Summary: Delia Busby starts Midwifery Training
Disclaimer: Call The Midwife belongs to the BBC and others - I am simply borrowing their wonderful characters.
Author's note: Cross posted from Archive of Our Own. This is not my usual Patsy/Delia fic. I have tried to write a story that is much more similar to an actual episode of Call the Midwife. I have tried to include most of the regular characters - mainly because I very rarely write some of them. I'm not sure if this sort of story line has been done on the show before as I've only seen series 4 and 5. I think I have captured the emotional feel of the show, but I'd be happy to hear your thoughts about it.
My grateful thanks as always to Sittingonthis for her invaluable input into this. It has taken a long while for me to compose this, and it now looks very different to when I first started it. Thanks too must go to Jlynnsca for her wonderful editing skills.
"Hop up onto the couch, Mrs Jenkins," Shelagh Turner invited.
"I keep telling you to call me Sally," the woman scolded as she did as she was told.
Shelagh smiled amiably. "I can't help it. It's force of habit. How are you feeling today?" The Scottish nurse glanced through the manila folder of notes as she asked.
"Tired. Permanently tired. It's much worse than the last," Sally replied, rubbing her tummy absently.
"That's only to be expected at..." Shelagh trailed off as she realised her potential faux pas.
"At my age? Don't worry, nurse. I keep telling myself I shouldn't be having babies at my age either. I think this one needs to be my last," Mrs Jenkins decided, smiling.
"Well, let's just look after the little one you have here, shall we?" Nurse Turner's soft Scottish brogue was as reassuring as ever as she began her exam. "Your blood pressure's a little high, so we'll need to keep an eye on that."
"Pre-eclampsia? Yeah, we went through all that for the last one," Sally commented.
"You're practically as knowledgeable as I am," Nurse Turner agreed. "And all yours is through experience. So, does anything feel different this time? Now you've gone through seven pregnancies, I think it's perfectly reasonable to ask you if you're not feeling quite right."
"Other than being tired you mean?"
Shelagh looked over her glasses at the brunette. "Yes," she confirmed.
Mrs Jenkins shook her head. "Nothing really," she stated.
Shelagh reviewed the rest of the observations she had just taken. "Alright," she commented. "Well, other than a blood pressure that I would expect to be a little higher, frankly, I think we are all doing just fine," she declared. She frowned as she recalled something. "Didn't you mention something about going into the hospital for the delivery of this one?"
"That's right," Mrs Jenkins replied. "My husband booked me in. He says I shouldn't be taking risks giving birth at home."
"We are all quite skilled you know," Shelagh replied, feeling a little slighted by the move.
"Oh, I know that. But you know what my Harry is like. He's insisted. I'd rather have any one of you midwives from Nonnatus help, but he wouldn't stop going on about it after he read the leaflet." Mrs Jenkins sounded apologetic.
Nurse Turner was instantly contrite. "Don't worry. It's your choice where you wish to go. We're more than happy to see you for a little while longer but you might want to consider using their local services in order to keep all your notes together. These things have a habit of getting lost."
Mrs Jenkins nodded. "If I'm honest, I'm looking forward to going in and having a rest. It'll make a nice change not to have to worry about the washing and cooking for a few days."
"Is Mr Jenkins prepared?" Nurse Turner asked, a hint of amusement in her voice.
"He better be."
"Stand up straight Nurse Busby," Nurse Crane commanded as she stood before the new trainee midwife. The senior nurse looked at the young woman's uniform and polished shoes critically, circling round before making a minute adjustment to the collar of her cape. "You'll do, I suppose," she decided eventually.
Behind Nurse Crane, and therefore out of sight, midwives Mount, Franklin and Gilbert stood pulling various faces at Delia as she tried her best to ignore them.
"If you three have finished your larking about, perhaps you'll ensure that your kit bags are ready for today?" Nurse Crane didn't even turn around as she spoke, instead keeping her gaze focused firmly on Nurse Busby. Hurried footsteps indicated that she had made her point.
"This is a marvellous opportunity for us to understand exactly what can be offered in a hospital for our expectant mothers," she told Delia. "Although I am still a firm proponent in the belief that our ladies are not sick and therefore do not need to attend a hospital."
