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00:01In the heart of Yorkshire...
00:05Bouncy, I need a panel.
00:07Just a busy day.
00:09Everybody's decided to come today.
00:11An unbeatable team.
00:13Have you given it a clean, or did you just put that on?
00:15No, I wouldn't let my wife anywhere near it.
00:18Slide.
00:18Hard at work, 24 hours a day...
00:22Sorry.
00:23You've got the boobie fries, you've got me.
00:26Seven days a week.
00:30Saving lives.
00:33Oh, no.
00:34Helping loved ones.
00:36Well, this is shocking. They're actually broken bones.
00:39Making the community they serve better.
00:42As long as everybody's safe, that's all that matters.
00:45A health service treating anyone...
00:47Restrain your temperature, Jane.
00:49...and everyone.
00:51In and out, keep going.
00:52A team doing anything and everything for each other.
00:57The staff have been amazing.
00:58They've now been able to know enough for us.
01:02This...
01:02...is Barnsley Casualty 24-7.
01:05It brings me faith in the staff and NHS, definitely.
01:09Ha, ha, ha, ha.
01:11Ha, ha, ha, ha.
01:13Ha, ha, ha, ha.
01:18Ha, ha, ha, ha.
01:19On shift tonight...
01:20Advanced clinical practitioner, Chantelle...
01:22Sounds like you're a trapped little hamster on a wheel.
01:27Ha, ha, ha, ha.
01:29This is going to stink.
01:31Ha, ha, ha, ha, ha.
01:32Ha, ha, ha, ha.
01:34Have you ever got into cubicles round here?
01:36And sister Kim.
01:38You're not looking for a job, are you?
01:40So...
01:40Get ready to share a shift.
01:42Ready, ready, slide.
01:45Sharp scratch coming, OK.
01:46With the team at Barnsley Casualty.
01:48You can't leave me here.
01:50What if I faint?
01:57Hello lady, Kim speaking.
01:59It's one o'clock.
02:00She's ready to come back.
02:01I'll send somebody round, darling.
02:03And sister Kim has just taken over for the afternoon shift.
02:07Yeah.
02:07There's two that are both going to come through.
02:09The problem is, is the fact that there's just nowhere.
02:10I know.
02:11They're on the background using 9 and 13.
02:12So I'd...
02:13So I'll pop them into resource for assessment.
02:14Yeah.
02:15Casualty is almost full.
02:17It's 16 free.
02:19But new patients keep arriving.
02:26It'll probably raise us.
02:30A 53-year-old man is being blue lighted in.
02:34With shortness of breath and chest pains.
02:39Down at the bottom for me.
02:41And say, this is what we've got even.
02:43Richard, who works as a chef,
02:44has a heart condition called atrial fibrillation.
02:47Feet on the floor for me, darling.
02:50That's the one.
02:51He woke up with his heart pounding.
02:53But it's not stopped.
02:56My name's Amy.
02:57I'm one of the nurses.
02:58You're mine.
02:58Come on.
02:59You're all right?
03:00You'll be fine.
03:01If we could have cardiac monitor and a set of arms.
03:06He'll be treated by Dr. Nick Orcroft.
03:09If you start with what's happened this morning,
03:11what specifically brought you in this morning,
03:13then we can backtrack through the other side of us.
03:15Just waiting for a bit of work.
03:15So I came off of work.
03:17Yeah.
03:17Oh, my God.
03:18I'm back before it's hot.
03:20And I just really started to struggle.
03:23Really panicked.
03:25Managed to calm him down.
03:26Yeah.
03:28Completed pain, so he's had morphine.
03:30My heart feels like it's coming out of my body.
03:35Atrial fibrillation is a condition of the heart.
03:37The inflammation from the top of your heart,
03:39which is your atria,
03:40is misfiring and sending too much information
03:43down to the bottom of your heart.
03:44And that makes it beat fast and irregular.
03:47I feel as if I'm running all the time, but I'm not.
03:50Any chest pain at the moment?
03:52Yeah.
03:52Where's it hurting?
03:53It's all around here.
03:56It feels like, really, like a bruised pain.
03:58What's that mean?
03:59Someone's pressing up my chest.
04:00Yeah.
04:01It's calmed down a little now since I've had my morphine,
04:04but I've been getting really sharp, stabbing,
04:08really bad stabbing.
04:09So we're getting into my pain.
04:12The main priority is to make sure the blood pressure's OK,
04:15they're not getting fluid in the lungs where it shouldn't be,
04:18they're not at risk of collapse,
04:20and they're not having a heart attack.
04:22Does it go anywhere else apart from your chest?
04:26Yeah.
04:27I've had a very numb left arm.
04:29I'm struggling to pick things up last night.
04:32I think what we need to do...
04:35Yeah.
04:35Heart rate 164s.
04:37The longer we're leaving that heart beating too fast,
04:40the greater risk of it causing strain to the heart
04:43and damage of the heart.
04:45We need to take some blood tests off here
04:47and try to give you some medication to help slow down this heart.
04:52Richard's heart needs to be brought back under control quickly,
04:55and he needs tests to check if he's in fact having a heart attack.
05:01Have you got into cubicles round here?
05:03Back in the hub,
05:05Sister Kim needs to find beds for all the new patients.
05:0914 and then 15 in a minute.
05:12And more staff to treat them.
05:14John, which one are you doing now?
05:17I'm just going to do...
05:19The one in two is waiting and there's a new one in one.
05:22There is a lot of pressure in A&E.
