Emergency: Nurse in Need

by Laura Iding

  EMERGENCY: NURSE IN NEED

  Laura Iding

  Trinity Medical – Book 1

  Past feelings are reawakened for critical-care nurse Serena Mitchell when her ex-fiance, Detective Grant Sullivan, is brought into the trauma room. Serena broke off their engagement when he refused to quit his dangerous job, and now her fears have been proved right.

  But caring for Grant during his recovery shows Serena that she still has feelings for him. Dare she risk her heart to a man who is determined to be a hero?

  CHAPTER ONE

  A full moon hung ominously in the dark sky.

  Serena Mitchell entered Milwaukee's Trinity Medical Center with a shiver and a deep sense of foreboding. A full moon was never a good sign. She should have checked her calendar before giving in to Dana's plea to cover her call shift for the night. But how could she turn Dana down, especially after hearing about Dana's mother's debilitating illness? Serena had started back to work in the trauma intensive care unit a few months ago, and was finding the old familiar routine was more difficult than she'd imagined. Not because of the patients themselves, they hadn't changed.

  Because of the nightmares.

  Maybe she should just quit. Home health nursing was an option. And then her patients would actually talk to her, rather than persist in hanging on the brink of a cliff, suspended between life and death.

  Inside the trauma ICU she was greeted by a cacophony of noise and color. She took a deep breath and smoothed her damp palms along the sides of her scrubs. Everything would be fine. She'd gotten her life back on track. Returning to her old job proved it.

  "Serena, I'm glad you're here." The charge nurse, Tess Walker, glanced up from her clipboard. "The trauma room needs help."

  Serena stifled a gasp and paled. "But I don't work the trauma room any more."

  "You have trauma room experience, don't you?" Tess's voice rose in agitation.

  "Well yes, but—"

  "Look, we're having a bad night. They need your help. The trauma call just came in a minute ago. They've had their hands full down there all night. Later, you can report back up here." Tess turned her back, conversation over.

  Serena wanted to argue, to flatly refuse to go. But when she glanced around, there wasn't an idle nurse in sight. Refusing her assignment in the trauma room would be the epitome of patient abandonment. No way was Serena willing to do that. And Tess was right about one thing—Serena was probably the only one here in the ICU with actual trauma room experience.

  Experience that haunted her still.

  She headed downstairs to the ground floor. Her rubber-soled shoes squeaked loudly on the shiny linoleum floor. Her trepidation deepened with every step. The thought of going back to the trauma room made her feel physically ill. She pushed back a wave of nausea with an effort.

  Come on, Serena. You can do this.

  She hesitated for a moment outside the doors, then forced herself to scan her name badge and walk inside.

  The trauma room was busy, but not the worst she'd ever seen. Nothing looked horrifically different than the last time she'd been here, eighteen months ago. She was surprised to notice the two of the trauma bays stood empty.

  "Hey, Serena!" Dr. Steve Anderson, the senior ER resident grinned at her. "Glad to have you back!"

  "I'm not back, not really. Just helping out for a few minutes," she quickly qualified. Steve's cheerfulness was difficult to face. She forced herself to take a deep calming breath. "So what's going on? What are we waiting for?"

  "Two victims with gunshot wounds to the chest." Steve gestured to the furthest trauma bay. "Why don't you take the right side over there?''

  "What's the ETA?"

  His answer was lost when the double doors slammed open and a bevy of paramedics burst into the emergency department wheeling a gurney between them. She could see a second patient not far behind. Shifting her feet slightly, she took her assigned place in the trauma bay.

  Her heart pounded a deafening rhythm in her chest and she prayed she wouldn't disgrace herself by passing out cold. For a moment the room faded into a blur, the pounding in her ears growing louder, blanketing the noise around her. Serena brought the room into focus with a concentrated effort.

