01x02 - Delay

[bunniefuu]

BORIS JOHNSON: 'First of

all, let's be in no doubt,

'this has been a sad, sad day.

563 more cases, a record.'

REPORTER: 'Doctors and

healthcare staff are saying that

'a shortage of kit and a lack of

clarity over what should be worn,

'when and where,

'could potentially

cost them their lives.

REPORTER: 'One trust said to

me today that they've only got

'three swabs per

day to test staff.'

'There are stories from

the frontline of doctors

'living in mobile

homes at the moment.

'They don't want to

infect their families.'

REPORTER: 'You've got deaths

rising in a straight line.

'We've had a big leap in cases.'

BORIS JOHNSON: Our thoughts go out

to the families of the victims,

but let's be in no doubt that

if we can follow the programme

that we're currently set upon,

then I've absolutely no doubt

that we will begin to start to

push those numbers down,

and we'll turn the tide

of the coronavirus.

ABBEY: OK, bank staff, agencies?

No-one at all?

ON SPEAKER-PHONE: 'I've tried

them all, and they're all full.

What about DJC locums?

REPORTER: 'The issue of

staff absence is huge.

'You know, staff themselves really

want to get back to the frontline.'

ABBEY: No. God, no, it's

fine. You just take it easy.

That sounds really

ON SPEAKER-PHONE: 'Look,

I'm really sorry, Abbey.

'I still can't even

get a test.' Yeah.

REPORTER: 'Lots of hospitals

are reporting unease

'that they may run out of

oxygen, sedatives, anaesthetic.

'What system do

you have in place?'

ABBEY: Yeah, but can Anj

swing over to cover for me?

ON SPEAKER-PHONE: 'Anj is down

too. I only just heard myself.'

Oh, sh*t.

So we can't cover

the ward SHO bleep.

Firm A is down.

Half of Firm B is urology F1s.

And Firm C is basically

just Sunil and Grace, so

Hi, it's Abbey. Yeah, so basically

just totally failed on that one.

All the staffing

banks are empty.

Hi. Morning.

Hey. Hiya.

Thank God, you're

back. Are you OK?

No, I'm shattered. I

mean, it's not nothing.

No.

Staffing told me about

the current sh*t-show.

I know. Half of the hospital

is off sick or isolating.

You'll be lucky if you get

an orthopod as an SHO today.

Save us.

Hi, Emma. Hiya.

Ant, how are you feeling?

Yeah, not bad, thanks.

So

we had three deaths overnight,

bed four's in their last hours

and ITU are on their

way to review 12 and 16,

but the pit's rammed, so

Right. Yeah.

How's Divina?

Not great.

Emma, look, I

I don't know if anyone is

thanking you for volunteering,

but it really is wonderful.

Everyone in my

year has. BLEEPING

I need some help in here,

she's unresponsive. Coming.

Cardiac arrest, call, please. Emma,

could you get the PPE trolley?

Get the defib, please.

Danielle Evans, 43, COVID

day ten, Type 2 Diabetes.

She was stable on six litres,

but in the past half an hour

she's needed more and

now she's just crashed.

She's arresting.

Compressions, please.

No, no, no, we need Level 3 PPE.

Why is there no supply by the

beds? We don't have enough kit.

Where's that PPE,

Emma? PPE's here.

Does this patient

have an active DNAR?

No, she's for resus.

I've just had it. I could

get on with compressions.

No, that's not allowed.

They're aerosol-generating.

Get the pads on. Thank you.

We're running out of time.

I'll help you with that. Yep.

MACHINE: Connecting electrodes.

Ready? Yep.

Non-shockable rhythm.

We need to start CPR.

We're wasting time here.

Ant, stop it!

Emma, curtain, please.

Nearly there, Ant?

Yeah, seconds away.

No, Emma, outside. Droplets.

Get the EMI bag,

please. Yep. Get ready.

OK, start compressions.

We've wasted too much time.

MACHINE BLEEPING

Are you OK?

Yeah.

