Critical Care: 1 (Mercy Hospital) Page 7
Logan’s arms closed around her tentatively as if he knew there was a line he couldn’t cross. His chest was warm and solid against her cheek, and Claire could hear the muffled thudding of his heart. For one crazy moment the world felt right again. “No problem,” he whispered, his chin brushing the top of her head. “And I want to thank you for . . . the afternoon.”
Claire closed her eyes, feeling the comfort of his warmth against her. Then she moved away.
+++
Smokey dragged a piece of reheated chicken enchilada from his bowl and ate it under the kitchen table, growling low in his throat. He watched Claire warily.
“Great manners,” she told him. “See if I bring you any leftover sushi next time.” She sighed. Except there wasn’t going to be a next time. Couldn’t be.
She’d wrestled with the idea all the way home tonight after Logan drove her back to the fairgrounds and dropped her off in the parking lot. She’d driven Kevin’s SUV to Kevin’s house and then took a long run before the sun set on her brother’s beloved foothills. She let the endorphins replace whatever she’d felt in Logan’s arms.
Ever since she’d been called back to the ER, her plan for a peaceful new life had begun to erode into confusion and chaos. There were flashbacks the first time she walked into the Sierra Mercy trauma room, followed by that awful sense of suffocation at the CISM debriefing. She’d battled sleeplessness and nightmares almost nightly since.
Now there was Logan Caldwell, the source of the worst confusion of all. When Claire was around him, her usually well-controlled emotions got the best of her. There was that strange, prickly anger that seemed to go deeper than mere advocacy for the nursing staff, a raw new awareness of her loneliness, and—worst of all—an unbearably painful need for . . . hope. Hope that it might be possible to feel good again. That happiness could be as real as those glorious hills of daffodils.
The trouble was, she couldn’t seem to have one without the other. It was like one emotion set the others spinning; a sliver of hope—that wonderful hug—started a painful rush of memories. Claire wouldn’t risk that. She couldn’t come undone again, because she might not survive it this time. Even if Logan’s arms around her and the brief silly laughter had made her feel more alive than she had in a long, long time.
She wasn’t going back to the ER. She was sticking to the plan she’d made. She’d pray harder, that’s all.
Claire tossed the dusty silk daffodils into the wastebasket. They didn’t fit in Kevin’s house, and she couldn’t look at them anymore. She rinsed Smokey’s dish and headed for the shower.
The blinking light on the bedroom answering machine caught her eye. Claire shook her head. Mom again, she’d bet, with information on Phoenix hospitals. She’d told her mother that she’d consider moving only as a backup plan; she was going to get that clinical educator position. She’d been interviewed, and she’d hear within a couple of weeks. Sorry, Mom. Claire sat on the bed and pressed the button.
“Claire, Merlene Hibbert. I’m sending you to the urgent care clinic tomorrow. One of the ER nurses quit, and I can’t find a replacement.”
Claire held her breath as the nursing director continued.
“I know how you feel, but this is temporary. Erin’s pulling the clinic nurse into the ER. She’ll do the acute care, and you’ll take her place in the clinic. Should be a snap for you.” Merlene sighed. “I know you want all your hours assigned to the education department, but your hiring status allows us to float you to other departments when need arises. And right now I’m in a bind. If Dr. Caldwell is short-staffed tomorrow, there’ll be the devil to pay.”
Chapter Six
Sarah Burke checked her watch and picked up her pace, her lavender clogs squeaking double-time against Sierra Mercy’s flooring.
She popped the pull tab on the morning’s second Diet Coke and held the can safely out of splash range as she hustled. It wasn’t that she was late, but she wasn’t as early as she’d wanted to be today. Six thirty, and she’d planned to be in the ER by six fifteen, which would have given her plenty of time to make sure things were organized and ready to go by the start of day shift. She didn’t give a flying fig that the night crew hated her second-guessing their ability to stock the department. Or that she didn’t trust them to check the resuscitation equipment: cardiac defibrillator, bulbs in the laryngoscopes, the suction machines, oxygen tanks . . .
