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Sadie Drummond, large-boned, plain-speaking and very competent, was orientating her two new nurses to the department. The interruptions were rampant, yet she soldiered on.

'Let's get out of here into my office and have a cup of coffee,' she said, turning away from the busy scene at the door and striding down a side passage, with the two nurses following her. It was ten o'clock in the morning.

'You'll both start off working in the reception area where we do the assessments when the patients first come in.' She continued talking as she moved. 'That's where we separate the ambulatory patients from the more serious cases. Then you'll gradually work your way through all areas of the department so that at the end of your three-week orientation period you will know precisely how each part of the system works. Later on you'll be assigned to an area where any previous experience you've had can be put to good use.'

She swept into a small cubby-hole which was her office. 'You, Miss Stanton,' she said, 'I shall probably put to work in one of our small operating rooms because of your extensive OR experience.'

Lisa nodded, giving Miss Drummond her full attention. They had been in the department since half-past seven that morning, and already it seemed to Lisa that she had put in a full day's work. The emergency department was unpredictable.

'We do things like tracheostomies there, and the treatment of gunshot wounds, as well as the stabilization process for the road-traffic accident cases and other accidents before the patients get transferred to the main operating room or the intensive care unit. We do a lot of intubations and the insertion of chest tubes for crushing injuries, fractured ribs, and so on,' Miss Drummond said.

Lisa nodded enthusiastically, already looking forward to the challenging work that she knew lay ahead. 'I should like that,' she said.

'Help yourself to coffee,' Sadie Drummond said, indicating her coffee-maker on a side table. While the two nurses moved to comply she went on talking, filling them in about the workings of the department.

Lisa glanced sideways at the other woman, Diane Crane,
RN,
who was a little older than she was herself. Diane grinned slightly. They were both very impressed with Sadie Drummond.

'Of course,' Miss Drummond went on relentlessly, 'you will have to be competent in—and be prepared to work in—any part of the department at a moment's notice. Every few months you will be expected to do a rotation through all the areas, just to keep your hand in. We get a lot of cardiac arrests here.'

A young intern poked his head round the open doorway.

'Excuse me, Miss Drummond,' he said reverently, his tones soft, 'Dr Claibourne's here and he wants to have a word with you.'

'That man!' Sadie Drummond expostulated. 'Why does a perfectly competent surgeon always want his hand held the minute he gets down here? Eh? Why can't he just get on with things, just do what he's told, like the rest of them?'

The intern made no comment, just smiled.

'Excuse me, girls.' The head nurse expressed regret. 'I'll be back in about fifteen minutes, which should just give me long enough to strangle that Dr Jerry Claibourne. Take a coffee-break.'

For a few seconds after her departure the two nurses sipped their coffee in silence, then Diane Crane looked at Lisa and they both erupted into uncontrollable laughter.

'I can't imagine any stalker getting on her back, can you?' Diane spluttered.

'No, I bet she's a self-defence expert,' Lisa agreed, knowing that she was going to like the department very much.

'Yeah, hand-to-hand combat, I should think.'

'Sounds like we're going to need it here.'

They both wore white uniform pants suits and the regulation white shoes. Where Lisa was auburn-haired and full-breasted, Diane was fair-haired and skinny, her arms almost as thin as a child's.

'I've worked in emergency departments before,' Diane said, 'but nothing as big as this, or as busy, and not in an inner city area either.'

'I bet you're not as fragile as you look, Diane.' Lisa smiled at the other woman, sensing that they were going to have a good working relationship and perhaps becoming good friends.

'No, I'm not, although sometimes it's convenient to let the male sex think so,' Diane said succinctly. 'Talking of men, what do you think of the head of department.. .Dr Blair? It's a long time since I've seen such a gorgeous-looking guy, who also seems pretty decent as well. I guess it's too much to hope for that he isn't married.'

'Um. . .I think he's a very nice person, and a good doctor. I don't know him very well.' That was true, Lisa told herself, not wishing to deceive the other woman and yet not wanting her to pick up any hints that she had anything special going with Dr Blair. After all, she didn't, did she? 'I do happen to know that he isn't married.'