05:24So, obviously, as a coordinator, as a person in charge department,
05:27you've got to look at every area,
05:29making sure, do you need any more staff down in triage,
05:32see what your ambulance weight is,
05:35making sure you've got no ambulance on that corridor piling up,
05:37them kind of things, really.
05:39So, you've got to have eyes at the back of your head.
05:42And now there's an emergency in the hospital main entrance.
05:47A woman arriving for a hospital appointment
05:49has fallen down the escalator.
05:5384-year-old Sylvia is taken straight to recess
05:56to be urgently assessed.
06:00She's got a really bad bump in the back of her head.
06:04She'll be treated by advanced clinical practitioner, Chantelle.
06:08Hello. Hi.
06:10Just get a sunglasses.
06:12Sorry, darling.
06:13No, you're fine, don't worry.
06:14Sylvia was taken into recess because she, one, fell from standing,
06:19so fell from height, being over 65-year-old,
06:21and she fell backwards down an escalator,
06:24which is quite a significant mechanism.
06:26I'm Chantelle, one at ACPs in A&E. Are you OK?
06:28Yeah. What's your name?
06:30Debbie. Debbie.
06:31And is this your...
06:32Mum. Your mum?
06:33Was you with your mum?
06:35What happened?
06:36Can you remember?
06:37I was going up the escalator.
06:39I put one foot on.
06:41Yep.
06:41And the other foot I just couldn't place.
06:43So you were going up it?
06:46Before they managed to stop, the stairs were still going underneath her.
06:50So she's got a great lump at the back of her head.
06:52It sounds like you were a trapped little hamster on a wheel.
06:55Yes, I was.
06:55Aww.
06:58I'm still in shock, if I'm honest.
06:59I think, like, the whole thing's just...
07:01It was just, like, you were trying to save her, but you couldn't.
07:06Automatically, you think of the worst,
07:08and, like, she was obviously in quiet state
07:10at the bottom of the escalators.
07:12Can I have a quick look of your head now?
07:16Is it right at the back?
07:17Just there.
07:18There?
07:19Yeah.
07:19Where that little lump is.
07:21Let me feel it.
07:23And are you on blood thinners?
07:25Yes.
07:25OK.
07:26So I want to strip you off and get you in a gown
07:28so I can have a good look at all your body.
07:30Yeah, yeah.
07:31So I don't miss any injuries.
07:33OK.
07:33Open your hands later.
07:36Sylvia needs an urgent examination
07:38to check the extent of the injuries to her head and body.
07:54Sister Kim is two hours into her shift.
07:57Right, let's just move you into another room, sweetheart.
08:00And with more patients than usual flooding into casualty today...
08:04There's three pre-alerts all coming into resource,
08:07so if we pre-empt this room,
08:08then obviously one of the pre-alerts can step down
08:10cos that'd be resourceful.
08:12She's battling.
08:14So step one out, ADC1's free.
08:17I've just cleaned it.
08:18..to make room for new arrivals.
08:22Working a stressful job like this is hard.
08:24And I couldn't do my job
08:26if I didn't have the people that I worked with.
08:28And obviously, you know,
08:29it's not just me as a person being coordinated,
08:31it's all my team.
08:33What is it?
08:35150.
08:36It's not as bad as it were earlier.
08:38Oh.
08:39Back in recess,
08:40Chef Richard's heart is still beating abnormally fast.
08:44I've been the head chef at Sheffield
08:47United Football Club.
08:49I've been head chef at Sheffield Wednesday Football Club.
08:52I've been head chef at Hilton in Sheffield.
08:56I've worked in Paris.
08:57I've worked in Blackpool.
09:00And I've had a...
09:02..really good career.
09:04I don't worry because the chief's happening.
09:07You know, I just want a solution.
09:11Right, darling.
09:12Sharp scratch coming, OK?
09:14Staff nurse Amy is monitoring him.
09:19Absolutely smashing.
09:21It's as if I knew what I were doing.
09:23Yeah.
09:25I'm not just winging it like they all say I do.
09:28Great challenge.
09:31I won't be doing my job right if I weren't kind.
09:35Dr. Orcroft needs to urgently slow down Richard's heart
09:38and make sure he isn't having a heart attack.
09:42Where's hurting at the moment?
09:45Still up there.
09:46Hopefully, once we get this heart rate a bit more slow,
09:50it should make you feel more comfortable, OK?
09:51So we'll get on to that now, OK?
09:56No worries.
10:00Student Dr. Jack Hatton is shadowing Dr. Orcroft today.
10:05We could think about cardioversioning him
10:08because he does have some chest pain.
10:14Cardioversion has its own risks to it.
10:16A cardioversion is when we reset someone's heart.
10:21So that's what you see on the movies
10:23where they have the pads on the chest.
10:25We would think about doing that
10:27when they're having signs of a heart attack,
10:30signs of heart failure,
10:31or their blood pressure's so low they're causing collapses.
10:34And it's trying to work out, is it safe to do?
10:37Because, as you might imagine,
10:40electrocuting someone's heart comes with its own risks.
10:42He's also asking for some more pain for us, please.
10:45Yeah.
10:45He had 10 more feet in the house.
10:49If once the treatment starts going in within half an hour
10:52he's not feeling a bit better from the chest pain point of view,
10:54we may need to think about cardioverting
10:56just because he has got significant chest pain
10:58in the context of a fast heart.
11:03Yeah?
11:04No, you're welcome.
11:07Hopefully it slows that heart rate down of yours.
11:09My heart just feels like it's trembling of, um...
11:13Pop me that arm straight for me.
11:18I've got you some magnesium
11:20to try and slow your heart rate down as well.
11:23I don't want to feel tired all the time
11:26and everything being an extra effort.
