Nathan Spencer is a businessman and the former corporate director of Holby City Hospital's emergency department. He began working at the hospital in November 2005 and was fired in October 2007 for incompetence.
Introduction to the emergency department
In November 2005, the Holby City Hospital board appointed Nathan as the emergency department's corporate director. Tasked with making the department more efficient, he immediately had several "patient tracking" monitors installed to maximise the number of patients meeting the four-hour rule. Many of the staff took issue with the additional pressure put on them by the monitors, (CAS: "Getting Involved") and Clinical Director Harry Harper took issue with Nathan having them installed earlier than he anticipated. When Nathan instructed the staff to minimise the number of breaches, Harry argued that Nathan was not qualified to make clinical decisions and defied his orders. Later, Harry told Nathan that his monitoring system was putting his staff under undue stress, but Nathan told Harry that "things [were] going to change" and warned him that he would lose the position of clinical director if he continued to resist. (CAS: "Enough's Enough")
The following day, a disabled man named David Anderson presented the ED with a cheque for £20,000 that he had raised by dancing; Harry wanted to use the money to pay for a portable defibrillator, but Nathan insisted that it needed to be used to offset the overspend on the department's equipment budget. After hearing that the money had been seized by hospital management, David confronted Nathan at a Christmas party, and Nathan assured him that the money would be put towards the defibrillator if the department wanted it. (CAS: "Do They Know It's Christmas?")
Relationship with Selena
On 21 January 2006, Nathan's mother Peggy was admitted to the ED following a fall. Harry managed to treat and discharge Peggy within the four-hour rule, but it later transpired that he had reviewed the wrong X-ray, leaving Peggy at risk of further injury and Nathan furious. (CAS: "The Things We Do for Love") The following week, Nathan brought Peggy back into the ED after she experienced another fall; Selena Donovan examined her and found that Peggy had an irregular heartbeat. Nathan thanked Selena for her help and asked her out for dinner to show his gratitude; Selena wanted to go out for dinner with Harry, but, after learning that Harry was in a relationship with Ellen, she accepted Nathan's invitation. (CAS: "It's a Man Thing") By the following week, Nathan and Selena had bonded and began dating. (CAS: "Trust in Me")
In March, after Selena endured a difficult shift as a police surgeon and decided to resign, Selena took issue with Nathan's lack of support (CAS: "Nobody's Perfect") and started to feel as though she was not getting anything out of their relationship. Selena informed Nathan that she was breaking up with him, citing his lack of intimacy and affection as factors in her decision, but Nathan twisted the situation into making him look like the arbiter. (CAS: "Family Matters")
Following their break-up, Selena grew increasingly suspicious of Nathan's increased presence in the department and confronted him; Nathan claimed that he was observing the interactions between patients and senior members of staff for a management review for the hospital board, but Harry stated that the board had not requested a survey. (CAS: "Walk Before You Run") In April, Selena was disturbed to find that Nathan had requested CCTV footage taken during her shifts. With help from Maggie Coldwell, Selena broke into his office and reviewed the tapes which confirmed her suspicions. However, Nathan insisted that he was conducting a personal review of security measures in the department in the wake of Guppy Sandhu's attack. (CAS: "Going Under") The following week, Nathan had new CCTV cameras installed throughout the department to identify blind spots, but Selena believed that he was trying to "cover his tracks". (CAS: "Blind Spots")
In July, Nathan discontinued the department's internal cleaning services and began outsourcing cleaners from a third party, but the new cleaners failed to make an appearance in the department, leaving it filled with litter. Nathan argued that the new contract delivered the same specification but for less money, but Nathan's decisions regarding the allocation of cleaners resulted in overflowing toilets which caused several patients to slip and injure themselves. While picking up a filled bin bag, Nathan sustained a needle-stick injury. (CAS: "Needle")
A few weeks following the incident, Nathan confessed to Selena that he was already HIV positive, which came about from sleeping with a prostitute prior to his arrival at the hospital.
Due to Nathan not being too sure about his HIV status, Selena requested that he should get a test. Nathan denied at first due to being too nervous about what the result would be, but eventually caved in and took the test. The result revealed Nathan didn't have HIV, much to his relief.
Selena and Nathan reconciled their relationship following the incident.
Selena and Angel's deaths
Nine days after Angel's birth, she suffered a brain haemorrhage which affected her breathing centre. On 14 September, she was deemed fit enough to be taken off the ventilator, but she struggled to commit to the new effort she had to make. The next day, Angel went into asystole, and paediatrician Andy Fishman decided to put her back onto the ventilator. Later that day, Nathan was informed that Angel had been diagnosed with an E. coli infection, and her kidneys were shutting down. Charlie and Andy warned him that Angel was beyond the point of recovery, but he refused to believe that his daughter was dying and demanded her to be kept ventilated. However, after Andy suggested that they take her off the ventilator and allow him to hold her during her final moments, Nathan began to accept her impending mortality and agreed. In a private room, Nathan cradled Angel until she passed away. Less than an hour after Angel's death, Nathan returned to the ED and started berating the other members of staff for failing to run the department "smoothly", suggesting that, following the bombing the previous week, they would have "learnt [their] lesson"; this outburst resulted in Guppy's public resignation. After Nathan left, Charlie informed the team of Angel's death. (CAS: "Meltdown")
- Nathan, according to journalist Peter Camden, plays squash "like a demon". (CAS: "The Things We Do for Love")
- When he was six, he created a little shop and insisted on giving back the correct change. (CAS: "The Things We Do for Love")