by AB Morgan
The timing of this request was immaculate, and Giles Sharman was gushing with self-importance as he immediately reached inside his briefcase for his mobile phone. With an audience to hand, he contacted Gordon Bygraves, instructing him to make welcoming arrangements for a photographer from the Daily Albion to visit Pargiter Ward on Sunday. Thus he ensured that the pictures would be available for the newspaper to go to print on the Monday, when the weekly health section appeared.
Over the phone to Gordon Bygraves, he went to loud and detailed lengths to describe the news that he, Dr Giles Sharman, was to be a central feature in the Monday edition of the Daily Albion. Jock had hooked him with assurances that he would be ideal for their series on “Medical Trail Blazers” and that he had been sent especially to meet with Dr Sharman at the conference to ensure that as much accurate and interesting fact as possible found its way into the feature article.
At the other end of the phone, Gordon Bygraves’ face fell and he sat forward in his chair in an attempt to contain his anxiety. He had been backed into a corner and not given any leeway to negotiate the management of this intrusion. Added to this was his sure and certain knowledge that the whole building looked tired and unloved. Nothing short of a miracle was required if the place were to be acceptable enough to appear in the national press. Despite these reasons for declining the demand from Dr Sharman, he could do nothing other than to give his weak approval. ‘Yes, that should be fine, we’ll expect a photographer on Sunday then.’
As soon as he ended the call from Dr Giles Sharman, Gordon picked up the phone again and rang as many of the hospital board members that he could find on a Friday, those who weren’t playing golf or on a long weekend. The ones he did manage to speak to, seemed unconcerned and mostly flattered by the attention that the hospital was about to receive. Gordon was given the green light to spend money on superficial cosmetics to smarten the place up. His first response was to call Harriet Morris from the Mental Health Act department into his office and he asked her to bring a few of the medical secretaries with her. Between them they rapidly pulled ideas together. This was done far too swiftly, even for a most basic plan for upgrading and improving the overall ambience and the outside initial impression of the unit building.
Not until the end of the day did it occur to Gordon Bygraves that he would need to inform the staff and patients of Pargiter Ward, and the other wards and departments contained within the unit, that they were to expect a visit from the press.
He only thought to do that, because he had been informed that Mark El Amin, their mystery man who looked like Jesus, had gone AWOL. He hoped the police would have returned him before Sunday, and that the coppers did not appear on the doorstep with a man in handcuffs when photographs were being taken by the press, that would not be the sort of publicity he was anticipating.
Thankfully he had a positive response from the occupational therapy department, whose staff offered to come in on their days off, the next day, to create one or two large posters and to put artwork on the walls. They had a number of designs in mind that Gordon was certain would be useful, and he gratefully accepted their offers of help.
The Pargiter Ward staff nurse in charge, Bob, was not so enthusiastic and he raised a stream of queries about how the press visit was to be managed in terms of safety, confidentiality, dignity, and timing of the usual ward routines. He also wiped the floor with Gordon’s plan to paint the corridors and ward doors before Sunday.
‘That’s not even remotely possible. Painting has to be carried out with estates staff doing the work in stages, and the paint will not be dry on the ward doors in time for Sunday as you are about two weeks’ short for the requisitions to be put in place.’
Gordon Bygraves felt embarrassed because he had not even thought through the vast majority of these issues, and had less than two days to ensure that he had a well-designed plan for each contingency. Gordon bluffed his way through Bob’s queries by outlining that in the morning, on Saturday, a team of staff and helpers would be arriving with the intention of making the place look ‘a little more welcoming’ and he updated Bob with the offer from the occupational therapy department which seemed to be well received.
‘Yep, big old posters, that should hide a multitude of sins.’ Bob was, in reality, rolling his eyes and shaking his head in despair at the other end of the phone line.
It was suggested by Bob, to Gordon Bygraves that the most obvious first step would be to alert the staff members who were to be on duty on Saturday and on Sunday, including the night staff.
‘Of course,’ replied Gordon, writing down each of the valuable points that Bob was coming up with, while simultaneously acknowledging that the staff nurse seemed to have a lot of common sense. Gordon himself was sadly lacking this characteristic. He had no idea how he had ended up as unit manager, and neither had any of the nursing staff. They assumed he was one of those sideways promotions that happened in the NHS because senior management didn’t know what else to do with him. Most of the nurses on the unit thought he was a nice enough chap, who used to be an average nurse, but was simply not very good as a manager.
‘I tell you what, I’ll ring the ward staff to warn them. You concentrate on organising tomorrow’s redecoration efforts,’ said Bob. Undertaking the whole task was more than Gordon was capable of on his own.
Bob had a habit of singing tunes relating to whatever had been said in a conversation, or which related to certain people. In this case, he left the office to tell the staff the news and could be heard singing an old track, by Jilted John, which contained the immortal line ‘Gordon is a moron …’
On Saturday morning, hours after the routine handover meeting, pandemonium struck Pargiter Ward. It came in the shape of Gordon Bygraves, Harriet Morris, and one or two unfamiliar faces, who arrived carrying armfuls of new bed spreads, scatter cushions, plastic flowers, vases, and framed pictures. Gordon announced that there was a box van full of other items yet to be transferred up to the ward.