Right, are you OK to

call the next of kin.

Just let me know if there's any

problems or if you need anything.

Thanks, Maddie.

Right Shall we go round?

Yeah.

I think we should

start with Mr Williams.

He had a bit of a rough night.

He's on the high flow now,

but sats are still low.

Thank you.

Hello, Mr Williams.

LABOURED BREATHING

Emma's just going to

quickly present your story.

She's keeping us

all up to speed.

OK, this is Mr Williams, 81.

WHEEZING

I met Mr Archie in

the cupboard in EAU.

That bloody cupboard.

He had flash pulmonary

oedema, went to resus,

and since then has been

doing amazingly well, really.

But then seven days ago,

tested positive for COVID,

and has sadly

deteriorated since then.

He's got his wife

Florence at home.

She's not allowed

here, obviously.

Thanks, Emma.

She did well, didn't she?

Archie,

I think we need to talk about doing

a bit more for your breathing.

I'm afraid catching COVID's

really knocked you for six.

Your lungs are struggling a

bit and you're getting tired,

so I want to give you a form of

breathing support called CPAP.

What we do is we put a mask on your

face that's strapped quite tightly.

Then the CPAP machine pushes

air into your lungs for you.

Will it hurt?

I'm afraid it can

feel quite aggressive,

quite claustrophobic, yes.

BREATHLESSLY: And if I don't?

Archie, I want to be

completely honest with you.

Without CPAP

I'm not sure you

can survive this.

COUGHING IN BACKGROUND

I love my life

but not at all costs.

Emma, can you get my photos?

OK. Of course. The code is

It's 4th of April.

Wedding day.

I've had a blessed life

with Florence.

We met

in an orchestra.

I was a second violin.

BREATHLESSLY: She was

a cell cellist.

Archie?

Shall we try this?

And if it's too much, then we'll

talk about what we're going to do.

Yeah?

LABOURED BREATHING

Emma, how do you feel about

phoning Mr Williams' wife?

You know him.

You could talk her

through what's going on.

Er yeah. Sure.

OK?

OK.

Good.

Moisturise you hand.

There we go.

All right, my darling.

Shall we get your cross out?

Is that any better,

Divina, my love?

Hello, Mr Williams.

How are you doing?

WHEEZING

I've got something for you.

We sent one of these

to Florence too.

You have a matching one.

You're all right.

Hey, Mr Williams.

I've got the mask here that

we spoke about earlier.

I'm just gonna change

that round for you now.

There we go. Take

this one off for you.

Well done. There

you go. Straight on.

You let me know if

that's too tight, OK?

There we are. How

does that feel?

You're doing great, Mr Williams.

You OK?

Just hold your heart

and think of Florence.

So, this might feel a

bit of a powerful blast,

but it will stabilise, OK?

You'll get used to it.

A bit like having your head out

of a car window on the motorway.

LABOURED BREATHING

You're doing really

well. How does that feel?

Good?

Hi, Sally. Did you

want to have a chat?

Is that gonna happen to me?

No. No.

You're doing well.

Yes, you have COVID.

But your sats are holding.

Is that good?

I'm confident.

Well, I'm glad someone is.

I thought it would be breast

cancer that k*lled me,

not coming into hospital.

You got in before we knew.

I'm so sorry you

caught it in here.

But no-one is giving up

on you, Sally, I promise.

Look, I know you've had

your restaging scan done,

so I'll speak to

the radiologists,

see if they can hurry the

report along while you're in,

and I'll come straight up to see

you as soon as it's on the system.

Yeah?

OK. Great.

Hi, there. Hey.

Just checking in.

Yep, what's your name?

Dr Abbey Henderson.

Yeah, got you right here.

Staying with us for nine days.

ON VIDEO CALL: 'Mummy!

Mummy, Mummy, Mummy!

Hi.

'Hey. Divina?'

'Mummy, Mummy, Mummy.

'Mummy, Daddy wouldn't let me

watch any screens after dinner

'and he shouted at

me for no reason.

