Christmas Angels

by Nadine Dorries

  With mouths dry, palms damp and hearts beating faster, both nurses noted the swift sweep of her eyes across their shoes and uniforms. They almost let out an audible sigh of relief when she made no criticism. Beth’s hand flew to the fob watch pinned to her apron under her cape and straightened it. As if alerted by the movement, Matron turned to her.

  ‘Nurse Harper, there have been a few changes. You are no longer on ward four today.’

  Beth’s eyes opened wide in surprise, and relief hovered in the wings as she almost didn’t dare let herself believe she might be spending her Christmas on the same ward as Pammy. The Tanners were as close to Beth as any family she had known. She marvelled at their disorder and closeness, and in her heart, Beth, the keeper of lists, loved it.

  ‘We have a very special case on ward three, admitted as an emergency last night. Come with me, both of you.’

  The nurses looked at each other and Beth furiously motioned to Pammy to wipe the make-up off her eyelids. She could barely believe that Matron hadn’t spotted it. Some ward sisters tolerated a little foundation and blusher, but Matron most certainly did not. Beth had no idea, however, that Matron had been up all night, nor that, without sleep, her eyesight was blurred at best.

  The two girls tripped along behind her, Pammy at the back rubbing at her eyelids with her handkerchief. The ward doors opened and they were in for a second shock when they were greeted by a very tired-looking PC Freddie Watts.

  The words fell out of Pammy’s mouth, as they often did, before she could stop them. Handkerchief held mid air and covered in powder-blue Outdoor Girl eye shadow, she exclaimed, ‘Freddie, what on earth are you doing up here in children’s? Not following me around, are you?’ She laughed and gave him a cheeky wink.

  Matron glanced at her. She was well used to Nurse Tanner’s impetuous nature. Her eyes narrowed and focused on the hankie, then they moved up to Pammy’s face and frowned. They had been through a drama or two together in the time Pammy had been at the hospital, but Matron knew enough from Sister Haycock to make allowances. She had been left in no doubt that Pammy excelled at patient care, and a close second to that was the loyalty she showed towards St Angelus. If a nurse demonstrated an absolute commitment to the St Angelus family, it travelled a long way with Matron.

  ‘Into the office, please, nurses. At once. The night staff are exhausted and will not appreciate your delaying them with chitchat,’ said Matron. ‘Now, please! Constable, you look exhausted. Is someone on their way to relieve you?’

  Freddie looked nervous. Matron’s reputation was legendary in Liverpool. ‘They will be, Matron. There’s a full manhunt about to begin for whoever abandoned the little boy. Norman, er, Constable Bartlett, has been undertaking door-to-door enquiries. It appears that no one in the road had ever seen a baby at the house and the people who lived there spoke to no one. The super will be sending a plainclothes CID officer down this morning, to speak to the doctor. I’m off home for a sleep now, and then I’ll be back later, to take over and to help. If that’s OK with you?’

  ‘Good man. We’ll see you later then. Don’t you worry, he’s in safe hands with us. Make sure you have your full quota of sleep. We all know what happens when people skimp on that and the last thing you want is to be ill for Christmas.’

  She watched Freddie as he went out through the ward doors. Then she turned towards Sister Paige, who was standing in the doorway to the office. Sister Paige was also watching Freddie with more than her usual degree of interest. Matron’s heart sank. Only a blind man would fail to notice how pretty Aileen Paige was. She, however, appeared to have no idea of the impact she had on others. Matron had seen heads turn and necks craned as people tried to brighten their day by catching a second glimpse of the passing beauty. She projected warmth as well as professionalism, and that she had a caring heart was abundantly clear. There was something special about her and she was instantly noticed and not easily forgotten. Now that she was a new ward sister, promoted by Matron herself, she appeared to glow with pride in her navy-blue uniform.

