Читать книгу One Tiny Miracle... - Carol Marinelli, Carol Marinelli - Страница 7

‘CELESTE, what are you doing here?’ Meg, the charge nurse, shook her head as Celeste handed her a return-to-work certificate as she joined the late-shift emergency nurses to receive handover.

‘I’m fine to work. I saw my obstetrician again yesterday,’ Celeste explained.

Meg scanned the certificate and, sure enough, she had been declared fit, only Meg wasn’t so sure. ‘You were exhausted when I sent you home last week, Celeste. I was seriously worried about you.’

‘I’m okay now—with my days off and a week’s sick leave…’ When Meg didn’t look convinced Celeste relented and told her everything. ‘My glucose tolerance test came in high, that’s what the problem was, but I’ve been on a diet for ten days now, and I’ve been resting, doing yoga and taking walks on the beach. I feel fantastic—some people work right up to forty weeks!’

‘Not in Emergency,’ Meg said, ‘and you’re certainly not going to make it that far. How many weeks are you now?’

‘Thirty,’ Celeste said, ‘and, as the doctor said, I’m fine.’

Which didn’t give Meg any room to argue and, anyway, here wasn’t the place to try. Instead she took them through the whiteboard, giving some history on each of the patients in the cubicles and areas. ‘When the observation ward opens, Celeste can go round there…’

‘I don’t need to be in Obs,’ Celeste said, guilty that they were giving her the lightest shift, but Meg fixed her with a look.

‘I don’t have the resources to work around your pregnancy, Celeste. If your obstetrician says that you’re fine for full duties and you concur, I have to go along with that—I’m just allocating the board.’

Celeste nodded, but no matter how forcibly Meg said it, Celeste knew she was being looked out for as far as her colleagues could—and for the ten zillionth time since she’d found out she was pregnant she felt guilty.

Finding out she was pregnant had been bad enough, but the fallout had been spectacular.

Her family was no longer speaking to her, especially as she had steadfastly refused to name the father, but how could she? Having found out that not only was her boyfriend married but that his wife worked in Admin at the hospital she worked in, even though no one knew, would ever know, guilt and shame had left Celeste with no choice but to hand in her notice. Then, just as it had all looked hopeless, she had found out that she been accepted at the graduate emergency nursing programme at Bay View Hospital, which was on the other side of the city.

She hadn’t been pregnant at the time of her application and the polite thing to do might have been to defer—perhaps that was what had been expected of her—but with such an uncertain future ahead, a monthly pay cheque was essential in the short term, and, as a clearly single mother, more qualifications wouldn’t go amiss. Also, moving away from home and friends would halt the endless questions.

It was lonely, though.

And now her colleagues were having to make concessions—no matter how much they denied that they were.

‘Cubicle seven is Matthew Dale, eighteen years old. A minor head injury, he tripped while jogging, no LOC. He should be discharged, Ben’s seeing him now.’

‘Ben?’ Celeste checked.

‘The new registrar. He started this morning. Here he is now…’ Meg waved him over. ‘What’s happening with cubicle seven, Ben?’

‘I’m going to keep him in. Sorry to open up the observation ward so early but…’ His voice trailed off as he caught sight of Celeste, but for whatever reason he chose not to acknowledge her, just carried on giving his orders for the patient. Although she had to offer him no explanation as to her being here, and though there was absolutely no reason to, again, for the ten zillionth and first time, Celeste felt guilty.

Almost as if she’d been caught.

Doing what? Celeste scolded herself, as she walked round to the closed-off observation ward, flicked on the lights and then turned back a bed for Matthew.

She was earning a living—she had to earn a living.

She had ten weeks of pregnancy to go and the crèche wouldn’t take the baby till it had had all its inoculations, so if she stopped now she wouldn’t be working for almost six months.

The panic that was permanently just a moment away washed over her.

How was she going to cope?

