Читать книгу The Baby Emergency - Carol Marinelli, Carol Marinelli - Страница 8

PULLING up a chair at the nurses’ station, Shelly smiled at a now much happier Nicola.

‘She’s great, isn’t she?’ Nicola said, happily munching into a huge slab of walnut cake.

‘Told you. Melissa’s bark is far worse than her bite. Once the day staff are gone she relaxes—and feeds us,’ Shelly added, helping herself to a generous slice.

‘Save some for me!’ Ross perched on the edge of the desk, depositing a mountain of files and X-rays as he did so.

‘How’s the baby in Emergency?’

‘Heading this way,’ Ross sighed. ‘He’s pretty sick but he’s holding his own at the moment. The children’s hospital has got an ICU cot but not a general one, whereas we’ve got a general but no ICU. I can’t believe I’d managed to forget the constant battle with the bed state.’ He rolled his eyes. ‘Looks like we’re in for a long night. Hopefully Melissa will go easy on me, I didn’t really have any choice but to admit him. Emergency’s steaming down there, it’s no place for a sick baby.’

‘I agree.’ Melissa, coming up behind Ross, caused him to jump. ‘I don’t mind being busy, Ross, it’s just the general thoughtlessness that annoys me. Annie should have had him up here hours ago. Instead, we’ve got a sick baby to assess and an overwrought mum to deal with in the middle of the night. A little bit of foresight wouldn’t have gone amiss.’

Ross nodded his head in agreement. ‘Right, what have you got for me? I’d better clear the pile before Kane gets here. Who knows when I’ll find time otherwise?’

‘Just a couple of IV orders that need updating, and I think Shelly wants some antibiotics written up for cot five—his blood culture results are back.’

Ross nodded. ‘Yeah, the lab just paged me.’ One hand tapped away on the computer as he brought up the results. ‘This is the life,’ he sighed. ‘Pathologists on call, X-Ray just a stone’s throw away.’

‘I thought you said it was civilised where you were,’ Shelly teased, desperately trying to resume normal services despite her internal bombshell.

‘It was. The clinic I worked in at Tennagarrah was comparable to a luxury caravan. All the basics were there but you weren’t exactly spoilt for choice and you had to work for everything. This in comparison is a five-star hotel.’ With an exaggerated whoop of delight he jumped down and opened the drug fridge. ‘And just look at the mini-bar, where do I start? Bactrim, flucloxacillin, gentamicin, vancomycin. What can I get you, Sister?’

Shelly peered at the monitor in front of her, reading the blood results and the antibiotic sensitivities. ‘Well, a large dose of flucloxacillin would hit the spot.’

‘Coming right up.

‘Anything else I can get you?’ Ross asked, carrying on the joke as he pulled the vial of antibiotic out of the fridge. ‘Have you had a look at the room service menu yet?’

‘This will do just fine.’ Picking up her cake, Shelly effectively ended the playful conversation. Images of five-star hotels and bubbling spas and four-poster beds weren’t exactly doing wonders for her blood pressure, and the sight of the porter wheeling in the gurney carrying the baby provided a very welcome diversion.

‘Kane Anderson,’ the emergency nurse informed them as Shelly pulled down the cot side and greeted Kane’s mum with a warm smile. ‘He’s been down in Emergency so long he’s part of the furniture now. This is his mum, Angela.’

‘Hi, Angela, we’re just going to get Kane into the cot and then I’ll get the handover from Emergency. Once that’s done I’ll come and settle you both in.’ Gently she lifted the infant over, handling him deftly and with minimum fuss so as to avoid any unnecessary exertion.

Although the handover was important and the emergency nurse was obviously in a rush to get back to her department, Shelly took a moment or two to explain how the oxygen tent worked, realising how alarming it must look to Angela.

‘This monitor tells us the oxygen concentration in the tent, it’s very safe.’

‘He can’t suffocate?’ Angela checked.

‘Definitely not,’ Shelly said firmly. ‘If the level drops in the tent the alarm goes off, and this little probe I’ve attached to his foot tells us Kane’s own oxygen levels. I’ll be back in a couple of moments. I’m just outside but if you’re worried at all just bang on the window or call.’

‘She’s being a bit difficult,’ the emergency nurse started.

‘No doubt because she’s worried and exhausted,’ Shelly said quickly, refusing to get drawn into a discussion on the mother’s emotional state, preferring to make her own observations. ‘And eighteen hours in Emergency wouldn’t exactly have helped matters. What’s the story with the baby?’

The story wasn’t very good. Three days of a worsening cough and struggling to feed, two different types of antibiotics from the local GP and a long wait in Emergency. ‘His respiration rate is still very high and his heart rate’s elevated. He’s very grizzly, which isn’t helping his breathing, and he just won’t settle.’

‘Any wet nappies?’ Shelly asked, flicking through the obs chart.

‘Three. He was moderately dehydrated when he came to us but the IV fluids have kicked in now. He’s still very sick, though.’