Emma had been due on the late shift, but when Bob had spoken to her at home, she had volunteered to start much earlier in anticipation of extra help being required. It was more than helpful. She and one of the more-experienced healthcare assistants found themselves policing the plans that had been made to dress-up the ward.
The office staff and the management team had, in their infinite wisdom, failed to ask for input from the staff on the ward, and thus had singularly failed to take into account the issue of risk when it came to items considered safe enough to have on an acute psychiatric ward.
The occupational therapy staff were pressganged into helping, not only in the creation of posters, but in redesigning items, particularly the paintings and pictures that had been purchased that day and brought on to the ward. These were immediately diverted back downstairs to the OT art rooms to have the glass removed. The pictures could not be hung using wire and picture hooks, and had to have mirror hangers screwed on to them for safe and secure attachment to the walls of the corridors.
‘Which bright spark decided that buying a mini pool table was a good idea to have in the large dayroom?’ Emma shouted above the mayhem that was taking place in the main reception area downstairs. She had taken on the role of head controller in deciding the safety of each item being unloaded from the van.
There was no help offered from the security guard who sat at the reception desk by the entrance to the unit.
That was pretty much all he did.
He sat.
He would rise from his seat to ensure that the main unit doors were locked at nine pm, when his replacement took over until the Sunday morning. Then he came back and sat for another twelve hours doing nothing. He said hello to everyone who entered, asked them to sign in and sign out, and that was his contribution to security. If the alarms sounded he did not react, as he was not permitted to leave his desk other than to go to the toilet.
On that Saturday he sat and watched the proceedings with fascination.
‘Don�
��t you worry, Rocky, you just sit there and watch us do the hard work!’ shouted Emma. She received a big grin, a nod and no comprehension of her sarcasm.
Emma diverted several items to OT staff for modification, and others she returned immediately to the van.
The mini pool table was one of the items returned.
Gordon Bygraves challenged Emma’s decision making, until she asked him if he had ever experienced being on the receiving end of a sock full of snooker balls. ‘Effing idiot,’ she muttered as he walked off in embarrassment at his own stupidity.
She then sent back, using a few ripe phrases to emphasise how astounded she was, the box of glass vases. ‘Anyone for wrist slashing? Glass available here, free of charge! But try not to make a bloody mess on the effing carpet because the effing press might notice!’
It was indeed fortunate that, as usual, the vast majority of the patients were on day or weekend leave because the chaos of the to-ing and fro-ing made management of ward safety troublesome for the staff. Emma, having taken overall control of proceedings, had ensured that the ward revamp took place in sensible stages to offset the increase in disruption.
They had to wait for a man from the estates department to arrive with his special secure toolbox and a drill, before the pictures could be hung on the walls. Meanwhile, the focus was on new bedspreads, new chairs, scatter cushions, and putting plants around in giant planters. The planters had to be filled with additional weight to make them too heavy for an angry person to launch. Gordon was therefore dispatched to the local builder’s merchants for heavy ballast. The plants were only plastic so this was not difficult to achieve.
New soft furnishings in the shape of chairs for visitors and patients replaced the ancient vinyl ones in the dayrooms. It had not occurred to Gordon Bygraves that the reason the vinyl chairs were so old, was because they had withstood the tests of time and damage, and were specifically designed for use in hospital dayrooms. Cheap furniture was not going to survive much beyond six months, if that.
Emma instructed that the old vinyl chairs be stored in one of the unused rooms in the basement, knowing that they would have to be returned to their rightful places on the ward in the not too distant future. She had more sense than the whole makeover team put together. She also knew that the scatter cushions would be gone as soon as the photographer had finished his assignment on the ward. They were too tempting as a hiding place for contraband, for self-harming tools, or drug paraphernalia.
There were new board games, packs of cards, second-hand books, and magazines being unloaded. Once scrutinised by Emma, these were taken to the ward, to the delight of the patients who were stuck there for the weekend. They were given the special task of trying out these items, and did not hesitate in giving their valued opinion. There was an overwhelmingly positive response.
Once the OT staff had completed the required modifications to the items sent to them, they turned their attention to creating their artwork and made posters from pieces of creative writing that the patients had produced over the previous few months. The vast majority of patients took their artwork home when they were discharged from hospital, but others left their creative efforts to decorate the OT department walls and provide inspiration for others.
By the time the end of Saturday arrived, the place was feeling more homely, depending of course on what sort of home you came from. It wasn’t luxurious but the unit was definitely not so dreary or soulless as it had been previously.
The final instruction from Gordon had been to create a ward supplies shop where patients could purchase toiletries and washing powder, and borrow second-hand clothing. This had been magically provided through use of a storeroom full of broken furniture which had been forgotten about and left undealt with. This was mainly because the requisition form, for removal of these items, had been swallowed up in the chasm of endless processes required to get any simple practical task achieved in the inefficient leviathan of the NHS.
