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“ 
Most people's instincts, especially a nurse, is to protect. I never thought that I wouldn't stop to help someone.
Well, you did stop - it worked out very well. Saved the day.
Duffy:
No, they saw the uniform, I didn't feel I had a choice. I kept thinking, "What if I don't know what I'm doing any more?" That thought crosses my mind all the time. But today was different. How I reacted, how others did.
 ”
— Duffy upon deciding to quit nursing.

The 40th episode of series 33 is the 1132nd episode of Casualty overall. It was directed by Nimer Rashed and written by Johanne McAndrew and Claire Miller.

Plot

Duffy leaves her house and makes her way to work. On the bus, she spots a girl named Carrie running blindly across the neighbouring park. Duffy orders the bus to be stopped, and the girl collides with the side of the vehicle. As the passengers go to assist the girl, one asks Duffy if she is a nurse. She initially hesitates, but she subsequently agrees to help. Duffy assesses her condition and discovers that Carrie has lost the ability to move her fingers due to her open fracture, so she reduces it. However, as her panicked foster mother Emma arrives on the scene, Carrie begins to have difficulty breathing.

While looking through photographs of himself as a young child, Jacob responds to Omo's calls and visits her in her bedroom. She asks him if he could buy her some more bush tea, and he begrudgingly agrees. Outside the emergency department, Ciaran stops Archie on her way out and asks her about her working relationship with Connie. She insists that it is fine and turns down his offer of a chat. At the scene of the accident, Duffy learns that Carrie is diabetic and feeds her a sports drink to help treat her hypoglycaemia.

3340CiaranTellsDuffyToBackDown

Ciaran urges Duffy to consider precautions and liability.

Back at the ED, as Connie departs for a budget meeting, Carrie is taken into resus, and Ciaran takes issue with Duffy's decision to intervene. In her kitchen, Omo informs Jacob that the church has asked her to help out with a bake sale, but he objects and urges her to give herself a break; she leaves, regardless. In resus, Duffy returns wearing her uniform, but Ciaran suggests working in Minors and considering precautions and liability, given her dementia. However, when Emma backs her up and claims that Duffy saved Carrie's life, he stands down and allows her to see the case through.

In admin, Jade logs onto a computer to complete her personal statement for her bursary application, but she struggles and claims that she will need Marty's help. However, David informs them that he will be assessing them on taking care of adults with minor injuries or illnesses, and he introduces them to their patient - Logan Morley. Back in resus, Duffy asks Charlie if he heard what Ciaran said to her, and he argues that he is "playing it by the book". She presses him to support her and affirms that the ED is where she belongs. Nearby, Carrie comes around and tells Emma that she tripped on her shoelace.

In cubicles, Logan explains that he accidentally stabbed himself with a screwdriver whilst trying to remove his ankle tag. Marty suggests checking his vitals, and when David asks for more tests, he cues Jade, catching her off-guard. She confronts Marty for putting her on the spot and presses him to work faster so she can continue working on her application. At the bake sale, while organising a table of cakes, Omo vomits up blood into her handbag. She calls Jacob, and Robyn urges him to help her.

While waiting for a scan, Carrie explains to Duffy that she and Emma have their six-month review in the afternoon and, to Duffy's shock, asserts that she wants her to praise her so she can get a "good one" next time. Nearby, with David's encouragement, Jade draws attention to Logan's markers for sepsis and proposes taking blood samples and doing a wound swab. He praises her thinking, and she reluctantly asks for his help with something "sort of work-related". Jacob meets Omo at the church, and she asks him to take her home. However, he discovers the blood in her bag and insists on taking her to the hospital. She reminds him that she is dying and beyond help, but he becomes irritated and declares that he "[knows] what's best". Once Carrie is moved into a cubicle, Duffy connects her to a bag of water and glucose. Carrie asks her how many calories are in the bag, and Duffy assures her that it has been calculated for her. With Emma gone, Carrie asks Duffy to make her attend the review, claiming that it would better for both of them. Meanwhile, a frustrated Omo is taken into HDC.

