Читать книгу The Pregnant Midwife - Fiona McArthur - Страница 8

KIRSTEN’S first shift as a night neonatal nurse started off quietly, if you could call the beep of two dozen heart monitors and the hiss of several ventilators breathing for tiny infants quiet. It was strange but good to be back in an Australian hospital and she glanced around at her workmates. In Dubai, the eclectic mix of nationalities was always fun but she had missed the twangy accent and dry wit of the Australians.

Kirsten was rostered to start at MIRA headquarters on Monday morning, but for tonight it would be good to have a chance to see what had changed on the home front. Around midnight, though, her leisurely check was cut short.

Twenty-eight-week twin girls were rushed in from the delivery suite with very little warning, and Kirsten was actually happy to see Hunter follow them in.

Kirsten took over the care of one child, Kinny Baker, and her coworker, Patricia, took the other sister, Carla. Weighing in at just eight hundred and fifty and nine hundred grams respectively, Kirsten spared a brief thought for the long road the girls and their parents had ahead of them as the tiny infants were placed in the humidicribs to keep warm.

Hunter had already intubated the girls in the delivery suite within a few minutes of birth and the babies had been hand-ventilated with tiny resuscitation bags by delivery-suite staff until they could be transferred to the nursery and connected to the ventilators. Kirsten attached Kinny’s three leads to the heart monitor and clipped the pulse oximeter to her tiny foot to check peripheral oxygen saturation. The capillary oxygen saturation in an infant, or sats, was a good indication of how the respiratory system was coping.

Silently, Hunter appeared beside Kirsten and she could feel the warmth from his body beside her as he attended an initial physical examination while Kirsten was establishing baseline observations.

‘Hello, little one,’ he murmured to Kinny as he moved to listen to her heart and lungs. Then he examined her tiny body for any abnormalities. Kirsten checked the endotracheal tube was secure now she was hooked up to the ventilator.

She tried to ignore the seeping heat that burned into her hip from his nearness and her chest ached with unwilling sadness. She watched Hunter deftly insert a tiny intravenous cannula into Kinny’s arm and together they splinted the little girl’s tiny forearm to safeguard the line. They’d done this for so many infants in the past. Tonight it was all achieved without speaking.

Kirsten found she could still anticipate Hunter’s treatment plan and the thought brought a pang to be shrugged off as she considered what they’d achieved. Airway was secure, breathing was controlled via the ventilator and circulation didn’t seem to be a problem. Kinny looked good.

The IV would avoid the need for feeding until Kinny’s condition had stabilised and provide immediate access for antibiotics and any other drugs the premature infant would need.

Kinny’s arm, smaller than Hunter’s little finger, emphasised the extreme fragility of their tiny charge. Next to Kinny’s shiny, transparent skin, Hunter’s brown hand looked like carved stone. A little like his face whenever he needed to look at her, Kirsten thought dryly.

Kinny’s dad, Ken Baker, arrived from the delivery suite and his eyes misted at the sight of his tiny daughters as they lay pink and fragile amidst the technological paraphernalia. Attached to each baby, a network of leads snaked out through a port in the side of the humidicrib and connected to the digital monitor beside Kirsten’s and Patricia’s work area around the cribs.

Hunter’s voice was quiet as he spoke to Kirsten. ‘Now that we have them connected, if you want to get the surfactant from the fridge, I’ll have a quick word with their dad.’

Kirsten nodded and turned to go, but Hunter stopped her. ‘We can use half an amp for each baby down the tube—that will be plenty.’ She dashed off and Hunter gently steered the babies’ father closer to the cribs so he could watch their progress.

He shook Mr Baker’s hand. ‘It must look pretty daunting to you but both girls are doing really well.’ As an opening line it must have worked, Kirsten thought as she returned, because Ken seemed to sag a little with relief at Hunter’s smile.

She carried a tiny feeding tube to help ensure the hormone reached well into the little girl’s lungs.

Hunter went on. ‘Your daughters are sedated to allow them to rest while the ventilator expands and deflates their lungs for them. The tiny amount of liquid that Sister is squirting into their breathing tubes is a hormone to help stop their lungs from sticking together, which means less pressure is needed by the ventilator to expand their lungs.’ Ken nodded that he understood and Hunter went on.

‘Less pressure from the ventilator is a good thing because it means less long-term damage and less chance of a hole in the lung occurring.’

Kirsten listened to Hunter explain the humidicribs to the babies’ father with a small smile. ‘It’s like a miniature rainforest in that crib,’ he said, and his hands illustrated his point. ‘All premature babies around your daughters’ gestation are about eighty to ninety per cent fluid and they need moisture or they’ll dry out, a bit like chips.’

