rocking backwards and forward in the nursing chair. Harry had dealt with lots of anxious parents. NICUs were the most intimidating places on earth. Parents frequently felt everything was out of their control, and he was used to comforting and supporting parents who were overwhelmed with helplessness and focused on every word that was said to them. This mother was young. Her lank hair was pulled back from her face. It looked as if it hadn’t been washed for a while and from first appearance he actually wondered when she’d last eaten. Now he understood just why Esther was being so protective of Billy’s mum. It was clear she didn’t have many support systems in place.
‘Jill, this is Harry Beaumont. He’s the surgeon that’s going to do the surgery on Billy.’
Harry crouched down so he was level with Jill. She’d sat forward but hadn’t stood up. He gave her a broad smile. ‘It’s a pleasure to meet you, Jill. I’m here to take a look at Billy. I’m hoping we’ll be able to take him for surgery later today. Do you mind if I examine him?’
Jill paused for a few moments as her eyes filled with tears, then she gave a tiny nod. ‘Of course.’
She was terrified. He got that. Harry used some of the NICU hand sanitiser before opening the crib to examine Billy, while Francesca introduced herself as Billy’s anaesthetist. He could tell straight away that Esther completely understood, and after a few moments, he could see the tension in Jill’s shoulders start to dissolve as he spoke to Billy in a calm, quiet voice as he examined him.
‘Hi, Billy, I’m here to see how you’re doing. Let’s have a little listen to your heart and lungs.’ He took his time, listening carefully, then checking his oxygen sats, his feeding tube and his colour. Babies this small frequently had skin that was almost translucent. Their circulatory systems—and particularly Billy’s—weren’t functioning quite right, and they often couldn’t regulate their temperatures. Operating and anaesthetising these babies carried huge risks. He gave Francesca a nod as he moved his stethoscope back to Billy’s chest. ‘Want to take a listen?’
She nodded and moved alongside him. There was no point her touching Billy too when she really just needed to listen to his heart and lungs. So, she listened through Harry’s stethoscope, nudging him to move it on occasion.
Harry could sense Esther watching them curiously. She wouldn’t know they’d done this a dozen times before. As Francesca finished her examination it struck him how similar Esther and Jill looked. Exhausted and tired. He could understand it for the mother. But for a member of staff—it wasn’t good enough.
Francesca gave him a nod and he removed his stethoscope and pulled a chair over next to Jill and spent the next few minutes explaining Billy’s surgery to her in simple terms. He brought out some notes that he’d prepared earlier. He always gave the parents of the babies he operated on some clear notes that they could refer to later. Experience had taught him that although parents listened, anxiety meant that they didn’t always remember or understand what they’d been told.
He could feel Esther’s eyes on him the whole time. He would expect the midwife assigned to this child to listen to his explanation. It would mean that she could reiterate anything to the mum at a later date. But somehow, today, it irked him. And he couldn’t quite understand why.
‘Do you have any questions?’ he checked with Jill. She shook her head and he gave her a small nod. ‘If you think of anything later I’ll still be available to answer any questions. I’m going to organise some theatre time now. I hope to take Billy later this afternoon. We’ll stop his feeding for the next few hours, and I’d expect the surgery to last around six hours. You can come down to Theatre if you want while Billy goes to sleep, and I’ll come and find you as soon as we’re finished to update on how things have gone. Okay?’
Jill gave a nod.
‘I’m just going to have a chat with your midwife, and then I’ll talk to you in a while and get you to sign the consent forms.’
He smiled and walked back over to the nurses’ station with Francesca and Esther. Francesca sat down and started making some notes. Esther turned to look at him. ‘You aren’t doing the consent form now?’
He shook his head. ‘No. I’ve given her a lot to process. I want to give her a bit of time to think about everything I’ve told her before I get her to sign the consent form. She might have more questions later.’
Esther gave a brief nod.
He narrowed his gaze. Was she actually listening? He glanced at the board he’d noticed yesterday. It was a shift rota for staff.
The next few days would be vital for Billy. It was important that whoever was looking after him was at the top of their game. Esther’s name was on the rota for tomorrow. He couldn’t let that go.
‘You’re tired. No, scrap that, you’re exhausted. And I think you’re sick. I don’t think you should be at work and I certainly don’t think you should be assigned to Billy. For the next few days he’s going to need someone who’s alert and on their game.’ He paused for the briefest second, because he knew what he was about to say wasn’t exactly nice. ‘And to be honest, I’m not convinced that’s you. I want another midwife assigned to Billy.’
‘What?’ Well, that had certainly gotten her attention.
‘I’m sorry. But I can’t take the risk of performing this surgery and having his postoperative care compromised.’
‘How dare you!’ she hissed at him. She glanced down. ‘What? Because I have a little coffee spilled on my scrubs and I haven’t had a chance to get changed yet, and because I dared to close my eyes in the hospital canteen, you’ve decided I’m not fit to do my job? Just who do you think you are?’
He cringed. He hadn’t exactly said those words but it was certainly how he’d felt. ‘I think you’re sick,’ he said quickly. ‘I think you might need to be checked over, and have a few days’ rest.’ He could see a couple of other staff members looking their way—as if they’d picked up that something was wrong. The last thing he wanted when he was taking up a position here was to cause a ruckus with the staff.
‘My priority is my patient,’ he said quietly but firmly.
‘And mine isn’t?’ He could tell she was mad.
That wasn’t what he meant, even though he’d clearly just implied it. But then again, did he really want this midwife looking after his patient if she wasn’t at the top of her game?
Francesca glared at him from over her computer. Oh no. That didn’t usually happen. Francesca normally had his back.
He took a deep breath. ‘Esther, I have to call things the way I see it. I think you’re running a temp and maybe need to take some time off. You agreed you’d go down to A&E and get checked over. Why don’t you do that and we’ll take it from there.’ It was a compromise. But it was the best he could do right now.
She kept her face entirely straight and pulled up a few things on the computer and grabbed the chart from the base of Billy’s crib.
‘Here, Mr Beaumont. I’d like you to check my work. Here’s all the orders I made for Billy on my shifts for the last few days. Here’s all my nursing notes. Here’s every temp, blood pressure, pulse and respiratory rate. Here’s his medications I’ve administered, and his feeding. Here’s his skin care chart. Here’s his colour chart. Here’s how many times I’ve sounded his chest to ensure that it remains clear. Here is exactly how many