11:32Hello there.
11:33Hello.
11:34So, we're going to keep going with the medication
11:36and give it a little chance to take effect.
11:38But what we may need to think about
11:41is whether we need to try and cardiovert you again.
11:44Now, you've had this done quite a few times in the...
11:47Twice in the past, was it?
11:49When you had it done in the past,
11:50did you have any problems with it that you remember?
11:53No, no.
11:55No.
11:55Whenever we do any sort of shocks of the chest
11:59is just thinking there is a risk that your heart
12:01could go into a different, unusual rhythm.
12:05And that could result in the most extreme cases
12:08with something like a cardiac arrest,
12:10which would be very unlikely,
12:12but we just have to talk through it.
12:13Yeah.
12:13OK?
12:14I imagine they've gone through this spiel with you before.
12:16Yeah.
12:17With that all in mind,
12:18if, sort of, our chest pain's not getting better
12:20and our heart rate's not getting better controlled,
12:22would you be happy for us to do that?
12:24I would. I'd be happy just to...
12:26It's affecting...
12:27It's starting to affect me mental health now because...
12:31Yeah.
12:32I don't want to lose my job.
12:33Of course.
12:34It has not to affect it.
12:36Yeah.
12:36I want to be well...
12:37I want to be well again, mate.
12:39Yeah, yeah.
12:39Completely understandable.
12:41DC Cardio version for atrial fibrillation.
12:44Dr. Allcroft would prefer not to shock Richard's racing heart.
12:48That's what I need to sign.
12:50Patient needs to sign up here.
12:52But if tests confirm he is having a heart attack
12:55and his heart rate stays dangerously high,
12:57it may be essential.
13:02In the hub...
13:03The patient's actively bleeding.
13:05A patient needs life-saving treatment.
13:10None on that side, absolutely.
13:14A little bit.
13:15Yeah.
13:16Oh!
13:17Yeah, sorry.
13:18Sorry.
13:2042-year-old farmer Duncan
13:22has been crushed by one of his herd of bulls.
13:26That way down.
13:27His spleen has ruptured
13:29and he needs to get to the specialist trauma team at Sheffield.
13:33What's he doing going to Strait Teresa's at Northern?
13:38That bull's got a lot to answer, hasn't it?
13:41Came out of nowhere.
13:42What happened today?
13:42Were you just on field then?
13:43No, they're all inside.
13:45All inside?
13:45Yeah, they're all in power.
13:46And just...
13:48went a bit...
13:49Yeah, yeah.
13:50What are you doing?
13:51Knocked you to the floor?
13:52Knocked me into a steel girder.
13:55Very lucky then, aren't you?
13:56Yeah, yeah.
13:57Have you got quite a lot?
13:58250.
14:00Wow.
14:01What are you going to do with this bull?
14:03We're good at marking.
14:07Couldn't get the bull off him or count the bull down
14:09so his dad would literally just run into a pen
14:12and pulled him out at pen.
14:14Then obviously rang an ambulance
14:15and the man's done his spleen
14:17so that's why I'll get Trent sent to Northern.
14:21But with ambulances in short supply,
14:23Sister Kim must work quickly to get the transfer he needs.
14:30waiting to be seen in minor injuries is 56-year-old Tracy.
14:34I might go to my shopping.
14:37You can't leave me here.
14:39What if I faint?
14:41Tracy's sliced her finger on a vase.
14:44Just got all hydrangeas in me thing
14:46and it was that paper thin I didn't realise.
14:48So I picked it up and it just crushed in me hand
14:51and then obviously I was bleeding to death.
14:54It's a good job Kathleen.
14:56She'll be treated by emergency nurse practitioner, Claire.
15:02Tracy?
15:05Hello, come in love.
15:08Have a seat, I'm Claire.
15:10Hey love.
15:10What's happened my love?
15:11I've cut it in my hand with some glass.
15:13On some glass, how did it happen?
15:15I've bought a vase for some new flowers
15:17and it's just gone in my hand and cut me out.
15:20Shattered, okay.
15:20Have a seat on there and I'll get some bits
15:22and we'll have a look.
15:23And what time did you do it?
15:25About an hour ago.
15:27I'm not very good with blood so I nearly passed out.
15:29Oh dear.
15:31Nice nails.
15:33Holiday nails.
15:33Holiday.
15:34Been or going?
15:35Been.
15:35Where have you been?
15:36Anywhere nice?
15:37Marbella.
15:38Marbella?
15:40Lovely.
15:42Turn over.
15:44When I started my nurse training I always wanted to work in accident and emergency.
15:49And every day brings a new set of patients with different injuries.
15:54Pop your hand down flat for me.
15:55Lift that finger up for me.
15:57And then turn over.
15:58Make a fist for me.
16:01And straighten out.
16:04And then again like that.
16:06Bend again.
16:07Straighten.
16:08Bend again.
16:10Straighten.
16:11Bend again.
16:11Bend again.
16:12I'll just pop this on it.
16:14I'll give it a good clean and have a look how deep it is but we'll get an x-ray
16:17and make sure there's no glass in it first, okay?
16:20If something external has contaminated then we need to make sure that we've cleaned it as
16:27best we can before we close it to reduce infection and to aid healing.
16:35As well as causing infection.
16:38Tracy.
16:39Have to come down.
16:40Glass in a wound can sever a nerve.
16:44What are you doing to it?
16:45Cut it up with some glass.
16:47Really still there for us.
16:53Lovely.
16:55All finished for you.
16:56Lovely, thank you.
16:57Tracy must now wait for the results of the x-ray.
17:04In recess...
