Читать книгу One Night in Emergency - Carol Marinelli - Страница 8

SO MUCH for patient confidentiality.

Rory Hunter’s injuries and treatment became seemingly the sole topic of conversation for the entire hospital.

At least it felt that way for Eleanor as she stumbled through her week on nights. Every ward she took a patient to, she was sure the nurses were nudging each other. Even the cleaners seemed to be smiling as they quietly mopped the long lonely night corridors as Eleanor made her way back. But as hard as the nights were, nothing was going to compare to facing the man himself and it took a good deal of foundation and a lot of deep breaths to arrive at the nurses’ station for handover the following Monday.

‘You’ll be working the trolleys,’ Mary instructed. ‘Anything you don’t understand, you ask me, not the nurse who happens to be passing, not the doctor who looks approachable. You ask me. Until you feel confident to make decisions for yourself, I’m the one you run things by.’

‘Fine.’ Eleanor nodded, her hackles immediately rising. She was tired of Mary constantly talking down to her and treating her like a child that needed to be told everything not just twice but very loudly, too.

‘Good. Now, in cubicle eight is an Emily Nugent. She’s ninety-four with end-stage COAD. What does that stand for?’

‘Chronic obstructive airways disease,’ Eleanor answered with a slight edge to her voice. She may not be the most experienced of nurses but she wasn’t a complete hick and it was time Mary stopped treating her like one. Taking a deep breath first, Eleanor looked the older woman straight in the eye. ‘I’m not a student, Mary, I’m not even a grad nurse. I’m a registered nurse and I did do some nursing before I came to Melbourne Central. We do have COAD patients in the country.’

‘Do you, now?’

‘Yes,’ Eleanor replied curtly.

‘Well, as I said, Miss Nugent is end stage. Now, she’s been seen by the medical registrar and she’s not for any active treatment and definitely not for any heroics. You’ll not be offended if I ask you to confirm you know what that means.’

‘She’s not to be resuscitated,’ Eleanor responded, ignoring Mary’s sarcasm and still trying to look her in the eye but it was getting increasingly hard.

‘Correct. Now, that might seem like a very basic question, but the fact is, unlike the wards, all patients who come through our doors are resuscitated unless it’s documented otherwise, and the last thing poor Miss Nugent needs is a bunch of over-zealous doctors jumping on her ninety-four-year-old chest. Now, we’re to make her comfortable while the bed manager tries to find a bed for her on the wards.’

‘Does she have family with her?’ Eleanor asked as they headed for cubicle eight.

‘She has no one, so our job…’ Mary paused outside the curtain, opened her mouth as if to speak then instead gave a small nod. ‘In we go.’

Eleanor’s jury was still out on her feelings for Mary Byrne the woman, but if ever Eleanor made it into an emergency room at the grand old age of ninety-four she hoped there would be an equivalent of Mary Byrne there to look after her. For though Eleanor had looked after a few terminal patients, though she had worked alongside a lot of nurses, no one held a candle to the way Mary gently fussed over the frail elderly woman, chatting softly to Emily as if they were old friends as they turned her onto her other side to relieve the pressure from her emaciated hips, gently stroking her forehead as the old lady whimpered in pain.

‘It’s OK, Miss Nugent,’ Eleanor said softly. ‘I know it’s uncomfortable while we move you, but you’ll feel a lot more comfortable once we’ve settled you.’

A tiny nod indicated a response and as a frail thin hand peeped out from under the sheet, Eleanor took it and gave it a gentle squeeze.

‘Do you have any pain, Miss Nugent?’

Another nod was punctuated by a grimace. ‘Em.’

‘You like to be called Em?’ Eleanor checked, stroking the frail skin beneath her fingers. ‘Then that’s what we’ll call you. My name’s Eleanor.’

‘Give her hair a brush,’ Mary instructed, rummaging through Emily’s bag and pulling out a brush. ‘While I go and find someone to check…’ She paused for a moment, taking the brush herself and running it through the straggly hair. ‘Miss Nugent, I mean Em,’ she said softly into the elderly women’s ear, ‘Sister and I are just going to get you some medicine that will make you more comfortable.’

Eleanor almost had to run to keep up with Mary’s brisk strides, but she was walking on air, thrilled that far from the dressing down she had expected Mary finally seemed to be coming around.

‘OK, you need to use your swipe card to gain access,’ Mary instructed needlessly. Eleanor had checked plenty of drugs in her week in Emergency, just not the controlled ones, but Mary, it would seem, couldn’t pass up any chance for a quick lecture. ‘And it pays to look over your shoulder before you go in—there can be a few undesirables hanging around just waiting to get in here.’ A loud tut came out of her pursed lips as they pushed open the door and stepped inside. ‘For the love of God! Would you believe that her medical registrar has written in his notes that he wants her to have morphine, yet he hasn’t written up an order?’

