by Laura Iding
“Okay.” Debra led the way over to where Barton’s bassinet was located and quickly logged onto the computer to pull up his flow sheet. “He’s up to two and a half ounces per feeding and he gained three ounces. His weight this morning is four pounds twelve ounces.”
“Awesome news,” Cassie said with a smile. “What about his breathing? Any periods of apnea noted on the monitor?”
“None. He’s been clear for twenty hours now.” Debra beamed as if she were the proud mama. Actually, they all tended to take great satisfaction from watching their tiny patients’ progress. “If he lasts until tomorrow morning, Dr. Ryan is going to move him over to the level-two nursery.”
“Wonderful,” Cassie agreed. “His parents are going to be thrilled.”
“They won’t be here until later this afternoon, but I’m sure they will be.” Debra clicked through the rest of the assessment, including the amount of time he needed to be placed under the bili lights, along with the medication list.
When they finished with Barton they went back over to Emma’s warmer. Cassie was relieved yet oddly disappointed that Dr. Ryan had left. They quickly reviewed Emma’s vitals, her vent settings and her medication list before Debra left to head home.
About an hour later Emma’s IV pump began beeping. Fearing the worst, she hurried over to shut off the pump and check the IV site.
Emma’s little vein had blown earlier than she’d expected. She removed the catheter, feeling bad about the bruise that marred Emma’s pink skin.
“I’m so sorry, sweetpea,” she murmured. “Unfortunately, I’m going to have to put this IV back in.”
As much as she detesting having to poke the baby, she knew it was for Emma’s own good. The poor thing needed to get her medication to prevent seizures. She was especially anxious to get some tube feedings into the little baby. Emma had lost the three ounces Barton had gained.
This time, she chose the opposite arm for the IV. Tiny beads of sweat rolled down from her temples as she concentrated on finding the vein. For some reason, putting an IV in Emma was much more stressful than when she placed them in other patients. Thankfully she managed to thread the tiny catheter in and breathed out a sigh of relief.
“Nice job,” Dr. Ryan said from behind her.
Somehow she managed not to jerk the needle out of Emma’s arm, in spite of the fact that he’d sneaked up on her. Again.
Completely her fault. After all, he had mentioned coming back after rounds to insert the feeding tube.
“Thanks. Just give me a minute here,” she murmured, using the same contraption that she’d used yesterday to cover the IV site from being accidentally pulled out.
When she’d finished she stepped back and stripped off her gloves, trying not to imagine that most of her makeup had been sweated away. One thing about working over infants in warmers, you were never cold, even in the winter. In the summer, like today, it was downright steamy.
Although worth the discomfort, since their tiny babies needed every bit of the warmth.
“Has the social worker been by?” Ryan asked as he set out the feeding-tube supplies.
“Yes. She informed me that someone from Child Protective Services would be here between nine and ten.”
“That should give me enough time to get the feeding tube placed.”
“The pump is here and the formula you’ve ordered is ready to go.”
A smile tugged at the corner of his mouth and she stared, acutely aware of how his face softened, making him look lighter. Younger. Not as detached.
“I should have known you’d be ready,” he said. “Okay, Emma, we’re going to have to get this nasty tube in,” he said in a soft voice as he leaned over the baby. He lightly ran his finger down the length of Emma’s arm and she was struck by the fact that this was the second time he’d soothed Emma, something she hadn’t seen him do to any of the other babies in their care. “But, trust me, you’ll feel better with some food in your tummy.”
Just like the IV, a feeding tube was a necessity for babies on ventilators. Even without the breathing support, Emma would likely need to be tube fed because of the seizure medication.
She helped hold Emma’s head and body steady as Dr. Ryan inserted the feeding tube. Emma didn’t like it much. Her tiny arms and legs flailed a bit, but then the tube was in her stomach and the worst of the discomfort was over.
“I’m so glad she won’t remember this,” Cassie murmured. “I feel like we’re torturing her.”
