Critical Care: 1 (Mercy Hospital) Read online

  As she picked up her jacket and reached for the door to the deck, she saw the fire pit and paused. She needed to stop by the ER to talk with Erin today, and Logan would be there working. How awkward would that be? Could she stand in the emergency department and act casual after . . . Claire’s breath snagged. I kissed the medical director of the emergency department. A newly hired nurse who was being considered for a key administrative position. Doing what—fraternizing? Was there a policy? If Merlene found out . . .

  Claire swung the door wide and hit the deck running. Pace yourself, Lord. You’re getting an earful today.

  +++

  Logan scraped the blade across the last of the shaving cream and then splashed water against his face. Colder than socks on an Eskimo clothesline. He smiled at his father’s old saying. But that’s what Logan got for showering and shaving in Sierra Mercy’s surgeons’ lounge. Although the alternative was to show up in the ER smelling like he’d been wielding an ax against an oak stump since dawn. Which he had.

  He gazed into the mirror, imagining the complaint crossing the chief of staff’s desk on that one. “Dr. Caldwell is an insufferable beast and smells like one too.” Probably not worth it. Even if the ax time had taken Logan a few millimeters closer to pouring his house foundation, it hadn’t helped him answer the question that kept him awake half the night. What was he going to do about Claire Avery?

  He tugged a scrub top over his head, stowed the shaving gear in his backpack, and headed out of the lounge toward the cafeteria. Coffee. Black. And out of a decent, fist-size mug, not a torturously small china cup. He shook his head. Claire had surprised him by returning that kiss but had been shy afterward, filling the awkward silence with a steady stream of disconnected chatter. About today’s predicted weather, the chest tube demonstration she’d be giving to the student nurses, and her speculation on when she’d hear something regarding her upcoming promotion. Logan chuckled, recalling her similar nervousness at Daffodil Hill. If there had been a chicken on her deck last night, Claire would have flattened it.

  Still, he couldn’t shake the feeling of holding her in his arms. How right it seemed and how unbelievably at ease she made him feel. For the first time in so long. Why else would he have told her about his mother? He’d given Beckah, his wife of nearly three years, far fewer details. And he’d never told anyone about stealing that page from the Bible storybook. Why Claire? Logan squinted, remembering her face in the firelight, her words. “I understand. . . . I care.” Was it possible there was something different about this woman? Maybe so, but . . .

  He winced. She was also a Christian, same as Beckah. What on earth was he supposed to do with that? She’d practically dared him with the question, “You don’t believe in God?” Who actually said things like that? He needed to face it: beautiful or not, this woman spelled nothing but trouble. Logan strode through the cafeteria to the coffee station.

  He depressed the spigot on the coffee urn, filled his cup, and then nodded to convince himself. He ought to be glad Claire’s mind was set on taking the job in the education department way across the hospital campus. Otherwise she’d be joining the God huddle with Erin, and before you knew it, his entire staff would be praying instead of working.

  Frankly he didn’t need that kind of aggravation. He had enough on his mind with building the house and convincing the chief of staff he could play nice with the employees. Plus Beckah’s wedding at the end of the week. A familiar wave of confusion washed over him. He took a gulp of coffee hot enough to blister his lips, frowned, and checked his watch. Still early. Enough time to visit Jamie.

  Logan headed out the door and down the hallway, passing Merlene Hibbert as she gave animated directions to a volunteer balancing a huge vase of red roses. He finished his coffee in the elevator and arrived on the pediatric floor within a few minutes. Jamie grinned as he walked in, and Logan’s chest squeezed unexpectedly. This kid was exactly what he needed right now.

  “Doc Logan!” The three-year-old waved from his bed and then turned to his mother to share the excitement. Though his facial bandages were gone, Jamie’s blond hair, clipped away in spots to accommodate burn care, still stuck up in tufts like fledgling feathers. “Mommy, it’s Doc Logan. He rides the motorcycle, ’member?”

  “Hey, little buddy.” Logan winked at Carly, noticing that the young mother was no longer in a wheelchair. Her lower leg, injured in the explosion, was encased in a bulky orthopedic walking boot. Only a few dabs of burn ointment dotted the side of her freckled face, and her eyes were bright and far more hopeful than when he’d last seen her. Some of that due to Erin’s Little Nugget Victim Fund, he assumed. He made a mental note to make another donation today.

