bit better
12:06Already walks off
12:07Yeah, your body doesn't like it when your heart goes this fast
12:10I don't know why I'm telling you that, you know it
12:15Do you mind if I use your lap as a table?
12:20Yeah, you've got some lovely veins but they do like to wriggle around
12:24I know it's miserable being poked and prodded
12:35So we've got the bloods we need, which is good, so we can send those off
12:38I need to put a cannula into it, we can give you this medication
12:41Right, ask the nurse to get that medicine, okay
12:44It does take 20 minutes, half an hour, it's going to work
12:47Now, sometimes we need to give either more of that medicine
12:49Or a slightly different medicine, if it doesn't work
12:53I've never gone anywhere
12:55No, I'd rather you didn't
12:57We'll give you one medicine that will slow your heart down
12:59And another that's what we call magnesium, which
13:02Sort of stabilises the heart
13:04Yes
13:06If you start getting any chest pain, anything like that, you tell us
13:08But hopefully we'll get your heart rate down
13:10Thank you
13:12Alright
13:15At the moment I feel like a wet dish club
13:19Oh dear
13:20Once you get up this morning, is she looking dreadful?
13:22I feel dreadful
13:25You don't feel well
13:27These girls will sort her out
13:30Right, so
13:32The heart rate, sort of when we did your ECG on here
13:35Was 112, so that's fast
13:38But it's not outrageously fast
13:40It's not that sort of fast one that you were in when you were about 180 and so
13:43What we're going to do is we'll wait for your bloods
13:46If your heart rate jumps back up again and it's staying up
13:49Then we will give you that medication
13:52But what I don't want to do is give you that medication to slow things down
13:55When you're already a lot slower
13:57If we're still a bit dizzy and if the heart rate goes up and we need to treat you
14:01It'll probably be on the ward
14:02Yeah
14:03Basically, when you've got atrial fibrillation, rather than your heart going boom, boom, boom, boom
14:08Nice synchronous beats
14:10They kind of go like this, the ventricles
14:13And when they go like this, rather than the sort of smooth contractions
14:17You can build up sort of little clots in the heart
14:21Okay, and that puts you at high risk of things like stroke
14:24So it's potentially going to be that one of the things they look at is starting on medication to slow things down
14:30But also starting on a medication to thin the blood a little bit
14:33Thank you
14:35Again, it's not something I'm going to do right now
14:37Because right now we're just focused on the rate, okay?
14:41The blood test may reveal the cause of Patricia's rapid heart rate
14:45But until then, the team must carefully monitor her
14:48Morning, everybody
14:58Good morning
15:00Can we have a bit better good morning, everybody?
15:02Good morning
15:04Thank you very much
15:06Make it like you like to be here
15:08It's the start of volunteer Jane's shift
15:11And she's in high spirits
15:14Oh, favourite volunteer
15:16What do you mean your favourite one?
15:19No, I'll let you off then
15:21I want a big sack
15:23First job is lost property
15:25I'm never surprised what's in lost property box
15:28Really?
15:30Especially them, aren't they dear?
15:32Is that an iPhone?
15:34Is that an iPhone?
15:35I bet none of them works anyway, they'll be out of battery
15:37Will one of these charges work, do we think?
15:41If I plug it into that
15:43Smartphones
15:45I mean, I forget it's a smartphone
15:46Plus all the usual, like, you know, your dentures, your hearing aids, your glasses
15:52Oh, it's an handbag
15:55So, I wonder if it's a Chanel
15:58Alright, it's not a Chanel handbag
16:00Beer?
16:01A can of beer, anybody?
16:02Now you see, what's that for?
16:03Oh, it's a crack pie, you know?
16:04Oh, crack?
16:05I thought it was something to do with a wrench
16:06Crack pie
16:07Crack pie
16:08Crack pie
16:09Crack pie
16:10Crack pie
16:11Do you know, you have educated me all this year?
16:13So it's usually quite interesting to try and find out, um, all they belong to, I feel a bit like Miss Marple
16:29Oh, ah, wait a minute, so if I rung that, Steph
16:33Good morning, um, is this Steph? Right, this is going to sound a bit weird, Steph
16:46I found this mobile phone, I don't know it belongs to
16:49I work in Barnsley A&E
16:51I'm just saying that I've got this telephone, so does somebody want to come and pick it up at some time?