She huffed slightly before softening, noticing Nurse Busby's nervousness. "I know you want to be out in the community, but a placement there will give you excellent grounding. Maximise your time at the Maternity Hospital, Nurse Busby. You will be our link to the future for midwifery. I'm relying on you." Nurse Crane fixed the small brunette with a hard stare before winking slightly. "Go get them, kid. I'm proud of you."
Delia couldn't help but grin back as she spun on her heel and made her way to the bicycle shed. As she pulled her bike from the rack she heard another set of footsteps approaching. She turned to see Patsy walk towards her, a proud grin on her face. "Come to wave me off?"
"Yes. And wish you luck. Although I'm sure you won't need it." Patsy picked at some non-existent fluff on Delia's cape. "I can't tell you how much I was wishing it was me making the final adjustments to your uniform this morning."
Delia blushed. "It's just a uniform. You have the same one."
"It looks different on you," Patsy countered, watching Delia's blush deepen. "I might have to ask you to keep it on later."
"Pats!" Delia feigned outrage. She glanced at her watch. "I have to get going. Don't worry, I'll be careful," she assured, catching the look of worry that ghosted across the red-head's features.
"I'll see you tonight," Patsy promised as she waved the brunette off. As soon as Delia was out of sight, she spun on her heel and hurried back to the preparation room. Nurse Crane would not tolerate any tardiness.
Trainee midwife Delia Busby formed part of the gaggle of students following the Obstetrics Consultant as he made assessments of the women due to give birth at the Maternity Hospital. They halted in a ragged group in front of the next bed.
The consultant picked up the chart that hung at the foot of the bed and flipped through the notes quickly before looking at the patient. Delia bristled slightly; she could see that the woman was nervous and she looked uncomfortable, too. It didn't take much to provide a bit of assurance but the consultant was clearly only interested in getting through the list.
"Ah, Mrs. Jenkins." Dr. Benson began. "According to your notes you came in last night with abdominal pain."
The patient, a thin, dark-haired woman in her early 40s nodded.
"And you're 36 weeks pregnant?" He was merely confirming the information that had been recorded. Again the woman nodded.
"How are you feeling today?"
Mrs. Jenkins swallowed nervously. "I've still got a bit of pain." She rubbed her swollen belly unconsciously as she spoke. Delia was convinced she was under playing her discomfort.
"Well, your observations all look normal. Pulse and blood pressure are all fine. Apyrexic. Any dizziness? Spots before your eyes? That sort of thing?" The questions were fired off rapidly.
Mrs Jenkins shook her head in response. "No. It's just the pain. I've never had anything like that before."
Dr. Benson, a portly man in his early 60s, looked over his half-moon spectacles at her. "How many pregnancies have you had?"
"This is my seventh. I've got five children."
"Thank you." He smiled at her curtly before looking at the group of student midwives. "Well, do any of you have an opinion on what we should do with Mrs. Jenkins?"
Delia bit her tongue. It was all very well being brusque with his own questioning, but the consultant should have at least advised the patient that he was going to discuss her case so openly with the group and explained their presence.
Someone to her left spoke up. "Brixton Hicks contractions? Given the length of gestation and no other symptoms, it looks like false labour."
"Very good," Dr. Benson commended quickly and he turned back to the patient. "You're not quite ready yet. Back home for you for another fortnight, I think." He started make notes at the bottom of the page.
"Wait a minute," Delia interjected. "Mrs Jenkins said that she's never had pain like it before. She's got five children. Surely she's had Braxton Hicks before?"
Dr. Benson looked up irritably; he had clearly already made up his mind. "What are you suggesting, Nurse?"
Delia shifted, nervous by the scrutiny, but she wouldn't simply stay quiet when she had concerns. She looked at Mrs Jenkins and smiled apologetically before speaking again. "Mrs. Jenkins is complaining of continuous pain. Given her age and the number of pregnancies she has had, shouldn't we be worried about something else?"
Dr. Benson raised an eyebrow. "Should we?"
Delia tried to explain. "I mean, I remember reading something about continuous pain being an indicator for..." She trailed off as she saw Dr Benson scowl at her.
"Are you suggesting that I wouldn't know what signs and symptoms might indicate, Nurse?"