‘Do you want me to page him,’ Eleanor offered, but Mary shook her head.

‘He’ll be starting his ward round now, it will be ages till he comes back down.’ She shook her head again. ‘I’ll have to ask one of our doctors to do it, which isn’t really fair on them, given Miss Nugent’s status. They’ll need to examine her and go through all the notes, which will take for ever. Oh, poor Miss Nugent.’ As she pulled open the drug-room door Eleanor went to follow, but instead ducked back in as Mary’s tone took on a distinctly friendlier note. ‘Rory! The very man who can help.’

‘What’s the problem?’

Eleanor heard him before she saw him, cringing behind the door as Mary patiently explained the problem. ‘The med reg will be doing his rounds and the poor lady’s in distress. I don’t want her to be prodded and poked just for the sake of it.’

Eleanor had rather hoped her next glimpse of him would have been from a safe distance, that somehow she could have blushed unnoticed from afar, but instead six feet four of dark-suited, heavily aftershaved, damp-haired, masculine beauty squeezed himself into the drug room and gave her the briefest of nods.

‘Good morning, Sister.’

‘Morning,’ Eleanor croaked.

‘Could I see the notes, please?’

Her hand was shaking so much as she passed them to him, she was practically fanning him, but Rory didn’t seem to notice, taking them with a murmur of thanks and then reading them through carefully. If he’d looked gorgeous in jeans and a T-shirt, he looked divine in a suit, those sexy dark blond curls combed back smoothly now, and first impressions clearly counted for nothing because Rory Hunter up close and personal looked every inch the consultant. He had an authoritative air, a distinguished look about him, nothing like the tousled man who had lain on the gurney just over a week previously.

But it wasn’t just his hunk status that was causing a tremor to ripple through Eleanor. As senior as Mary and Rory were, Eleanor wasn’t quite sure how she’d react if Rory just wrote up the morphine without laying eyes on the patient. It was all very well for Mary to call in a favour, all very well for Rory to trust in her, but as junior as she was it was still Eleanor’s responsibility, if she were to sign her name in the drug book, to assure that due care had been given.

‘I’ll need to see her,’ he said finally, and Eleanor let out a relieved sigh. ‘I’ll do my best not to upset her, though. Can one of you give me a hand?’

‘Eleanor will go with you.’ Mary beamed. ‘And thank you for this, Rory, I know it’s not your problem.’

‘If it’s in my department it’s my problem.’ Rory shrugged, nodding to Eleanor to follow him.

It was the longest walk of Eleanor’s life. Apologies bobbed on her tongue, but she bit them back. Clearly Rory wanted to pretend the whole embarrassing incident hadn’t happened, which suited her just fine.

‘It won’t take long.’ Rory gave a brief on-off smile as they reached the cubicle and, utterly unable to look at him, Eleanor gave a small nod. ‘Is everything all right, Sister?’

‘Fine,’ Eleanor croaked.

‘You do understand why I need to examine her?’

She did but, given a sudden dry throat and a face a darker shade of purple, even a simple ‘yes’ was impossible at the moment and a rather unconvincing nod was the only response she could manage, putting her hand up to pull the curtain back, wanting to just get inside. But Rory had other ideas, calling her back and addressing her sharply.

‘While morphine will certainly make Miss Nugent more comfortable, it will also compromise her level of consciousness and her breathing.’ Rory’s eyes were boring into her as Eleanor stared down at her hands. ‘Now, I know it’s not ideal that I have to examine her again, and I know it must be rather annoying for you to have to walk all the way from the drug cupboard and then back again, but for the record, Sister, I’m not prepared to write up a strong injection like morphine without having first seen the patient.’

‘Mr Hunter.’ Somehow she found her voice, somehow she managed to tear her eyes from her hands and look up at him, if not into his eyes at least in general direction of his face. Uncomfortable she may be, facing him, but Rory Hunter’s biting sarcasm needed to be addressed. They mightn’t have got off to the best start the week before last, she might have come across as the worst nurse in the living memory, but his hint at laziness was unjust and unfair. ‘I have no problem with you examining Miss Nugent. In fact, I was thinking back in the drug room that had you just written up morphine for Mary, I would have refused to give it. I most certainly wouldn’t be happy giving a strong drug to a patient as sick as this one, prescribed by a doctor who hadn’t even laid eyes on her.’

‘Good,’ Rory replied crisply.

‘And the inference that I somehow resent making two trips to the drug room is unfair.’

‘Then I apologise.’