16:58I'll have a look, see if I can find a bracelet, love, but...
17:05Yeah, thank you, love, bye
17:09I like to reunite people with their belongings, um, I think I probably am a repressed detective somewhere along the line
17:16I think I would have liked to have been an investigator, to investigate things
17:20Whether I'd be any good at it, I don't know
17:23Miss Marple did
17:25This telephone, it's this person's daughter that I've managed to get
17:29But she said, was there a bracelet?
17:31She said it's a Pandora bracelet
17:33I wondered if it'd be in when it draws, because some people put valuables in there, don't they?
17:39No, not in there, not in there
17:42Do they ring to bracelet?
17:45Oh, sweet draw, it's pathetic
17:47It's pathetic
17:49Oh dear
17:50Whilst there might be a shortage of sweets, the same can't be said for the number of patients still waiting to be seen
18:02Over in the minor injuries unit, and there's a new arrival
18:05Hiya, partly, I've sent up from A&E
18:09What's your name?
18:10It's Shane
18:11Come on, can you just take a seat for us?
18:13Super, cheers buddy
18:16Shane has injured his foot, after his gym session took a painful turn
18:22I was sliding some weights off of a bar, and I'd pulled a 20kg weight off, I'd forgot there was a 10kg in front
18:28So as I pulled that off, the 10kg just fell off, straight down onto my foot
18:32I embarrassingly hobbled out of the gym, didn't tell anybody, I was too embarrassed to say anything to anyone
18:38Just soaked it up until I got into the car, and then I had a little bit of a cry
18:41Nah, I don't know
18:44I don't know, it's cracked, broke, I'm not sure, but it definitely feels like something
18:51Emergency nurse practitioner Claire will assess the damage
18:55Great, not turning on, bumps off to my T problems
19:00Fingers crossed
19:06Hey, success, turning on and off, it always works
19:12Shane
19:14Oh, it's you
19:16It is I
19:18How you doing?
19:19I'm alright, are you?
19:20I'm not coming through
19:22And by happy coincidence, Shane and emergency nurse practitioner Claire, already know each other
19:29It's nice treating people that you know, and that's one of the reasons why I came back to work in Barnsley
19:34Because I do know a lot of people, and those people do come in as patients
19:38Yeah, you're friends with my wife's best friend
19:42Yeah, and there's a group that go out
19:44Food, no alcohol, obviously
19:47Keep it nice and sensible
19:49Okay, Shane, what's happened to you?
19:51Dropped a weight on my foot this morning at gym
19:52Oh dear, what time were you at gym?
19:54Happened about quarter to seven
19:56Just pop your foot flat down on the floor for me
20:00Any pain up here?
20:01No
20:02Any down there?
20:03Yeah, yeah
20:04Any across here?
20:05Yeah
20:06Can you lift your toe up?
20:07Just your toe?
20:09No
20:10Oh yeah
20:11Yeah?
20:12Yes
20:13And then can you curl it round underneath it in itself?
20:14No
20:15So, pop your shoe back on
20:18And you can go and have an x-ray
20:20Lovely
20:21Okay
20:22Blue circles on the floor, gets you up to any x-ray
20:26About two miles away
20:27Not too far
20:29The x-ray will reveal the extent of the damage to Shane's foot
20:43In the hub, the pressure is growing
20:46Vinny, pop him in high dependency one, I've closed the curtain
20:50One, two, three, four, five, six
20:53As the number of patients in the waiting room increases
21:00Amongst them is Adam and his wife Debbie
21:03Who has functional neurological disorder known as FND
21:07Taking the shed down in the garden, just wanted it gone
21:11So, it is gone, we've just tidying up
21:14And my wife decides to face plant into the floor
21:17So, she's not the most stable person on her feet as it is
21:20She has sticks to walk with
21:22Stumbled forwards and didn't put her hands out
21:24So, she just went head first into the floor
21:26And then just slid down the garden on her face
21:29There was a lot of blood all going in her eye
21:32The nose had opened up, a big gash
21:35We went to a pharmacy
21:38Yeah, we went to a pharmacy
21:39But it's like no, because she banged her head
21:40And she's feeling sick
21:41You've got to get away and eat with
21:43Here we are
21:44What's the matter?