Delia's eyes widened suddenly. "No, absolutely not."
"I must say it's rather unusual to find a nurse who automatically thinks of the worst possible outcomes. You're usually all so optimistic." Dr. Benson smiled tightly at the rest of the group who giggled slightly at his jest but it was clear that he was annoyed.
"I'm sorry sir. I'm just concerned," Delia continued.
Dr Benson sighed heavily. "Listen Nurse...?"
"Busby, sir."
"Nurse Busby." He looked down at her with a slight moue of disgust. "I have been an Obstetrics consultant for 25 years. Do you know how many obstetrics emergencies I've had to deal with?"
"Sir, I was just suggesting that there might be another cause for the pain." Delia could feel every pair of eyes on her now, including the Matron who looked distinctly disapproving.
"And are you also suggesting that I would neglect to consider all the causes?" Dr. Benson was angry now.
This was rapidly getting out of control, Delia realised. "No sir, but I was reading something..."
"And there it is," the consultant interrupted as he smiled condescendingly. "You may be book smart, Nurse Busby but I have years of experience in diagnosing and managing patients." He looked back down to the chart and carried on writing his notes.
"But, sir." Delia didn't know when to quit.
"That is quite enough, Nurse Busby," Matron Cox admonished sternly.
Delia clenched her jaw to stop herself responding to the Matron.
Dr. Benson looked over his spectacles at the patient. "So sorry you had to hear that." He finished the notes with a flourish and stabbed his pen onto the paper to place a full stop. The gesture signified that he considered the discussion to be over. Dr .Benson handed the board to the Matron before making his way to the next bed.
Delia could feel her cheeks burn with embarrassment and anger. She had been publicly admonished for raising what she believed to be a legitimate concern. She had also successfully managed to get into both Dr. Benson and the Matron's bad books. This was not the start to the placement she was hoping for. She just hoped that it didn't get back to Nurse Crane and Sister Julienne. Delia sighed heavily and was just about to follow the group when she heard a voice and turned round.
"Nurse?"
Delia smiled apologetically. "I'm so sorry, Mrs. Jenkins. You shouldn't have had to see or hear that."
Mrs Jenkins smiled back, but it was broken as she winced in pain again. "I just wanted to say thank you, Nurse Busby." She had caught Delia's name from the exchange. "It was nice of you to stick up for me."
"It didn't do much good," Delia admitted.
"I'm beginning to wish I hadn't listened to my husband and decided to have my baby at home. At least I was treated like a human being." She sighed. "You never said what you thought I might have."
Delia winced. "I'm not allowed to diagnose, Mrs. Jenkins. We simply get asked our opinions to check on our levels of understanding," she explained.
"But the doctor said you were wrong."
Delia couldn't lie. She was worried. "The doctor thinks you're experiencing Braxton Hicks contractions."
"But I've had false labour before. I've got five kids. I told that nice Scottish nurse that." Mrs Jenkins was indignant.
Delia wondered why the woman had not found her voice in front of Dr Benson, but also recognised that many patients were too cowed by the presence of consultants to do anything other than what they were told. "Perhaps you should speak to the Matron again. Or ask to see Dr. Benson. Are you still in pain?"
Mrs Jenkins nodded. "They keep telling me to rest, and not to worry." She looked at Delia critically. "You're very kind. You're the first one here that's actually take the time to listen to me."
"Patients are our best source of information for diagnosis," Delia told her cheerfully. "And I happen to like talking to patients."
"I don't think you fit in here, Nurse Busby. You find a place called Nonnatus House, and be a midwife there. You'd fit right in there."
Delia grinned. "I already lodge there, Mrs. Jenkins. And don't worry. I fully intend being a community midwife. This is far too impersonal."
Mrs. Jenkins sat up and clasped Delia's hand. "Don't fret nurse. And don't give up sticking up for us patients."
Delia squeezed Mrs. Jenkins' hand. "Good luck with the baby, Mrs Jenkins. And don't stop pestering people if you still feel unwell. Promise me you'll get help if your pain gets any worse."
"I promise," Mrs. Jenkins vowed with a soft smile.
