right.” In just a few minutes Miguel had given her the quick history of the clinic, how he had taken it over on the brink of closure and brought it to life again. “The really unfortunate part is that our grant money is ending and the city is uncertain whether they can find money for this place. The state of the economy has hit them, too.” He tugged at the lapel of his lab coat, and his lips pressed together firmly for a second. “I’m working every angle I can but it’s just not coming together yet. There’s got to be something else that will help.”
She could see the worry etched on his lean face. He put a lot of energy and probably his heart into this clinic. “What about having a fundraiser?”
“The only fundraiser I’ve held myself is a bake sale, and we can’t have enough of them to fund the clinic. The community has put together some car washes, stuff like that, but it’s just not going to be good enough for long-term funding.”
“No, I mean a big fundraiser where people and corporations donate large amounts of money for tax deductions. That’s the kind you need.” She’d put together a few of them herself and knew what it was all about. At least that’s how things got done in her family’s world. Things just snapped into place when a Sterling-Thorne wanted something done. You called your wealthy friends for donations or put on dinners and gave everyone a good time for their money. Couldn’t that be done in this community, as well? Though it was foreign to her, there had to be some common ground.
Miguel heaved a sigh that spoke of long frustration and Vicky sensed that she’d unwittingly brought up something she shouldn’t have. “I’m sorry. I didn’t know the clinic was in a bind.”
“You couldn’t know.” He gave an unhappy smile. “We’ve fortunately had a benefactor for several years. He died last year and the family has decided not to continue his charity work. The city might come through, but maybe not. We won’t know until July or so what they can do, when their budget is finalized.”
Anger surfaced in her at the injustice. She’d just started there and now it was in danger of closing. “That’s just wrong. Is this a historic building or something?” Vicky asked, wondering how she could help save this little clinic.
“Good idea, but no. It’s not old enough to be considered of historical significance, so there’s no help there either.”
The door to the tiny lounge burst open and a young man popped his head through the doorway. “Chest-pain patient coming.”
“Chest pain trumps everything else,” Miguel said, and they rushed out the door.
They dashed into a patient room where the young man she assumed was Carlos had disappeared into. Miguel was a man of energy, each movement strong, self-assured and confident, even though the patient looked quite gray. Vicky gritted her teeth and prepared herself, immediately switching on the E.R. nurse in her. Now was not the time for nerves.
“Get the crash cart ready,” he said, his voice low, “and then get a line in him. Two if you can manage it.”
Tilly hurried into the room. “I’ve called 911 for transport.”
“Thanks, Tilly,” Miguel replied. “He’s going to need hospital care for sure. We’ll get him as stable as possible first.”
“Code cart is ready, Doctor,” Vicky said, after tugging the massive tool kit on wheels to the patient’s bedside. “Do you want to start a nitro drip?” Knowing her emergency medicine drills by heart, she hoped that she could anticipate Miguel’s needs, as he hadn’t been able to do any orientation with her yet.
“Yes.”
The other two in the room seemed to know their roles well. Carlos hooked up the heart monitor, which looked as if it had come from an old hospital supply house. It was practically an antique, but it worked, and that was probably all Miguel wanted out of it. Next, he applied the automatic blood-pressure cuff. Tilly inserted an IV with a sure hand and hooked up the nitro drip that Vicky had prepared.
“The medication we’re giving you should ease your pain quite a bit,” she said to the male patient, who appeared to be in his mid-sixties. With one hand, she adjusted the oxygen mask over his face. His breathing was shallow and grunting, which was extremely worrying. She glanced at the monitor, interpreting the squiggles immediately. “Looks like he’s having an infarct right now.”
Miguel also looked at the monitor then at Vicky with surprise at her precise interpretation. “You’re right. Start a potassium drip and give him an amp of magnesium.” Leaning over the patient, he said, “Try to slow your breathing down.”
“I’ll do the mag—you get the drip ready,” Tilly said, and together they got the medications prepared and into the patient.
Soon they heard the sound of sirens. “I’ll go and get them,” Carlos said, and dashed to the door. Vicky called out vital signs now and then so Miguel didn’t have to keep looking up at the monitor.
Miguel remained focused on the patient situation, not being distracted by the other activity. “Keep the fluids going, increase the nitro drip.”
“Yes, Doctor,” Vicky responded, and although her hands trembled slightly, she changed the setting on the IV pump to the next level. “I hope it opens his vessels a little. He needs better circulation than he’s got.”
“Agreed.” Miguel hit the print button on the old monitor that hung on the wall and a segment of the ECG appeared on paper, which he tore off. “He’s got some serious S-T segment changes.”
“Should we send that strip with him to the hospital?” she asked, knowing that the E.R. doctor there might appreciate that additional information to compare with further ECG interpretations.
“Yes.” He pushed the print button again and a second strip printed from the machine.
The E.R. crew arrived, following Carlos, and in just a few minutes they had the patient transferred to their stretcher and he was out the door.
Vicky took a few deep breaths and placed a hand on her chest. “Wow. That was something.”
Miguel’s lips compressed into a line momentarily then he nodded, as if conceding something. “That was something. A trial by fire on your first day. Good job, everyone.”
A flush of pleasure pulsed through her. Compliments certainly were unexpected at this point, especially after some of his earlier comments. “Why don’t I get the room ready for the next patient?” she asked. A few minutes alone would do her some good, and she hoped that her limbs would stop shaking. She hadn’t been prepared for such an urgent situation on her first day.
“I’ll get the next few patients lined up,” Tilly said, and returned to the nurses’ station.
“Sounds good.” He stepped out the door with Tilly and after a glance back he paused. “I’ll just wash up first,” he said, and returned to the room.
This was usually the time she collected her thoughts, after the scary stuff was over. A time she could allow herself to mentally go over the situation, make sure she’d done everything she could have and settle her churning stomach.
Miguel cleared his throat and looked at her, then his glance bounced away. “You were fine, Vicky,” he said, startling her. She hadn’t realized that he’d finished and was standing so close to her.
“I always second-guess myself, you know? Did we do everything and do it right?”
“I do know, and that’s good, not bad. Reviewing a situation with a team member is always good to do. Emergencies like that don’t come through the door every day, so it can be a little nerve-racking.”
“I’m just thankful I didn’t forget anything in the middle of it all, you know?” She opened the top drawer of the code cart. “I suppose you have replacement medications somewhere?”
“In the med room. Tilly can show you where.” Vicky stopped and looked up at him. He was a head or