‘Sister, we’re bringing in a forty-five-year-old female. Fell from a horse. Possible loss of consciousness and a left ankle injury.’
Lila frowned at the telephone. Why on earth were they alerting her about a simple head injury?
‘The problem is that the patient concerned is your unit manager.’
‘Hester!’
‘That’s right. She was very reluctant to come in, but she needs stitching and she’s slightly disorientated and agitated. The paramedics have managed to persuade her to come, but I thought we should warn you.’
‘Thanks so much.’
Poor Hester. As much as Lila didn’t like the woman, she meant her no harm. Arriving in your own department as a patient was embarrassing to say the least. Protocol bound the paramedics to bring all patients to the nearest emergency department. The least Lila could do was ensure Hester’s privacy as much as possible and try to keep the amount of staff that dealt with her to the minimum.
‘Can I do anything to help?’ Vera’s rouged cheeks and reddened lips seemed ridiculously out of place with her shabby jacket and unkempt hair. ‘You look ever so busy.’
‘We are tonight, Vera.’ Lila spoke kindly. ‘But the doctor will take a look at your leg just as soon as the department quietens down.’
‘Oh, that’s all right, Lila, you know I don’t mind waiting. It’s just I feel so useless sitting there, doing nothing. Surely there must be something I can do?’
The most helpful thing Vera could do right now was take a seat and be quiet and a lot of staff would have told her to do just that, but it wasn’t in Lila’s nature. It would also have been entirely counterproductive as unless Vera was given something to occupy her, the incessant pleas to help would only increase.
Grabbing a pile of dusters and bin liners, Lila handed them to a beaming Vera. ‘These have to be folded, Vera. I hate to ask but we really are busy.’
‘I’d be happy to.’ Her toothless smile was as wide as her face.
‘But very neatly, mind,’ Lila said seriously. ‘Or my boss will be very angry. It’s going to take you a while, Vera. Are you sure you don’t mind?’
‘Not a bit. I’m just glad to be some help to you all. I know how hard you all work.’ And taking the pile of dusters and bin liners, she walked importantly off to the waiting room.
Happy Vera was settled, Lila set about preparing a cubicle for Hester. She’d have a fit if she saw Vera handling the hospital supplies, but it was only a pile of dusters and bin liners after all. Poor old girl. After Hester’s clamp-down she couldn’t even give Vera a breakfast in the morning. Still, Hester couldn’t stop her giving Vera a cup of tea and some biscuits and cake from the night staff’s own stash.
The paramedics’ warning had been spot on. Hester was indeed less than happy to be a patient, although one look at her cut and swollen face left Lila in no doubt that she needed medical intervention. Ushering the paramedics into cubicle one, she smiled warmly at her senior.
‘Hi, Hester, we’ll just get you over on to the trolley and make you a bit more comfortable.’
‘I can manage fine myself.’ Pushing away Lila’s helping hands, she attempted to sit herself up, only to stifle a scream as she collapsed unwillingly back onto the stretcher.
‘Steady there, love.’ The paramedic’s kind words only inflamed Hester further.
‘I’m not your ‘‘love’’. Now, if you’ll leave me be for two minutes you’ll realise that I can manage fine myself.’
But her second attempt at moving proved equally futile, and with a yelp of pain and frustration Hester lay defeated against the pillow.
‘Perhaps if I hold your ankle, you could lift yourself over,’ Lila suggested, her voice steady and firm.
A small hint of a nod deemed that Hester was at least prepared to finally accept some assistance.
Her ankle was grotesquely swollen and cold but, given that she had been outside for some hours, that could be more due to exposure than lack of circulation and Lila would make a more careful assessment once her patient was safely on the trolley. Concentrating on holding the leg steady as Hester painfully inched her way over, Lila noticed that Hester quickly covered herself with the blanket.
‘Thanks, guys.’ She noticed the wide-eyed look the paramedic gave her, which indicated there was more to be said. Covering Hester with a further blanket, Lila excused herself and slipped outside.
‘I think she’s had a bit of an accident, and not the falling-off-your-horse kind.’