The father blinked at the graphic image and Kirsten turned away to hide her smile. Hunter was right but a less graphic description might have been better.

Ken shook his head at all the technology. ‘So how long do they stay here?’

‘This young?’ Hunter looked at the girls thoughtfully. ‘They stay on average the time it would have taken for them to come to term naturally. So about twelve weeks! If all goes well, we’ll wean them off the ventilator in about a week and even start them on maybe a few drops of breast milk every four hours in a few days. But they won’t get anything to eat till then.’

The girl’s father rubbed his stomach in sympathy. ‘But they get what they need out of the drip, right?’

Ken looked as though he couldn’t take much more information.

‘That’s right,’ Kirsten said. ‘I think you’re doing really well with the day you’ve had. Did you want to get back to your wife? You know you can come back any time.’ Ken nodded with relief. She handed him two instant photos of his tiny daughters which she’d taken while she and Patricia had weighed the babies earlier. ‘Take these with you. Please, let your wife know she’s welcome to come down and see your daughters any time.’

Kirsten showed him how to get back to the delivery suite and when she returned, Hunter was beside Kinny’s crib, looking in. ‘Dry out like a chip?’ she said, and shook her head.

Hunter had the grace to look embarrassed. ‘Well, they do dry out.’

‘The poor man will worry that his babies will be crinkled when he comes back.’ Kirsten laughed and sat back on her stool to do the next round of observations and for the briefest moment they both seemed to forget the past as they shared a smile. Then they both looked away.

It was after three a.m. before Hunter decided he could leave his charges in the NICU staff’s hands.

Patricia looked up. ‘Do you want a coffee before you go, Hunter?’

Kirsten was surprised when Hunter agreed because the last thing he’d seemed had been eager to stay around. She wondered at his motives.

‘Sure. You ladies have done a great job tonight.’ By the warm glance that passed over her, Kirsten gathered even she was included in the compliment. He always had been fair with his appreciation. She looked away.

The last thing she needed Hunter to see was her confusion at approval when he’d been impersonating the basilisk all night. She knew she was good at her job, so why should it mean so much for Hunter to say it?

‘Decaffeinated shouldn’t keep me awake for what’s left of the night,’ he said. ‘I almost envy you girls a night shift if it means you can sleep through the day.’

‘You must get very tired,’ Patricia murmured sympathetically, and Kirsten shifted on her stool with resignation. And she’d thought Patricia a sensible woman. As if Hunter sensed her distaste at the drift of the conversation, he turned himself fully to face her. ‘And are you sleeping today, Kirsten?’

‘After lunch,’ she said shortly, and turned back to record Kinny’s vital signs on her chart. He came to stand beside the crib and looked down at her as she sat on the stool. They weren’t touching but she was aware of how close he was. She could have lifted her fingers a centimetre and she’d have been able to feel the warmth of his skin. It was strange, the way she could force herself to ignore these thoughts while they were working, yet when the tension was over it was as if the build-up she’d ignored took over.

‘So what’s planned for you this morning that’s more important than sleep?’

Kirsten smiled noncommittally and unconsciously leaned her body slightly away from him. ‘My new unit. I’ve unpacking to do.’ Her tone didn’t encourage further questions and he shrugged. Then she glanced back over her shoulder. ‘If you want to grab coffee, Patricia, I’ll stay here and watch both girls until you and Hunter come back.’

Patricia’s pleased smile wasn’t reflected in Hunter’s face and Kirsten stowed that piece of useless information away for later. The good news was he moved away to follow the younger woman to the tearoom and Kirsten felt the tension ease from her neck.

This was ridiculous. Already she could tell that half the women in NICU were attracted to the man and she knew better than to join the ranks. She’d seen how fickle he could be and how cold he became when he withdrew his favour. A brief glow under the Hunter Morgan sunlamp, despite the memories that could make her smile softly in weak moments of the night, were not worth the chill of being discarded. Now she knew why she preferred a non-threatening platonic friendship with men. She’d get on with her satisfying life as a single woman, and for male companionship she’d stick with those who were no risk to her peace of mind. Maybe she’d tattoo ‘Just friends’ on her forehead.

As if conjured up, a pair of masculine hands encircled her eyes from behind. ‘Boo,’ a male voice whispered, and Kirsten spun around under his light hold. Thin and blond, Marcus Gleeson, a young registrar she’d shared some of her MIRA experience with last time, grinned cheekily at her. ‘Hey, Wilson, where’d you spring from? You’re more gorgeous than ever.’

Kirsten looked him up and down. ‘I morphed out of this stool here. Gorgeous, eh? I’m sure three in the morning is my best time.’ She looked critically at the bags under the young man’s eyes. ‘How are you, Marc? Still playing the field?’