21:49What?
21:51You got me?
21:52Okay, I'm going to need a nurse
21:54She's having seizures
21:58Is she okay?
22:01That was a short lift one
22:03She has FND, so she has seizures
22:08Hello darling
22:09Are you okay?
22:10Can you talk to me?
22:12Can you open your eyes?
22:14She goes non-verbal when she's having seizures
22:16Okay, right, we'll get her on her trolley
22:18Don't, don't, don't
22:21Excuse me
22:22What?
22:23You don't need to be sorry
22:25You're not choosing this, so don't be sorry
22:29Hello darling
22:30My name's Tucker, I'm one of the doctors to be today
22:33FND can be life-changing
22:36Causing seizures
22:38Reducing mobility
22:39And slurred speech
22:41Can you get her trolley?
22:42Yeah, we've got one here
22:43We'll get around there
22:44And we'll get a set of walking
22:47Dr. Toka Salim transfers Debbie to Majors
22:51So her condition can be stabilised
23:02PHONE RINGS
23:03PHONE RINGS
23:04PHONE RINGS
23:05PHONE RINGS
23:08In the hub, there's no let-up as patients continue to arrive
23:16Zoe, when that lady comes in, that 91-year-old
23:21Cos he can come out of high dependency
23:24And sister Jane is still having to deal with the broken chute
23:27Put your bloods in
23:31Four, four, four
23:34Bend down
23:36Put it in the chute
23:39So you've got to wait for the light to go green
23:42Because there's a lot of traffic in this chute
23:46Oh no, we've got amber, there's a traffic jam
23:49I've never seen the amber light
23:52As sister Jane waits for the traffic to clear
23:54Dr. Salim is stabilising Debbie
23:59Who had a seizure in the waiting room
24:02How are you feeling now, Debbie?
24:04I'm sorry, I'm sorry
24:09Debbie, can you open your eyes?
24:13Can you tell me where you are?
24:15I won't know where you are
24:18We were taking the shed down in the back garden
24:20And she just stumbled forwards
24:21And then banged her head
24:23So she's feeling quite sick and unwell
24:25Okay, did she lose consciousness?
24:26No
24:27Is she vomited?
24:28No
24:30Has she got any medical conditions?
24:31So the FND, functional neurological disorder
24:34Is what's causing tough seizures
24:35So stress, anxiety, pain, centering to seizure
24:42Hi Debbie, how are you feeling now?
24:44Can you remember what's happened?
24:46I know, so tell me what's been going on
24:47Tell me what's been going on
24:48I know it
24:50It's all over
24:51Okay
24:53My head
24:55Okay, right
24:56What were you doing when you fell over?
24:58Where was that?
25:00The garden
25:02Do you know where we are at the moment?
25:05Where is that?
25:07At the hospital
25:09Right, okay
25:10That's good
25:12And do you know who you're here with?
25:13I don't know, I don't know
25:15I don't know
25:17Okay
25:18That's okay
25:19Right
25:20Am I okay to just shine some light into your eyes?
25:34Okay
25:35We just need to get one of the consultants
25:36Just to let them know and be involved
25:38And then we might get you some imaging done
25:40Like a CG head
25:41Is that okay?
25:43What?
25:44Am I okay?
25:46Tell me
25:47Pain
25:48Pain
25:49Pain
25:50What's hurting you the most?
25:52Your head
25:54Okay, fine
25:55You'll get that sorted
25:57Yeah, no worries, thank you
26:01I've always knew that I am going to be a doctor
26:03I've never thought of a plan B
26:05It's not always easy and it's not always fun
26:08But there's something that I've always been passionate about
26:11Since I was four years old
26:13I just want to let you know about one of the patients
26:15She hits her head
26:16She's got some lacerations on the forehead and the bridge of the nose
26:19She has a medical history of FND
26:21That's where she gets seizures whenever she's stressed
26:24She was sat in the waiting area when I got called by one of the nurses to come and check on her
26:28She was probably having a seizure then
26:30And then we wheeled her into cube A
26:32While she was in there, she's got two seizures
26:34What are the seizures like?