Even working full time it was a struggle to meet the rent. With no help from her family, she was saving for the stroller and cot and had bought some teeny, tiny baby clothes and some nappies, but there was so much more she needed. Then there was her bomb of a car…

Celeste could actually feel her panic rising as she faced the impossibility of it all and she willed herself to be calm, willed herself to slow her racing mind down. But that was no help either, because the second she stopped panicking all Celeste felt was exhausted.

Holding the bed sheet in her hand, she actually wanted to climb in, to lie down and pull the sheet over her head and sleep—and get fatter—and read baby magazines and feel kicks and just rest.

‘Feeling better?’ Celeste jumped at the sound of Ben’s voice. ‘After this morning?’

‘I had a stitch,’ Celeste responded just a touch too sharply. ‘And, before you ask, I am quite capable of working. I’m sick of people implying that I shouldn’t be here. Pregnancy isn’t a disease, you know!’

‘I was just being polite.’ Ben gave her a slightly wide-eyed look. ‘Making conversation—you know, with my neighbour?’

She’d overreacted, she knew that, and an apology was in order. ‘I’m sorry—I’ve had a bit of trouble convincing the doctor that I’m capable of coming back to work, and I’ve got Meg questioning me here. I just…’

‘Don’t need it.’

‘Exactly,’ Celeste said. ‘I’m hardly going to put the baby at risk.’

‘Good.’

She waited for the ‘but,’ for him to elaborate, for the little short, sharp lecture that she seemed to be getting a lot these days, but ‘good’ was all he said. Well, it was all he said about her condition, anyway.

‘I’ve booked Matthew in for a scan. He had a small vomit, and I’d rather play safe. He’s a bit pale, and I’m just not happy—they should call round for him soon. I’ve also found a hand injury to keep you occupied…’ He gave her a nice smile and handed her the notes. ‘Fleur Edwards, eighty-two years of age. She’s got a nasty hand laceration, probable tendon, though the surgeons won’t be able to fit her in till much later tonight. Given her age, it will be under local anaesthetic, so if you can give her a light lunch and then fast her—elevation IV antis, the usual.’

‘Sure.’

‘Could you run a quick ECG on her, too? No rush.’

He was nice and laid-back, Celeste thought. He didn’t talk down to her just because she was a grad, didn’t ream off endless instructions as if she’d never looked after a head injury or hand laceration before. And, best of all, he hadn’t lectured her on whether she should be here.

The observation ward was rather like a bus-stop—you were either standing or sitting around waiting, with nothing much happening for ages or everything arriving at once.

Matthew was brought around first, pale, as Ben had described, but he managed a laugh as he climbed up onto the bed as Celeste had a joke with him.

‘You do know exercise is bad for you?’ His mother and girlfriend had both come around to see him into the observation ward, but now he was there and settled they would be heading home. Celeste did a careful set of neurological observations, warning Matthew this would be happening on the hour, every hour. ‘Whether you’re asleep or not…’

She told Matthew’s family about visiting and discharge times and wrote down the hospital and extension numbers for them. Just as she was about to get started on the admission paperwork, the doors opened.

‘Another admission for you…’ Deb, a fellow grad, was wheeling round a rather delightful Fleur—with rouged cheeks and painted on eyebrows, she was dressed in a blue and white polka-dot skirt with a smart white blouse, which unfortunately had been splattered with blood. ‘Fleur Edwards, 82, a hand injury—’ Deb started.

‘Ben’s already told me about her,’ Celeste said, sensing Deb was in a rush. ‘Any family?’

‘Her daughter’s coming in this afternoon.’ They flicked through the charts. ‘No allergies, she suffers with arthritis, but apart from that she seems very well…’

‘I’ll sort things out, then,’ Celeste said, smiling over at Fleur, who was patiently sitting in a wheelchair, her arm in a sling. ‘Is it getting busy out there?’ she asked Deb.

‘It’s starting to—we’ve got a multi-trauma coming in.’