Lila grinned at the paramedic’s description.
‘Of course she won’t admit it but, given that she was out there for four or five hours, it’s hardly surprising. We offered to cut her trousers off and put her into a gown but she wouldn’t have a bar of it. Not the sunniest person, your boss, is she?’
Lila feigned surprise. ‘I don’t know what you’re talking about. She’s an absolute sweetheart.’
‘Sister Bailey!’ The angry shout from the cubicle made them all grin. ‘Told you,’ she said with a wry grin. ‘I’ll catch you later.
‘Hester, I’m just going to do your obs and have a look at your ankle then I’ll get you into a gown and Declan will come and take a look at you. I’ve spoken to him already and once he’s checked you’re stable he’ll ring Mr Hinkley and have him come in and check you out.’
Calling a consultant in from home for such a minor injury wasn’t necessary, more a courtesy extended as Hester was the manager of the unit.
‘I don’t want Mr Hinkley brought in. I just want some strapping on my ankle. Hopefully by then my husband will be here to take me home.’
‘Hester, please, you know your ankle needs more than a bit of strapping. Now, can I do your observations?’
With a heavy sigh Hester leant back on the pillows. ‘If you must.’
Her observations were all within normal limits, except a slightly low temperature. Checking her foot, Lila was pleased to see that Hester could move her toes and when pushed gently the colour soon returned, showing she had good circulation to the affected area. A nasty gash on her forehead required a few stitches. The paramedic had said that she’d seemed disorientated but that didn’t appear evident now. As for agitation, Lila guessed it had rather more to do with the embarrassment of finding herself in the department, particularly if she’d had an ‘accident’.
‘What happened, Hester?’
‘I’m sure the ambulancemen told you.’
‘Of course, but I need to hear it from you.’
‘I was riding,’ she said grudgingly. ‘And obviously I came off.’
‘Why?’ Lila pressed, though her question visibly irritated Hester. It was important to ascertain whether some event, such as a faint or convulsion, had caused her fall or if it had been a straightforward accident.
‘Trigger just started suddenly—something must have scared him—and then he threw me. And, yes,’ she snapped, ‘I remember everything. I wasn’t knocked out.’
Lila didn’t say anything for a moment, just busied herself placing some sterile gauze over the laceration on Hester’s forehead. ‘You’re sure about that?’
‘Maybe I was knocked out for a couple of seconds, but no longer,’ Hester admitted. ‘But Trigger was still fretting when I came to, so it really wasn’t for long. Poor thing.’ Lila watched as Hester’s face softened. ‘He stayed by me the whole time, whinnying and worried. He’s such a brave horse. I’ll be sure and give him an extra treat for breakfast.’
Lila bit back a smart reply as she thought of dear old Vera folding dusters, desperate to help. Hester would rather the horses were fed than her patients.
‘Good.’ Lila wrote down her observations on the back of the casualty card. ‘Let’s get you into a gown.’
In a second the barriers that had come down slightly were erected again. ‘I don’t need a gown. Now, will you, please, leave me alone!’
Lila knew that for once Hester’s sharp words weren’t personal. Lila saw Hester for what she was, a strongly
proud woman, embarrassed with absolutely no need to be. They were both nurses, both women, yet Lila knew she would have felt the same. She thought for a moment how to play this, how she would feel if it were her lying there and her colleagues needed to have instant access to her body at such a vulnerable time.
‘Hester, I know this must be difficult for you,’ Lila said gently. ‘It is for me, too.’
Hester looked up sharply at Lila’s admission.
‘I know how I’d feel if I’d been lying out on a field somewhere for five hours and Declan Haversham had to come in and examine me.’
The tiny grin on Hester’s face told Lila she was on the right track. ‘A girl’s got her pride. Why don’t I get you a bowl and you can have a wash? I’ll find you a comb and you can put on a gown. I can help you off with your jodhpurs and top and then I’ll leave you.’
Hester nodded. ‘Thank you. It’s just that while I was lying there, while I was waiting to be found, there was nothing I could do. I had—’
Lila patted her arm. ‘Leave it to me.’