Shelly nodded in agreement. Her brief assessment of Kane had done nothing to reassure her. He was working hard with each rapid breath, using his stomach muscles, his tiny nostrils flaring, all dangerous signs. ‘I’ll get Ross to have another look at him,’ Shelly concluded, anxious to get back to her small charge. ‘Thanks for that.’

Ross was already at the cot side, rubbing his stethoscope between his hands to warm it before placing it gently on the baby’s rapidly moving chest as Angela stood anxiously wringing her hands, every bleep of the monitors making her jump slightly, every tiny jerking movement Kane made causing her to step forward anxiously, bombarding Ross with questions as he tried to listen to the baby’s breathing.

‘He’s hungry,’ Angela said the second Shelly entered. ‘The sister in Emergency said he might be able to have a bottle once he got up to the ward.’

Pulling the stethoscope out of his ears, Ross straightened, carefully zipping up the oxygen tent and pulling up the cot side. ‘He can’t have a bottle at the moment, Angela, he’s too exhausted to feed.’

‘But he isn’t settling.’

Shelly could hear the slightly hysterical note creeping into Angela’s voice and stood back quietly as she carried on with her outburst.

‘They said they were going to put a tube down his nose and give him the milk that way, but they haven’t even done that. No one seems to be doing anything. He’s not even on any antibiotics!’

‘Look, why don’t you sit down for a minute?’ Ross started, but his well-meant words only inflamed Angela further.

‘I don’t want to sit down,’ she shouted. ‘I want someone to tell me what’s being done for my baby.’

‘I know you’re upset—’ Shelly started.

‘Oh, what would you know?’ Angela snapped, turning her fury on Shelly, her face livid.

‘That you’re exhausted, and terrified?’ Shelly ventured, her stance relaxed, her voice calm and sympathetic. ‘That you’ve probably had more people offering their opinions and telling you what might be, could be, should be done than you can even count?’

Mistrusting eyes finally made contact and Angela gave a grudging nod.

‘Well, you’re on the children’s ward now, and Ross is the doctor and Melissa and I are the nurses looking after you and your son tonight. If you’ll let us, we can tell you what we’re going to be doing, but shouting and getting upset is only going to unsettle Kane—can you see that?’

The nod Angela gave wasn’t so grudging this time, more sheepish, and Shelly felt her heart go out to the other woman as she burst into noisy tears. ‘I’m sorry, it’s not you, I’m just so scared, he keeps getting worse.’

‘He’s been sick for a few days, hasn’t he?’ Shelly asked gently.

‘Since the weekend. I thought it was just a cold at first then he got this cough and then he started wheezing. I haven’t slept for the last two nights.’

‘Kane has bronchiolitis,’ Ross broke in, gently taking Angela’s arm and guiding her to a chair before pulling one up for himself. ‘It’s a respiratory virus that can be particularity nasty in young babies. Now, because it’s a virus antibiotics aren’t going to do any good, none at all,’ he emphasised as Angela opened her mouth to argue. ‘What Kane needs at the moment is what we call supportive care. That means he needs to be kept warm and rested, with lots of oxygen to help him breathe and fluids through a drip to keep him hydrated. All of this we’re doing for him, and this in turn gives his body a chance to concentrate on fighting the virus. If we give him a bottle now he wouldn’t be able to cope with it, he simply hasn’t got enough energy to feed. If we give him one at this stage he could become a very sick little boy indeed.’

‘What about the tube they were talking about?’ Angela asked hopefully, her mind still focussed on her baby getting fed, but Ross firmly shook his head.

‘The tube we would pass is very small and fine, but it would still upset him while we passed it and I don’t want to cause him any more distress, that’s why I’m going to try and not to do any blood tests or anything that might upset him, for now we just want him to rest. Kane’s getting what he needs from the drip and we can give him a dummy to settle him.’

‘He keeps spitting it out.’ Angela’s voice was rising again, her shredded nerves ready to snap at any moment, but Ross carried on chatting, his voice amicable and easy.

‘We can soon fix that.’

‘How?’ Angela snapped.

‘Glycerine.’ Ross gave an easy shrug as Angela immediately shook her head.

‘You’re not supposed to put anything on their dummies, it says so in all the books. The child health nurse said—’

‘Kane’s very sick,’ Ross interrupted gently. ‘He needs to rest, and if a smear of glycerine on his dummy achieves that, then it’s merited.’

‘Ross.’ Shelly gave him a wide-eyed look and Ross frowned slightly at the interruption. ‘Can I have a quick word, please?’

‘What’s up, Shelly?’ Following her outside, there was a slight impatience to Ross’s stance. ‘I’m trying to calm the mother. Pulling me outside isn’t really helping.’

‘I know that,’ Shelly responded. ‘But putting anything on the babies’ dummies really is frowned on. Tania will have a fit…’

‘Tania isn’t here,’ Ross pointed out. ‘And if she was I’d tell her what I’m about to tell you. That baby’s sick—any further slide in his condition and he’ll be on a ventilator in intensive care. Now, given this hospital hasn’t even got an intensive-care cot, that will mean sending him and Angela for a ten-minute jaunt in a helicopter. Now, if a bit of glycerine on a dummy can prevent that, I’m all for it.’