'You said I was allowed

cartoons when you were at work,

'so I basically hate Daddy now.'

'Can't win.

'Tom, say hello to your mum.'

Tom? Are you gonna say

hello from under there?

Hey, love.

I miss you.

Are you OK?

'Tom, come on.'

What is it?

Please tell me.

'You shouldn't be there.

You should be here.

'You've just left us to look

after all the patients at work,

'everyone else's family.

'So, what do you

want me to say?'

Look, I'm not gonna lie to you,

Tommy. I know this is really hard,

but 'If you catch

it, you'll die.

'So that basically means you

don't even care about us.'

Oh, my God, Tom, I am so

careful. I promise you.

'You can't promise

us you won't die.'

Sweetheart

'I'm sorry, love. I told

him you're fit and well,

'it would be like the flu.

'He's obviously scared,

you know?' Have they eaten?

'Yeah. Yeah.'

I should eat, so

'We'll try again in

the morning, OK?'

MACHINE BLEEPING

Sats 60. Still falling.

58. Oxygen?

100%.

Let's prone her.

Emergency prone, please,

in here. Quickly.

PPE on everybody.

Straighter, please.

All right, Divina, we're

gonna pop you on your front.

This should help with

your breathing, OK?

Quick as you can

everyone, please.

She's a Ward ACA from

Level 6, thank you.

Take that. Thank you.

That's it. One

more. OK, secured.

On my pull we're gonna slide her

in this direction, all right?

Happy everyone? Yeah.

Ready. Ready, steady, slide.

We're gonna put her

on her side. Go.

Right, nearly

there. Change over.

Nearly there, Divina,

nearly there, OK?

You'll feel better

on your front.

Everyone happy? Yeah.

Gently now. Go.

All right. Still ventilating.

Back on, please. Hold,

please, everyone.

Probe back on.

45. Come on, Divina.

We tried to get her

on the haemofilter

but her BP's too unstable.

Come on.

43, come on, Divina.

Her sats aren't

improving at all.

It's not working.

Hey.

Hi, Enrico, it's Metin

Ozkul here again.

ON VIDEO CALL: 'Yeah, hi.'

So, we hoped the proning might help

with Divina's breathing, but

I'm afraid it stopped

working for her.

The CT scan we did of her lungs

shows they really are

very badly damaged.

We tried to put her on a

machine a bit like dialysis,

but she was too

unstable for that, so

I'm really very

sorry, Enrico, but

we've explored all the

treatments we have.

Enrico,

I think it's time we consider

stopping active treatments,

and move towards

palliative care.

'What do you mean?

What does this mean?'

Hi. Hi. Hello, Enrico.

'Hi, yeah.' It's

Abbey Henderson.

What Doctor Ozkul is saying is

that we've reached a point now

where we need to focus on

Divina's end-of-life care.

'Mm-hmm.'

She's receiving a lot of

invasive treatments at the moment

that aren't helping her

and we can remove a lot of that

which would make her

much more comfortable.

SOBBING 'Yeah.'

Enrico, I'm so sorry to say you

can't come and visit Divina.

The rules prevent

any visits to ITU.

'She didn't have the right PPE

but she wanted to keep going.

'She was so brave.' She was.

She was.

'We'll be praying

for her.' Yeah.

'She will be so alone.'

Hi, Enrico.

Hi, I'm Jules. 'Hi. Yeah.'

I'm the nurse looking

after Divina here in ITU.

We're gonna take such

good care of her, Enrico,

that's my promise.

I promise you that.

I promise you she

will not be alone.

'I know. Thanks. I know.'

I'm so sorry, my love.

'I need to go now. I need

to go.' I'm so sorry.

CALL END TONE

a 250ml bolus

Yeah. and monitor his BP.

We've been told medically fit

patients with a care home bed

have to be discharged

straight away, no delays.

Is he unwell?

Well, no, but he hasn't been

tested for COVID, though.

They said it doesn't matter, we're

not allowed to wait for tests.

But we've had two confirmed

cases in here today.