  Controlled chaos prevailed. A throng of uniformed police officers filtered into the unit behind the gurneys and Serena experienced a horrible sense of deja vu. The influx of cops reminded her too closely of the multitude of firefighters who'd invaded the trauma room when her brother Eric had been brought in. She closed her eyes against the painful memories.

  Oh, God—Eric.

  Someone grabbed her by the shoulders and shook her. Her head jerked up. Steve Anderson's face loomed over her.

  "Snap out of it. We have work to do."

  His stern tone made her blink—she hadn't been aware of Steve standing beside her. Then her gaze fell on the prone figure of her patient.

  "Thirty-year-old white male police officer with multiple gunshot wounds, right chest and thigh." Another ED nurse shouted statistics above the din. "Two eighteen-gauge IVs of Ringer's lactate running wide open for hypovolemic shock. Intubated in the field. He needs six units of O-negative blood, stat."

  Automatically assuming her role, Serena connected the patient to the monitor, intent on getting a baseline set of vital signs. She reached across the broad chest of the police officer, quickly placing EKG patches on the least bloody spots while trying to avoid the blood-soaked dressing over the wound on the right side. She concentrated on one task at a time, blocking out memories of Eric. She glanced up at the monitor and mentally noted a dangerously low blood pressure, before turning back to her patient.

  She caught a glimpse of the officer's face and drew a harsh breath. Once again, the room spun wildly. Her fingers turned numb as she fumbled with the blood-pressure tubing. She grabbed the gurney for support.

  Not again—please, not again...

  Sweat popped out on her forehead. Serena blinked to bring his face back into focus, thinking that there must be some sort of mistake. But when her vision cleared she couldn't deny the truth. Despite the liberal splattering of blood, she recognized her patient.

  Grant Sullivan.

  The man she once promised to marry.

  Another nurse had already hung several units of blood on the rapid infuser on the opposite side of the bed. Steve barked out orders. "This guy needs a chest tube. Serena, what the hell are you doing? We need that blood, stat!"

  Serena jerked her gaze away from Grant's face and grabbed two units of O-negative blood. Years of deeply imbedded training took over. She announced the vital signs for everyone's benefit. "Heart rate 160, blood pressure 70 over 30, core temp 96 degrees. He's still in shock."

  Steve didn't waste any more time. "Hang four more units of blood on the rapid infuser. He needs a chest tube." As he spoke he prepared the right side of Grant's chest with antimicrobial solution.

  Struggling to suppress her horror, Serena's nightmare became grim reality. Functioning solely on autopilot, she hung more units of blood onto the tubing of the rapid infuser. Somehow, even with high-tech machinery, she couldn't seem to get the lifesaving fluid into him fast enough.

  Don't die, Grant. Damn it, don't you dare die on. me!

  Serena checked his blood pressure again, her heart sinking when she realized they hadn't made much headway. The nurse on the other side of the bed also hung more blood. Heaven knew, Grant's vital organs needed what little blood he had left in his system.

  Grant flinched beneath her hands when Steve placed the chest tube. She swallowed a wave of nausea even as she helped to connect the tubing. Aghast, they both stared as bright red blood poured from Grant's lung.

  "Dammit!" Steve yelled to a nurse across
the room. "Get me a CT surgery consult—now This guy needs the OR."

  He left the dressing of the chest tube site to Serena but her fingers didn't readily co-operate as she tried to tape the gauze in place. The chief resident of cardiothoracic surgery walked over from the other side of the trauma bay. Serena was vaguely aware of the activity surrounding the second patient that had been brought in with Grant.

  "What do you have?''

  "Gunshot wound to the chest and thigh, profuse bleeding and hypovolemic shock. He needs the OR, stat."

  "Yeah? Well, so does the guy over there." He jerked a thumb in the general direction of the second patient. Then the chief resident noticed the large pool of blood pouring through Grant's chest tube. He sighed. "Hell. We'll call in a second team and take both of them at the same time."

