First shifts in the emergency department
On 23 November 1996, following the resignation of consultant Mike Barratt, Jack began working in Holby City Hospital's emergency department. On his first day, Jack suggested to receptionist Matt Hawley that he implement a hospital information support system after the latter complained of the current computer system underperforming, but Jack became frustrated when hospital administration failed to immediately supply him with an adequate computer.
In resus, as registrar Barbara "Baz" Hayes treated a 28-year-old male with an extradural haematoma, Jack suggested drilling an emergency Burr hole themselves; Baz believed that it was unnecessary and wanted to wait for the neurosurgeons. However, after one of the patient's pupils had blown, Jack was forced to intervene and managed to successfully remove the clot. Afterwards, Baz took issue with Jack's inclination towards risky procedures, but Jack insisted that the burr hole was in the patient's best interest and told Baz that he expected her trust and loyalty "from day one". Later that day, Jack decided to reduce a displaced Colles' fracture sustained by a 13-year-old patient named Ruby without her parents' consent. (CAS: "Made in Britain")
By the following week, Jack had begun developing a computer-based diagnostic tool for triage nurses to use while consulting patients over the phone; Baz had concerns about its maintenance and believed that they did not need to start replacing "humans with machines". (CAS: "Mother's Little Helper") On 14 December, charge nurse Charlie Fairhead proposed enlisting a general practitioner to treat inappropriate attendees waiting in the ED to help decrease waiting times; Jack believed it would be better to teach people how to use their GPs properly. (CAS: "Do You Believe in Fairies?")