Yeah, well, just keep

a close eye on him

Don't you think we should

be just a little bit more

It's taking five days to

get test results back.

He can't sit here until then.

We need to be sure

that he's not positive.

If he takes COVID

back to the care home,

the other residents

are sitting ducks.

If he sits here for five days

he's probably going to get COVID,

isn't he? Can I help at all?

Thanks, Abbey.

Emma and I were just discussing

discharges to care homes.

All the discharge planners have been

told not to wait for negative tests.

There's ambulances

queuing to the roundabout.

Which patient is this?

OK, no COVID symptoms

on admission.

UTI, treated with antibiotics,

medically fit for discharge.

Is there a new

suspicion of COVID?

No, it's just that we've had

others confirmed in here today.

OK. The national guidances don't

wait for negative COVID tests.

Yes, the patient's going home.

His care home is his home.

He doesn't have COVID, so

Well, to be fair to Emma, we

don't know that without testing.

So, what shall we do?

SIGHS

I don't think we

have a choice, do we?

There's no tests.

He's going to have to go

back to his care home.

BORIS JOHNSON: And we're also

massively increasing testing

and I want to say a

special word about testing

because it is so important,

and as I've said for weeks and

weeks, this is the way through.

This is how we will unlock

the coronavirus puzzle.

This is how we will

defeat it in the end.

And what we need to do is

Sally?

Sorry to wake you.

Oh, hi, Doctor.

Oh, God, what's going on?

Your scan is clear.

What? Really?

The scan report just

came on the system.

There's no sign of cancer.

I think we can hope

for the best now.

Oh, my God.

I'll go through it all

with you in the morning.

I just wanted you to know.

And we'll get you away

as soon as we can.

Oh, God, thank you, Doctor.

It's a team effort.

Thank you, thank you.

Thank you so much.

Could you pass me my phone?

Are you heading

home, then? No.

God, when do you all sleep?

We don't, really.

Hi. Hi.

Yeah, no, I'm fine.

Oh, my God, love. I'm clear.

Side room seven.

Thank you. No problem.

What's your name, Doctor?

Abbey. Abbey.

E-Y.

You're all done.

Thank you.

Let's talk later.

OK, Divina, we're gonna turn

off some of these machines now.

MACHINE BLEEPS

BLEEPING STOPS OK.

There we go, Divina.

That's it.

You can rest now, my love.

No more pain.

"Divina, every day

I came to work,

"your smile told me

how to do my job.

"I'll miss you. We'll

look after your family.

"Love you, Alison."

"I will love you forever, my

darling, my beloved, Divina."

It's from Enrico.

Beautiful, wasn't it?

Now some from us too.

Everyone's written to you.

This is from Lauren.

HUSHED SOBBING

"Dear Divina, I was still

a student when we met.

"Your smile lit up the ward.

"I will always remember

your love and kindness."

INHALES, EXHALES DEEPLY

This one's from Vicky.

She's just had her

baby, by the way.

"I can't believe you're gone.

We're gonna miss you so much."

HUSHED SOBBING

INTERVIEWER: 'Thank you, Mr

Hancock. Could I firstly ask,

'how many frontline NHS workers

have died from COVID-19?

'And secondly, could I ask when a

healthcare worker does pass away,

'has there been some form of

investigatory process put in place?'

Yes, I think this is a

question for you, Ruth.

OK, thank you very much.

We know that any death, if it were

due to coronavirus, is a tragic one.

'We do have numbers of

people that have died,

'whether they're nurses, midwives,

healthcare assistants, doctors.'

It would be inappropriate

for me right now

to go into listing them

and numbering them.

I'm so sorry to have to share

this news with you all

but I'm afraid Divina

passed away overnight.

Enrico and the kids

send their thanks.

HUSHED SOBBING

There's some counselling

being arranged.

I'll put the details

on the board.

Please use it.

The trust is going to provide

some extra ward cover,

so if anyone feels unable to

work you absolutely must go home.

PAGER BLEEPING

Oh, sorry, everyone.