The only time Sarah could be assured everything was done right was when she did it herself—lives depended on that. And Logan counted on Sarah’s extra diligence. Respected her competence. She wasn’t about to let that end; it had become as important as breathing. Sarah swallowed against a lump in her throat. The truth was, Logan’s respect made Sarah feel better about herself than anything had in years.
She rounded the corner at the radiology suite, snapped a salute as she passed Merlene Hibbert riding herd on a group of nursing students, and strode along the last corridor leading to the ER. She frowned as she spotted overfilled linen carts, several abandoned wheelchairs, and an unloaded supply cart.
Then she continued past the doors to the chapel. Open doors . . . Oh, that’s right. Sarah slowed, then stopped and backed up a few steps to peek into the drab, nondenominational sanctuary. She took a sip of her cola and shook her head. Erin and her Faith QD. She’d never met a more dedicated charge nurse, and she had to give her an E for effort on this undertaking, but was Erin ever going to find any more recruits? Only two people had ordered those logo T-shirts.
Sarah peered cautiously into the room used most often by families of very sick patients, a place to pray for the strength needed to wait, to cope, and sometimes to let go. It was where the hospital chaplain offered informal services for staff pulling shifts on Easter and Christmas, and once the site of a wedding between two wheelchair-bound oldsters who’d fallen in love in the skilled nursing wing. Someone said they’d had accordion music and bread pudding with pink candles instead of wedding cake.
But now it was just Erin, Inez, and a ruddy-cheeked woman with a hairnet whom Sarah vaguely recognized as a new cafeteria employee. Bowing their heads and voicing concerns, asking God to be present during their workday. Or at least that was the plan Erin described when she invited Sarah. An invitation she’d quickly declined.
Sarah stepped backward as Erin raised her head; then she hurried toward the ER before the charge nurse could spot her.
Erin didn’t need to know that Sarah left God on the outskirts of Pollock Pines a few years ago. That awful Sunday morning her mother confronted her in the church parking lot. “You don’t belong with these good people,” she’d hissed. “Sin’s written all over you, and I can’t bear it—be packed and gone by the time your father and I get home. You’re a disappointment, Sarah Lynne.”
Faith QD: faith every day. Nice thought. She hoped it worked for Erin and the rest of her staff. But Sarah wouldn’t be ordering a T-shirt. You could count on that.
Sarah emptied the cola can and took aim at the trash container outside the emergency department doors. Then noticed the tremble in her fingers. Too little sleep, too much caffeine. She was so tired, but she had to soldier on. There was work to do.
+++
Logan bit back a curse and forced himself to concentrate on the task at hand, stitching up a writhing, tattooed drunk. So far it was the highlight of the day, which explained his mood. Not that Merlene Hibbert hadn’t just come right out and asked, “Now then, what’s got our knickers in a twist today, Dr. Caldwell?”
Logan chuckled to himself; the woman was one of a kind, for sure. Maybe he was irritable but not without reason. Two very good reasons. One of them was the fact that the hospital’s chief of staff was suddenly nosing around, his crisp khakis, blue blazer, and dotted Brooks Brothers tie standing out like a foreign costume in the ER’s sea of scrubs. What was up? Was it about the nurse who had walked out after her public tirade about Logan? All he needed was another barrage of complaints like he’d had in Reno.
The
other reason for his mood, the one that was making him even edgier, was the fact that Claire had shown up this morning. The educator, but without her usual workday suit and briefcase, too-tight smile, and armload of pamphlets. Dressed instead in soft pink scrubs and white clogs, a purple stethoscope around her neck, and all that dark hair piled on top of her head like she was headed for a garden party instead of a clinic shift. In truth, she’d taken his breath away.
She’d parked her SUV beside Logan’s bike and stridden in with her shoulders squared and pretty chin lifted with determination, but he caught the look in those gray eyes. Easy to diagnose: out of her element and a little vulnerable. He already knew her enough to know she’d hate feeling that way. It had taken all his strength to resist putting his arms around her.