  Matron recognized the look she’d seen in Sister Paige’s eyes as the ward doors swung back and forth and Freddie ran down the stairs. It was unmistakable – she’d seen it in so many nurses’ eyes, so often. Including, only seconds before, in Nurse Tanner’s – who was also impossible to ignore or forget, though for entirely different reasons – when she’d caught her talking to Dr Mackintosh. Although, Matron would admit, Nurse Tanner had hid it well in her presence – or at least she thought she had. It had been in Dr Mackintosh’s eyes too, as he’d looked at Nurse Tanner. Oh, here we go, Matron thought, that’s all we need. A flirtation on the children’s ward at a time like this, and my best ward sister too, distracted by a police officer.

  But as they filed into the office, that was the last thought she gave to it. On the ward, a child was fighting for his life and if it was a battle she was going to win, she needed every one of them on her side. They all had a job to do.

  Sister Paige stood to the side of the office door, her back pressed against the wall to let Matron walk in ahead of her.

  Matron smiled and stopped in her tracks. ‘Not at all, Sister Paige. You may be a new ward sister, but this is your ward now. You are in charge, you are the one who will hand over the report, not me. I am only here to reinforce the conditions of confidentiality we face with the new admission and the added complications of a police investigation.’ She could see that Sister Paige was nervous, and so she should be. There would be a great deal of interest in this case and it was a big one to handle in her first week.

  As Sister Paige spoke, Beth was struck by the sweet and melodious tone of her voice. She went through the patients, starting with the cubicles but leaving out cubicle number one, the closest cot to the office. ‘There is a great deal to say about the baby in cubicle one, so I will leave him until last.’ And then, without further ado, she worked her way down the ward, case by case, around the large bay at the bottom with its windows that looked straight on to Lovely Lane and then back up the cubicles on the other side, finishing with a five-year-old boy, post inguinal hernia, due for discharge that morning. She didn’t leave out a single detail and Beth found herself imagining what it must feel like to be sitting in the sister’s leather chair; to be in charge. She could only imagine how satisfying and rewarding that would be.

  ‘And, finally, nurses…’ Sister Paige’s voice cut though Beth’s thoughts. ‘Back to cubicle one. We had a very distressing admission during the night. This will be of interest to the police, the welfare department and the press, and I wouldn’t be surprised if it ended up in the news on the new televisions everyone in Liverpool seems to be renting.’

  There was a sharp intake of breath from the nurses standing around the room.

  ‘As St Angelus nurses, Matron expects nothing less than your absolute discretion. Not a word of this case must be revealed to anyone outside of this ward, do you understand?’

  The nurses were lined up against the wall for day report, each one holding paper and pencil, waiting to write down their duties for the morning. They all nodded in almost stupefied acknowledgement of the instruction.

  Only Pammy Tanner spoke, looking up at Matron and Sister Paige as she did so. ‘Yes, Matron.’

  Matron’s eyes scanned the remaining nurses, who, realizing what was expected of them, answered as one. ‘Yes, Matron.’ Not one of them had ever experienced Matron being present for day report. That in itself was enough to tie their tongues.

  Matron, happy that they all understood the gravity of the situation about to be revealed to them, took the report Kardex from Sister Paige’s outstretched hands, held it face down at her side and continued. She had been there all night and knew every detail, didn’t need to reread her own notes. ‘Late last night, a baby was found abandoned in the garage of an empty house. Male, approximately six months old. He was hypothermic and dehydrated and is malnourished, severely underweight and developmentally impaired. He has pneumonia, with the l
eft lung being much worse than the right. He was lying on his left side when he was found, which would account for this. The houseman and night sister have been with him all night long. The consultant, Dr Walker, was called in from home and was here by 1 a.m. Gone by 1.30.’

  The assembled nurses almost gasped at the hint of derision in Matron’s voice. It was a badly kept secret that Matron had little time for Dr Walker and his lazy ways.

  ‘He is a very poorly baby and is failing to thrive. There is no doubt that if he hadn’t been found when he was, following the drop in temperature during the night and given the fact that his left lung is almost fully congested, he would not be with us this morning.’

  Beth swallowed. The air in the room felt heavy and oppressive. The implication that a life had been saved with very little time to spare was something they were all desperately trying to absorb.