Abbey, can I just say something?

Please.

Look, I don't want

to speak for anyone.

I don't know about you

guys, but I know that

I know what Divina would

have been doing today.

She would have carried on

caring for her patients.

So I think I'm just gonna

do that, if that's OK.

Thanks, Tracey.

We've seen, very sadly,

four doctors die so

far and some nurses.

They've not even counted the

nurses, Matt. I've got to have a

conversation with you.

OK, we'll talk about that.

Sorry, Doreen, just

say that again?

We haven't even

counted the nurses yet

cos I keep asking for the stats

on nurses that are ill and

I didn't know that, we will

sort that out. The But

You've k*lled him.

This place has k*lled him.

You've m*rder*d my dad.

Please keep the volume down.

There are other patients here.

Hello, I'm Doctor Henderson,

I'm the consultant on the ward.

My dad had COVID because

of you. You've k*lled him.

OK, I just need to come up

to speed. So you tell me

You sent someone back to

his care home with COVID,

now they've all got it.

This lady's father was admitted

last night from Pennyfield.

OK. Dad, it's OK.

We recently discharged a patient

from the cold zone back there.

She doesn't have a f*cking

clue what's going on.

OK, I'd really appreciate it if

Pennyfield House. ..you didn't use

language like that

Dad's the 11th resident

and threaten staff. to

get it, did you know that?

I didn't know that, madam,

no. Seven people are dead

because you didn't test them

before you sent them back there.

And now you've got your

beds for the younger ones.

Murderers!

She's right.

We're k*lling people

with these discharges.

OK, I hear you No,

Abbey, they're dying.

but can we not do this

in the middle of the ward.

And it's literally us sending COVID

in to k*ll people. She's right.

Ant, you need to calm down, now.

I'm going to talk to

the CEO about this, OK?

What, like you

did about the PPE?

We'll both go. Right now.

Abbey? Good to see

you. Come on in.

Thanks.

So I'm just gonna jump

straight in, if that's OK.

Suits me.

We need to delay these

discharges to care homes

until we can ensure that patients

have a negative COVID test.

Without symptoms?

Yes. They incubate the

virus asymptomatically

and return to the nursing homes,

and we're seeing admissions from

those same nursing

homes down the line.

Is that causal? Sorry?

Have you demonstrated

a causal link?

Yeah. The index cases are the

patients coming in and out of here.

Are you serious?

I can't shut down hospital

discharges on that scale.

You just need to

authorise testing.

It would be risking skyrocketing

hospital-acquired COVID infection

because of anecdotal

community transmission.

It's not anecdotal.

This comes from the

Department of Health.

Every single trust has

the same set of orders.

Orders? Yes, get 15,000 people

out of hospital beds right now.

Clear them out. No need

for negative tests.

Even if there were enough tests

for clinically well people

They have coronavirus. ..it takes

five days to get results back.

We can't wait that long.

Then you need to come down

and write that in the notes.

SCOFFS I'm sorry?

That you're taking over

the care of these patients

from the clinical teams.

Abbey, these are not my rules.

This comes straight

from the top.

Look, residents can be isolated once

they're back in their care homes.

How about patients

with dementia?

You're welcome onto the wards

to show us how that might work.

Discharge them home

or to isolatable beds,

but not to care homes or they're

gonna die in their hundreds.

This isn't your decision.

Please just do your job.

Doing your job down there is

a potential death sentence.

Members of our team, the most

exposed members of staff,

are wearing aprons and bin bags

and going home wondering if

they're gonna die in the night.

I truly am sorry

about your colleagues.

As a hospital trust

Oh, it's just HCAs and staff

grades to you, isn't it,

in the firing line? Do you

know who's dying down there?

Certainly not the

white people up here.

Sorry. I was out

of line earlier.

No, no, it's

Dad's got COVID.

He got admitted last week.

Oh, God.

I'm so sorry.

Yeah.

There's no plan, is there?

No.

They're just making this

up as they go along.

Those live, those don't.