When Lila returned with a bowl and towels she gave Hester a smile. ‘I’m sure these aren’t to your taste but I ordered them from Sue’s lingerie party. They’ve been in my locker.’ She handed Hester the underwear, still in its Cellophane.
‘I’ll pay you.’
Lila winked. ‘Take it as a first payment on the bandages and breakfasts.’
‘And you won’t write it down on my casualty card.’ She watched as Lila frowned. It could be relevant. ‘Of course, you’ll have to let the doctor know but, Sister Bailey, you know as well as I do that everyone who comes in contact with my casualty card will be sure to have a good read.’
Lila nodded. Hester had a point. Just the fact she now knew Hester’s age was more personal detail than five years in the department had given her.
‘I wouldn’t worry, Hester.’ Lila couldn’t resist the dig. ‘When do I get a chance to document things properly? You know yourself how bad I am at that.’
Once cleaned up and in a crisp lemon gown, Hester was the perfect patient, answering Declan’s questions politely, gratefully accepting the painkilling injection Lila gave her.
Once she was safely wheeled off to X-Ray, with her rather nervous-looking husband hurrying behind, Declan gave Lila a grin.
‘I’ve rung Mr Hinkley and he’s on his way, I know she said not to but I’m sure it’s expected really. He’ll have a look at her X-rays and make a few polite noises. Hopefully that will appease her. She should really be admitted overnight for neuro obs.’
‘Not a chance.’ Lila shook her head. ‘The obs ward’s full and there’s no way you’ll persuade her to go up to a ward. You know how difficult she can be.’
‘What if she stays down here on a trolley? You could do her obs and I’ll check her over before the day staff arrive and hopefully she’ll be able to go home. It would save her the embarrassment of a full admission.’
‘I don’t have a problem with it, so long as Hester doesn’t moan when she audits the trolley times.’
Declan laughed. ‘I’m sure she will. Still, there’s obviously more to Hester than meets the eye.’
‘In what way?’ Lila found herself smiling as Declan started to laugh.
‘Well, not that I’ve ever pictured Hester in her undies but, if pushed, black velvet wouldn’t have been the image I’d have come up with.’
Thumping him on the arm, Lila laughed as she blushed. He probably knew the undies were hers—after all, she had told him about Hester’s accident. Still, it was a good reason for a giggle.
And heaven knew, they needed it. The tension between them recently had been almost unbearable.
‘Over here a minute, Lila.’ Sue’s voice had a note of urgency in it that snapped Lila to attention. Helping Sue with the trolley she was pushing, she guided it into Resus, looking at the flushed child lying drowsily on it.
‘What’s the problem?’
‘She was just lining up with her parents in the waiting room and the triage nurse asked me to see her straight away. Flu-like symptoms, pain in the legs, reluctant to walk. I’ve told her parents to wait in the interview room.’
‘What’s her temp?’ Declan’s deep voice had an edge of concern as he pulled his stethoscope from around his neck and Lila put the tympanic thermometer into the child’s ear.
‘Thirty-nine.’
Declan started his examination as Lila undressed the little girl. Pulling off the child’s jeans, Lila felt her throat tighten. ‘Declan.’ The note in her voice was enough to immediately get his attention. Looking down to where she was pointing, Lila watched his brow furrow as he saw the insidious purple rash appearing on Amy’s legs.
‘Sue,’ Lila called. ‘Page Paeds now. Do you want me to set up for a lumbar puncture?’ she added, addressing Declan.
He shook his head, concentrating on trying to find a vein so he could insert an intravenous bung—no mean feat in a child as sick as this. ‘Not yet. I’ll take some blood off now and then let’s get some antibiotics and fluids into her, stat. Put on some oxygen.’
As Lila did so he looked up briefly. ‘Do we have a name?’
Peeling the name band off the top of the casualty card, Lila wrapped it around the child’s limp wrist. ‘Amy Phillips.’
He stopped for a second. Although time was of the essence, so was reassuring the patient, however sick.
‘Amy, my name’s Declan. I’m a doctor. You’re just going to feel a small scratch in your hand and then I’ll be able to give you some medicines that will make you feel better soon.’