17:05You don't feel sick?
17:06No.
17:08You've not vomited?
17:09No.
17:09Since you've hit your head?
17:10No.
17:11You can remember what you did this morning?
17:12Yeah.
17:13You can move your arms and your legs?
17:15Yeah.
17:15Advanced clinical practitioner Chantelle is assessing the extent of Sylvia's injuries
17:20after she fell down an escalator in the hospital.
17:24When she fell down the stairs and banged her head my concern would be that one,
17:29has she got a cut and will it stop bleeding?
17:32And two, has she got a bleed inside the head that I need to act upon now?
17:35And you know where you are at the minute?
17:37Oh, where am I?
17:38Who are you?
17:39Exactly.
17:40You failed on that one.
17:41Right, I'll give you a minute.
17:42OK.
17:45I'm going to examine this patient in a minute.
17:47She has a head injury on blood thinners.
17:49She's had some transient unable to move her leg and that's what stopped her from...
17:55That's what caused the fall.
17:57But I'm just going to check all her body for injuries.
17:59So pull yourself up.
18:01Hey, well done.
18:03Right.
18:04So you've got some scuff marks here.
18:07So this is where you've hit the stripes on the escalator, isn't it?
18:13And if I touch your neck here is this painful?
18:17A little bit, yes.
18:19Can you look up to the ceiling?
18:21Is that OK?
18:22Yeah.
18:23OK.
18:23Let's have a look at her head now.
18:25Let's see if it's got any bigger.
18:31At least you've not caught your head.
18:32That's really good.
18:34I know she's got some bruises coming on her.
18:37Yeah.
18:37As well.
18:38You're going to have loads of bruises, I think, doing roly polies down an escalator.
18:42Especially when you're on blood thinners.
18:43Yeah, exactly.
18:45Have you had some painkillers?
18:46No.
18:47We'll get you some.
18:47OK.
18:49Sylvia needs an urgent scan to check if the blow to her head has caused a life-threatening bleed on
18:55the brain.
18:59Let me just dip outside.
19:02Sister Kim needs to get farmer Duncan to Sheffield for urgent treatment.
19:08Any of y'all want a job?
19:10With his blood pressure falling...
19:13You're not looking for a job, are you?
19:17I've got a cat transfer, a spleen bleed.
19:19She takes matters into her own hands.
19:23Northern trauma centre, yeah.
19:25I could see the patient deteriorating.
19:27It's looking quite pale, clammy.
19:28We're just finishing his paperwork on the...
19:31Luckily enough, on this day, we're a winner.
19:34There were a crew sat outside, and he managed to...
19:37We're getting transferred straight to Northern General Hospital.
19:40Adam, crew outside's going to tech.
19:45Here, sir.
19:52But as one critically unwell patient leaves...
19:56ANOTHER EMERGENCY ARRIVES...
20:02..and is rushed straight through to radiology.
20:07Ready, steady, slide.
20:0979-year-old Alan needs an urgent head scan.
20:12Keep nice and still.
20:14This table's just going to go in and out a few times, OK?
20:17Get nice and still, folks.
20:18He had a fall at home two days ago.
20:22Alan, just keep your jaw really still now.
20:25Very still.
20:26..and woke up this morning with intense pain in his head and neck.
20:31Smash it.
20:35Are you from Barnsley?
20:37Morning, Brad.
20:40I did it on Sunday.
20:42I woke up with this head.
20:45And I couldn't tell the pain.
20:50He'll be seen by Dr Helena Wilkinson.
20:54Alan? Yes. Hello.
20:56I'm Helena from one of the doctors.
20:57You too.
20:58What's brought you to A&E?
20:59I fell on Sunday.
21:03And, er...
21:04..everything's all right.
21:06But I woke up this morning.
21:08Tell me a bit more about the fall.
21:09What? What were you doing?
21:11Getting up.
21:13Just getting up.
21:14So you were getting up from your chair?
21:16Yeah.
21:17OK.
21:18Had you been asleep?
21:21Maybe, yes.
21:22OK.
21:22Do you think you stood up too fast?
21:24Stole.
21:24Could be, yes.
21:26So what's happened today?
21:27Woke up.
21:28Four o'clock.
21:30But I never helped you.
21:31OK.
21:32So, you've had a CT of your head and neck.
21:36Yeah.
21:37Which says that there is no bleed, which is good,
21:41and there is no fracture of your skull.
21:44OK.
21:44So, any other symptoms?
21:47None.
21:49Back from the nose.
21:51You mean the grace to your elbow?
21:53Yeah.
21:53Childhood knee.
21:56One.
21:59Two.
22:00Yeah.
22:01Three.
22:02OK, OK.
22:05OK.
22:06Oh.
22:07You've got a little skin tear there, OK?
22:09No, it's junky.
22:12That's skin tear.
22:13Well, the skin tear there, skin tear there.
22:15There's probably one up there, OK?
22:17Again, that's...
22:18You just made the skin straight off.
22:20The skin's not even...
22:21Oh, have you chopped it off?
22:22Yeah.
22:24So, the problem is, you've chopped the skin off,
22:26and we've got this big wound now
22:30that I can't pull the skin over.
22:32No.
22:32We will give that a clean
22:33and get it some proper dressings, OK?
22:36So, I'm going to get some...
22:37Sort those out.
22:39Not done, will it?
22:40It's coming out.
22:43Dr Wilkinson needs to act fast
22:46to stop Alan's wounds becoming seriously infected.
22:55PHONE RINGS
23:01Hello, Bansley.
23:02Four hours into the shift...
23:05I wrote nothing on this log me today.
