Read Emergency at Bayside Online
Authors: Carol Marinelli
‘What’s your name?’
‘Debbie. Debbie Evans.’
‘How many weeks are you, Debbie?’
‘Thirty-three. I’m supposed to be going to my antenatal appointment.’
Turning, Meg addressed the porter, who was patiently awaiting her instructions. ‘Mike, grab a trolley and call for some help.’ Meg turned back to the woman. ‘It’s okay, Debbie, we’re going to get you inside now.’ A small crowd had gathered now, as
Meg got what further details she could from the pale woman.
‘What have we got?’ Flynn rushed the trolley forward
‘Thirty-three weeks pregnant. She was on her way to the obstetrician when she started bleeding.’
‘A lot?’
Meg gave him a worried nod as she made her way around to the passenger side. Slipping in beside Debbie, she undid her seatbelt, helping as much as she could from her end as the strong arms of Mike and Flynn gently lifted the woman onto the waiting trolley.
By the time Meg had extracted herself from the car the trolley had disappeared inside and, slightly breathless from exertion and nervous energy, she followed them, instantly going to Flynn’s side to assist in taking blood and establishing IV access. Oxygen was already being given to the shocked woman, and Meg shouted her instructions in clear tones as Jess assisted. Carla, back from her coffee and hesitant at first, soon forgot her nerves and even ran an IV infusion of Hartmann’s through the giving set, passing it to Meg as intravenous access was established.
‘Good work,’ Meg said encouragingly, without looking up.
‘Debbie, my name is Flynn Kelsey. I’m the Emergency consultant.’
Passing Flynn the necessary tubes for an urgent FBE and cross match, Meg set up another flask of fluid as Jess appeared.
‘Need a hand?’ Mike was still discreetly hovering,
knowing he would soon be needed. As part of the Emergency team his role might not be hands-on, but his input was just as vital as the medical staff’s if the department was going to run smoothly.
‘Please, Mike. These bloods need to go, stat, as soon as Flynn signs off the form. Make sure the lab knows they’re urgent.’
Picking up the telephone, Meg punched in the radiography department’s number. ‘It’s Meg in Emergency. We need an urgent obstetric ultrasound in resus.’ Meg paused.
Flynn was busy examining Debbie’s abdomen. He felt the baby’s position for a moment, before attempting to find the heartbeat with the Doppler machine Jess had just passed him. The tiniest collective sigh as a heartbeat was picked up made Meg realise she hadn’t been the only one holding her breath.
‘Your baby’s got a good strong heartbeat.’ Flynn’s words were calm and assured and he held Debbie’s gaze. For an instant Meg felt her mind flash back to the accident, and those same grey eyes as he told her she was safe, that everything was going to be okay. She watched Debbie relax a fraction, the utter fear in her face fade a touch. Flynn was certainly a good doctor; he managed to combine a relaxed bedside manner with an air of concentrated efficiency and direct honesty. ‘But you are bleeding a lot, Debbie. I’m going to do an ultrasound to see exactly what’s going on. Has anyone told you that your placenta is lying low?’
Debbie nodded. The loss of blood was making her drowsy. ‘Stay with me, Debbie.’ The same sharp
voice he had used on Meg was dragging Debbie back to consciousness.
‘I was going to have a Caesarean. Placenta pr…’ Her voice trailed off and Meg watched as she closed her eyes.
‘Come on, Debbie.’ It was Meg speaking sharply now, forcing Debbie to stay awake as Flynn concentrated on the ultrasound.
‘Placenta praevia,’ Flynn said, confirming the assumed diagnosis. ‘What’s her blood pressure?’
‘Eighty over fifty.’
‘Will she be transferred to the maternity hospital?’ Carla’s voice was a loud whisper, and Flynn looked up and made his way over.
‘Good question. But no. She needs to go straight to Theatre.’
Carla’s eyes widened. ‘But there’s no Obstetrics here at Bayside.’
Flynn nodded ‘If Mohammed won’t go to the mountain…’
Carla gave him a completely nonplussed look.
‘Meg will explain. Call me the second you’re worried.’ With a brief nod he left the room. Meg knew he would be on the telephone, safely out of earshot of Debbie.
‘What was that about mountains?’
Meg grinned. ‘The mountain will have to come to Mohammed. It’s a saying. He’ll be ringing the emergency obstetric team to hotfoot it over here.’
‘They’ll do the Caesarean in the Theatre here?’
Meg nodded.