26:35Seizures are on the right hand side
26:39Okay, okay
26:40What was her name again?
26:41Debbie
26:42Hello Debbie, my name's Sarah, I'm one of the doctors
26:45How are you?
26:46You've had quite a stressful day I think today, haven't you?
26:51Do you want that oxygen mask off?
26:53Shall we try taking that off for you?
26:55Are you in any pain at the moment?
26:58Mm-hmm
26:59Yeah, I bet you are
27:00Have you had any painkillers?
27:02The first thing we should do is probably try and get you some pain relief
27:06And get you a bit more comfortable
27:07Um, please, stop
27:10I feel sorry
27:11You feel sick as well? Yeah, absolutely
27:13Do you feel like you could swallow anything?
27:15Or do we need to re-attempt that cannula and try and get you a needle in some way?
27:19I... I... I...
27:22But they're better with...
27:24With a cannula
27:25Yeah, that's fine
27:26That's fine, well
27:27Have you got a bad headache?
27:28Mm-hmm
27:29Yeah, of course you have
27:30Your oxygen levels are okay, actually, without that oxygen on
27:33So I think we'll try and leave that one off
27:36How is the speech at the moment?
27:38Um, following a seizure, standard
27:41If this is your normal type of pattern, let's just watch and wait and see what happens
27:46Obviously, go in England and get you some painkillers and the other sex
27:50And we'll see how I get off
27:52Is that all right?
27:53Yeah
27:55Because of Debbie's seizure history, blood tests are ordered to eliminate other factors that could affect her recovery
28:02In the hub, volunteer Jane has a very important job to do
28:16Let's put some spices in the drawer
28:18The sweet drawer has always been and always will be an essential part of the department
28:25Pathetic, some of these putts
28:27So if I put, not any more
28:28Yeah
28:29They've all got a sweet tooth
28:33Some more than others
28:35Yeah, they're like vultures
28:38Yeah
28:39Gummy bears
28:41I think it's true that the doctors and the staff, they do need the sustenance
28:46They do need the break
28:47And it is true
28:48They do say that an army marches on its stomach
28:50And we are an army
28:52And we need to be sustenet
28:54I think there's a word for that, isn't it?
28:56We need to be sustained
28:57God
28:58They'll have gone by tea time, I reckon
29:00You know, as soon as I know it's there, it'll be
29:02Shoo
29:03Sweets, everybody
29:04Sweets
29:05Come and get your sweets
29:07In radiology, Shane is heading for an x-ray
29:12After injuring his foot at the gym
29:15We're looking at your left foot
29:18Looks like your big toe area
29:19Yeah
29:20Let me slide off her
29:24Then we're going to have your left foot on here
29:26And I want the bottom of your foot on this cassette
29:28So if you're bending it up
29:29That's it
29:30That's it
29:31Perfect
29:32Go on
29:33Right, Shane, all finished?
29:34Superb
29:35Yes, you're just heading back round to where you need
29:49Superb
29:50Cheers, Mark
29:51It's down to emergency nurse practitioner Claire
29:56To reveal the results
29:58You can go straight back in my office, Shane
30:01Let's have a look
30:03Who's also a friend of Shane's
30:06Have I got handsome feet, Claire?
30:08See, shall we?
30:11So that's your x-ray
30:13Looking for fracture
30:15Shane definitely thinks it is, don't you?
30:17Feels like it's been chopped in half
30:19Yeah
30:20So this is your toe
30:22And then this is your metatarsal
30:24That's where it's mainly tender
30:25Ah, okay, yeah
30:26But your bruising is around your toe
30:29Yeah
30:30Which is natural for when you have broken something higher up
30:33Bruising travels down
30:35Yeah
30:36There's not anything jumping out at me
30:37No
30:38As like a big fracture
30:39But there's a little bit of a lucency there
30:41Which could represent something
30:43So I'm going to give you a shoe to wear
30:45Which is really trendy
30:47Oh, brilliant, yeah, yeah
30:48Is it a crock?