23:07Nothing but all.
23:08And sister Kim is still feeling the pressure,
23:11as an unusually high number of patients continue to arrive.
23:16Just got the graph up.
23:19We're about 50 all over expected this afternoon already.
23:21So, from the hours between one o'clock and four o'clock,
23:25we've had 50 over expected.
23:27It's challenging, it's difficult.
23:29You just have to pull staff from where you can
23:30and obviously move to every area
23:32and just help each other and work with the team
23:34just to try and battle through.
23:37One of those helping out in majors...
23:40So, I've come prepared.
23:42..is Dr Wilkinson,
23:44who needs to dress Alan's open wounds.
23:47I don't intend to pay him to do it.
23:51It's just part of my job.
23:54He's cut off the broken skin that should be protecting it.
23:57Right.
23:59I'm going to clean this area, OK?
24:01It's going to be sore, isn't it?
24:02Yes, yes.
24:03Yeah? I'm sorry.
24:04No, no.
24:05You don't look sore.
24:06I know.
24:09I'm using these tweezers, yes.
24:11I know, it's going to be sore.
24:12I'm sorry.
24:13What you want to do is not have
24:15the top of the skin folded underneath.
24:18So, I'm kind of unfolding it all
24:19and then stereostrip it.
24:21Take your mind off me!
24:24So, that one's done.
24:27This is going to sting.
24:29Because you've taken all the skin off.
24:31All right, all right.
24:34Right.
24:36There's not much more we can do to that
24:37apart from put this dressing on.
24:39Right.
24:40This is just a dressing that doesn't stick to the wound.
24:43Bit of gauze on top.
24:46Right, we can sit you up
24:48and then, let's have a spin on your neck.
24:50Is it sore where I press there?
24:52It's not with you, it's with me.
24:54It's when you're moving.
24:55Yeah.
24:55OK.
24:57That's fine.
24:58Don't, don't do it anymore.
24:59It's OK, it's OK.
25:02Over the next few days, it's going to be sore,
25:04so I'd recommend taking two tablets four times a day, OK?
25:07Yes.
25:08So, regular.
25:09Because you need to get on top of the pain
25:11so that you can then move your neck normally, OK?
25:14Otherwise, you will start to be stiff
25:15and then you'll end up just getting stiff and sore
25:18and you get in this cycle of it being a problem.
25:21Do you want any pain for this before you go?
25:23No, absolutely not.
25:24How are we going to get you home?
25:26Bye, someone touch me.
25:27OK.
25:28You can...
25:30We'll kill some time.
25:32You're welcome.
25:33The pain in Alan's neck is getting better
25:36and his wounds are healing well.
25:38See you later.
25:39Yeah, bye.
25:46In radiology...
25:47Two, three...
25:49Sylvia's already had an urgent CT scan of her head.
25:53Well, we'll go back to X-rays.
25:55..and has been taken straight to X-ray
25:57to check for injuries to her body.
26:00So?
26:01I'm all right.
26:02..after tumbling down the escalator in the hospital entrance.
26:06I feel myself rolled up like a ball.
26:08Did you? Oh, gosh.
26:09Do you remember it?
26:10Sometimes it takes you and you can't remember, can you?
26:13Yeah.
26:14She's waiting with Nurse Emma.
26:16I was just trying to get on the escalator
26:18and just couldn't get one leg up, you know, on the escalator.
26:22You know, as the steps go up.
26:23Have you got any grandchildren?
26:25Yeah, I've got two.
26:26Oh, it's a good story to tell them then, isn't it?
26:28Yeah, but I've got two great-grandchildren.
26:30Have you?
26:30Yeah. Wow.
26:31How old are they?
26:33They're 12 and seven.
26:35Mm.
26:36Oh.
26:36Two little boys.
26:37Are they well-behaved?
26:39Very well-behaved, yes.
26:41Were they brought up by the best?
26:43Yes, of course.
26:49Hello, Sylvia.
26:51Hello.
26:51We've got some extra release to do, sweetheart, OK?
26:54Yes, of course.
26:54We've got a few.
26:55I think we've got your hip.
26:57Yep.
26:59Lower leg.
27:00Yep.
27:01Elbow.
27:02Yep.
27:02And finger, is it?
27:04Somewhere?
27:05Yeah.
27:06I'll have a look.
27:08OK.
27:09Just move your hands away from me.
27:11That's lovely.
27:12Just a second.
27:14Right.
27:15Lovely.
27:16Well done.
27:17You did really well.
27:19Sylvia must now wait to hear if the injuries she sustained
27:23mean she'll need emergency surgery.
27:25Oh, beautiful.
27:28In the hub...
27:29So, I think you've caught up with all the ambulances, haven't you?
27:32There's a brief lull in the number of patients arriving.
27:36But it's only...
27:37It's just a 25-minute walk in wait,
27:39so I've just got three ambulances now waiting to hand over.
27:42Longest one's been here 40 minutes,
27:44so it's better than the hour and ten minutes that we had earlier on.
27:48Hi, Lou.
27:48You're going to add to two now.
27:49Two jobs as well.
27:50Let's see.
27:51We're winning.
27:52Two parts of jobs from 20.
27:53It's all coming together, isn't it?
27:55It is.
27:57Fist down.
27:58Yeah.
27:59But still needing close monitoring in resus is Richard.
28:02Hello, is it Richard?
28:03Yeah.
28:04Hello, my name's Shelley.
28:05I'm just going to take a quick chest x-ray.
28:07Hello.
28:08And then I'm going to sit you up nice and straight.
28:10Just try bending the middle for me.