“We’re not,” Dr. Ryan said softly. “She’s strong, she’ll pull through this.”
“I know,” she said huskily, trying not to give in to the urge to cry. No baby should have to suffer and it was hard not to pass judgment on the baby’s mother for allowing this to happen.
She subtly swiped at her eyes and turned to the feeding pump to program in the proper rate. Ryan came up beside her and put his hand lightly on her arm.
“Are you all right?” he asked in a husky voice.
She wasn’t, but partially because his skin was so warm and tingly, she couldn’t think. “Um, sure. I’m fine. Emma’s the one I’m worried about.”
“Me, too. But I’m confident you’ll take good care of her. You’re an incredible nurse, Cassie,” he murmured.
“I’m not,” she protested. “I just happen to love babies.”
“I can tell. As I said before, you’re a natural.”
She glanced up at him, mesmerized by his ocean-blue gaze. Awareness shimmered between them, and suddenly she couldn’t seem to remember why she needed to keep her distance from him. He seemed to understand her so well.
Better than her husband ever had.
With an effort, she tore her gaze away to glance back down at Emma. She knew very well why she needed to stay away. She’d suffered two miscarriages and her doctor had told her not to get pregnant until she’d had surgery. And even then, he’d told her, there could be scarring, preventing her from ever having a baby of her own.
And deep down she was afraid to risk getting pregnant again. She might not survive the emotional distress of another miscarriage.
“Cassie?” Ryan’s voice pulled her from her sad thoughts. But before he could say anything more, the social worker approached, accompanied by a woman in her midforties wearing a badly fitting suit.
“Hi, Cassie, Dr. Murphy. This is Judith from CPS.”
Cassie stepped away from Ryan and nodded at Judith. “Good morning.”
“Good morning. What can you tell me about Emma’s condition?” Judith asked, getting right down to business. The way she barely glanced at the baby grated on Cassie’s nerves.
“She’s been a sick little girl, but she’s stable at the moment. We’re supporting her breathing and giving anti-seizure medication.”
“I see. What’s the cause of her illness?”
“Her lab tests just came back positive for opiates, although the level isn’t as high as I expected,” Ryan admitted.
“So the mother was a drug addict.” Judith didn’t look at all happy with the news. “We could go after the mother for child abuse.”
“Please, don’t.” Cassie spoke up. “She gave up her child under the safe-haven law. If the word gets out that we’re going after the mother, others may not risk doing the same.”
Judith grimaced and nodded. “I know, but it still makes me angry. How long before the baby is able to be discharged?”
“I can’t tell you for sure, but probably a week or two, maybe more. Depends on how well she responds to treatment.”
“Do you have foster care lined up yet?” Cassie asked.
“No. Actually, the fact that she’s likely going through withdrawal and will probably have ongoing medical issues makes placement more difficult.” Judith scowled, as if Emma had done it on purpose.
“Why is that?” Cassie demanded. “What difference does it make if she has medical needs?”
Judith shrugged. “Many people aren’t willing to take on that kind of commitment,”
she said.
“I will,” Cassie blurted, without stopping to think. “I’ll go through the process of becoming a foster parent and I’d be more than willing to take Emma home with me. No matter what her medical issues are.”
Judith and Ryan stared at her as if she’d lost her mind, but now that she’d said it out loud, she knew she’d meant every word.
She couldn’t help thinking that this was meant to be. That she was meant to be Emma’s mother.
And she knew she’d love Emma as her own child, if given the chance.
CHAPTER FOUR
RYAN WAS STUNNED to hear Cassie blurt out how much she wanted to be a foster parent for Emma, although truthfully, he shouldn’t have been. Her gaze was bright with compassion and from the way she cared for their tiny patients, he knew she’d make an excellent mother. In fact, he was surprised she hadn’t already been snatched up by some lucky guy.
Just the mere idea of Cassie being with anyone else was repugnant, and he clenched his jaw, trying to hide his reaction. Certainly she wouldn’t blush the way she did every time he spoke to her if she was seeing someone else.