  ‘I will let Sister Paige continue, but please be assured that I’ll be keeping a close eye on this case, for reasons which will become apparent over time.’

  Aileen Paige reached out to take back the long metal Kardex which held the buff cards containing the ward notes. Taking her pen out of her top pocket, she made a note.

  Matron’s eyes flicked towards her to see what she’d written. To be special nursed. A nurse would now be stationed inside the cubicle at all times, leaving them one down out on the ward. She was aware of the wide eyes and bewildered looks on the faces of the nurses around them and decided to fill the silence while Sister Paige read through some of the night nurse’s notes.

  ‘Because the child is in a very bad way, nurses, we need you to be prepared before you see him for yourselves. The police are obviously concerned to find who abandoned him and so evidently neglected him for the duration of his short life. They are treating it as attempted murder – as indeed it very nearly was…’ She paused for a moment and took a breath. ‘And indeed still may be. Whatever the outcome, he is both a patient of St Angelus and the subject of what will be an intensive and sensitive police investigation. This child appears to have never eaten food. He appears to have no real sucking reflex. Dr Walker said that there were some bowel sounds – in his opinion, just enough to try him on a liquid diet. Night Sister attempted to feed him some watered-down milk, but it was impossible as he vomited it straight back up and then, following that exertion, he slipped into unconsciousness. He was found with an empty glass formula bottle in the pram. Its rubber teat appeared to have been chewed and swallowed as it was not found in the pram with him, according to the CID who visited the scene. His skin is chafed from the leather reins that were used to strap him into the pram. He is gaunt and frightened and because of his dehydration on admission his eyes are quite sunken. His clothes were in rags, his skin has broken down in places, particularly along his left side, and he is teetering on the edge. He is alive now, but with the possibility of infection and other complications, he may not be so for very long. Indeed, that is the very definite opinion of Dr Walker.’

  Matron paused and shifted in her chair slightly, leaving them all in no doubt regarding her opinion of Dr Walker.

  ‘He requires intensive nursing care. That is why Sister Paige needs an extra pair of hands here on ward three. That will be you, Nurse Harper, until the situation alters.’ Matron raised her eyebrows and nodded towards the Kardex, indicating to Sister Paige to continue.

  ‘Right. So, as Matron has explained, this is going to be difficult. I shall pass a nasogastric tube as soon as we finish report. As you all know, that is a tube we pass into the stomach in order to introduce fluids and a liquid diet. I know you would all appreciate the chance to have that procedure ticked off in your assessment books. However, this little boy has been through a great deal. Night Sister attempted to pass a tube during the night and has been unsuccessful…’

  ‘Sister Paige is being modest, nurses,’ said Matron. ‘She can pass an NG tube in twenty seconds flat, causing minimum discomfort to the patient, and that is what is needed today. Watch her and learn. She is the best I have ever seen. What is your secret, Sister Paige?’

  Aileen blushed as she replied. She knew exactly what her secret was: it was confidence in her own ability and the swiftness that resulted. She was unafraid, and she focused on the job in hand to the exclusion of all else during those vital seconds while she pushed the tube up the patient’s nostril and then down, following the path of the oesophagus all the way into the stomach until she felt the soft resistance as the rubber tube yielded between her fingertips.

  Before she taped the tube into place, she would apply a syringe to the bung at the end of the rubber tube and aspirate. As she did so, she would pray that a sample of green bile would appear in the syringe; when this happened, she would squirt it into the metal kidney dish on the trolley and on to the litmus paper, which would immediately turn pink, confirming that the aspirate was stomach acid and that the tube was in the correct position. Passing the tube into the lung by mistake could be fatal. Had been fatal, in living memory at St Angelus and during Matron’s own tenure. Since that time, Matron had insisted that all student nurses had to pass nasogastric tubes under supervision and that it had to be signed off five times in the assessment book before third-year finals.