Though she smiled as she went over to help Fleur, Celeste was hit with a pang as Deb left, just a pang of something. She should be out there, would have loved to really immerse herself in this emergency programme, and though she hoped to when she came back from maternity leave, Celeste was also realistic enough to know that her head would be full of other things by then, and that she’d be exhausted for other reasons, namely the baby who was kicking at her diaphragm right now. Still, it wasn’t Fleur’s problem.

‘Hello, Mrs Edwards.’

‘Fleur.’ Fleur smiled.

‘I’m Celeste—I’ll be looking after you this shift.’

‘You should be the one being looked after.’ Fleur clucked. She really was gorgeous. Widowed for twenty years, she was an independent old lady, and she had cut her hand peeling an orange for her morning snack, Celeste found out as she took her history.

‘Well, for now we’ll get you into a gown and into bed, so that we can elevate your hand on an IV pole. You’ve had something for pain—has that helped?’

‘I can hardly feel it, the bandage is so tight.’ Fleur said. ‘Would you mind taking me over to the ladies’ before I get into bed?’

‘Of course.’ Only at that moment Matthew sat up, with that anxious, frantic look Celeste knew all too well, and with a quick ‘Won’t be a moment’ to Fleur she raced over, locating a kidney dish just in time and pulling the curtain around him.

‘It’s okay, Matthew,’ she soothed. ‘I’ll just fetch you a wet cloth…’ And run another set of obs, Celeste thought. He really was terribly pale.

‘I’ve got to get work,’ Matthew muttered. He wasn’t a particularly large 18-year-old, but none the less he was trying to climb out of bed and he resisted as Celeste tried to guide him to lie back down. ‘I have to get to work, I’m going to be late…’

‘You’re in hospital, Matthew,’ Celeste said. ‘You’ve had a bang on your head, remember?’

She was trying to reach for the call bell to summon help, worried that if he became agitated he might fall if he did get out of bed and hurt himself further, but as quickly as it had happened, Matthew seemed to remember where he was and stopped trying to climb out of bed and instead lay back down. ‘Sorry.’ He gave a wan smile and said it again. ‘Sorry. I’m fine now.’ And he seemed so, except, like Ben, Celeste was now worried.

‘Matthew. Do you know where you are?’

‘Hospital.’

She went through his obs—they were the same as before, his blood pressure a smudge higher, but his momentary confusion still troubled Celeste and she buzzed on the intercom. ‘Can you send a doctor round to the observation ward?’

‘Is it urgent?’ Meg checked. ‘They’re just assessing a multi-trauma.’ Celeste looked over at Matthew’s pale but relaxed face and wavered for a moment. He seemed absolutely fine now and his obs were stable but, still, she just wasn’t sure.

‘I need the head injury assessed again,’ she said, thinking it was likely Meg was rolling her eyes now. ‘Let Ben know—he saw him.’ She headed back to Matthew and Fleur gave a worried nod when Celeste said, ‘I’ll be with you soon.’

‘Look after him!’ the old lady said. ‘Don’t worry about me.’

Of course, by the time Ben arrived Matthew was sitting up and joking about his moment of confusion and refusing the oxygen that Celeste was trying to give him. ‘Look, I’m sorry to pull you away,’ she told Ben.

‘No problem. The trauma team is with the patient and he’s actually not that bad. So what’s going on with Matthew?’

‘Nothing!’ Matthew said and it certainly looked that way.

‘He was fine,’ Celeste explained. ‘In fact, he seems fine now, but he had a vomit a little earlier and was certainly confused and restless for a moment. He didn’t look at all well—’ She was trying to think up reasons to justify pulling a registrar out from an emergency, but Ben quickly interrupted.

‘I agree.’

He didn’t seem remotely annoyed that she had called him. Instead, he was checking Matthew’s pupils and his blood pressure for himself as Celeste explained that he had tried to climb out of bed, insisting he had to get to work.

‘How are you feeling, Matthew?’

‘Fine. Well, a bit of a headache…’

‘Okay,’ Ben said, ‘I’m just going to lay you flat and have a good look at you.’ It was Ben who never got to finish this time as Matthew started to retch again, his face more grey than pale now, and he was moaning loudly about a pain in his head.

