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she is on her rounds, I need help NOW. This is a emergency!”
“Sorry, I always stay on late and have to sort things out, but not tonight! I am going now. You can handle it.” Thomas said with a wink and he quickly popped into the lift as it arrived on our floor. I looked at him in utter astonishment as he said just before the lift doors closed: “Call Angela, the Sister in Charge, she will help”. I wanted to tell him that there was no phone, so how was I supposed to call anyone, but I was too late, the indicator above the lift showed that Thomas was well on his way down.
“Unbelievable”, I muttered to myself and I quickly ran back to the female changing rooms to check on the old lady. I looked for an ID band but could not remember seeing one on the lady's wrist earlier. Perhaps it had come undone whilst she had been trying to move about. I spoke to her and asked her if she could hear me and what her name was, but this time she seemed less responsive than before. I grabbed for my bag and got out my mobile phone and decided to dial the hospital's emergency line. If I had been able to use a normal hospital phone I could have just dialed the Crash Call number, but with no phones present I had to think and act quickly. Having worked in a various hospitals when working as an Agency Nurse, you come to understand that there are a lot of differences between all the hospitals and the way their emergency systems run. As I had worked in this hospital for a long time before I had joined the Agency, I could still remember the different numbers and 989 could be used from any phone, including mobiles, to report any problems: from needing assistance with a violent patient or relative, to reporting a theft, as long as the 'emergency' wasn't a Cardiac Arrest or Fire. It had always worked quite well in the sense that it separated the real urgent matters, that is the life and death situations, from any other occurrences, plus most people could remember it, as it looked very similar to the national 999 emergency call. I hoped by dialing 989 I would get at least some help my way, despite probably preferring the Crash Team in this case. As I ran back to the ward, my phone in hand, I heard a voice say: “What is your emergency?” “Urgent assistance needed on the third floor west wing, fema...” I couldn't finish my sentence as I had dropped my phone, whilst trying to push open the door of the treatment room and finding it partly blocked. Bloody workmen, I swore under my breath. My phone's back cover had come undone and as fast as I could, I tried to piece it together and dialed again. Once more, I got through and although being aware that this time the reception was not as good as it had been the first time, I said again at the prompt: “Urgent assistance needed on the third floor west wing, female changing rooms!” I pressed 'end call' and looked around in the treatment room. As fast as I could, I took a trolley from the corner of the room and loaded it with various bits and pieces I thought I would need: a few bags of intra venous fluids, an intra venous giving set, a few cannulas, and some tape. It took me a little longer than I anticipated as everything seemed to be stored at the wrong place – very likely another result of the workmen's presence. I even found a phone, but it had no lead to plug back into the socket. I also took a portable monitor, an oxygen cylinder with a face mask and, on my way back to the changing rooms, I took some warm blankets from the hot cabinet that was situated alongside the corridor. Just as I was ready to enter the changing rooms, I saw Susan emerge from one if the rooms.
“Sue, there is a sick patient in the female changing rooms. Can you call the crash team please! There is no phone at the reception desk and I need some help here!”
Susan looked surprised for a moment, as if I was playing a prank on her, seeing me in my ordinary clothes and not in nursing uniform, and still damp hair, she probably had not recognized me initially. But as she had known me for many years, she would take my word for it and do what I had asked her to do as I made my way back to the old lady ready to see if I could at least do something for her that would improve her current status.
I tried to rouse her again, only to get a very faint whimper in return. I took the oxygen cylinder, opened the flow valve , connected the face mask and gently put this onto the lady's face. Oxygen is our source of life, without it we will die. When someone is in a poor condition, sick, cold or feverish, the body's oxygen consumption is increased and vital organs can be at risk especially in children and the elderly. I continuously spoke to the woman, reassuring her and telling her what I was doing even though I was not sure if she was truly hearing what I was saying. I took the warm blankets and wrapped them around her, hoping they would transfer some of the warmth to the poor cold woman. I had no idea how long she had been lying there but knew that any given time being exposed to a cold empty bathtub would made anyone feel like freezing after a while, leave alone on a winter's night! I was seriously worried about the woman and convinced she was severely hypothermic