‘But, Ross.’ Shelly pulled at his sleeve as he turned to go, the contact tiny but enough to throw her, the sleeve of his white coat new and crisp, the solid bulge of his forearm, even the scent of his aftershave wafting over as he turned to go, all enough to distract her. Shelly fumbled to finish her argument.

‘I know it seems petty, but the department has strict guidelines on this. The dental damage—’

‘Shelly.’ Ross’s voice was quiet, but his words were very clear as he spoke, his eyes looking right into hers, unblinking, unwavering. ‘Let’s get this little guy through tonight, huh? Lose this battle and tooth decay will be something Angela can only dream about.’

Shelly’s eyes were wide with surprise as Ross turned and went back to Kane. His words made sense, good sense, and in truth Shelly felt ridiculous arguing about such a tiny detail, but rules were rules…But it wasn’t Ross’s little lecture that had left her reeling.

The few years in the bush had changed him. That easygoing, eager-to-please guy was gone, and in his place, just as gorgeous, just as stunning, was a rather more confident version, a man who knew what he wanted, and would make sure he got it.

Heading to the treatment room, Shelly took a while to find the little-used jar.

‘The contraband’s arrived,’ Ross said dryly as Shelly joined him at the bedside, Angela looking on anxiously, still dubious that it would work.

‘It’s just while he’s sick,’ Shelly said confidently, noting the tiny smile of appreciation on the edge of Ross’s lips as she put aside her own misgivings and beckoned for Angela to come closer. ‘What’s more, it’s something you can do for Kane to help him settle.’

Her words hit the mark. As Angela took the dummy, Shelly went into greater detail, showing Angela how to open the tent, how she could slip her hands in and even put her head in the cot to cuddle and speak to her child. Thankfully the glycerine worked and after a few goes baby Kane finally took his dummy. With the tent delivering a high dose of concentrated oxygen, he lay back exhausted, his little arms and legs flopping outwards like a washed-up frog as he drifted into a spent sleep.

‘How’s he doing?’ Melissa’s knowledgeable eyes scanned the monitors and baby in a moment.

‘He’s asleep, his saturations are ninety-two on thirty-five per cent oxygen.’

‘Turn it up to forty per cent,’ Melissa said after a moment’s thought. ‘Let’s give him as much help as we can.’

Ross nodded his approval as Shelly fiddled with the flow meter.

‘Come and have a cup of coffee,’ Melissa offered to Angela.

‘I’d rather not leave him. Can I have it in here?’

‘Sorry, but the last thing you or the staff will be thinking of if Kane gets worse suddenly is a hot cup of coffee balanced on the locker.’

‘Fair enough.’ Angela was positively meek now, but even Shelly thought Ross was pushing things with what he said next.

‘Go and have a coffee.’ Ross’s voice was assured. ‘And then come back and have a lie-down.’

‘I’m not sleeping,’ Angela flared. ‘How can I sleep when he’s this sick? What if he gets worse?’

‘He probably is going to get a bit worse.’ Ross’s eyes held Angela’s terrified ones. ‘And then he’s going to start getting better, and when he does he’s going to have you running in circles, feeding him, amusing him, spoiling him rotten…’ He gave a tiny smile and to Shelly’s amazement Angela gave a reluctant one back. ‘You need some rest, you need to try and trust us to look after your baby, and you’re going to be right next to him.’ He gestured to the camp bed, his eyes never leaving Angela’s face. ‘And if anything happens, we’ll wake you.

‘I promise,’ he added.

‘You’ve got the A team on tonight,’ Melissa broke in, her brisk, efficient voice such a contrast to Ross’s calm one, but somehow the balance worked. ‘Your baby’s in good hands. Now, come and have a coffee with me while we go through the admission forms. I need to know his little ways, what formula he has, how you generally settle him, that type of thing.’ Technically the job was Shelly’s, she was looking after cots tonight so the admission was hers, but Shelly was more than happy to defer to Melissa. They were a team and Melissa was what Angela needed right now—someone a touch more authoritative, less close in age, someone to lean on.

‘She’ll be right now,’ Ross said quietly as Melissa led Angela out. ‘That’s why I wanted to just get them up here. The poor woman was beside herself down in Emergency. A slice of Melissa’s cake and a bit of a rest and she’ll be a new woman.’

He was right, of course. Ross was always right when it came to dealing with women, Shelly mused, fiddling again with the flow meter to get the concentration right now that the cot was zipped up and Kane was quietly resting. Someone must have given Ross a glimpse of the rule book the day he hit puberty, told him how to turn on that winning smile and work that velvet voice to gain maximum impact. Oh, he wasn’t a flirt, he didn’t turn on the charm to beguile people, it was all just so damned effortless with him and it would be so, so easy to let it go to her head.