"Nurse Busby!" Matron's severe bark gained Delia's attention instantly and she swung round. "We have moved on to the rest of the patients, Nurse Busby. Or is it your intention to only deal with one per day?"
Delia bit back a retort and quickly squeezed Mrs. Jenkins' hand again. "Look after yourself," she whispered before hurriedly catching up with the rest of the group.
Matron looked absolutely furious. "You will see me in my office at the end of your shift, Nurse Busby."
Delia nodded, knowing that a dressing down was coming. "Yes, Matron."
Delia tugged the door to Nonnatus House shut behind her and headed wearily for the stairs. At the end of her shift, she had been given a stern reprimand from Matron and was joined by Dr. Benson for good measure. She had reached the first landing when she heard her name being called.
"Nurse Busby. Is that you?" Nurse Crane's clear northern tone carried through the convent.
Delia turned on her heel and descended the stairs. "Yes, Nurse Crane," she called back, once she was in closer proximity. The last thing she wanted to happen now was to be told off for shouting.
"You're late," Nurse Crane commented tersely as she emerged from the Clinical Room.
"I was detained after my shift," Delia explained before frowning. "I'm sorry, Nurse Crane. Did I have an appointment with you?"
"Not until I received a telephone call from the hospital, but now you do," the tall nurse told her brusquely.
"What did you hear from the hospital?" Delia asked, a sinking feeling developing in her stomach.
"I do not expect nurses from Nonnatus House to be rude and disrespectful to medical colleagues at other establishments." Nurse Crane had warmed to her subject now.
Delia's shoulders drooped. That was all she needed. "I'm sorry, Nurse Crane," she stated, trying to defuse Nurse Crane's mood.
"What were you thinking? Telling a consultant that he was wrong?"
Delia tensed. "That wasn't what happened, Nurse Crane."
"That's not what Matron Cox told me."
Delia gritted her teeth. She had the distinct impression that nothing she said would make a difference right now. "I'm sorry," she repeated softly.
"Hmm." Phyllis studied her with a beady eye and realised that Delia was already feeling dejected enough. "We'll talk after dinner about how to address consultants," she advised and spun on her heel to head back into the Clinical Room.
Delia hurried to her room and got changed, feeling a fraud in the light blue of the Midwifery uniform. She sat at the desk and flipped open a textbook, seeking confirmation that she had been right to raise concerns.
Shelagh pushed her shepherd's pie around her plate but was in no real mood to eat. Patrick looked up from his meal and frowned. "What's bothering you?" He asked.
Shelagh smiled softly at her husband. "Oh, nothing really. I'm just beginning to wonder how long community midwives will be needed," she admitted.
The craggy faced man frowned. "What's provoked this?"
Shelagh sighed as she laid down her fork. "Oh, another expectant mother told me that she was using the Maternity Hospital to give birth. That's the third one this week."
"Well, it's a sterile, safe environment," her husband reasoned.
Shelagh nodded. "I know, but they aren't sick. They are simply undertaking the most natural act. They shouldn't need to be in a hospital to have to do that."
"In most cases, I completely agree with you," Patrick placated. "But we've both visited houses that leave much to be desired with respect to general hygiene. You have to admit that for those women, it is probably safer for them to be in a clinically clean environment."
Shelagh shrugged. "In general, it's not those mothers-to-be who are choosing to go in." She sighed. "I just remember Sister Julienne describing her experience. It was so," she paused as she looked for the right word. "So impersonal. They haven't even met their midwife before they go in."
"Are you talking about what's right for the mother, or what would feel right for you?" Patrick asked intuitively.
"I know I'd prefer someone I know to deliver my baby," Shelagh replied firmly.
Patrick smiled lovingly at his wife. "The one thing we both know is that medicine and treatment moves forward all the time. We need to move forward with it," he advised.
"That might be more true than you think, Patrick," the slight nurse demurred. "If patients keep deserting us like this, we'll soon be obsolete."
"Don't worry, Mum," Timothy chipped in. "There's an Obstetrics article in this month's Lancet about length of hospital stay post delivery."
"Is there now?" The Scottish nurse sounded intrigued.
"You see? Community midwives and nurses will still be needed if patients are going to be discharged as quickly as possible." Patrick sounded unperturbed by the issue.