28:15A chest x-ray is checking for fluid on his lungs.
28:19So, I'm going to shout for you to breathe in and close your breath.
28:21I'll let you know when.
28:23Or for any damage to the heart.
28:28Richard, big breath in.
28:33Breathe normally.
28:35You're welcome.
28:36I'll rest you back.
28:37Tell me when.
28:39Is that all right?
28:40Yeah, that's all right.
28:41That's all right.
28:45If tests show Richard has had a heart attack, Dr Orcroft may decide electric shock treatment is needed to reset
28:53his racing heart.
28:54So, we'll have a little check of his bloods, because they're all back now, which is really helpful.
28:58TROP is actually eight, which is actually really reassuring from a heart attack point of view.
29:19Yeah.
29:21It's not horribly, horrifically imploded that would make you worried or anything.
29:36So, we're going to have the patients on board to slow down your heart and try to switch it back
29:39that way.
29:40Because I think if we do a shock down here, it might work for a little bit, but we won't
29:44have got the long-term organisation to hopefully keep you symptom-free and better for longer, if that makes sense.
29:51We want to put a proper plan in so we can properly fix you, rather than knee-jerk, try and
29:56get it sorted, OK?
29:57So, what we're going to do is get you up to the ward shortly, where we can get you seen
30:01by our medical team and kind of make plans of what we do to try and prevent this happening a
30:05bit more in the long term, OK?
30:11If we admit him into hospital, we'll have a better chance of controlling his rate of his heart, but also
30:16discussing him with the specialist heart doctors to decide
30:19how best to proceed with managing his atrial fibrillation.
30:23Right, darling, all the best. I hope you get sorted, OK?
30:26Well, we'll be giving some up, thank you, that's when I get up.
30:29Yeah, it's wrote up. It's already wrote up, he's already prescribed it. Keep it straight.
30:32Oh, sir.
30:34I do, though.
30:36No, I'm not.
30:37That's why I'm getting rid of it.
30:42I just like to see people laugh before they leave them.
30:47Well, I'll probably do one trip I'd like to say.
30:51What, three and a half stars?
30:52Yeah.
30:54In a nice way, I hope to not see you again.
30:57Richard spent two nights in hospital.
31:00He's now back home while cardiology decides on a long-term plan for his heart.
31:09Back in the hub...
31:10What are we like for beds now? Is there any movement or...?
31:14Sister Kim's brief respite seems to be over.
31:17I've just got 20 down here waiting beds.
31:20And I've, like, got handles off that corridor and I've just got no movement at all.
31:24The backlog in patience is building once again.
31:28It's how we fixed it.
31:2920 to triage again.
31:33It's...
31:34See?
31:35It's what happens.
31:36The thing is, obviously, in A&E, you never know what's going to come through the door.
31:39So, you're turning one place around, but then, obviously, another place has just...
31:43It's just...
31:44It's just like a rollercoaster.
31:46It just never, ever stops.
31:49In minors, Tracy's waiting to find out if there's glass in her cut finger.
31:54It's paining a bit, but if it were dripping, I'd be...
31:58I don't like blood.
32:00Emergency nurse practitioner Claire checks the X-ray.
32:04Right, no glass in there.
32:06So, we'll give it a clean and see how deep it is, all right?
32:08All right, love.
32:10We, as practitioners, can't change how people heal.
32:13So, thinking about where the wound is,
32:15how you can close it in a better way for the patient,
32:18such as steady strips while we're closing,
32:20so that you don't make extra holes, then that's good for the patient.
32:26Yeah, so it's OK that it's just in your skin.
32:29Right.
32:30No deep structures involved.
32:32So, I think we can get away with some glue on it.
32:34Great.
32:34As long as it's not bleeding.
32:36You've got me out of ironing tonight, haven't you?
32:39I did all mine last night,
32:40cos I'm going to Tunisia on Friday.
32:42Oh, I love that.
32:43I've never been to Tunisia.
32:43Me neither.
32:45Nice.
32:46Just relax that finger for me.
32:49I've been all over at Wilbur Benidorm, I love.
32:51I love Benidorm.
32:53The beaches in Benidorm are stunning.
32:55Clean, long, sandy.
32:57Yeah, white.
32:58Old town's beautiful.
32:59Not that I see much at all town, but it is lovely.
33:03You can't beat it.
33:04It's cheap and cheerful, and it's great.
33:06Ooh, that hurts.
33:08I'd be putting a call on me if I had a hope really bad happened to me.
33:11I could do a bit on my face, ten years off and like that.
33:18LAUGHTER
33:24It's dry up now, and how long will it take?
33:26Yeah, they say that it is instantaneously sealed.
33:33Oh, did you have it pull through?
33:36Unfortunately for Tracy, there's no two-for-one on gluing today,
33:40but the outlook for her finger is good.
33:44That's better.
33:46Right, so keep it clean and dry for a couple of days.
33:49OK.
33:50You can let some air get to it in between times,
33:52but cover it over if you're out and about doing something or in bed.
33:56Cheers, darling.
33:56And then it should be fine.
33:57Thank you very much.
33:58Treat it like any other wound.
34:00I will, thank you.
34:03With her finger covered, Tracy can go home.
34:06I've glued it.
34:10Oh, mended.
34:11And it should heal in time for her next trip to Benidorm.
34:16Oh, I'm glad that were quite quick, really good for Amy and old staff were amazing.
34:24Also battling the high number of patients today is the paediatrics department.
34:29The next patient waiting to be seen...
34:32Is it hurt?
34:33Yes, Mum, it hurts.
34:35..is 14-year-old Poppy.