30:49Is it a crock?
30:50Really lovely shoe
30:51And that basically supports it so that you can walk on it
30:54Right, okay
30:55It's going to be painful for a few days
30:56Yeah
30:57Bruised, swollen
30:58So treat those symptoms
30:59Ice pack, paracetamol, elevation
31:01Yeah
31:02I'm out round Barnsley tomorrow
31:04Do I need to wear my shoe round Barnsley, Claire?
31:06Maybe not
31:07I don't think that's street credible
31:10But you can tell me, I'll go and get it
31:18It's medium and small
31:19We'll try these
31:20I hope
31:21Fancy shoes
31:22Aren't they?
31:23You'll have to get
31:25To paint your toenails
31:27Yeah
31:31Well, there you go
31:32You'll pull that onto your foot
31:33And put your foot right back in it
31:35And see where your toes get to
31:37Ow
31:40Yeah, your foot
31:41Foot right at that
31:42It is
31:43I've got some matching shorts at home
31:45That I think will look lovely with these shoes
31:47Where are you going tomorrow?
31:49Erm
31:50We're going on that and then map I think
31:52Oh yeah
31:53So I've got some friends coming over from Leeds
31:56You think you'll wear that tomorrow?
31:57I think it suits me
31:59Yeah
32:00I'm not sure about tomorrow
32:01Have a go, see how it feels walking in it now
32:04Don't I get two?
32:07Can I have two so at least they match?
32:09Yeah
32:10Yeah?
32:11Yeah, I'll take them please
32:13It's a bit better than your sliders
32:15OK, and it'll get better over the next two to four weeks hopefully
32:19Man up
32:20That's it, you've said it
32:21Lovely
32:22Lovely
32:23Lovely
32:24Lovely Claire, thank you
32:25Alright my love
32:26Lovely, I'll see you soon
32:27And tell Vicky hello from me
32:28I will do
32:29See you later
32:30Alright, speak to you soon
32:34Really pleased that it's not broken
32:36Erm
32:37So hopefully we want rotary recovery a lot quicker than if it were fractured or broken
32:42Erm
32:43And I can get back in gym
32:45Shane was back at the gym a week later
32:48Over in Reesos, Patricia's high heart rate is still being monitored by Dr Anderson
33:00Hmm, that rate just jumps up and down
33:03Might be 105 one minute but then the next minute it's 160
33:07Patricia's blood test reveals she hasn't had a heart attack
33:13I'm just having a look at her blood to see if there's anything on there that might be why
33:16She's got AF
33:19There's nothing particularly alarming in her blood that would explain it
33:23There's no black and white in medicine so things change quickly
33:26And for her, the AF, sometimes it can be constant
33:29And sometimes it can be what we call proximal
33:31So you get sort of maybe 20 minutes of it, it might go away
33:34And I was hoping that with her heart rate coming down
33:37That it might be that, that it's resolving
33:40But it's not and it's back up at sort of 190
33:43So I think we just need to treat her now
33:45See if it hopefully brings it down
33:48Hello darling
33:49Hiya darling
33:50So your heart rate, I mean it's, it's very stubborn
33:52And it's come up again
33:53So we're going to give you that metoprolol, that, that, to slow it down
33:56I've just had one, they've...
33:57You had it again
33:58I can't take splits, it kind of goes all over my body
34:01Yeah
34:02My head, it's...
34:03I think that's your heart rate going off
34:05Sometimes these episodes, they come and then they go away
34:08Yes
34:09But it's...
34:10No
34:11Looks like this one's a bit more persistent
34:12Well, nursing colleagues, just getting your medicine
34:14Thank you
34:15Sister Vicky will administer the medicine
34:18So this is a drug to try and get this heart rate down a little bit, okay
34:22Alright, love
34:23You keep having a bit of excited runs, don't you?
34:25I do
34:26You get giddy
34:27What are you going giddy about?
34:28Oh, I'm going to see Barry Mandelow
34:31Oh, God, is he still going?
34:33Don't you start
34:34Yes, I am
34:37I've loved him for years
34:39Where's he playing?
