Dr. Ryan was sitting at the computer, reading through the baby’s progress notes.
You are not a slave to your hormones, she told herself sternly. You need to get over him already!
She forced herself to continue walking, even as she swept her gaze over the area, looking for Debra, the night-shift nurse, who needed to give her the update on how Emma was doing.
“Good morning, Cassandra.”
She blushed, giving him a nod. “Good morning, Dr. Ryan, and, please, call me Cassie.”
There, she’d finally managed to sound casual, as if he were any other physician on staff.
“Only if you call me Ryan. And as you have such a beautiful name, it’s a shame to shorten it.” For a moment she felt her jaw drop in shock and did her best to close her mouth so she didn’t look like a gaping fish. She was relieved when he changed the subject. “Emma’s doing well this morning. I think we’ll try to wean her a bit from the vent.”
Okay, patient care she could handle. She took a deep breath. “That sounds like a good plan. What about nutrition?”
“She hasn’t had any seizures since we started the medication, so it’s probably okay to begin feeding her. As soon as I finish my morning rounds I’ll come back to insert a feeding tube. Maybe you could get the pump set up so everything is ready to go.”
“Of course.” She avoided his direct gaze, not trusting her ability to stay cool, calm and collected.
Had he really called her beautiful? No, he’d called her name beautiful. And that was completely different.
Wasn’t it?
Of course it was.
She pulled out her stethoscope and warmed the diaphragm in the palm of her hand before leaning over to listen to Emma’s heart, lungs and abdomen. As she went through her basic assessment she swore she could feel Dr. Ryan’s piercing gaze on the back of her neck.
Just as she finished her assessment Debra came rushing over. “Sorry I’m late, had to finish feeding Barton.”
“We can start at his bassinet,” Cassie said, hoping her need to escape Dr. Ryan’s overwhelming presence wasn’t too obvious. “I don’t mind.”
“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