34:38Hiya, love. I'm Greg. I'm one of the nurses.
34:40Hi.
34:40This is your mum.
34:41Yeah.
34:41Shall we wait for her so we won't leave her?
34:43Yeah.
34:45She's come in with Mum Elizabeth.
34:46Come with me. Nice to meet you. Come on.
34:48After a prank during school break time,
34:51left Poppy with a nasty gash on her chin.
34:54I want you to stand on here just so I can wait for you, please. Is that all right?
34:56I'm just going to be embarrassing.
34:57Yeah, take your bag off.
34:58All right, yeah, that's going to be good.
35:00Yeah.
35:00Ooh, what is in that?
35:01She'll be assessed by charge nurse Greg.
35:04Lovely. I'm going to go and take it here.
35:08Let me just pull this up because we've gone all digital.
35:11It's at school.
35:13You're digital at school?
35:14Yeah.
35:15Really?
35:16Yeah, everything's on...
35:17Everything's on a laptop at school?
35:19That's mad, isn't it?
35:20Yeah.
35:21I have textbooks and that and some...
35:22But everything else is digital?
35:24Yeah, and then that.
35:25Homework through it and everything.
35:26That's crazy.
35:27Easy.
35:29No more.
35:29My dog ate my homework then.
35:30No.
35:31No more of that.
35:32Right, Poppy, what have you done?
35:33Er, I curb stomped myself.
35:35You curb stomped yourself?
35:36Explain how you did that.
35:37I ran...
35:38I ran...
35:38I don't know what that means.
35:40Sorry.
35:41I ran and I slipped and I, well, curb, and I didn't smash my head on the curb and I
35:49know
35:49I've not got concussion because I've had that before.
35:51So you hit your chin?
35:52I hit my chin.
35:53Yeah.
35:53It's not gone through my lip.
35:55Yeah.
35:55I have bust my lip.
35:57Okay.
35:57And my teeth aren't wobbly.
35:58Good.
35:58And it's just cut.
36:00You're answering all the questions I would have asked.
36:02That's fantastic.
36:02But why was your face so close to the floor?
36:06Slims?
36:06It's not my fault.
36:07I'm really trying to figure out how you did this in mind.
36:09Basically, what?
36:10I need to do an example.
36:11What were you actually playing with, your friends?
36:14I took Penelope's shoe when she came running off me.
36:16Oh, well, there you go, then.
36:19You're the loudest patient that I've had all day.
36:21And I've had screaming babies as well.
36:24All right, thanks.
36:25You're welcome.
36:26I'd rather me be honest.
36:27I think having a sense of humour and having a laugh is really, really, really important to the job.
36:33You've got to have a laugh to get through the day.
36:34You've got to joke with each other, because otherwise it's just serious all the time.
36:39Can you look over my shoulder, please?
36:43Lovely.
36:44Hi.
36:46Squeeze my hands out as you can.
36:47Lovely.
36:48You can stop looking over my shoulder now.
36:49You're giving me a dead pan stare.
36:50Put your hands like this.
36:52Lovely.
36:52And push against mine.
36:53Lovely.
36:54Fab.
36:54And the other way.
36:55In.
36:55Fab.
36:56Can I have a look at the inside of your lip?
37:02Fine.
37:02Lovely.
37:03Yeah, so it's not gone through or anything like that.
37:04It's just a little graze.
37:05Yeah.
37:05So I can put a little...
37:09Mmm.
37:14Mmm.
37:16So if I can close it, you can go home without seeing a doctor,
37:20because we've got a new nurse-led head injury.
37:23So we don't do anything in this triangle, but yours is below the lip.
37:26You've not got a hole through your lip and all your obstacles are fine.
37:28So I can glue you up and you can get gone if you want.
37:30Or you can wait a couple of hours to see a doctor.
37:32It's up to you.
37:32No.
37:33Right, fine, cool.
37:33Let's try that then.
37:35So I qualified in October 2020, started working here as a student when Covid first hit.
37:41And I've never looked back.
37:43It's the best decision I've ever made in my entire life.
37:45I absolutely love working in Barnsley.
37:47And now I live in Barnsley as well.
37:49So I'm converted.
37:50I love it.
37:51Look up for me now.
37:52Yeah?
37:52No, shut down.
37:53Alright, good.
37:55Let me just double check with our ACP.
37:59If he gets the go-ahead, charge nurse Greg will glue the gash on Poppy's chin and spare her
38:05the need for stitches.
38:18Almost six hours in.
38:20Keep smiling.
38:23And Sister Kim is still juggling an overflowing department.
38:27No cubicles.
38:29Is there none at all?
38:34Obviously, being in charge of the department, it reflects on all my colleagues and all my
38:37staff.
38:38So if they see me smiling happy with all the pressures I'm dealing with, then obviously
38:42them as their team, they can smile and be happy and they manage to deal with all their
38:46pressures.
38:47Hello, it's only Kim.
38:48Have we got an up-to-date bed state?
38:50With the end of her shift fast approaching, she's trying to get things moving for the night
38:55team.
38:55It's just really busy down here.
38:57Obviously, doctor weight's just gone up.
38:5918 waiting beds, waiting on half-feeling beds.
39:03So it's not going to really get much better for nights.
39:13In recess, hoping she won't have to stay in overnight is Sylvia.
39:18Advanced clinical practitioner, Chantelle, has the results of her scans.
39:22So Sylvia, your CT head's normal, no fracture, no bleed, and you've got no fractures anywhere
39:29else.
39:29So that's good news.
39:30Do you think there's going to be any sort of like reaction later or anything?
39:34No, there's just some superficial braids as cuts.