. Hypothermia is a condition characterized by a core body temperature lower than 35 degrees Celsius. When untreated, the body's metabolism and natural functions will significantly slow down and eventually cease, and if not treated, very likely result in death.
The next thing I did was trying to find a suitable vein and get venous access

. This is important in order to get either fluids or medicines into the body in the fastest possible way. Especially in emergency situations, having established venous access can be the difference between life or death and this was a serious emergency situation. As I expected, the peripheral veins were hardly palpable and very hard to find, a sign that she was shut down, which meas that the body was trying to keep the main supply of the blood circulation focused to the vital organs by constricting the peripheral veins of the body. This is a pure survival reaction, but in the case of getting venous access a serious hindrance. It was also quite a balancing act: I was just not able to insert an intra venous cannula by being positioned outside the bathtub, so I carefully had positioned myself inside the bath with her, careful not to sit on her, hurt or injure her by accident. Only then was I able to have a good position for venous access and after tapping her arm for a while, as this can make veins more palpable, I could very faintly feel something and I was just inserting the cannula when three people with the crash trolley arrived. The Resuscitation Team was here! I secretly thanked Susan for doing as I had asked, despite her stunned expression.
“What do we have here?” asked one of the team members, his name was listed on his uniform as John, SHO.
“I am not quite sure,” I responded, connecting the intra venous fluids to the cannula I had just managed to insert.
“I found this lady here as I was ready to leave for home after my shift tonight. She must be a patient, deducting from the gown. I have no idea how long she has been here and how she got here!” I added as I climbed out of the bath.
“Are you agency?”, he questioned.
“Yes, I am, but I used to work here permanently for many years”, I answered, aware that I sounded defensive.
“I just managed to get venous access,” I said.
“Well done,” said one of the nurses as she slapped the monitor pads on the old lady's chest and connected the ECG leads.
“Maybe you can find out who this woman is and we can take it from here!” said John authoritatively, addressing me and glancing at me suspiciously.
“As I told you, I have no idea! Perhaps we may find her ID band once we have taken her out of this bathtub! She may be lying on it!” I said.
“I would also like to know who this woman is!”, said a deep voice behind us.
All of us turned around and looked at the man who had just entered the female changing rooms. He was dressed in a grey suit covered by a dark winter coat. His hair was black but showed signs of grey at the temples. He had light piercing eyes.
“I am DCI Milton. Someone dialed 999?” he explained.
John, the SHO, looked at me: “Did you call the police

?”
“No, I never!” I replied.
“Well, someone did!” DCI Milton said.
As the crash team was ready to transfer the old lady onto the height adjustable trolley, I helped them with getting the lady across. John told me in very few words they – the Crash Team – would take it from there. He still tried to push me to find out more about the patient! I looked at the bathtub, now empty with the lady safe on a trolley: there was no sign of an ID band anywhere!


2
Interrogation part 1


DCI Milton asked for my name, which I gave him and he told me that he would appreciate it if I could also provide him with the names of the people of the crash team and any other staff members working there that evening and night. Then he asked me if there was a place he could talk to me first, as I had been the one to have found the old lady. John nodded as to indicate it was alright for me to do so.
“We are fine now and will take the woman to ITU”, John said. Once on the trolley, connected up to a monitor, with oxygen administered and with warm fluids running into her veins, the Crash Team quickly ran through the corridor into the direction of the ITU department where she would receive further care and treatment. My offer to come with them seemed to fall on deaf ears and I was left a little deflated, seeing them disappear. I sighed deeply, looked at DCI Milton and said:“I suppose we can go to the Nursing Station, if that is alright with you.” He nodded and followed me down the corridor.
“Is there somewhere more private?” Milton asked as he looked at the open plan layout of the Nursing Station.
“Eh, let me think! Yes, we could use the small office at the back behind the Nursing Station or the treatment room”, I replied. “I have to check though, they have been refurbishing the department and there are still areas where they have not completely finished yet”, I added.
As the office at the back seemed full with stored items, old and new – drip stands, monitors, lamps and bedside cabinets- plus various painting and decorating materials, we decided on the treatment room, which was, after having more

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