  ‘I will let the nurses watch me,’ she said to Matron. Then she addressed the nurses themselves. ‘I’m sorry I can’t let you do it yourselves in this instance. The thing to remember is that it is mainly a matter of confidence. You cannot doubt you are going to succeed on first attempt. It is a case of setting up the trolley correctly and making sure you have someone with you to reassure the patient in order that you can give the procedure your one hundred per cent attention. It is impossible to do on your own as you cannot then focus fully on passing the tube swiftly and painlessly. The patient needs to be coaxed all the way through because if they panic and grab at the tube and pull it away, you just have to set up and start all over again.’

  Sister Paige paused, looked up and gave the nurses an encouraging smile.

  ‘Don’t look so alarmed. Once you are ready to go, it is just a case of taking a deep breath, making sure all the Ts are crossed and, in my case, telling myself and the patient that this will all be over very quickly indeed. Then you need to get right on with it, without any hesitation. If you start dithering or become alarmed by the patient’s gagging or attempts to grab at your hands, you’ll prolong the distress. It’s not cruel to get someone else to hold on to the patient’s hands tightly so they can’t distract you and by doing so, prolong the entire ordeal for them, it’s being kind.’

  Matron appeared to be more than satisfied. ‘Well, did you hear that, nurses? I would like every nurse in this hospital to be as confident as Sister Paige, because good nursing, the best nursing, should be our only objective. Now, with this case, we must be very careful. As I have already mentioned, it is a CID investigation and that means no talk outside of this ward. Not a single word. Night Sister has given our abandoned baby a name, after her own father – Louis. No one must discuss baby Louis outside of here, not a single word, do you all understand? Not even in the Lovely Lane home.’ She glanced straight at Pammy.

  More confident now of what was expected from them, the voices came as one. ‘Yes, Matron.’ They only ever saw Matron on her ward rounds and when they were in trouble. Pammy had needed to visit Matron in her office a number of times.

  ‘Also, be alert as to who comes in and out of the ward. The new cleaning rota kicks in today and you will have Branna cleaning on days up here from this week. You know who the doctors are, but if you see anyone entering the ward and you don’t know who they are and you have the slightest suspicion, do not be afraid to ask. There is a thought that if whoever left this baby knows he is here, they may try to remove him. He has a mother, and one assumes there is also a father involved. The police will be looking for them now. However, do not waste your sympathy. Baby Louis was abandoned and almost lost his life. Any longer out there and he would not have been alive this morning. During the war
we found our share of babies left on the hospital steps, but we have never had a case of neglect like this. His mother may come looking for him, and, even worse, the press may come sneaking around. There is of course the possibility that his mother is ill, or was forced to abandon her child. The fact is, we just don’t know, so be vigilant at all times.’

  ‘There’s just one more thing to add to the morning report – something to try and keep things on as normal a footing as possible,’ said Sister Paige. ‘Although it seems quite trivial now, in light of last night, I will mention it anyway as we do have other patients on the ward, many of whom will not be going home for Christmas and must not be forgotten. The Nursing Times is running a national competition for the best Christmas decorations on any hospital ward that will have in-patients over Christmas. I thought we might enter. The Christmas tree is already leaning up against the window in the bay and some of the children are very excited. I would like to keep things as jolly as possible for our post-operative children. Matron and the doctor are discharging as many as they can from ward four and sending them here for Christmas. There will be no new operating lists on four from the day after tomorrow and those children left with us will have their beds wheeled into the bay at the end of the ward. We have a responsibility to all of them to make Christmas as fun as possible. Sister Tapps is having a well-earned holiday…’

  ‘It is such a shame as we have so many children on the ward looking forward to it all. But now, because of baby Louis,’ said Matron, ‘I’m not sure how you will manage it all, however, I have every faith that you will.’

  Pammy put up her hand. Report was a little like school: no one spoke without putting their hand up first.

  ‘Yes, Nurse Tanner,’ said Matron, not in the least bit surprised that she was the first to ask a question. Never backwards in coming forwards, Pammy always wanted to know the ins and outs of everything, sometimes giving the impression that she hadn’t understood what she had been told when in fact she was simply gathering more information to deepen her knowledge.