Emma could not get the old and dusty contents of that room into the back of the hired van speedily enough. She instructed the husband of one of the secretaries, who had been bribed to drive the hire van, that he was to take these items to the tip. The other items were for return to whichever shop they had come from, and the glass vases needed ‘replacing by plastic ones please.’
Gina the cleaner was like a terrier down a rat hole. Straight into the storeroom, she had it scrubbed and sparkling in no time. It was lined with shelves and would be immensely useful in future. The OT staff made a lovely sign for the door: Ward Shop and Clothing Store. They then made a neat square blackboard to go below the sign, to indicate the opening times, once it had been decided what they were to be.
The store was stocked with toothpaste, soap, toothbrushes, ladies sanitary items, tissues, shampoo, and the like. This only served as a reminder of the lack of basic patient provision to-date. The staff team on the ward was delighted with the result, but painfully aware that the task of managing the shop had yet to be thought through.
When the mayhem settled down and the mess tidied up, Emma found time to phone me at home to give me an update on what to expect when I arrived for the Sunday early shift. Emma was proud of herself for leading on the formidable undertaking on Pargiter Ward that day, and she let me know what a trial it had been to ensure dangerous items were not ‘dumped on an acute psychiatric ward by people who should know better.’
I had been in a hell of a stew all day long. I had tried to keep myself busy at home, catching up with mundane household chores and shopping, mainly to keep my mind from dwelling on the distinct possibility that I could get the sack any day. I demanded to know from Emma if the police had returned Mark El Amin to the ward yet.
‘No. We haven’t heard a peep. I think they may have more important things to do. Besides which everyone here has other things on their minds. I think he’s been forgotten about. He’s probably miles away if he has any sense. Anyway, Mon, he’s better off out of here. It was chaos earlier.
‘Now then, tomorrow …’ Emma prompted. ‘The photographer man is coming late morning and has been told he can only stay for one hour. He’s not allowed to take proper photos of the patients or staff, so he’s going to take shots from behind and out of focus in an arty-farty way. I think Gordon Bygraves is in charge of escorting him around, so there should be no specific impact on our staff. What a bloody fuss for a few photos.’
I agreed, a right bloody fuss. I chatted with Emma about what she feared Dr Sharman’s reaction would be, when he found out that Mark had gone AWOL.
‘I shouldn’t think he will be bothered one way or the other. He’ll be far too busy revelling in the press attention. The article is supposed to be in Monday’s paper, so we may not even see him in ward round,’ suggested Emma after time to reflect.
‘Oh. I never even considered that possibility, Em. What a relief that would be. If he does turn up he’ll be unbearable, insufferable, and other adjectives that I can’t think of, but they probably end in …able.’
We were both of the opinion that Dr Sharman’s horse was getting higher and it would take something spectacular to knock him off it. We even made suggestions to each other, and amused ourselves for many minutes inventing a new game called ‘knock the git from his high horse’.
34
Photographic Evidence
Sunday morning arrived, and the newly purchased plastic plants, plastic vases containing plastic flowers, posters and pictures remained as they had been strategically placed the day before. I was in charge of the morning shift, and there were more than one or two issues to contend with.
The new admission, the young lady by the name of Tania, had managed to get hold of a craft knife left unattended by one of the helpers during the ward tart-up. During the night, Tania had done a fine job of carving up her left arm and had been taken over to A&E by the night staff to be stitched back together. I had to review the situation, and assess the level of risk that Tania was presenting with, in order to update
the on-call doctor.
The decision had been made the night before to place Tania under close observations, but this, I knew, could be detrimental, as it often resulted in lots of positive attention being given in response to an unhelpful self-harming strategy. A bit like rewarding bad behaviour. It was a difficult decision because not enough attention in reaction to self-harming, could every so often result in the person upping the ante. Result? More blood.
There were probably long and complicated psychological theories to describe that particular set of dilemmas and behaviour, but I tended to be more practical in my analysis. To me, Tania was a person who didn’t understand or recognise her own emotional responses and who could therefore not talk about them. She acted out her feelings by demonstrating hurt or anger, offending others and by injuring herself. Simple.
I decided that it would be wise to be cautious, rather than have a dramatic blood bath for a press photographer to take sneaky snaps of. Tania would be kept out of the way in a side room with the brilliant Margaret for company. There were lots of new books to be read that day and Margaret was keen to share out loud the gift of a good story.
All was calm when Gordon Bygraves entered the ward accompanied by a middle-aged man in a crumpled suit carrying an expensive-looking camera. He was introduced to me as, ‘John Starkey from the Daily Albion newspaper, who has come to take photos to support the article about Dr Sharman. It’s due to be published in Monday’s edition of the paper.’ I tried to look impressed as I double-checked with both men that they knew they ‘should not enter the female dormitory area’, and that no photos of patients or staff were permitted; although out of focus, or shots from behind, would be acceptable. ‘These requirements must be explained to any of the patients who try to get into a shot, or who happen to appear in front of the lens. That is vital,’ I asserted.