The first unit of blood had arrived, along with a
breathless Mike, and Meg thanked him for his speedy work. As it required two qualified nurses to check it, Carla observed as Jess and Meg ran through the formalities, carefully checking the patient’s identity badge with the corresponding number on the bag of blood. The painstaking checking was all the more essential now the patient was barely conscious.
‘We’re going to put the blood through the blood warmer,’ Meg explained. ‘This blood is cold, and as we want to transfuse her quickly this will warm it to body temperature.’ She showed Carla the long coil inside the machine that would warm the blood. ‘The usual obs apply—close checking of pulse, blood pressure and respirations—but variations due to the blood are harder to detect in someone so sick, as their obs are unstable anyway. Any rash or rise in temperature is of particular importance and must be reported immediately.’
‘Debbie?’ Flynn returned, the consent form in his hand. ‘Debbie!’
Her eyes flicked open, too shocked and exhausted now to be scared. ‘We need to perform an urgent Caesarean.’
‘It’s too soon.’
‘Your baby has to be born.’
Debbie rallied a bit then, her maternal instinct forcing her to concentrate to stay awake and fight for her baby.
‘It’s too soon,’ she repeated.
‘There’s no choice.’ His words were forceful, yet gentle. ‘Debbie, we have to get your baby out, for both your sakes. You’re thirty-three weeks—it’s
early, but not impossibly so. Your baby really needs to be born.’
Meg watched with compassion. She knew so well how Debbie was feeling—that overwhelming urge to just close your eyes—yet Debbie was struggling to focus.
‘Will you do it?’ Debbie asked.
Flynn shook his head. ‘No, the obstetric team are on their way. But if they don’t get here in time and it becomes necessary then I will. I’m going to do everything I can for you and your baby.’
Her pale hand accepted the pen and, shaking, Debbie managed a weak signature on the paper.
‘My husband…’
‘We’ve contacted him, and he’ll be sent straight up to Theatre when he gets here.’
Meg smiled at the woman and then looked up to Flynn. ‘Shall we get her up?’
‘Yep.’
Mike didn’t need to be asked even once. He arranged the IV pole and the cardiac monitor onto the trolley and switched Debbie’s oxygen piping over to the portable cylinder as Meg collected the emergency boxes containing drugs and resuscitation equipment.
If Debbie suddenly went off
en-route
the safest thing would probably be just to carry on running as, realistically speaking, Theatre was her only chance. But, as Flynn had only so recently pointed out, oxygenated blood was vital for Debbie and her baby. Slipping an airway and ambu bag under Debbie’s pillow, silently hoping she wouldn’t need to use them,
Meg made a final quick check that everything was in order.
Going out with the Mobile Accident Unit was probably the most exciting thing in Emergency—the kick of adrenaline as you pulled on your gear, the call of the unknown as the ambulance drove off with sirens wailing, running through blood, checking equipment
en-route
, the crackling details coming in over the ambulance radio. But running through a busy hospital at high speed—curious stares, the lift held as you dashed past, the rush of excitement a true crisis generated in an Emergency nurse’s stomach—well, usually that came a close second.
But not today.
Today Meg was just desperately concerned for her patient and the unborn baby. All she wanted was to get them to Theatre—get her patient the help she needed. It was as if a light had gone off inside her: the adrenaline buzz that emergency nurses survived on just wasn’t happening for Meg as they ran along the corridor. And run they did. Flynn gave them no choice, his long legs making the dash seem effortless. It was all right for him, Meg grumbled to herself as they stood in the lift. Meg was struggling to catch her breath while Flynn stood there calmly eyeing the cardiac monitor. It was all right for him,
he
didn’t have a ribcage that felt like a used football.
‘All right Meg?’
‘Couldn’t be better,’ she answered dryly as the lift door opened and the mad dash to Theatre started again.
But there was no rushing once they stepped into
the hallowed grounds of the theatre. Here the staff were never ruffled, were almost relaxed, even, as they accepted the patient and lifted her over onto the operating table. Everything was in place already—the resuscitation cot in the corner of the room, the packs being opened. No one would have guessed that an emergency Caesarean hadn’t been performed in the small theatre for well over two years. Theatre, like Emergency, had to be prepared for every eventuality.
‘We’ll take it from here, thank you.’ The theatre sister smiled as the anaesthetist appeared. ‘The team’s just arrived and they’re on their way up.’
Which was a rather polite way of telling the trio to leave. But they didn’t want to; Meg could sense even Flynn’s reluctance. There was a baby here about to be born. Debbie was their patient, and letting go was sometimes hard.