‘Oh.’ Eleanor blinked at him.

‘You seemed a bit uptight. I assumed that was the reason.’

‘Well, it wasn’t.’

‘Clearly.’ He cleared his throat. ‘Now, let’s have a look at the patient.’

Any grievances were left firmly at the cubicle’s entrance. Rory Hunter’s bedside manner was impeccable. Politely he introduced himself to Em, his huge hands gently closing around her frail wrist as he located the flickering pulse, before pulling his stethoscope out of his pocket, even rubbing the bulb to warm it before listening to her chest.

‘Can you help me sit her forward so I can listen to her back?’

They gently lifted Em forward, Eleanor talking soothingly as the old lady whimpered at the intrusion.

‘Nearly done,’ Rory soothed as they laid her back against the pillow. ‘We’ll go and get you that medicine now. You’ll soon be much more comfortable.

‘Poor thing,’ he added as they got outside. ‘How long till she gets up to a ward?’

‘I’m not sure. Mary said that the bed manager is trying to locate a bed, but the medical and geriatric wards are all supposedly full. Perhaps a few will be freed up after the ward rounds.’

‘Hopefully she’ll make it till then,’ Rory said pointedly, scanning the department with those navy eyes. ‘It looks like Mary’s tied up. I’ll go and get the keys off her and check the drug with you—the patient’s already waited long enough.’

Which was the last thing she needed, but at least it meant Em would soon be more comfortable, Eleanor consoled herself as again she found herself in the drug room with him.

‘We’ll just give her 2.5 mg for now,’ Rory said, talking aloud as he wrote up his notes. ‘If that doesn’t settle her, let me know, but she’s so tiny I’m sure it will be plenty.’

‘Sure.’

Of course, because Mary had never let her so much as touch the sacred controlled drug keys, it seemed to take for ever to work out which one to use, especially with Rory tapping his pen impatiently as she fumbled. ‘Sorry.’ Pulling out the drugs, she showed him the morphine vials. ‘Twenty ampoules, after this one nineteen.’

‘Agreed.’

Thankfully he took it from her to pull it up, so at least Eleanor was spared the indignity of getting a thin needle into tiny ampoule with a hand that wouldn’t stop shaking.

As Rory pulled up the drug, Eleanor filled in the drug book, carefully writing in the patient details and the amount of morphine to be both given and wasted before signing her name.

‘All done?’ he checked.

‘I just need your signature.’

‘Sure.’ She waited as he signed, stood with keys poised, ready to close the cupboard once he’d finished with the drug book, but Rory seemed to be taking an inordinate amount of time to sign his name.

‘Is everything all right?’ Eleanor asked anxiously.

‘Fine.’ With a flurry he signed his name then waited patiently while she locked up. ‘Sister Lewis.’ His lips twitched around the words and Eleanor stood frozen as he continued with a grin, ‘So that’s the reason you were so uptight.’

‘Obviously,’ Eleanor muttered through gritted teeth, the drug room seeming to implode on them as Rory started to laugh.

‘It was you who…’

‘Shaved you? Yes! Charged you ten dollars for crutches? Yes!’ Eleanor answered hotly. ‘I can’t believe you’ve only just recognised me.’

‘I recognised your name,’ Rory corrected, still laughing as her blush deepened. ‘Sister Lewis. And before you assume I was blind drunk last week, I wasn’t.’

‘I beg to differ,’ Eleanor scoffed. ‘You could barely focus! You didn’t even recognise me this morning!’

‘Oh, I’m sure I’d have remembered that face.’ Rory grinned. ‘But the simple fact of the matter is I lost my contact lenses in the accident. And if you don’t believe me, wait till you work a Saturday night with me and half the department’s scrabbling around the floor because I’ve lost a lens. I really can’t see beyond my nose without them.’

‘You’d lost your contact lenses?’

‘I’m as blind as a bat without them,’ Rory explained, his smile fading as he registered the tense look on her face. ‘Are you all right, Eleanor?’

‘Shouldn’t I be asking you that?’ Eleanor bristled. ‘Given that you were the patient I mistreated.’

‘You didn’t mistreat me,’ Rory said slowly, a frown marring his forehead as he eyed her thoughtfully. ‘You were very—’

‘Efficient,’ Eleanor finished for him. ‘You already said.’

‘Hey, Eleanor, you really are upset, aren’t you?’

‘Oh, what do you care?’ Eleanor snapped, then, remembering Rory was a consultant and she a very new nurse, she gave her head a small shake, running a worried hand across her forehead before dragging her eyes up to his. ‘I’m sorry. Sorry for snapping just now and I’m sorry about the other night.’

‘Forget it.’ Rory shrugged. ‘Look, I never meant to upset you.’