In Logan's cubicle, Jade attempts to insert a needle into his arm, but he suddenly jumps off of his bed, claiming that he does not like them. David understands and instructs Marty to help him back onto the bed, but he vehemently refuses, insisting that he has "form". Outside the department, Duffy finds Emma and informs her that Carrie wants her to attend the review and views her as "just another temporary placement". Emma insists that she is desperate to connect with her, and Duffy suggests helping her manage her diabetes. Duffy takes her to visit Carrie in her cubicle, but they find her having a seizure on the floor. As she is taken into resus, Ciaran instructs Charlie and Ethan to take over treating her and asserts that they cannot afford any more mistakes. Duffy maintains that she gave Carrie the correct concentration of glucose, but Ciaran dismisses her and orders her to stay nearby so Emma does not ask any questions. When Carrie does not respond to being given lorazepam, Ciaran suggests that they are dealing with a case of status epilepticus and prepares for a phenytoin infusion, but Carrie comes out of the seizure.

Elsewhere, Jade tries to convince Logan that he needs to have his blood taken for his own good, but he loudly demands her to back off. Outside the cubicle, David reminds her that she should never antagonise a patient and that they need to find a way of encouraging Logan to relax. She suggests using a technique that she learned in Obs and Gynae, but she is hesitant to try it herself. David evokes her claims of being a "survivor" and being unwilling to give up that she made on her bursary application, and Marty presses her to "put [her] personal statement where [her] mouth is".

3340JacobDecidesForOmo

Jacobs insists that Omo undergoes the endoscopy.

In HDC, Dylan informs Omo that her pancreatic tumour is pushing against the wall of her stomach and is about to recommend performing an endoscopy, but she insists on receiving no more treatment and returning home. Jacob takes issue with her decision and explains to her the consequences of her decision on her health, but Dylan maintains that it is ultimately her decision to make. Jacob accuses him of taking sides and asserts that Omo is incapable of making a rational choice, given her history of schizophrenia. Dylan subsequently leaves them alone so they can talk.

Jade guides Logan through a breathing exercise, and, to Marty's bewilderment, she manages to obtain a blood sample. Jacob insists that the endoscopy is in her best interests and acknowledges that he has made decisions for her in the past, but she interrupts and asserts that they were bad decisions. Jacob affirms that he has always done what he thinks is right, and Omo asks him if that includes having her locked up. To her shock, he says yes as he was always afraid of her schizophrenia manifesting, as well as the thought of him suffering from the same hallucinations. She insists that the voices in her head claimed that it was his fault and that they got angry whenever she attempted to defend him. She asks him what the procedure is for, and he explains that it will stop the bleeding so that they could have more time left together. She questions his judgement and suggests that he does not like her very much, and he claims that he wants to learn.

In resus, Emma tells Carrie that she is determined to learn as much as she can about diabetes and help her with managing it, but Carrie states that she does not need her help and that she is not a substitute for her deceased daughter Evie. Emma pleads her to stop, but she calls her "pathetic" and claims that she is the reason she killed herself. Horrified, Emma leaves. In admin, Marty praises Jade's treatment of Logan, and Dylan asks for help with the endoscopy. David prompts Jade to assist, and she reluctantly agrees. Outside resus, Ciaran informs Duffy that there needs to be an ongoing dialogue as her dementia progresses, but she maintains that she is not at fault. He claims that working with memory issues is "tricky" due to a lack of insight into one's own behaviour and recommends spending the rest of the day making a rational decision about her future in the department. Duffy refuses "to be bullied into resigning", and Ciaran sarcastically asks her to let him know if anyone gives her trouble.

As the team prepares for the endoscopy, Omo asks Jacob if his memories of her are all bad, and he recalls her singing loudly and out of tune whilst making him breakfast. Dylan and Jade return, and the former suggests having her sedated for the duration of the procedure. Jacob thanks her for agreeing to have it done, and she asserts that she wants to. In resus, Carrie asks Charlie if she is better now and if anyone has spoken to her social worker Sally. As he goes to find her, Carrie disconnects herself from the monitor and leaves her bed. Meanwhile, in resus 3, Omo claims to not be drowsy at all, so Dylan elects to perform the endoscopy while she is still awake. However, as he begins the procedure, the sedatives finally take effect. Jade suggests collecting Omo's belongings, but Jacob insists on staying by her side. However, Dylan claims that he is in his way, prompting Jacob to leave.