'Wow!' Diane said, opening her eyes wide in appreciation. 'I could sure weave a few fantasies around him!'

'Yes,' Lisa agreed thoughtfully, 'I second that.'

'Well, Lisa, what name are you going to give yourself on your ID badge? I thought I'd call myself Anne. At least the other nurses will know my real name.'

'I could call myself Liz, I guess. That's about the closest to my real name.'

'Come with me, girls.' Sadie Drummond was back. 'I've shown you the main waiting area for the ambulatory patients, the reception and the assessment areas. Now we're going to take a look at the treatment cubicles for the stretcher cases, then our three small operating/resuscitation rooms for our accident cases. I may have to leave you to your own devices very shortly. Things are hotting up around here.'

Hastily the two nurses put down their coffee-cups and followed her out. The whole place was humming with activity. Stretchers, wheelchairs, ambulatory patients and staff weaved around each other in a kind of controlled, urgent dance. Ambulance drivers and paramedics were issuing instructions to each other as they came and went.

'This is sure different from the way it was yesterday,' Lisa confided as they all set a brisk pace to the stretcher cubicles.

'This is more like normal,' Miss Drummond stated flatly. 'We're going into a crisis room. Patient with an overdose of drugs—street drugs, probably heroin. I'm going to be helping here so you stay well out of the way and just watch for now.'

As they walked quickly down a wide passage to the treatment area for stretcher cases three doctors, all wearing scrubsuits, operating caps and masks, came out of one of the operating rooms.

Diane nudged Lisa as they walked. 'There he is,' Diane hissed. 'Dr Blair. That's the first I've seen of him today.'

Over a green scrubsuit Dr Blair wore a clear plastic apron that had smears of blood on the front. Lisa looked at him expectantly as the two groups converged, waiting for him to acknowledge her presence. He looked tense and absorbed, talking rapidly to his two colleagues.

Dr Blair's eyes skated over the trio of nurses, giving no indication that their presence had actually registered
with him. His expression did not change. Then they were gone.

Lisa felt a sharp, irrational disappointment as she hurried to keep up with her head nurse. That was probably how things were going to be from now on. She and Dr Blair would be colleagues, nothing more.

 

At two o'clock in the afternoon Lisa prepared to go off duty, which was the end of her designated work shift as a part-time nurse. All the time she had been at work part of her mind had been on Emma Kate. She knew that once the orientation period was over all her attention would have to be on the job. Clearly, it was going to be very demanding—she was actually looking forward to rising to the challenge.

She had a shower in the nurses' change-room, before putting on her outdoor clothing and walking out. A streetcar would take her very close to home, even though it was a slow journey. She had cancelled the insurance on her car, not being able to afford to run it. 'I don't really miss it,' she said to herself as she walked out into the almost balmy air of early spring. After the winter almost anything would seem balmy, she mused.

Throughout that busy morning she and Marcus Blair had not said one word to each other.

 

'She's getting a bit cranky.' Mrs Stanton greeted Lisa with those words as she let herself into her flat from the back garden where she had her own private entrance. 'I held off giving her the bottle for her feed because I knew you would want to feed her yourself when you came in.'

Lisa's mother was holding Emma in her arms with the baby's head up against her shoulder, jiggling her up and down. 'Do you think it's going to work this way, Lisa— you trying to continue with the breast-feeding?'

Flinging her raincoat and bag onto a chair, Lisa reached for her baby. 'I've missed her so much.' She kissed the plump cheek that was nearest to her. 'Thanks, Mum. I'm going to try to keep my own milk going as long as possible. I know it won't be easy—my breasts feel pretty engorged right now. All through the morning I was worried that I would be leaking milk through my uniform.' She exchanged commiserating smiles with her mother.

'She's just working up to a temper,' her mother cautioned. 'You know, she gets red in the face, and then she lets out a yell when she's really mad.'

'Yes.' Lisa laughed. 'I'll feed her right away.'

'All right. I'll take myself off. I've got some phone calls to make. All in all, she's been pretty good—slept a lot of the time.'