And now Claire was working in the urgent care just a few steps away. A clinic he was responsible for, but it was under the direct supervision of a very competent nurse-practitioner. So competent, unfortunately, that there was little likelihood Logan would need to go over there. Unless . . . No, he wasn’t going over there. Just like he wasn’t going to lose any more sleep thinking about what it might have been like to kiss Claire yesterday. Ah, man, he’d wanted that. But she hadn’t wanted to be kissed. She’d probably rather slug him. Hadn’t she tried to take his head off when she accused him of not caring about his staff? Yes. But then there was that look on her face when she’d thanked him for the daffodils, followed by an out-of-the-blue hug.
“Hey, buddy, hold still, okay?” Logan tapped a gloved finger against the green towel covering his patient’s head. He skillfully pierced each edge of the scalp wound with a semicircular cutting needle, grasping its end with a needle holder and pulling the nylon suture taut before tying triple knots. He snipped the suture and inspected his work. It would likely take a total of eighteen stitches to repair the damage caused by the business end of a broken bottle. This guy wasn’t having much of a morning either. After a night that had continued long after the bars closed.
Logan set the scissors down and sighed with frustration as the man thrashed on the gurney, sending a stack of iodine-soaked gauze squares hurtling to the floor. The sterile drape slid away from the tidy line of sutures to expose the man’s bullish, blood-speckled neck and a partially visible Born to be Wild tattoo.
“Easy, Wild Man,” Logan said, trying to protect his sterile field. He nodded with gratitude as Sarah arrived from out of nowhere to assist. “I’m not a rodeo vet,” he advised his patient. “Hold still for me, okay? Almost done here.”
The man mumbled, gave a beery belch, and Logan grimaced. Not that he wasn’t used to moving targets, or drunks, for that matter. He’d learned way too much about alcoholics firsthand. It was the reason he never took a drink himself.
The painful lessons started early. When at age eight Logan learned to hide his mother’s car keys, snuff her discarded cigarettes, cajole her during raging hangovers, and make excuses to friends and teachers. More than once Logan had to talk his father out of punching the daylights out of a neighbor man he’d caught her kissing. By twelve, Logan had taken charge of his two little brothers and struggled to hold his father together after she wadded her clothes into grocery sacks, drained their Christmas account, and caught a Greyhound bus.
“You’ll be out of here soon, pal,” Logan told the drunk.
Sarah reached a gloved hand over the sterile field to snip the last of the sutures for Logan, leaving the nylon exactly long enough for easy removal later on. Too long and the sutures would mat in the hair and increase the chance of infection. Too short and they’d be a beast to find later for removal.
Logan pulled the last suture through. “You spoil me for anyone else. How’d you learn to read my mind? I could understand if you were a battle-scarred nurse with fifty years in the OR, but . . .”
“My dad,” Sarah said, snipping the last suture. She smiled, and there was something in her eyes that Logan had never seen before. Wistfulness, maybe even happiness.
“Your father’s a doctor?”
“Nope. A mechanic,” Sarah said with a chuckle. “The best. He owns a body shop in Pollock Pines. I used to help him work on our cars at home and at the shop sometimes too when he stayed late and everyone else was gone. We’d have the Stones jammin’ on the speakers, and we’d drink bottles of Coke and eat spicy pepperoni sticks. I would do this impression of Jagger, holding a huge Crescent wrench like a microphone: ‘I can’t get no satis-fac-shun,’ and he’d laugh so hard. . . .”
Her voice got thick and she cleared her throat. “I knew all the tools, exactly what he’d need next. He used to say I could read his mind. Same way you did just now. Anyway, that was a long time ago. And lucky for you I went to nursing school instead of working at the speedway.” She grinned. “They begged me, you know.”
“I’ll bet.” Logan smiled back, having no problem imagining Sarah in grease-smudged overalls and a backward ball cap. It struck him this was the first time they’d talked about anything personal. “So you’re Daddy’s girl?”
Sarah hesitated before answering. “I don’t get to see him much.”
“But Pollock Pines is only like twenty minutes away.”
“My mother and I . . . have some issues.” Sarah looked away. “You want me to finish up here?”