His smile wavered for a moment and then he shrugged. ‘I might tell you later, you always were a good listener. But what about you?’

Kirsten tilted her head and noticed his usual mischief was missing. Unable to help herself, she stood up, reached out and drew Marcus into a quick sisterly hug. ‘Poor baby. We’ll have coffee soon.’ When she stepped back she looked up into the cold eyes of Hunter.

Kirsten resisted the ridiculous urge to explain and sat back on her stool and spun to look into crib. Both babies were stable and it wasn’t time for more observations so she turned back to find Hunter still staring at her. She raised her eyebrows in a ‘what?’ gesture and his gaze moved over her dismissively before he turned away without answering.

Marcus watched him walk away. ‘What’s wrong with the boss?’

Kirsten shrugged and tucked her hands into her pockets to hide the effect Hunter’s disdain had had on her.

Hunter glared at the point where the exit light showed the way out and strode faster than usual towards the door. He’d actually felt like lifting Gleeson up by the scruff of his skinny neck and tossing him out the third-floor window. Which was not a normal thought. Up until today he’d quite liked the young chap. Hunter frowned. He supposed Gleeson was only a couple of years younger than he was, but Hunter felt like an old man compared to his registrar.

He’d seen the smile Kirsten had given Gleeson and the way she’d hugged him. Hunter had thought Gleeson was enamoured by Patricia and had spent his coffee-break steering the young woman towards Marc and away from himself. That was probably why he felt so annoyed. The flat of his hand slapped the door open. Lack of sleep could make you intolerant—though he hadn’t noticed that problem before tonight. Perhaps he was getting old.

On Kirsten’s first shift back at MIRA she started at seven in the morning. It felt strange to be back in the familiar spread of rooms and balconies. She found her old locker with the key sticking out waiting for her, and she had to smile. Maggie would have done that.

Kirsten had brought a bag of things from home to keep on site and there was a feeling of déjà vu in packing them back into the locker, having emptied it eighteen months ago. She tucked her bathroom bag, small pillow and quilt at the back for those nights when all the checking and cleaning was finished and they were waiting for a call. If she was going to do extra nights in the nursery she might be glad of an hour’s catch-up sleep.

Headquarters had two bedrooms with proper beds, a sofa in the TV room and a fold-up bed that could be erected in the education room. But from past experience she knew there wasn’t usually much chance of sleep.

Most days, the MIRA staff averaged two retrievals per ten-hour shift, with each trip taking between three to five hours. Sometimes it was much longer if the infant was difficult to stabilise before transfer.

Hunter came into the room and Kirsten shoved away her box of emergency muesli bars, relieved she’d finished packing her locker. The sudden awkwardness at his presence made her press back to let him past.

The locker room was tiny and he couldn’t help brushing against her as she shrank almost inside her locker to keep out of his way. Just that minute contact made her stiffen in denial of an attraction she didn’t want to feel.

‘Worried about catching germs, Kirsten?’ he drawled, but didn’t look at her as he put away his jacket. Kirsten gritted her teeth as she backed out of the small space.

‘Don’t be a pain, Hunter.’

There was silence from behind her as she left the room. Great beginning to the first day, she chided herself, but he’d started it. She sensed him follow her out towards the kitchen. They really needed to get professional here and bury the past. She slid her lunch into the fridge and eyed the new vending machines in the kitchen that hadn’t been there last year and grinned. Sweets, chips, Coke and microwave meals—a truly balanced diet for those who wanted it.

One of the male registered nurses from the night shift wandered into the kitchen with an empty coffee-cup, let out a whoop when he saw Kirsten, picked her up and swung her around. ‘Kirsten Wilson. How the hell are you?’ he said, and gave her a big hug. At the look on Hunter’s face Kirsten could either have laughed or cried. She chose the former and hugged Paul Netherby back. Take that, Hunter Morgan, Kirsten thought as the big nurse put her down, but when she turned to see what his reaction was, Hunter had gone.

Suddenly she felt flat, and in denial she became more vivacious.

‘It’s good to see you, Paul. How’s Serena and the baby?’

The man’s face fell. ‘She left me. Not interested in taking her place, are you?’ He looked cautiously hopeful but Kirsten wasn’t fooled.

‘Nobody could take Serena’s place for you. If you’ve hurt that woman, you have some major sucking up to do and you know it.’

Paul hugged her again. ‘I love you, Kirsten Wilson.’ Hunter returned with a dirty coffee-mug and his lip curled as if he’d just swallowed a particularly loathsome insect. Kirsten signed. Paul was oblivious and dragged a stern-faced Kirsten out into the other room. ‘You know me so well,’ he chattered as they left. ‘Come and meet my partner from last night, the delectable Nicky.’