'Have you been good, eh?' Lisa crooned to her baby as she sat in a comfortable chair and prepared to feed her. Emma Kate gave her that gummy, adoring smile that she reserved just for her. Somehow it made everything worthwhile.

As the baby sucked vigorously Lisa's thoughts turned unwillingly to Richard. On and off, during the last three months, she had thought of contacting him and telling him that he had a daughter. During her pregnancy she had called his number four times. It had not been easy to get up the courage to do so. Always a woman had answered so she had hung up without uttering a word. Pride had prevented her from calling again.. .or from telling Marcus Blair that she had tried. Now she knew that Richard wouldn't give a damn.

There was an ache of longing in her heart when she thought of some of the good times they had shared. Being back in University Hospital had brought back to her, poignantly, all that had taken place between them, all the times they had worked together.

Lisa looked over at the telephone, standing on a small side table next to her comfortable old sofa. It would be so easy to dial his number, the number he had given her when he had left in case there were any messages for him. Then she knew that she would not do it, not again. Maybe it was pride—she wasn't sure what it was. She bit her lower lip hard. 'Don't cry,' she told herself sternly as she felt the sting of tears in her eyes, 'for God's sake, don't cry.'

At times like this, when she held her daughter, she thought that he ought to know—ought to be with them. Sometimes she longed for his arms around her—even though she knew he was a taker, not a giver.

'I'm beginning to think that you're the best thing that ever happened to me,' Lisa whispered to Emma Kate. 'We love each other, no holds barred.'

 

The rest of the week went by very quickly, with both Lisa and Diane working in the reception area with the two other permanent staff nurses who worked there. They were called triage nurses, which meant the sorting and classification of all patients who came into the emergency department. Behind privacy screens they examined patients to determine their priority. Stretcher cases had a separate entrance and triage nurse. For now, both Lisa and Diane were in the ambulatory patient section.

'Hullo, Anne,' Lisa greeted Diane on the Friday morning as she had greeted her on the other mornings, making a joke out of their enforced change of name.

'Hullo, Liz,' Diane replied, grinning. They had agreed to use their own names only when no patients were within earshot.

'Well, we've almost made it through one week,' Lisa said with satisfaction. 'Only two more weeks of this to go, then they'll throw us into the deep end and expect us to swim on our own.'

'I don't suppose we'll see anything much that we haven't seen before,' Diane said philosophically. 'After all, anatomy and physiology doesn't change. And we know the world's a violent place. Right?'

'Right.'

They waited expectantly together in the reception area, ready for anything that the ambulances might disgorge at the entrance or anything else. Already there were a number of people in the ambulatory area waiting room who had been categorized in order of priority. The more junior doctors in the department were working their way through them, together with the residents-in-training.

'Hi, what's next?' Dr Nathan Hanks, a senior resident, came into the triage unit and took the next patient card that the nurses had ready in a file of patients to be seen.

'There's a young guy in cubicle one,' Lisa said, intercepting him, 'that I'm worried about. He just came in. Could you see him first?'

'Sure, Lisa,' he said good-humouredly. 'Anything a former OR nurse says has to be believed. Lead me to him, but fill me in first.'

'Superficially, it doesn't appear to be much,' Lisa said, 'but with all the necrotizing fasciitis we've been hearing about in the last few weeks I don't feel happy about him.'

'What's he got?'

'A swelling on one side of his face, right over the cheek area, extending down to the jaw line and a bit beyond. And what I don't like is that he's got a faint red line extending down his neck. The funny thing is that he's got no injury, no abrasion, no pimple or anything like that. He's twenty-five years old. I asked him if he cut himself shaving—he said he didn't. It's a bit of a mystery.'

'Hmm. Do you think he's HIV positive?'

'I asked him that,' Lisa replied. 'He said not. He's never been tested because he has no reason to be, so he said.'

'OK. Take me to him.'

All the examination cubicles were full in the ambulatory section of the department, as well as there being a few people in the waiting room. Lisa felt uneasy about the young man she had just described so she had given him top priority for the moment. Dr Hanks followed her out.

BOOK: Unknown
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