  “They’re saying I might be able to take Jamie home tomorrow,” Carly said. “He’s healing faster than we thought.”

  Logan laughed as Jamie raised his little palm in a high five. He smacked his hand gently against the boy’s before facing Carly. “And his asthma?”

  “Not a peep.”

  Logan smiled at Jamie and lifted his stethoscope from around his neck. “Okay if I take a listen, pal?”

  “Yep.” Jamie stretched tall as Logan pressed the plastic disc to his chest.

  Lungs clear, heart strong and regular. Logan watched the child’s curious blue eyes. “Want to hear something cool?” He took the rubber earpieces from his ears and eased them into Jamie’s, then replaced the stethoscope over the child’s heart. “Do you hear that? that soft thumping inside there?”

  Jamie’s eyes widened and a sweet smile lit his face.

  “Know what that is?” Logan asked.

  “Uh-huh.” Jamie beamed with confidence. “It’s Jesus.”

  Carly chuckled as he lifted the stethoscope away from her son. “It’s part of our bedtime routine,” she explained. “Jamie has this favorite Bible story picture book. Since he first began to talk, he’s pointed at it and said, ‘Jesus is in there.’ So I started touching my finger first to his chest and then to mine, saying, ‘Jesus is in here too. He lives in our hearts.’”

  “’Cause he loves us and would never—ever—leave us.” Jamie reached out and pressed his small, warm palm against Logan’s chest. “Right in there, Doc Logan.”

  +++

  Sarah glanced across the ER toward Logan’s still-closed office door, then checked the clock on the wall above it. Logan, Erin, and Merlene had been in there more than twenty-five minutes. Not a good sign, but Sarah could have predicted Logan’s reaction to the male nurse the agency sent them this morning. Erin asked Sarah to show the man around the department, and she had—after he finally arrived twenty minutes late with no apology and a mouth full of fast-food breakfast.

  She guessed that this nurse, no doubt doomed to be called McMuffin from this day forward, would be sent packing within the hour. Dr. Caldwell had been surly and silent since the minute he hit the doors this morning. Though Sarah had done her best to get the new nurse oriented, the man had already made several serious errors in judgment and seemed unfamiliar with even basic ER procedures. Logan was beyond irate.

  Sarah chewed at a fingernail. She was prepared to stay as long as needed; if Merlene filled in on the clinic side, they could pull the clinic RN over here. Sarah could skip lunch, no problem. That would cover things decently until the evening shift came. But what about tomorrow? What would they do about that? Sarah wished she could think of something to help Erin with staffing, but . . . She pressed her fingers to her forehead, hating that her brain still felt fuzzy and haphazard. One and a half of the prescription pills and she still hadn’t slept longer than three hours. But she’d manage.

  “Sarah?” Claire peeked through the doors to the ER wearing one of her crisp suits and carrying the briefcase she’d had stuffed with pamphlets that first day. The day they’d lost the little girl, Amy Hester.

  No, stop. Sarah forced a smile and waved, watching Claire glance warily around the room, empty now except for an elderly woman awaiting a CT scan and one of the hospi
tal engineers replacing a wall oxygen valve.

  “I’m looking for Erin,” Claire said. “Is she here yet?”

  Sarah nodded, and Claire walked toward her. She stopped, as everyone had this last hour, to stare at the enormous bouquet of red roses sitting at the nurses’ station desk. “Wow. Who . . . ?”

  “Erin’s. From Brad the cad.” Sarah smiled at the look on Claire’s face. “He apparently stood Erin up last night. But he’s also promised to toss in a hundred bucks for Jamie’s fund, so between that and the flowers, our car salesman might be forgiven. The jury’s still out.” She sighed and swept a hand over her hair, trying to remember if she’d put on makeup this morning. Claire looked so fresh and pretty in that soft gray suit. Did I even take a shower?

  “You mean he didn’t meet her after she left the fund-raiser? I know how fast she was trying to get home. We rode together and then—” Claire stopped, and her face flushed. “Anyway,” she said after glancing toward Logan’s office, “I was sorry you couldn’t be there. I gave Erin your message, but my cell was acting up so badly I could hardly hear. In fact, you’re going to laugh at this one: I told Erin you’d said something about your baby.”