34:40Where's he playing?
34:41Leeds
34:42It's his last, last concert
34:44He's there
34:45I think I saw his first one
34:47And I'm going to see his last one
34:50I've been all over to see him
34:52Rodney always calls him my Barry
34:55Always had a wondering eye
34:57I have
34:58She has
35:00I think that's what slutters me
35:03Mind you
35:05He wouldn't be interested in me
35:08Because he's married
35:09To a man
35:10Yeah
35:11He could have a go at changing his mind
35:13Yeah, that's it
35:14You never know
35:15Years ago when I was
35:16Young and in my prime
35:17You never know
35:18Brother, love
35:19No
35:20No
35:21No
35:22No
35:23Oh, that's coming down a bit better
35:24Behaviour said no, huh?
35:26I will if I can
35:27Love, yes
35:30What's that?
35:31Gold leaf in your nails?
35:32Yes
35:33Yes, snazzy, ain't there?
35:34I saw you treat her well
35:36You'll have it gold leafing
35:37I wish you were going tomorrow to have them done
35:39I'll save a bit of money when they're not going tomorrow
35:43My friend Sarah does them
35:45And they like me clothes
35:46Me handbags and me shoes
35:50Oh dear me
35:51I shall have to stop buying
35:53I might not have much longer to live
35:55It's hoped the medication will steady Patricia's heart rate
36:00In addition to managing the patients
36:18Still, there's no beds, Mum
36:21It's the chute that's causing the issues
36:24Sister Jane is also dealing with a broken chute
36:27That's used to send bloods to other departments within the hospital
36:31I swear to God I'm going to really lose my patience here
36:36It's driving me mad now
36:38I've spent too much time on this
36:40They fixed that about 18 months ago
36:43And it's broke again
36:44Somebody said that it's going to take ages
36:48Because it needs a whole new thing
36:51With the chute now undergoing major surgery
36:56Back in recess
36:58Oh dear me
37:01All right, I will leave you to it
37:04I'll pop back in a bit
37:07Patricia, can you sit forward for me?
37:09Yes
37:11The x-ray results will show Dr Anderson
37:14Whether an infection in Patricia's chest
37:16Is contributing to her elevated heart rate
37:19Yeah, cool
37:22Your blood's looked okay, so that's good
37:24Your rate, it's sort of jumping about a little bit
37:28But still quite fast
37:30What I might do is just have a chat with the medical reg on the wards
37:34Okay
37:35Have you got any questions?
37:36No
37:37You've been very patient darling, so thank you for that
37:39Okay
37:40Right
37:41Although Patricia's blood and x-ray results show no cause for concern
37:45Dr Anderson is reluctant to discharge her
37:48Until her condition is stable
37:51Hello
37:52I've got an 82 year old lady
37:54She was going at about 180 on the monitor
37:56But by the time we'd cannulated her
37:58She was going at about 112 or so
38:00And so I sort of left her and thinking maybe this is sort of resolved
38:04But she's now going sort of anywhere between 120, 160
38:08She's stable but given sort of the symptoms she's not someone I'd want to rush to send home
38:15So I wonder if you'd have a look at her
38:18Thank you
38:23Honestly I've never been like this
38:25So Patricia's just waiting for the medical team to see her
38:30Her rate's much more stable, I think she's more comfortable, a bit less dizzy
38:34If she's feeling well enough, we can get her standing up and her rate's controlled
38:38It might be that she goes home, but has follow-up to figure out if she needs to be on blood thinners
38:43If she needs various medication to control her rate
38:45If her rate's not controlled, if she's not feeling right
38:50Then I think probably she'll come in for some observation
38:52And the medics will then decide what happens
38:54I'm just going to go find George who's in recess at the moment
38:57And just hand over, obviously if anything to happen
38:59George knows about how to treat her, so I'm good to go
39:04I feel better than I did when I came in
39:07Yes, I do
39:08She's got some colour now
39:10This morning she looked like a dragon
39:12And she was white, oh she was terrible
39:15I thought we were going to lose her this morning
39:17Yes
39:18But she's looking a lot better now
39:19Yes
39:20Tomorrow I was going for my nail stewing
39:23But unfortunately I don't think I could be going
39:26Patricia remained in Barnsley Hospital for a further two weeks
39:30She's now been prescribed new medicine
39:33To slow her heart rate down
39:35And is on the road to recovery
39:44Back in Majors, Dr Salim is caring for patient Debbie
39:49This one's tiny
39:51Do you want the drink?