‘Can Carla stay? She’s a student.’ It was worth a try—Meg knew it would be great experience for her.
The theatre sister hesitated for an age. ‘Show her where to change—but she has to stay at the back of the room.’
Meg grinned widely. ‘She will. Thanks.’
Carla was so excited Meg practically had to dress her. ‘Here’s your blues. Come on, Carla, quickly or you’ll miss it. Now, just grab some clogs—they’ll do—and tuck your hair into this hat. If you think Jess is strict, wait till you meet the theatre sister! Now,
come on
.’
Pushing her through the black swing doors, Meg just managed to call out, ‘Good luck!’ and then she was gone.
‘That was nice of you.’
Looking up, she was both surprised and embarrassed to see Flynn waiting for her to walk back to Emergency.
‘Asking if Carla could stay—she’ll really enjoy it.’
Meg realised she was frowning. Just what was it with those two? ‘Just so long as she doesn’t faint.’
‘Oh, she won’t. She’s been hanging out to get into Theatre for ages.’
Meg felt her frown deepen. Since when did consultants take such an interest in nursing students? Silly question, Meg realised with a stab of disappointment. Especially when you didn’t want to know the answer. ‘It will be good experience for her,’ she replied in efficient tones. ‘She’s only in her second year, so she hasn’t done Theatre yet. You can pore over the books, but nothing beats it first-hand.’
‘Absolutely.’
‘I had an ulterior motive,’ Meg admitted. ‘At least I’ll get a first-hand, in-depth report of what happened—not some cool message from Theatre.’ He didn’t respond, and they walked along in silence, flattening themselves against the corridor as a team pushing a huge incubator rushed past them. ‘There’s the mobile PICU,’ Meg observed. ‘They made good time as well.’
‘Meg?’ They were still standing against the wall and Meg turned, hearing the serious note in his voice. ‘About that kiss…’
‘What about it?’ Meg replied airily, setting off at twice their previous pace.
‘Don’t you think we ought to talk about it?’
Meg gave a scornful laugh. ‘Why? Are you worried I’m going to dash off to Personnel and squeal sexual harassment?’
‘No.’
‘Then forget it.’ She even managed to shrug. ‘I’m not expecting you to follow it up with a marriage proposal. It was just a kiss—a bit of fun.’
She was lying through her teeth. It had been far more than a bit of fun for Meg—her lips were still scorching from his touch—but she certainly wasn’t going to let Flynn see the effect he’d had on her. Unless one of them handed their notice in they were going to be seeing a lot of each other, and she was determined not to let him see how his reckless bit of fun had sent her into a spin.
‘When do you think they’ll transfer Debbie to the maternity hospital?’
It was a pointless question, an obvious attempt to change the subject, and Meg felt herself flush. Verbal diarrhoea wasn’t a condition she usually suffered from.
‘This afternoon, I guess, once she’s a bit more stable. She’s lucky she got to us. Heaven knows how she didn’t have an accident, given the state she was in when she arrived.’
‘Oh, well, at least you’ll have time before she goes to give her a quick lecture on the dangers of driving while haemorrhaging.’ It was a cheap shot, but she was still smarting at the harsh way he had spoken to her when she was a patient. Again Flynn didn’t answer. ‘So what do you reckon the baby’s chances are?’
Flynn pondered for a moment before answering. ‘Good,’ he said finally, and Meg rolled her eyes.
‘That’s it?’
She watched his eyebrows furrow. ‘What did you want me to say?’
Meg shrugged. ‘Good, I guess, but a bit of padding would be nice.’
‘I’m not one for small talk.’
‘Well, you could have fooled me. You never stopped talking when I had my accident, and you hardly hold back with the students.’
Flynn shrugged. ‘So I don’t treat the students like a bunch of gormless subordinates. It is the twenty-first century, you know, and as for the accident…’ It was Flynn stepping up the pace now, striding off down the highly polished corridor, forcing Meg to half run to keep up with him. ‘It was my job to keep you awake.’
Which should have made her cheeks scorch—but something stirred inside Meg. Something akin to anger. ‘And was it ‘‘your job’’ to dress me down in the obs ward?’
Flynn didn’t seem remotely fazed by her accusatory tones. With a wry smile he finally slowed down and, turning, caught her eye. They had arrived at the emergency department now and he held the door for her as they entered. ‘No,’ he admitted. But her victory was short-lived when he continued, ‘That was more a moral duty.’