  Sarah gasped against a rush of dizziness and her stomach lurched. “I . . .”

  Claire moved closer. “Hey, are you okay?”

  Smile. Stop this. Oh no. Did I? Sarah coughed, reaching for her Diet Coke. “Sure. I’m fine. . . . I’m great. Just fighting a cold. No big deal.” She turned and pointed toward Logan’s office, desperate to change the subject and get away. “Erin’s in there with Merlene and Logan. Raising her fists for our staff—you know how she is. But she should be finished pretty soon. I need to go check vital signs, but you could hang out at the desk if you want to wait.” She stood, avoiding Claire’s eyes.

  “Sure, okay. I—” Claire stopped midsentence at the sound of voices.

  Then it was only one voice—Logan’s, deep and final. “Let’s make this happen, ladies.”

  Merlene, Erin, and Logan exited the office. Merlene’s lips pinched together in a tight line. Erin yanked her hair up into a topknot as she walked. Sarah’s heart tugged. Logan looked frustrated and bone tired. Like her father at the end of a long day at the shop, a day when nothing went right.

  She watched as Logan rubbed the back of his neck, then rolled his head side to side. Stretching his muscles as if he’d been doing manual labor since dawn. Even though he did his usual diligent scan of the ER, there was something different about the look in his eyes. Almost as if he were troubled.

  Claire stirred and Logan spotted her. He took a slow breath before giving her a smile that seemed to ease the trouble in his eyes.

  +++

  “What? Oh, I haven’t even checked my calls yet,” Claire told Logan, dismissing his apology with a wave of her hand. And a half-truth. She hadn’t checked them again in the last fifteen minutes.

  She tipped her head to peer back through the glass doors and down the emergency department corridor. Claire still needed to catch Erin and make it clear she wasn’t available to work anywhere within a thousand yards of the ER. Standing outside its doors right now within inches of Logan was unnerving enough. Because after last night it felt like she was seeing him with new eyes—the way the sunlight played across his hair, the striking contrast of dark lashes and blue eyes, the shape of his mouth . . . Stop it.

  “Well, I’d intended to call.” Logan lounged against the metal railing outside the ambulance bay doors and squinted into the afternoon sunshine. “But I’ve been doing battle all day. First with an oak stump, now with—” he grimaced and his voice lowered—“McMuffin.”

  “Mc . . . ?”

  He laughed. “New nurse Merlene tried to force down my throat. That’s why I was holed up with Erin and her for so long. This is going to stop if I have anything to say about it.” He scanned the perimeter of the ambulance bay and beyond like a king surveying his realm. He turned to Claire and smiled. “Fortunately I have everything to say about it.”

  “I’m not sure what you mean. Why did you meet with Erin and Merlene?”

  Logan’s smile disappeared. “About the same thing I’ve been arguing for since I agreed to head up this department. Permanent staff. Moreover, competent staff. Honest-to-goodness ER nurses.” He shook his head and his tone hardened. “ER nurses staffing an ER—what a concept. But you know what I’m saying. You’ve worked ER. You know what it takes.”

  Claire stiffened. Everything I don’t have anymore.

  “You can’t throw just anyone in here and make it work. I need more nurses like Erin and Sarah. It takes the brightest and the best, staff who can fly by the seat of their pants, make decisions faster than that.” He snapped his fingers. “You and I both know that at any given moment, anything can come through those doors.”

  She nodded, fighting the image of those stretchers hurtling through the doors in Sacramento. Firefighter after firefighter, until . . .

  Logan’s shoulders sagged as he sighed, and then his gaze fixed on Claire’s. “Nobody gets that I’m not trying to be a tyrant. I don’t wake up every day planning to be some insensitive, controlling jerk that pushes the nurses too hard. Expects too much.”

  Sarah’s exhausted face flashed before Claire’s eyes.

  Logan rubbed his brow. “It’s true; I do push hard. Because I’m responsible for those patients’ lives in there. The buck stops with me. If someone doesn’t do her job, I’m the one who has to answer. I can’t afford to have any . . .”

  Weak links? Claire’s stomach sank.

  Logan continued without completing his last thought. “Maybe I just learned very young that I need to scramble to hold things together. Maybe I try too hard to fix things.”

