the department. For various reasons, some obvious and some completely obscure, certain symptoms seemed to present themselves en masse. Christmas and New Year were notorious for fights, the dangerous combination of alcohol and distant relatives in close proximity enough of a reason, hips and wrists were top of the list on a frosty morning, and on a wet night you could rest assured a higher proportion of road accidents would be present. And as to the obscure: any night nurse would testify that the slightly mad were barking on a full moon, but chest pains? Why did they all seem to arrive at once?
The handover did take for ever, the world didn’t stop in Emergency as it did on the wards. Ambulances still arrived, unstable patients still demanded vigilant attention, and one by one the entourage of nurses was trimmed down as Jayne allocated them tasks. Finally the rather depleted group, comprising Jayne, Bella, a couple of students and Hannah, were at the end of the resus list. ‘Charles Adams, seventy-four years of age, previous history of hypertension and angina.’ Hannah suppressed a yawn as Bella peered over at the patient lying exhausted on the gurney and attached to various monitors. A woman by his side, dressed in a massive trench coat, held his hand. Bella assumed it must be his wife, watching anxiously as a very tall blond doctor took some blood from the patient’s other arm, chatting away to both of them as he did so. Bella’s interest upped a considerable notch and it had nothing to do with the fact that the doctor was completely and utterly stunning. It was because from the description she’d been given, she realised this must surely be Heath Jameson, the consultant she was investigating.
She was investigating!
Every now and then Bella felt as if everyone must surely know, as if surely there was some massive sign above her head telling everyone the real reason she was here, but for a moment or two Bella realized it had seemed as if the clock had turned back, as if she really was just another nurse on a busy Monday morning listening to handover.
Heath Jameson.
Summoning details to mind, Bella stared apparently nonchalantly as Hannah gave the handover.
Recently divorced, massive custody issues with his ex-wife over the children and a hint of partying rather too hard since being reluctantly made single, though apparently in recent weeks that had all calmed down. With the promotion to Acting Consultant, it would appear that Heath had settled down and decided to concentrate firmly on his patients and career. Certainly, from the way he was chatting to Mrs Adams, he was doing a good job, taking some time to reassure the anxious woman instead of merely rushing off.
‘Charles woke this morning at five a.m. with central chest pain, radiating down his left arm. His wife Celia decided it would be quicker to drive him in than wait for the ambulance!’ Hannah’s raised eyebrows told everyone the unfortunate lack of wisdom behind that decision. Patients with chest pain could collapse very quickly and with no warning—and this, it seemed, had happened to Charles en route to the emergency department. ‘Now, I should warn you at this point, just so that you’re prepared, that there’s no telling Celia what to do. She’s read every article on the internet about her husband’s condition and as I speak is no doubt suggesting to Heath what blood tests he runs. I tried to tell her that next time her husband gets chest pain, assuming that her husband survives this event, she should call an ambulance because next time there might not be a police car travelling behind her. Thankfully, on this occasion the police officers realized she was in trouble and forced her to pull over so they could assist. He went into VF just as the paramedics arrived.’
‘Lucky,’ one of the student nurses commented, and Hannah nodded.
‘Very lucky! The paramedics shocked him once and he reverted to sinus rhythm.’ She gave a small grin. ‘And gave him some IV lignocaine as ordered by Celia! They basically got an IV bung in and scooped and ran, then brought him in, where he’s carried on misbehaving! He was just about to be given some morphine and promptly suffered another VF episode. Heath’s in with him now…’
‘Why aren’t Cardiology in with him?’ Jayne asked. ‘The man’s had two cardiac arrests after all. Surely they should be down here.’
‘Because they’ve had as bad a night as we have,’ Hannah sighed. ‘They’re stuck on ICU with another chest pain who’s had a full, extended arrest and a teenager who took every last one of her grandfather’s heart tablets. Heath is looking after him till they can get here.
‘Problem,’ Hannah said as a rather anxious-looking Trish returned.
‘There’s an ampoule of morphine missing!’
If Bella had felt conspicuous before, she felt as if she were glowing now, scarcely able to believe that after only half an hour in the department drugs were already missing. But her internal excitement was somewhat dampened by Hannah’s response.
‘Damn!’ she cursed, instantly putting her hand up. ‘That was my fault! We wasted the morphine Mr Adams was supposed to have prior to his arrest. Bethany and I signed for it but the patient got restless again as soon as he came round and Heath decided to go ahead and give the morphine but we’d already thrown it out. Bethany and I got a fresh ampoule but we were so busy we didn’t have time to sign for it at the time. She’s off duty now; I can ask Heath—’
‘Who checked the drug?’ Jayne broke in.
‘Bethany and I.’
‘So why would you get Heath to sign for something he didn’t check?’ Jayne’s voice was crisp, her stare direct. ‘Hell, Hannah, you know the trouble the department’s been in with drugs going missing, you know we have to do things by the letter. You’ll have to ring Bethany at home and tell her to come in and sign for it.’
‘But she’s got her driving test,’ Hannah protested.
‘And I’ve got a department to run,’ Jayne clipped back. ‘Now, I’m sorry to do this, Hannah, I know you’ve got the kids to get to school, but before you go off duty I need you to fill out an incident report.’
‘What?” Hannah’s voice was incredulous. ‘It’s a non-event, Jayne. You’re completely overreacting. I really can’t stay. I need to have a couple of hours’ sleep before I bring Ken back here for his outpatients appointment at eleven…’
‘Sorry to interrupt, but could I have a hand in here, ladies?’ A rather snobbish, very deep, very laid-back drawl halted the bickering, and Bella’s eyes widened as she turned around. The reading on the heart monitor that had been blipping along slowly but regularly had reverted to the wiggly line of VF and Heath was laying Charles Adams down before he even passed out, before his wife had even registered that there was something really wrong. As Trish dashed over and led her away, Heath was applying fresh pads to the patient’s chest as Jayne quickly pressed a button to charge up the defibrillator. The machine whirring into action was a sound Bella hadn’t heard for ages, but as instantly memorable as a dentist’s drill.
Heath was supremely calm, an utter contrast to Bella who could feel her heart fluttering almost as much as the patient’s—watching in awe as Heath pulled the paddles out of their trays.
‘Everybody back.’
Another memorable noise, listening as 200 joules were delivered to the patient, watching as his body spasmed, then turning to the monitor.
‘Still VF. Charge to 360 and could someone put out a code?’
On the wards a code would have been called immediately, but events like this were more commonplace in emergency and they had the equipment and expertise to deal with it. Once Charles’s heart had failed to respond, however, it was time to call for the team.
Heath’s hands were on his patient’s chest now, commencing cardiac massage as he called for drugs that would hopefully work on the irritable heart before they shocked him again.
‘Bag him, please, Bella.’ Jayne’s order was sharp and to the point.
Hell, she hadn’t even been shown around the department, but Bella knew that with the RN badge dangling from the cord around her neck she was responsible now, not an undercover cop but an emergency nurse, and a life was on the line.