Hunter stood at the sink and stared out the window, but he couldn’t see anything. Lord, he’d had a lucky escape. That woman attracted men like flies and she seemed to lack all moral judgement. Hunter knew about poor Serena Netherby and the flighty Paul, and he’d thought they were almost back together again. And they even had a baby. Netherby was just the sort of low-life Portia, his ex-wife, would have liked, too.

He couldn’t believe Kirsten could be so stupid as to believe anything Netherby said, but obviously they’d had some kind of past relationship to be that friendly.

It was all none of his business and he’d had a lucky escape. It was good to have a calm and safe life again. Now there was no reason he and Kirsten couldn’t be professional about this—she’d always maintained that in the unit.

Ellen wandered into the kitchen to find Hunter gripping a cup, white-knuckled, at the sink.

‘You OK, Hunter? she asked, and he blinked and smiled a perfunctory greeting.

‘Fine.’ He glanced down at the cup in his hand and loosened his fingers. ‘Looks to be good flying weather out there,’ he said, and walked away.

Ellen glanced out the window at the shredded clouds scattered ahead of a thick cumulonimbus front. ‘What planet are you on today?’ she muttered, as she switched the kettle on.

Paul, Nicky and the other night team members had left and Ellen cornered Kirsten to run through the protocols and check routines. All the time Kirsten nodded that she understood, she was aware of Hunter on the sofa as he pretended to read the newspaper. He kept staring at her over the top of the pages, trying to put her off, and if he didn’t stop she’d clock the man with one of the cushions.

She knew he could get up to mischief. It would be just like him to decide to amuse himself at her expense.

Before the battle of wits could escalate, the MIRA phone rang and personal tensions disappeared. Jim took the incoming call from a base hospital on the north coast and they all looked towards the conference phone as Hunter joined in.

A three-hour-old baby boy, Isaac Curtin, had been diagnosed with a large ventricular septal defect (VSD) or hole in the heart. Born in Taree, an hour’s flight north of Sydney, baby Isaac needed to be airlifted to a major centre for care and assessment by a paediatric cardiologist and probable urgent corrective surgery.

Kirsten listened to Jim as he outlined the hospital doctor’s problem, what his needs were and other possibilities, but she could tell they all agreed retrieval was the best option. Jim conferenced the call with Hunter, a paediatric cardiologist and a surgeon in Western Sydney, and Hunter took notes on the recommended treatment for stabilisation by the MIRA team after the decision was made to transfer.

Kirsten’s heart did a little flip-flop of excitement and she couldn’t help savouring the flush of adrenalin for her first retrieval in a year and a half despite the fact she was sharing the trip with Hunter and Ellen. She shrugged. The baby and parents were the important people.

The preparation and flight routine emphasised minimum delay in departure and Kirsten pushed the equipment out onto the roof ahead of the rest as all the sequences returned from memory.

The extra-warm greeting Kirsten received from the tall pilot, Keith, a man not noted for warm greetings, was observed stonily by the two senior staff members as they followed Kirsten into the helicopter. Kirsten rolled her eyes. Hunter probably thought she was having an affair with Keith now. She winked at Keith and watched Hunter’s eyebrows shoot up.

An experienced fixed-wing instructor, as well as helicopter pilot, Keith had flown many times in the past with Kirsten. She’d shared several hilarious picnics with Keith and his wife at the Camden Aero Club before she’d gained her own unrestricted pilot’s licence, and she considered them both good friends. Darned if she’d start feeling uncomfortable around Keith because of Hunter Morgan’s hang-ups.

‘Looks like it’ll be a bumpy ride.’ Keith seemed to derive a certain malicious satisfaction from the forecast and Kirsten grinned back. He hadn’t been able to make her airsick yet.

Stormclouds accumulated off the starboard wing and Kirsten was glad they were in the sturdy Bell 412 helicopter. At least there was plenty of room for the extra staff member and Kirsten didn’t have to stare at Hunter all the way.

Prior to take-off, baby Isaac’s weight and birth date had been fed into the computer and the MIRA program-generated drug sheets produced the correct dosage for every conceivable drug they might need on the retrieval. This double-sided printed sheet was a valuable tool in saving time in drug calculations and dramatically cut the chance of medication error. The team prepared the most likely drugs en route to save more time at the destination hospital.

Ellen ran through the probable scenario of arrival for Kirsten, as if she’d never been on a retrieval or even an aircraft before, and Kirsten listened and nodded. At least Ellen was a distraction from Hunter who was on the other side of the cabin, watching with his arms folded. She wished he’d recheck the portable crib or something because she found his scrutiny hard to ignore.

At last they arrived and Kirsten heaved a sigh of relief. Next time she’d make sure she had the window seat as a distraction.