  She winced, thinking of the twelve-year-old Logan trying to ease the grief of his father and younger brothers.

  “I don’t know why I’m the way I am, but I can’t take the time to figure it out. Because right now what I need is a team. And in a matter of minutes, I’ll be losing another nurse.” He nodded in response to Claire’s raised brows. “That’s right—McMuffin. Bottom line, I’ve seen enough and I’m not willing to take the risk with him. I’m not saying he’s a bad nurse, only that he hasn’t got what it takes for the ER. What if he’d been the one over there in urgent care when Jamie started going downhill? What if he didn’t make the connection that a kid’s slowing heart rate means he’s headed into respiratory failure? What if he hadn’t alerted the nurse-practitioner?”

  Claire swallowed, her mouth going dry as she remembered Jamie’s struggle.

  Logan’s thumb brushed against his stethoscope, and he was quiet for a moment. “What if he’d left Jamie alone in that exam room for ten minutes longer? It might have been too late.” His gaze connected with Claire’s, and it was all she could do not to look away. “But it was you over there in the clinic that day, and—”

  Before he could finish speaking, the glass doors opened behind him and Erin shouted, “Code 3 ambulance coming, Logan. Six minutes out. Unresponsive teenager. Looks like a drug overdose. We’re getting things ready.”

  Call respiratory therapy; get the cardiac monitor ready, intubation tray, IV supplies, overdose reversal drugs; prepare to pump the stomach, insert a Foley catheter . . . Claire’s pulse quickened and her legs tensed for action as her mind ticked off the list, responses that came automatically despite the fact that she had no need for them. Logan’s team would pull together to save this patient, not Claire. He’d have Erin and Sarah. They’d save this teenager. Claire breathed a silent prayer. Then her thoughts scattered as she heard the distinct wail of distant sirens.

  She touched Logan’s arm. “I came down here to tell Erin I’ll do everything I can to help your team. I’m going to put out the word, make phone calls to qualified nurses, start an aggressive recruiting campaign—”

  “Whoa, Educator,” Logan said. “Put down the phone and pamphlets. You won’t need them. I arranged it with Merlene. You’re handling urgent car
e tomorrow.”

  Chapter Ten

  Not my plan, not my plan, not my plan. Claire’s shoes struck the damp red-clay trail in perfect cadence with her thoughts.

  She raised her arms overhead, rotated her wrists, and gulped a deep breath of oak-scented morning air, realizing that the usual balm of running wasn’t happening. She’d covered more than three miles of the Gold Bug Park loop and hadn’t left any of her worries behind. She may as well have zipped them into her backpack along with the bottle of spring water. God wasn’t cooperating either. He was stubbornly allowing Logan and Merlene to send her to urgent care. Backward, not forward according to her carefully crafted plans. Why? He knew it was the last thing she wanted, knew that every minute near the ER was like ripping the scab off a wound.

  Claire’s stride shortened, her footfalls slowing and scrunching into the gravel as she caught sight of the familiar gnarled oak. Kevin’s tree. She stopped and brushed her arm across her forehead, letting the sleeve of his firehouse sweatshirt wick her sweat. The oak, easily sixty feet tall, stood out in dark relief, its spreading branches already lush with spring leaves.

  She circled the trunk slowly, her gaze traveling over the gray-brown ridges and deep crevices in the bark . . . there. She pressed her fingers to her mouth, blinking against a welling of tears. The letters carved just above her eye level had weathered since she’d last seen them but were still easily visible. K. A. and G. S. Kevin Avery, Gayle Satterfield. She traced the smooth hollows made by her brother’s pocketknife.

  Claire had been here when he’d done it. A fall afternoon three and a half years ago, just before Thanksgiving, when the air was pungent with woodsmoke, and crimson, orange, and gold fallen leaves crunched under their feet on the trail. They’d raced to this clearing, and she’d beaten him to the tree with a last lung-bursting sprint. Not that Kevin had cared. He was in love. He’d been giddy with it, boyishly vulnerable and invincible at the same time. Exuberant and hopeful. Loving Gayle had deepened Kevin’s faith, and they’d thrown themselves heartfirst into Bible study, church volunteer work, and Mexico mission trips.