‘Then why did you…?’ Tears were brimming now, angry, hurt tears, a whole week of humiliation rearing to the surface now. ‘Why didn’t you tell me you were the consultant of the department? Why on earth did you let me make such a fool of myself?’

He never got a chance to answer, the door opening and Mary bustling in. ‘There you both are.’ Taking the kidney dish with the drug in it, she gave Eleanor a wink. ‘You took so long I thought you must be shaving the other thigh.’

‘Mary.’ Rory’s voice was stern. ‘That’s enough about that. Eleanor’s upset enough, without having everyone constantly going on about it.’

‘Well, you should have thought of that,’ Mary scolded with another wink, flying out the door, ‘before you let some pretty young blonde thing shave your leg.’

Left alone Eleanor gave a brittle smile, as Rory stood there grim-faced.

‘Well, I guess Mary just answered my question.’

Without waiting for his response, she turned on her heel, pulling hard on the metal handle and escaping into the corridor, her mind pounding as she raced to catch Mary.

She’d been a fool to think a new start would change things. It was her old job all over again!

Worse even.

Slowing down, she caught her breath for a second, and reluctantly acknowledged why.

He’d seemed so nice.

Oh, not the Rory Hunter who’d paraded in this morning, but the tousled-haired rugby player she’d met that Saturday night. The man who’d made her laugh, the man who’d gently teased her. A man who, despite her embarrassment, despite her scorching shame around their first encounter, she’d been secretly looking forward to seeing again.

Secretly pleased she’d be working alongside.

Well, not now, Eleanor thought darkly, picking up her pace and heading for the cubicle. Rory Hunter was as bad as the rest and Mary was just the same.

She’d been a fool to think things would be different here.

The morning passed in a horrible blur. For once, Mary’s razor-sharp tongue seemed to have softened and for the most part she left Eleanor alone with her blushes as she gritted her teeth and tried to ignore the sniggers from the rest of the staff every time Rory came within a square mile of her.

‘Mary said you were to go to lunch now.’ Vicki smiled as she came over. ‘I’ll watch your patients while you’re gone. What’s happening?’

‘Not much,’ Eleanor sighed. ‘Most are waiting for beds.’ She took Vicki around the cubicles, giving her a brief handover of all the patients in her care, but as they got to cubicle eight Eleanor stepped inside, frowning as she felt Em’s pulse. ‘Her pulse is very irregular.’

‘Her respiration rate’s down, too,’ Vicki observed, glancing at the casualty card. ‘She looks very comfortable, though,’ she added as they stepped outside. ‘I don’t think Mrs Nugent will be going to a ward.’

‘It’s Miss Nugent,’ Eleanor corrected, ‘but she likes to be called Em.’

Vicki nodded, writing the preference in red on the card and circling it—something Eleanor hadn’t thought to do. ‘Go on, you’d better go.’

Eleanor nodded but her heart wasn’t in it, her eyes dragging back to cubicle eight. ‘I might just sit with Em for a while,’ she said as Vicki’s eyes widened. ‘I can have my lunch in there.’

‘Are you mad?’ Vicki shook her head. ‘Mary would have a fit. No, go and have a proper break. I’ll keep an eye on her.’

And she would, Eleanor knew that. In a little while Vicki would pop her head in, pat the old lady’s hands and check that she was comfortable, but that would be it. And no one was being cruel, no one was neglecting the patient or being indifferent. There simply wasn’t time for one-on-one nursing when it wasn’t intensive, weren’t enough nursing hours allocated in Emergency to hold an old lady’s hand for an hour or two.

But that was what nursing was about for Eleanor.

That was the nurse she wanted to be, the nurse she’d sworn she would be, and she wasn’t going to changer her priorities now.

Of course, Mary had to be talking to Rory, but Eleanor was tired of hiding from him anyway, tired of blushing at each and every turn.

‘Can I have a word, Mary?’

She glanced down at her watch. ‘I thought you were at lunch?’

‘I am.’ Eleanor gave a small shrug. ‘I was wondering if I could take it in cubicle eight.’

‘Cubicle eight?’ Mary stared at her, nonplussed. ‘But Miss Nugent’s in there.’

‘I know, I just…’ Eleanor faltered, aware Rory was staring at her, too. ‘She’s near the end now and she’s on her own…’

‘Vicki will watch her,’ Mary said dismissively. ‘Now, for the last time, will you go to lunch?’ Turning her attention back to Rory, Mary resumed her conversation but Eleanor most definitely hadn’t finished.

‘I am going to lunch, Sister Byrne.’ Eleanor cleared her throat. ‘And if you need to find me for anything, I’ll be in cubicle eight.’