Would she?
“Have you applied to be a foster parent?” Judith asked, staring at Cassie expectantly.
“No, but I’m happy to do that,” Cassie said without hesitation. “I finish my shift today at three-thirty. I can be at city hall before four.”
Judith’s expression wasn’t encouraging. “If you haven’t started the process, then you likely won’t be approved in time to take care of Emma.”
Ryan felt compelled to butt in. “Is there anything Cassie could do to expedite the process? If placing Emma will be as difficult as you say, this would be a win-win situation for both of them.”
Cassie’s gaze met his, full of silent gratitude. “I’ll do whatever you ask, provide whatever you need,” she said to Judith. “I’ll take days off work if I have to.”
“There’s no way I know of to get through the process any sooner, but you can certainly ask about that when you go to city hall.” Judith obviously considered the matter closed as she turned back toward Ryan and the social worker. “I’ll return to check on the baby early next week. If anything changes in the meantime, either for the better or for the worse, I’d appreciate a call.”
“Of course,” he agreed. Even though he didn’t particularly like the case worker, he knew that they needed to try to stay on Judith’s good side if at all possible. Especially if Cassie was really going to go through with the plan of becoming a foster parent, an idea he was still trying to wrap his mind around. “Is there anything else you need from us?”
“Not right now.” Judith glanced at them and shrugged. “Have a good day.”
“You, too,” Cassie said, with a forced smile.
He waited until the social worker had escorted Judith out of the unit before turning toward Cassie. “Do you really think this is a good idea?” he asked.
“Yes, I do,” she answered without hesitation. “I know it seems like a snap decision, but it’s not.”
Ryan wasn’t sure why he kept pressing the issue. “I know you love babies, but don’t you think that having a child as a single parent will be difficult? Not to mention putting a crimp in your social life?”
She squared her shoulders and lifted her chin stubbornly. “I don’t have a social life. After my ex cheated on me, I’m not anxious to trust men enough to try the dating scene again. I know being a single mother won’t be easy, but I’m determined to provide Emma with a loving home. And as a nurse I can help with any medical issues she might have. Maybe Judith is right and I’m too late, but I still plan to move forward, hoping for the best.”
He wanted to tell her that her ex-husband was a jerk to sleep around on her, but hadn’t he let Victoria down, too? Maybe he hadn’t cheated on Victoria but he hadn’t been there for her. Still, he deeply admired Cassie’s willingness to put her needs on the back burner in order to provide a home for Emma. “I’ll be willing to provide you a reference if needed,” he offered.
“Really?” The way her entire face lit up with hope and happiness made his pulse jump erratically. She’d never looked more beautiful to him than she did in that moment. She literally took his breath away. “Thank you so much, Dr. Ryan! You have no idea how much that means to me.”
He struggled to come up with a reasonable response when he could barely think straight. “No problem. And if you need help with the paperwork, let me know.”
“Oh, I’m sure I’ll figure it out,” she assured him.
He hesitated, loath to leave, even though he knew his colleague, Matthew Marks, would be there soon to relieve him. Matt should have been there already, but had asked for a couple extra hours off.
“Is there anything else you need, Dr. Ryan?” she asked, when she noticed him still standing there.
Irrationally, he wished she’d call him by his first name, the way he’d asked her to. Ryan knew it was better to keep things on a professional level, but he still yearned for her to address him as more than a colleague. He shook off his ridiculous thought. “No, just make sure you document how well Emma tolerates her feedings. I’m leaving as soon as I sign off with Dr. Marks, but I’ll check her chart later this afternoon.”
“Okay. She’s going to do great, I’m sure.” She turned and stroked Emma’s cheek, the way he’d seen her do many times before. “Hang in there, sweetpea. We’re going to give you some food to help you grow big and strong. You’re going to be just fine, you’ll see.”
The way Cassie soothed Emma made him wish desperately that things could be different. He’d been fighting the chemistry sizzling between them for a couple of months now, knowing he couldn’t dare act on it. Not just because they worked together, although that certainly didn’t help matters, but because she deserved someone better than him.