As Lila attached the intravenous infusion, Sue arrived back, breathless. ‘Paeds are stuck with a collapsed child on the ward, the anaesthetist too.’
‘What the hell is this, then?’ Declan retorted sharply, and Lila could hear the tension in his voice.
‘Sue.’ Lila’s voice was calm and assured. ‘Tell Switchboard to page the paediatric consultant at home. Declan or I will speak with him. Tell them also to page the second-on paediatricians. Then ring ICU and check if they’ve got a paediatric bed.’ She glanced over at Declan, who was administrating the intravenous antibiotics. ‘Do you want the second anaesthetist?’
‘Yep. Get these bloods off stat and tell the lab I want the results yesterday.’
‘Sure.’
The rash seemed to be darkening with lightning speed. A huge infection was literally overwhelming the little girl as they spoke, and the paediatricians were involved with another sick child.
Sue returned, and with one look at her anxious face Lila knew more trouble was coming.
‘The paramedics just alerted us. They’re at a house fire, four children inside and one adult. Two firefighters are suffering from smoke inhalation.’
Lila felt her heart plummet for a second. Catching Declan’s eyes for a second, she knew he felt it too.
This was the how quickly the wind on the front line could suddenly turn.
This was night duty in Emergency.
‘How long till they get here?’
‘Ten minutes.’
Amy was desperately ill, they had a department full of sick people, but in just ten short minutes four children and three adults were going to arrive, possibly all desperately ill.
Lila had to think on her feet. There was a thin line in Emergency between overreacting and calling a major incident or waiting to see how the events unfolded and running the risk of calling it too late.
‘Fast-page the nurse supervisor. I want the wards rung and told to come immediately and get the patients that are assigned to them.’
‘Right.’
‘Get the other staff down to Resus.’
The paediatric emergency trolley had already been opened for Amy and quickly Lila filled kidney dishes with intravenous bungs, alcohol swabs, paediatric airways.
Any patient that could be was moved out of the area in an attempt to clear some room. As the wail of sirens heralded the arrival of the first ambulance, Lila took the
phone from Sue.
‘Dr Harper here.’
Lila felt a wave of relief wash over her. Gerard Harper wasn’t only a brilliant paediatrician, he was also a nice man, happy to share a coffee and a chat. At least it wasn’t a virtual stranger on the other end of the line. ‘Gerard, it’s Lila Bailey here—I’m the nurse in charge of Emergency tonight. We have a five-year-old with suspected meningococcal disease and also an alert from the paramedics of an attempt to rescue four children from a house fire.’
‘I’m on my way, Lila. I’ll ring a couple of colleagues on my mobile.’
Lila didn’t bother to say thank you. There truly wasn’t time.
Mr Hinkley arrived with the first ambulance and Lila quickly briefed him. Mercifully the child the paramedics were dashing in with was crying loudly, a good sign by any standards.
‘Sister Bailey, what on earth’s going on? I heard all the emergency pages over the Tannoy.’ Hester’s face was anxious as she struggled to sit up.
Even though Hester was a patient, she was still the unit manager. The potential gravity of the situation would have made Lila consider ringing her boss even if she’d been at home, so Lila told her, watching as Hester’s eyes widened.
‘Are you calling more staff in?’
‘Not at this stage.’ Lila saw the flash of doubt in Hester’s expression. ‘Mr Hinkley was already here to see you and Gerard Harper is on his way to see a child with suspected meningococcal disease. I’ve spoken to him on his mobile and he’s going to alert some colleagues. I’ve also got the nurse supervisor plus an ICU nurse coming down.’
‘I should be out there. Sister Bailey, get me off this trolley and into a wheelchair.’ For a second the sight of Vera flashed through Lila’s mind, desperate to be of some assistance but getting in the way.
‘Hester, you’ve got a head injury and a fractured ankle. You’re a patient, my patient. The best thing you can do is rest quietly and let me get on with my job. I promise if I need advice you’ll be the first person I come to.’
Accidental Reunion Page 10