  One of the police officers not in uniform stepped directly into the path of the surgeon. Large and barrel-chested, the cop wore a loud plaid sports jacket that looked to be two sizes too small. In spite of his receding hairline and the wad of gum he chewed noisily between his teeth, he was obviously the senior officer in charge.

  "What did you say? You're taking both of them at the same time?" At the physician's confirming nod, the group of police officers subtly stepped forward in wordless support of their leader. "I'm Captain Reichert, and I insist you take Detective Sullivan first. The other guy is the perp who shot him. No point in saving him when he's going to do time for attempted murder."

  The surgeon didn't back down, despite the threatening tone of the police captain's voice, possessing more than enough arrogance of his own. "My job is to save lives. You're in my way."

  "Take Detective Sullivan first."

  The surgeon stepped forward as if to push past the officers, but the group of uniformed men didn't budge. The surgeon tried again. "I can't judge whose life is more important, they're all important to me. You have my word that we'll do everything possible to save your cop's life. But I'm telling you, we're operating on both patients at the same time."

  For a moment Serena wondered if a fight would break out in the middle of the trauma room. With a scathing look, the thick-set police captain eventually backed down. He gave one last parting shot. "We already lost one officer tonight. I promise you, my chief will personally call your CEO if Sullivan dies and the perp lives."

  After the captain had delivered that dire warning, the rest of the officers moved out of the way. Serena breathed a small sigh of relief. There'd been more than enough bloodshed for one night.

  Steve didn't have to tell Serena to give more blood—she automatically continued to hang one unit after another. Grabbing Steve's arm, she asked, "How bad is the thigh wound? Could his femoral artery be nicked?"

  "Possibly. Get me a vascular tray."

  Anticipating his request, Serena had it open and ready to go.

  "Nice job, Rena." They fell into an old familiar routine as he deftly arranged the instruments.

  Removing the paramedics' dressing on Grant's thigh, she exposed the injured area.

  "This is the exit wound." Blood gushed and Serena quickly covered the wound with a pile of gauze, placing both her hands over the area and bearing down with all her strength. Grant flinched. She bit her lip. The pain he subconsciously felt must be agonizing.

  She felt the heavy stare of each police officer in the trauma bay as they suspiciously gauged her every move. They couldn't know that hurting Grant was the furthest thing from her mind. Once she'd loved him with her whole heart. But that had been in the past. A memory that needed to stay dead and buried so that she could finish her job.

  "OK, let me see."

  Serena maintained pressure above the wound with one hand, removing the gauze with the other. Blood swelled, obscuring his view. She swiped it out of the way with another piece of gauze.

  "There. I found it." Working quickly, he clamped the artery and sutured up the tear. Serena didn't let up on the pressure, although her arms trembled and ached from the effort.

  "You're right, this is the exit wound. Strange, considering the wound in his chest is from the opposite angle. At least there's no bullet in this wound." Steve nodded to Serena and she backed off on the pressure. Elbowing the light out of the way, he ripped off his bloody gloves. "That's good enough until he gets to the OR."

  Serena covered the wound with more sterile gauze before refastening the mast pants. Then hung two more units of blood.

  "He looks like he's stabilizing, although that pressure isn't going to sustain him for long." Steve scowled, peering through the crowd. "Where the hell are those surgical teams?"

  Serena knew she should do a quick assessment, but her mind went blank. For the life of her she couldn't remember what to do first. The image of her brother's soot-blackened face swam in front of her eyes. She shook her head forcefully, willing the haunting memories away.

  Eric was gone, but Grant was here and he needed her expertise, inadequate though it might be.

  "Come on, think." Now that she had time, she couldn't string two coherent thoughts together. There was an intangible pressure from the bevy of cops that watched her. Finally, she began a neurologic assessment. A mistake, because when she looked down at Grant's blood-streaked face her eyes burned with unshed tears.

  Why hadn't he listened to her? She'd warned him that something like this would happen, but had he cared? No, he'd chosen life as a cop over her love. Once a hero, always a hero. And if Grant had his way, damn his stubborn male pride, he'd die a hero.