Shelagh shook her head. "To my mind, all that does it make it all the more impersonal."
"Adapt and survive," Patrick advised. "I really don't think you have anything to worry about." He frowned as another thought crossed his mind. "Wait a minute, how is it that you've read 'my' Lancet already? I say no reading until I've finished with it." He couldn't quite keep the grin off his face. He was exceptionally proud of his son, and fervently hoped his current passion for education continued for the long run.
"Sorry, Dad." Tim sounded nothing of the sort as he stood up and grabbed his father's now empty plate. "I can't help it if the elderly are too slow to take their opportunities while they can." He gave his father a wide berth as he headed into the kitchen while Patrick made the most of looking affronted.
Shelagh smirked, grateful for the levity and security her husband and son gave her.
Delia was back at her books. Phyllis had at least been discrete enough to wait until after dinner before offering her opinion and advice on dealing with consultants. The northern nurse had led Delia into her office and then made her thoughts quite clear. Delia gritted her teeth and took the admonishment in silence but the second Nurse Crane finished, she excused herself and returned to her room. She looked up when the door opened and Patsy poked her head in. "Is it safe to come in?" She asked with a grin.
"What's that supposed to mean?" After the day she had so far, Delia was automatically defensive.
The tall red head entered and sat down on the bed, leaning back on her hands. "Phyllis was telling us that you've been tearing strips off the consultants."
"Well this is escalating rapidly," Delia commented, exasperated. She huffed, and then described the events to Patsy. "I think there's been a massive overreaction because, heaven forbid a nurse question a consultant." She was angry again. "Pats, he barely looked at her. If you asked him to describe her tomorrow I bet he'd be able to say how many weeks pregnant she was and how many pregnancies she'd had but wouldn't be able to tell you the colour of her hair."
Patsy was frowning. "Mrs Jenkins. I think I helped deliver her last baby. She must be in her 40s now."
Delia nodded. "Yes. I'm guessing that's why her husband wants her to have the baby in hospital. I think she's regretting that now."
Patsy shrugged. "Well, she can still change her mind. She was only at clinic yesterday so it wouldn't be any bother, but it would be up to her to make the decision."
Delia got up and sat next to Patsy on the bed. "I know. It's just the more I read, the more worried I get."
"Read about what?" Patsy asked curiously.
Delia showed the red-head the page she was reading. "It talks about placenta abruption."
Patsy's eyes widened. "That's a bit of an extreme worry, isn't it?"
Delia sighed. "Not you, too," she grumbled, her shoulders sagging resignedly.
Patsy gave her a half smile. "Delia, I've never come across a case, and I don't recall any of the others dealing with one either. There are a whole ream of complications described for childbirth, which is why they're in text books, but don't they also tell you how rare they are?" Patsy wanted to be supportive but she wanted Delia to be objective too.
"Yes," Delia acknowledged.
Patsy looked steadily at the younger woman. "So, it's possible that Dr. Benson is right?"
Delia shrugged. "Possibly," she admitted. The brunette looked at Patsy. "But I just don't feel right about this. He should have at least done some tests to rule it out."
Patsy shook her head. "I'm not sure that there are tests, other than to do another X-Ray. They will be reluctant to do that with the baby so close to due date because of the radiation risk." She sighed as she took in Delia's dejected features. "I'm sure Dr. Benson is just as pompous as you describe, but he also knows about complications in pregnancy. If he was worried and tests could be done, I'm sure he would have arranged them."
Delia shifted miserably. She knew Patsy was trying to comfort her, but she wasn't convinced. Eventually, she nodded, trying to accept Patsy's guidance.
Patsy could see that Delia was struggling. She took Delia's hand and rubbed circles on the back of it with her thumb. "Look, if you're really worried about Mrs. Jenkins, I'll pop by and have a chat with her. I know Shelagh saw her yesterday. I'll speak with her first and see what we can do. If nothing else, we can at least raise the numbers of routine checks we give her, just to keep an eye on her."
Delia smiled. "Thanks, Pats." She leaned forward and kissed her gently. "Now, I'd very much like to have my attention thoroughly diverted."
"That I can definitely manage," Patsy mumbled into her lips.
To be Continued...