‘How do you get urgent help around here?’ Ben asked, and it was only then that Celeste remembered that it was his first day here—he seemed so assured and competent. He was also a lot bigger than Matthew. He ignored the patient’s protests to push off the oxygen mask and attempts to climb out of bed as Celeste pressed the switch on the wall. The light flashed above the door like a strobe as one of the team came to the intercom and Celeste explained what was happening.

The trauma team was still with the multi-trauma, so it was Belinda Hamilton, the rather snooty but exceptionally good-looking senior emergency registrar who came, along with Meg and a porter to get the patient to Resus if required. Had Matthew still been on a gurney it would have been easier to wheel him straight to Resus, but time was of the essence and the observation ward was set up, like any other ward, for such an emergency, so instead Celeste wheeled over the crash trolley. Matthew was like a tethered bull now, and it was Ben doing the tethering as he rapidly explained what had occurred to his senior. But he didn’t await her verdict, just told her what was required. ‘He needs to intubated and sent for a scan,’ Ben said. ‘Can you alert the neuro surgeons?’

Celeste was busy opening packs for the intubation, her heart hammering in her chest, stunned at how quickly Matthew had deteriorated.

Though Meg had also come to assist, she didn’t take over, just guided and advised Celeste, who was setting up for the intubation. Raji, the anaesthetist, arrived just as Matthew started seizing, his body jerking violently. The whole thing was horrible. In a matter of moments Matthew’s condition had become critical—his family would have barely made it to the car park.

Raji was shooting drugs into the patient as Ben gave him the lowdown and thankfully the jerking stopped. Matthew was taking long, laboured breaths, but at least he wasn’t seizing or fighting any more, though Celeste could feel her blood pounding, surely up near Matthew’s as she wrestled to remove the bedhead to give Raji more access to the patient’s airway.

‘Here.’ Ben must have seen her struggle and removed the bedhead easily for her. Raji was a pleasure to work with, a laid-back guy who really just got on with things, checking all the drugs she had prepared and pulling up for himself the others he required. Matthew was on a cardiac monitor, the seizing had stopped, but he was gravely ill and as Celeste watched Raji intubate the patient, Meg liaised with the porters and Imaging.

‘Should we let his family know?’ Celeste asked. ‘They only just left.’

‘Let’s just worry about the patient for now,’ Belinda snapped, and Celeste felt herself redden.

‘I’ll call them as soon as I can,’ Ben said. ‘He’ll probably go straight up to Theatre from Imaging.’

It took ten, maybe fifteen minutes at the most before Matthew was paralysed and intubated and on a trolley, being wheeled up to Imaging and probably then on to Theatre. All that was left from his time in the obs ward was a mountain of paperwork and a lot of chaos. The suction equipment was still on and gurgling, and would need cleaning, the oxygen tubing and masks would need replacing; the bedhead was abandoned on the other side of the room, there were packs open everywhere. The crash cart was in chaos and there were syringes and vials on its surface. Everything would need to be tidied and checked and replaced and then checked again.

‘So much for giving you a quiet afternoon!’ Meg gave her a sympathetic smile, but her pager went off, and there really was no chance of her staying to help.

Letting out a long breath, forcing herself to just get on with it, Celeste turned around and saw Fleur’s worried face.

‘Will he be okay?’ she asked worriedly.

‘I think so,’ Celeste said, and came over, her heart sinking as the proud, dignified lady burst into tears and said sorry over and over.

‘I’ve wet my pants!’

‘I’m so sorry!’ It was Celeste saying it to Fleur now. ‘It was my fault for not taking you.’

Ben was at the desk ringing the unfortunate family to tell them what had happened to Matthew, and Celeste and Fleur were in the bathroom. Fleur’s wet clothes were off and her hand was wrapped in plastic and elevated on an IV pole, with the old lady sitting in a little shower chair.

‘Let’s both stop saying sorry, shall we?’ A lot older and a lot wiser, Fleur caught Celeste’s eyes and smiled. ‘You could hardly leave the young man, could you?’