“Yeah, sure.” Logan said, sorry he’d pushed it. He was the last one to judge the dynamics of family relationships. “I suppose I’d better go see why the chief’s nosing around our department.”
“He’s gone.” Sarah pointed toward the door. “Out of the war zone and back to the safety of administration, no doubt.” She squeezed antibiotic ointment onto the flat end of a tissue forceps and smoothed it across the suture line. Her hand trembled slightly as she reached for bandaging material.
Logan noticed the shadows under her eyes and how her fair lashes seemed to flutter in fragile hollows. Had she always been that thin? Maybe he’d get her some pizza for lunch. Double cheese and make sure she ate it.
Sarah looked up, her pale eyes lit with sudden amusement. “Our Claire, on the other hand, has been drawn to the dark side.”
“Hmm.” Logan busied himself with prying the patient’s eyes open to check pupil responses. The man’s eyes were reddened and jerked slightly side to side—nystagmus, from the effects of alcohol intoxication. But his pupil sizes were normal and equal on both sides, constricting in reaction to the penlight. Wild Man would have a CT scan to check for brain injury, then a gurney to sleep on until his blood alcohol level legalized. Logan set the light down and glanced at Sarah, keeping his voice casual. He was not going over to that clinic. “So, how’s Claire doing over there? Using brochures as compresses?”
Sarah smiled and shook her head. “Hey, careful. Code of honor—can’t let you disrespect a fellow ER nurse.”
“Education nurse,” Logan corrected as he began to strip off his bloody gloves inside out. “There’s a mile of floor between those offices and ER.” And I’ve been tempted to walk it a dozen times this past week.
“But she worked ER first until a couple of years ago.” Sarah rolled a soft Kerlix gauze bandage around the patient’s head to cover the wound and reduce swelling. “I talked to one of the nurses at UCD in Sacramento, and she heard of her.”
Logan let the glove dangle and stepped back toward the gurney. “Really? The trauma center?” He shook his head, remembering asking Claire about her career yesterday. It was odd she didn’t mention ER. Most nurses considered that experience a badge of honor. He’d seen some with a few measly shifts in ER label themselves trauma nurses forever after.
“This nurse said Claire left after the big warehouse disaster a couple of years back.” Sarah’s brows drew together. “It sounded like she had a family member injured in that fire.”
“Whoa, that’s rough. I’ve talked with docs who worked that disaster. Weren’t there like seven firefighters—?”
“Dr. Logan!”
They both turned as Inez shouted outside the patient cubic
le.
Sarah pulled the curtain aside to reveal the breathless and flustered clerk.
Inez clasped her chest, her dark eyes wide and blinking. “Lo siento—I’m sorry . . . ,” she said, gulping for air, “but Erin said grab you quick. They’ve got mijo Jamie in urgent care. And something’s going very, very bad!”
+++
Claire fought a dizzying mix of emotions as Logan entered the clinic exam room, but bone-deep relief surpassed all else. Jamie had been sent down from pediatrics for a routine bandage change and a look-see at some breathing trouble, but now his asthma was full-blown and he was deteriorating fast.
No. Claire’s heart began hammering in her ears. This boy was the hospital darling, the sweet face of life after tragedy. Please, God, don’t let me crumble like that other time. Don’t let me fail this child.
“Second treatment’s nearly finished,” she explained as Logan bent down for a moment to make eye contact with the sick boy. She watched as he began to speak, eyes gentle but concerned, patting the boy’s shoulder. He called Jamie “buddy” and reassured him that Doc Logan was going to make him well. Claire’s heart squeezed. He does care. Overhead, the PA buzzed with a stat page for respiratory therapy.
Claire adjusted the misting treatment mask, alarmed that Jamie’s blue eyes now swam listlessly and his breathing rate was more than twice what it should be. His dark pupils drifted side to side and then partially disappeared beneath his drooping upper lids.
She stroked his head gently, trying to comfort him, then looked at Logan. “He’s far more fatigued now. Respirations are 56 per minute, and—” she glanced at the red digital display on the monitor, and her stomach sank—“oxygen saturation is still too low—only 86 percent, even with the supplemental.” Oh, please.