They're just numbers.

Have you made a will?

MACHINE AIR WHOOSHES

LABOURED BREATHING

GASPING

WHEEZING

Hey.

ON VIDEO CALL:

'Hi, love, you OK?

'Oh, is it three

already?' Er, yeah.

'Yeah, we're just'

She's gonna break

her neck doing that.

'Robby, Robby, do a

cartwheel for Mummy.

'She's really good.

'She's almost got it.'

You're a nightmare.

'Talk to your mum.'

Hi, darling. 'Hi.'

KNOCK AT DOOR Abbey?

We're heading up now. OK.

VOICE ON TV: 'We are gathered

here today to remember Divina,

'a loving wife and

mother to her family.

'And I would now

like to ask Enrico

'to come forward to

say a few words.'

ENRICO: 'She died

doing what she loved.

'Even in the last few weeks

when she came home so tired,

'she would say to me

'.."This is my work."

'Me and the kids

are so proud of her.

'I don't know what happens now.

'It was Divina who knew

how to take us through

'any dark times that

came to us as a family.

'But I feel, I know'

PAGER BLEEPS

'that we will find

our way somehow.

'That with the help of God

'and our friends, we will

continue in this world.

'But I also know that

'..I will always be alone

without you, my darling.'

BANGING, COMMOTION

CLAPPING, CHEERING

WHISTLING

BANGING CONTINUES

Oh, that looks so good

on you. Thank you.

If in doubt, go

all out. I know.

There.

How's that? There you

go, you look gorgeous.

And here she comes!

CHEERING AND APPLAUSE

Thank you all so much!

I don't ever wanna see

any of you lot ever again!

Florence.

Archie's finding CPAP too hard.

He's decided to stop.

And I'm afraid without it,

his lungs can't keep going.

But even with it, we don't

LINE BREAKING UP

ON VIDEO CALL: '..what to do.'

We just want to offer you the chance

to come in and visit the ward.

You're allowed in now

now that it's an

end-of-life situation.

'I want to.

'But my arthritis, my

rheumatoid arthritis'

Right. 'I'm on

immunosuppression.'

That's a really tricky

situation, Florence.

You need to be careful.

'OK.

'I don't want him to be alone.'

COUGHING IN BACKGROUND

Hi, Mr Williams. I hope you're

feeling a bit more comfortable now.

WHEEZING

LABOURED BREATHING

STRIKES NOTE

All right. All I'll

say, Mr Williams, is

keep your expectations low.

WHEEZING

PLAYS SHAKILY

Hope that wasn't too painful.

PAGER BLEEPING

All right then, Mr Williams.

Hey. Hey.

Heading in? Yeah.

I'll see you in

there a bit later.

I'm just popping back

for a quick shower.

Are you on again? Oh, yeah.

SIGHS

You're doing really well.

Doesn't feel like it.

No.

Don't suppose it ever

does, but you are.

You were right

about that patient.

The one we had to discharge

back to the care home.

We shouldn't have sent him back.

Just because it's harm we can't see,

doesn't mean we're not doing it.

Yeah.

And we're meant to do no harm.

All right. See you in a bit.

See you in a bit.

SHALLOW BREATHING

RASPY BREATHING

CALL DIALLING OUT TONE

I wake up and sometimes, honestly,

it's like I've wet the bed.

Soaked.

How does that feel?

CALL DIALLING OUT TONE

VOICEMAIL: 'Hi, this

is Nick Henderson.

'Please leave a message

and I'll get back to you.'

JULES: 'Can't breathe.'

Sometimes screaming.

I wake the kids, actually.

COUNSELLOR: 'Can you say more

about the feeling of drowning?'

SHALLOW BREATHING

JULES: 'There are

bodies everywhere.

'They've all got masks on.

'Their eyes are really wide.'

'I'm scrabbling in the water

to reach the surface'

'..and I'm pushing away the

bodies that are blocking my way.'

I promise you, I've never had

a thought like that in my life.

Just terrified.

What are you terrified of?

Sleep.