Finding Victoria and his unborn son dead from an accidental overdose had broken something deep inside him. A portion of his heart that he didn’t have a clue how to fix.
As much as he adored children, he wasn’t ready for a relationship. Not now.
Maybe not ever.
* * *
Cassie glanced over her shoulder, watching covertly as Ryan walked away. That had been the most personal conversation they’d ever had and she couldn’t imagine why she’d told him about her ex. And then he’d shocked her further when he’d jumped to her defense with the case worker from Child Protective Services. Maybe he had reservations about her idea of applying to be a foster parent for Emma, but that hadn’t stopped him from offering to give her a reference.
She knew she shouldn’t read too much into his actions, although at the same time she was certain she hadn’t imagined the spark of attraction that had sizzled between them.
The very idea that he might be as attracted to her as she was to him made her face go hot. And she couldn’t deny a tiny sense of panic. How could she go out with someone as amazing as Ryan? Her ex had been a handsome pharmacist, with women throwing themselves at him, and she hadn’t been enough to satisfy him. Plus, Ryan didn’t know the truth about her miscarriages, either.
She took deep breaths to calm herself down. Most likely Ryan was just being nice. He obviously cared about Emma’s fate. And she was exhausted from her restless night. Maybe she’d imagined the awareness between them. Imagined the husky way he’d said her full name.
Cassandra.
Her knees went weak and she dropped into the seat near Emma’s computer. What was wrong with her? This wasn’t the time or place to think about the attraction she felt for Ryan. She needed to keep her mind focused on important matters, like giving Emma her first tube feeding and placing eye protection on Barton prior to placing him beneath the bili lights.
But as she cared for little Barton, Ryan’s voice lingered in her mind. When the baby’s parents came in to give him his noon feeding, she was grateful to head over to spend more time with Emma.
The baby’s seizure precautions were still in place, despite the
fact that there hadn’t been any documented seizure activity since the first one shortly after her admission. Still, Cassie knew they needed to be careful not to overstimulate Emma. Too much stimulation could actually cause the seizures to return. So after giving Emma her second feeding Cassie settled behind the computer to look up information on being a foster parent.
The amount of paperwork was overwhelming, but she refused to let that stop her. She printed out the application and the instructions, tucking them in her purse so she could review the information on her break.
Her shift dragged by slowly, no doubt because she was anxious to get to city hall. The fact that Ryan had gone home, leaving Dr. Matthew as the neonatal intensivist in charge, had nothing to do with it.
At least, that’s what she tried to tell herself. Not very convincingly either.
To keep Ryan from crowding her thoughts, she focused on getting all her work finished. By two forty-five, Cassie was ready to go. She went over one last time to Emma’s warmer, realizing that as she was off on Saturday, she wouldn’t get to see the baby until her shift started on Sunday at three o’clock in the afternoon.
“You’re doing so well, sweetpea,” Cassie murmured, stroking the baby’s downy cheek. “I’m sorry I won’t see you for a day and a half, but I’ll be thinking of you.”
She gently checked Emma’s IV in her arm and stroked the tip of her finger down her forearm to her hand. The baby caught her off guard by grabbing hold of her index finger in a surprisingly tight grip.
“That’s my girl,” Cassie said, tears pricking her eyelids. “You’re getting stronger already, aren’t you?”
Emma clung to her finger for a long minute before letting go and Cassie found herself wishing Ryan were here to share the thrilling moment. With babies you had to measure success in small increments. Emma had kept down the two bolus feedings and had grasped her finger. Huge accomplishments for a three-day-old baby born addicted to narcotics.
Sheri, the second shift nurse, came over at ten minutes after three and Cassie quickly went through Emma’s orders with her. They double-checked Emma’s IV site and the pump settings together before crossing over to Barton’s bassinet. Sheri was familiar with Barton’s care as he’d been with them for a week already, so going through his orders didn’t take long.