  Not tonight, dammit. He's not going to die tonight!

  Sniffling, she blinked the wetness from her eyes and forced herself to listen to Grant's heart and lungs. She tried to look at him like any other patient, but it wasn't easy. Finally, the cardiothoracic team surrounded the bedside just as she finished her abdominal exam.

  "OK, let's move."

  Within moments they had the monitors disconnected and the surgical team took over, wheeling Grant, with the second victim right behind him, through the trauma bay to the elevator that would carry them to the lower-level operating suites. Serena walked alongside his gurney. She was only allowed as far as the perimeter of the OR suite, then could only stand and watch as they settled him on the OR table, draping him from view. His life was no longer in the hands of the trauma team, but in those of the talented cardiothoracic surgeons.

  She stared in numb exhaustion as the OR doors closed right in front of her face. A sob of despair rose from her throat. She'd thought she'd gotten her life back on track but coining face to face with Grant had only reaffirmed the opposite. How was it possible she'd never really gotten over him?

  Dear God, please let him live...

  CHAPTER TWO

  Her shift was far from over. The fact that Grant hadn't died beneath her hands only brought a small measure of relief. Grant wasn't out of danger yet. Serena wanted nothing more than to fall face first onto a cot in the nurses' lounge, but there was too much work to be done.

  The job of escorting the dozen or so cops milling around the ICU to the waiting room fell to her. She briefly instructed them to wait there while Detective Grant Sullivan was in surgery. After getting them settled with a fresh pot of coffee, Serena explained that once Grant returned, she or another nurse would call them in to see him.

  Most of the time the hospital only allowed immediate family members to visit, but in this case the officers would be allowed in two at a time in rotation. Serena was about to leave when the captain stopped her with a hand on her arm.

  "I'm Captain Reichert, ma'am. We need to be informed about the perp's condition." He frowned and shifted the wad of gum to the other side of his mouth. "Once out of surgery, we'll need to post a guard on him twenty-four seven."

  Serena nodded, knowing he was only explaining standard operating procedure. Seeing a guard posted outside a patient's room wasn't anything new, even while the prisoner was in Intensive Care and generally too sick to be considered a threat. She didn't know much about the other patient, her energy had
been focused on Grant. But from what she'd briefly overheard, this guy had most likely shot two police officers, leaving one of them dead. No question, he'd be in police custody from now on.

  "I understand. What was his name again? I'll give the information to the nurses." Serena had been far too busy taking care of Grant to spare a second thought to the victim that had arrived simultaneously with him.

  "Jason Roth." The captain nervously bobbed his head once more, clearly uncomfortable with the hospital atmosphere. She didn't blame him. This type of incident only reaffirmed your own mortality, especially when involved in such a dangerous profession.

  Steve gave Serena the OK to head back to the trauma ICU. She needed to update the charge nurse on the status of the two post-surgical patients and the fact that one of them would be under police guard.

  Tess Walker took the news in her stride and identified their last two empty rooms, which were side by side for the pending arrivals. She instructed Serena to stay in the trauma ICU to help with the activity there while they waited for information from the operating room. Serena pitched in, assisting her co-workers.

  Oddly enough, the critical care setting was a relief after her experience in the trauma room. Yet Serena couldn't stop thinking about Grant. She tried not to dwell on the fact that he might not make it. Eric, her brother, had been strong and healthy, too, when he'd died in the trauma room but the human body was designed to withstand only so much punishment. Two bullets ripping through arteries and vital organs, causing severe blood loss, tended to push the limit.

  How like Grant not to have his body armor on. He'd always acted as if he were invincible. She knew differently. The vision of him lying beneath her hands, bleeding profusely, hovered in her mind's eye throughout the next hour.

  The operating room called to report that Jason Roth would be coming out shortly. Serena walked down the hall to the ICU waiting room to give Captain Reichert the news. Understandably, he was less than thrilled with the situation.