‘I know.’

‘I just don’t want my daughter to know that I’ve had an accident—she’ll be in soon, and she’ll think I’m losing my faculties.’

‘Of course you’re not!’ Celeste exclaimed. Still, she’d have been embarrassed too, so she came up with a plan. ‘Why don’t I rinse out your clothes?’ Celeste suggested. ‘They’re covered in blood anyway. I’ll tell your daughter that’s why I washed them.’

‘What about my knickers?’

‘I’ll wash them and hang them by the vent.’ A little bit ditzy at times, Celeste could also be very practical. ‘They’ll be dry by the end of my shift—no one will ever know.’

‘You’re very kind.’

Not really, Celeste thought. Anyone should do it. She still winced when nurses stuffed filthy clothes into bags for relatives, wondering how they’d like it. Still, she couldn’t change the world, only her own actions. So she filled a sink with water…

‘Cold water for blood,’ Fleur prompted, and Celeste did as she was told then set about showering her patient. Firm friends now, Celeste smiled when Fleur asked what was surely a rare favour. ‘Would you mind giving my back an good wash?’ she asked. ‘I can never reach it.’

‘Of course.’ Fleur’s back was indeed grubby from, most likely, years of neglect, as her arthritis simply wouldn’t allow her arms to reach it.

‘I bought a brush from the chemist,’ Fleur said as Celeste gave it a good scrub. ‘You know, on a long stick, but I still can’t get there.’ So Celeste took her time to wash it as thoroughly as she could, wondering how best to approach this proud lady.

‘You’ll be needing some help with your hand out of action…’

‘I will not!’ Fleur said, as Celeste wrapped her in towels. ‘I’ll manage fine with one hand.’

‘You probably will,’ Celeste said, ‘but there are so many aids, like hand-held showers, and there are brushes for your back but with curved sticks. I’m not sure of all the things that could help, but maybe we could get you assessed.’

‘I like my independence.’

‘Well, this will help you keep your independence.’ Celeste shrugged. ‘You may as well while you’re here…Have a think about it.’

Fleur was right, Ben thought. Sitting at the desk for a moment, having made a very difficult call to Matthew’s mother and not ready to head back out there, he’d overheard the conversation between the two women. Celeste was kind, very kind indeed.

It was so easy to become hard working in Emergency—he’d seen it happen to so many colleagues. It was necessary almost if you wanted to survive in this area. He had become hardened too—switched off on certain occasions, because at times it was easier to deal with a patient than a person, kinder to yourself not to think about a family and friends and futures that were being obliterated, to just get on with the job in hand, rather than look at the bigger picture. But watching Celeste wheel out a smiling Fleur, all powdered and warm and well looked after, Ben was a mite conflicted.

Because pregnancy was his thing. One of his many things if he actually stopped and thought about it, which he tried very hard not to do.

Most people had one—Belinda had just told him on the walk back from Imaging how her younger brother had almost died from a head injury. The staff hadn’t noticed his deterioration and it had been Belinda herself who had recognised the signs when she had come to visit. Yes, they all had their things. And pregnancy was Ben’s—the one thing where he just had to detach and deal with a foetus rather than a baby, look at a set of numbers instead of the person.

He didn’t want to be hard, didn’t want to be bitter—except he was.

Yet watching Celeste rub her back after helping Fleur into bed, reluctantly watching the shape of her pregnant belly, he resisted the urge to just walk away, to shrug his shoulders and let her get on with it. She wasn’t a nurse, or a set of numbers, or a pregnant woman, she was Celeste, who was kind and tired and had had a difficult start to her shift and a lot of mess to clean up.

‘I’ve spoken to Matthew’s family…’ As he chatted to her, he lifted the metal bedhead from the floor and replaced it, then easily dragged the portable oxygen cylinder back to its spot—just doing a couple of little things that he didn’t need to, in the same way Celeste had done for Fleur, only she could never know the effort behind his easy gestures, because being around her was becoming unbearable for Ben. ‘They’re on their way back. I’ve told them to come to the front desk, but if they arrive here, just give me a buzz.’