39:39But no, it's fine.
39:41We're going to put a different type of dressing on that, like a spongy nice one.
39:45Yeah.
39:45OK.
39:46But no fractures to fingers, no fracture to elbow, no fracture to pelvis, no fracture to
39:50skull, no bleed, nothing.
39:52Thank you so much.
39:54OK.
39:55For daughter Debbie, the news is a huge relief.
39:59She's come out very lucky from it.
40:01Just like lots of cuts and bruises and I think she's going to be sore for a few days.
40:06Things that you should not worry about.
40:09Yep.
40:10Things that you should, things that can help recovery.
40:12OK.
40:13I do like working in resource.
40:14I would say it's my most favourite part of the A&E department.
40:18I like the severity of patients that come in.
40:22I like the variety.
40:22I like the acuity.
40:24I feel, given my experience and knowledge base, it's where I give the best care to patients
40:30and relatives.
40:31See you later.
40:32Bye.
40:34Sylvia returned home and is recovering well.
40:38After today, it's lift only, Mother.
40:40Yes.
40:41No more escalators.
40:43No.
40:50In paediatrics, Poppy is waiting to hear if she has to have stitches in her chin.
40:56Liam.
40:58Charge nurse Greg wants the go-ahead to glue the wound.
41:01I've got a young lady who's got a little bit of a lack below her lip.
41:04It's not across the vermilion border.
41:06It's not a through and through injury.
41:07It's literally just there.
41:09It's all right to glue it and send her home, aren't it?
41:11Yeah, as long as it's not prune.
41:13It's not prune.
41:13And she meets all the rest of the pathway and stuff like that.
41:15All the rest of the criteria, yeah.
41:16Yeah, and in age range and everything.
41:18In age range, yes.
41:19She's 14 years old, yeah.
41:20Yeah, mate.
41:21I'm happy to be here to send her home as long as you are.
41:23Lovely.
41:23And the parents are, yeah.
41:24Yeah, they're fine.
41:25Yeah, we can glue you and send you home.
41:27Ah, yes.
41:28So you're going to have to try and keep this little bit of your face dry for three to five
41:31days while it heals.
41:32That's going to be fun.
41:34No makeup.
41:35Nope, no makeup.
41:36No rugby playing.
41:37Nope.
41:38Lips together.
41:40I love A&E because you never know what's going to come through the door.
41:43Every day is different.
41:44And I find that if I'm doing the same thing day in and day out, I just get a bit
41:48bored.
41:51That's one.
41:52Let me do a little bit more.
41:53Looks better already.
41:54Is that glue?
41:54Yeah.
41:55Does it sting?
41:57A little bit.
41:59I love seeing kids when they leave the department.
42:01I love seeing, like, we've made a difference.
42:03You can see how happy they are, how much better they feel.
42:07Come here then, don't we?
42:09Look up again.
42:12Reels.
42:13Let's give it a second.
42:16Just shake your face to try and dry it.
42:19Saw that.
42:22It's all right, good job.
42:24It looks good.
42:25Yeah, you've glued my lip.
42:27I've not.
42:27Show your mum.
42:29No, no, you're not meant to touch it.
42:32Yeah, it looks...
42:33Yeah?
42:34Yeah, it's just like a film over it, isn't it?
42:36Yeah, so it has pushed it together.
42:38Yeah, yeah, yeah.
42:39With it being on our lip, it's never going to be perfect if it's quite open it.
42:42Yeah.
42:43You just have to be quiet.
42:44Yeah.
42:45No.
42:46Can we sew your mouth shut?
42:48Yeah, yeah.
42:48Use the glue on that.
42:49Yeah.
42:50That'd be a winner.
42:51I'll go and get you some advice sheets and you're good to go.
42:53Thank you very much.
42:54No problem.
42:55Two seconds.
42:57Look at that, Poppy.
42:59Better at home earlier than you would usually be.
43:05Poppy's chin is healing well and Mum Elizabeth hopes she's learnt her lesson.
43:10No, you won't be stealing your friend's shoes again, will you?
43:13And running off with them.
43:14You'll be mildly morbid tomorrow.
43:17Possibly.
43:18Yeah!
43:27It's finally time for Sister Kim to hand over to the night team.
43:31All aboard!
43:32All aboard!
43:33You don't...
43:34What are you doing?
43:36You'll have to say all aboard when you go out there.
43:39It's been busy.
43:40Really, really busy shift.
43:41I left it with 125 in the department.
43:44Er, yeah.
43:45There's not much you can really do, much you can say.
43:48Resource is full.
43:49There's five patients in there.
43:51You have got 18 awaiting beds.
43:53Some of them's medicine and orthopaedics.
43:56And then 14 walk-ins with a one-hour wait.
44:00It's just...
44:00It's meddling out there.
44:02I want to make people better.
44:04You know, I want to do good in myself, good for other patients.
44:07Make them comfortable.
44:09And, obviously, that's what A&E's all about.
44:11It's just a rewarding job.
44:13And, you know, that's what I'm here to do.
44:14Just to make things better.
44:17And as Sister Kim and her team get a well-earned rest...
44:20You know what?
44:21Wednesday's usually difficultly clear.
44:23She knows the night shifter also ready and waiting for whatever comes their way.
44:33And we're back in Varnsley when the new series continues next Thursday at 8.
44:37And if you or someone you know has been affected by the issues covered tonight, find information and support at
44:44channel5.com slash helplines.
44:47New next, steeped in maritime history, the Platform Tavern in Southampton is at risk of sinking.
44:53Can the hotel inspector save it?
44:55Find out in just a moment.
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