39:53Yes
39:54Brought into casualty after a fall
39:56Debbie has since suffered three seizures
40:03Dr Salim has requested bloods to be taken
40:07We're going to check the coagulation profile
40:09To see if there's anything wrong with the clotting factors of the blood
40:13We're also going to do a calcium profile
40:15To make sure that everything's okay after the seizures
40:17We're also going to do basic bloods to see if there's any source of infection
40:20Whilst waiting for the results, Debbie's condition seems to be improving
40:25I was really just supervising
40:29Yes, she was supposed to be supervising but
40:31I was supervising
40:32I was
40:33Who had the hammer?
40:34You
40:35We had five
40:36Mm-hmm
40:37I was just doing a little bit of sweeping
40:39So
40:40And then I find the nail
40:41I think
40:42I can just get that
40:44It gets really sad that you cannot do
40:49What you used to be able to do
40:51What you used to be able to do
40:52I should have been able to do some more
40:55And I should have been able to pull my nails out without falling over
41:04The fall was just what caused the seizures to start sort of thing today
41:08So
41:10Pain causes to have seizures
41:12It goes downhill rapid unfortunately
41:14It makes her very tired and her language goes a bit dodgy
41:18It used to be very scary when they first started
41:20But we used to know, we know what to expect
41:22So
41:23It's not as bad
41:24I've been not speak good for one year
41:30Yeah
41:31We don't know what happened but last year it all went very wrong
41:33She came to this hospital for a blood test
41:35And she didn't come home for six months
41:37She ended up in neural rehab for five months
41:40Learning how to walk and talk again
41:42So
41:44But not talk good stuff
41:47Do you think you can talk?
41:48I can't talk
41:49Better than no talk but not re-talk
41:55Like
41:57I mean it's like you all show access
42:01Yeah
42:02We're just waiting for the results of the bloods
42:04We've had an ECG done
42:05That's the electrical tracing of your heart
42:07That looks okay
42:08How long you've been so three years?
42:11Well
42:12If this is your usual
42:14And you do continue to be okay
42:17I don't think we'll need to keep you overnight
42:19I think you're going to go home
42:20Is that okay?
42:21Sure
42:22I know that patients dread staying in hospital
42:25And they don't like doctors very much
42:27Which is fine
42:28But
42:30We need to do what we need to do
42:32To keep our patients as safe as we can
42:34Until we're happy
42:35We're completely happy for them to go home
42:37We don't like being here longer than we have to be
42:39Unfortunately we spend far too much time here
42:42Just need to keep an eye on her to make sure
42:44That she doesn't get any seizures
42:46Or if they do, you know, last longer than what they usually do
42:49If the bloods are okay, she will be able to go home
42:52I'd be really careful to not drop any more seizures
42:56Yes, no more seizures
42:57Although I cannot control it
42:59That is the blood
43:01Everything's back and everything's okay
43:03There isn't any signs of infections
43:05There aren't really any metabolic issues
43:08So if she's back to her normal self
43:10We'll be happy to send them home
43:12Debbie was discharged from hospital later that day
43:15And has been recovering well back at home
43:22As Sister Jane's shift comes to an end
43:26When they send in three, four, five at a time
43:30It's heavy and it's the weight
43:31And that's what smashed all this
43:33Ah, see how we're thinking it when you are
43:36No
43:37Cheeky sod
43:39The chute is finally given a clean bill of health
43:43Here we go, a gentle weight
43:46Is it working?
43:47Has that meant your day, that?
43:49No
43:50Because you don't know how much time this chute has consumed of my day
43:58I won't be doing it anymore
44:00Shift finally complete
44:04Sister Jane can head home
44:06But the doors to casualty remain open 24-7
44:11Bye!
44:30Bye!
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