‘I will.’ She pulled over a linen skip and stripped the bed. ‘Do you think he’ll be okay?’

‘He’ll be in Theatre by now,’ Ben said, ‘so, hopefully, yes. I’ll let you know when I hear.’

Her quiet shift was anything but. By the time it came to a close the crash cart was checked and put away, the eight beds had been filled with patients, Fleur had agreed to a visit from Occupational Therapy and now that visiting time was over, the ward was actually neat and in order—at least the night nurse should have a quiet shift!

‘Thank you, Celeste.’ Fleur smiled as Celeste helped her into clean, dry undies before she headed off home. ‘For all your care and for washing out my clothes—my daughter never suspected a thing.’

‘That’s good. Theatre just called and it shouldn’t be too much longer till they’re ready for you.’

‘And I’ll just stay in for one night?’

‘If all goes smoothly, which I’m sure it will. I’ll see you in the morning.’ Celeste smiled. ‘I’m back on at seven.’

‘You work too hard,’ Fleur fussed. ‘I know it’s what you girls do now. Still, I hope your young man’s at home with dinner waiting so you can put your feet up.’

‘I shall!’ Celeste smiled and then blushed as she realised that Ben had come in. ‘’Night, Fleur.’ She walked over to Ben. ‘I don’t want her worrying.’

‘Sorry?’

Celeste hurried to explain. ‘Well, it’s just easier to sometimes let people think that there is a Mr Mitchell at home…’ Her blush darkened as it was only then she realised Ben would have neither known nor cared that she had just been caught fibbing to Fleur. ‘Have you heard anything about Matthew?’

‘That’s what I was coming to tell you about. I’m heading home, so I just rang ICU. I didn’t get a chance till now. Apparently his pupil blew in Imaging. They got him straight up to theatre and evacuated a massive subdural haematoma—so I came to say well done. It was a good pick-up—a lot of people might have hesitated seeing as his symptoms were so fleeting.’

‘How is he now?’ Celeste asked, warming at his praise. Matthew’s brain had been bleeding, the pressure building inside his skull, causing his symptoms. It was the scary thing about seemingly benign head injuries—and the reason patients were often admitted for observation afterwards. She had read about it, studied it, learnt about it, but now she had witnessed it for herself. The chore of regular neuro obs would never be considered a chore again.

‘On ICU. It will be a good forty-eight hours before we know anything, but there is hope…’

Which was always nice.

She handed over her patients and headed for home in a car that was making more new and rather worrying noises. She slowed down at the gates and indicated left for the block of units. She climbed out of the car, leaving it idling, too worried to turn off the engine, because one day it surely wouldn’t start again! Absolutely bone weary, she opened the gates and then realised someone had pulled up behind her.

‘I’ll close them,’ Ben called out, which he did, and she drove another hundred yards and then pulled on her handbrake and climbed out of her idling car again to open the garage, because the landlord was too mean to put in automatic doors.

‘I’ll get that.’ He walked over from the gates and made light work of the garage door, and even waited till she had driven inside and closed it for her as she walked out.

Which didn’t sound like much, but every stretch was one less stretch that she had to do and she was so tired that all she was was grateful.

‘Thanks for that.’ Celeste was too weary to even summon a smile.

‘No problem,’ Ben called, heading back to his own car to repeat the ritual for his own garage. And still he didn’t deliver a lecture. Still didn’t check that she was okay, or ask if she was sure she should be working.

Had he asked, Celeste thought, as she let herself into her little unit, she might just have burst into tears.

She had to eat, but she was too tired to cook, so she had a bowl of cereal instead.

Then a very quick shower. Knowing she’d regret it if she didn’t, she put out a fresh uniform for the morning, checked her alarm and slipped into bed, too tired to worry, too worn out for tears or even to think really.

She had to be back there tomorrow at ten to seven!