In cubicles, Duffy observes the mess in Carrie's cubicle and tells Robyn that she had another hypo. She asks her if another medic was with her at the time, and Duffy begins to realise that she deliberately made sure that she was alone and discovers that her pillow is drenched in the glucose solution. She returns to resus, but Carrie is nowhere to be seen. She finds her in the toilet and confronts her about getting rid of the glucose and using her insulin to lose weight. Carrie insists that nobody cares about her, but Duffy asserts that both she and Emma does. After retrieving her from the coffee shop, Duffy returns with Emma, and she tells Carrie that they want her to make the decision to let them herself. Emma apologises for leaving her, but Carrie suggests that it was easy to make her go away and claims that she has had "enough messed up stuff happen [to her]". Emma begins to panic, but Duffy reminds her that Carrie needs to let them in herself. Emma promises to stay with her no matter what and explains that, despite feeling angry and upset with her and having not been to a hospital since Evie's death, she remained nearby regardless. Using all of her strength, Carrie opens the cubicle door and allows Duffy to treat her.

3340CiaranApologisesToDuffy

Ciaran apologises to Duffy.

In Omo's house, Jacob finds photographs of himself as a child and one of his school books and takes them back to the ED with him. Outside resus, Robyn finds Duffy and suggesting coming over to her flat to watch Charlotte using a fork, but Ciaran interrupts and apologises to Duffy for jumping to conclusions regarding the Proctor case. Although he commends her for her "tenacity and patient care", he maintains that the hospital is no place of sentimentality and reminds her that she is "suffering from" dementia. However, Duffy corrects him and states that she is "living with" the condition.

Jacob returns to HDC with the bush tea and his school book, and Omo encourages him to sit by her bedside. In the book, they find a drawing of them outside their first flat, and Omo explains that he always closed the shutters as she "wanted to fly". Jacob apologises and closes the book, but she insists that "there is so much more to see". In the staff room, Duffy tells Charlie that she did not expect today to be "another last". He asks her to elaborate, and she explains that you don't know when something comes to an end until you lose your confidence. She tells him that she thought twice about helping Carrie due to her doubts about her competency, and the only reason why she helped her was because of someone recognising her uniform. She insists that she is fighting a losing battle and that it is already time for "Plan B". Charlie offers to tell the rest of the team, and she kisses and thanks him.

Jade visits Jacob in HDC and asks him if the large man he drew in his book is his father, but he tells her that he died before he was born and suggests that it is probably one of his uncles. Given how much the man appears in his drawings, Jade suggests asking Omo who he is, but he asserts that "any long-lost relatives made sure they were lost". She urges him not to miss out on people who care about him as, in her experience, they are hard to come by. Jacob thanks her and calls her a "good listener". She jokingly states that she can mention it on her personal statement, and, to her indignation, he mentions that Marty approached him for a reference the other day.

Outside the ED, Connie chases Ciaran and demands to know why he did not tell her about the situation with Duffy earlier, and he claims that she was busy "raiding the public purse". Connie maintains that any question of competency was proven false and that Duffy is "a lynchpin of [the] department", and Ciaran assures that she has his full respect for dealing with the situation with dignity and claims that he did her a favour. Meanwhile, Jade confronts Marty and demands to know why he did not tell her that he applied for the bursary, and he apologises to her for causing her trouble and claims that he would un-apply if he could. Nevertheless, she tells him to forget it and suggests that he is a better nurse than her anyway.

3340JacobRealisesOmoLied

Jacob realises that Omo lied about his father dying before his birth.

Back in HDC, Jacob shows Omo a drawing of them attending church in their car, and she recalls him standing up in the car and his father telling him to get down. Confused, Jacob reminds her that she told him that his father died before he was born and demands to know why he is in all of the pictures. Omo asserts that it is "easier for a father to have children than for children to have a father". Jacob asks her to explain, but she professes her drowsiness and goes to sleep. In admin, Charlie informs the rest of the nursing staff that, although Duffy is not leaving the department, she will not be doing anything clinical. By the staff room door, Duffy tells Charlie she loves him, and the two leave the department together.

Cast

Uncredited

Trivia

  • The photographs of Jacob as a child are actually photographs of Charles Venn during his childhood.
  • In the scene where Jade shows Marty her personal statement for her bursary application, the date on the computer reads as 15 February, suggesting that at least some of the episode was filmed during that month.

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