Chapter 8
Laurel sat in the staff parking lot and willed her heart to stop pounding. Though the sun shone bright in a nearly cloudless sky, she felt cold and scared. The only time she had felt this kind of anxiety had been during her second IHRM assignment when rebels had surrounded the medical station. She gulped a deep breath and left the car.
This is Eastlake Community Hospital, not a station in a war-torn country. But she wondered if she would face the same belligerent hostility from the doctors and the nurses here. She strode across the parking lot. I should be used to being the new kid. That position was the story of her life.
The sliding doors whished open. The security guard looked up and then nodded. Laurel smiled. The familiar aroma of disinfectants and medicines made her feel at home. Six thirty. Though her shift began at seven, she needed the extra time to find her locker, a cup of coffee and to orient herself to the department. She opened the lounge door and stepped inside.
Mary Karnes sat at the round table in the center of the square room. She cradled a mug. “Ms. Richmond, you’re early.”
“Good morning.” Laurel swallowed. The hostile glare in the woman’s dark eyes made her shiver. “I wanted to find my way around.”
“Why? You’ll be stationed in the waiting room.”
“If there are no patients to be triaged, I don’t plan to sit around. I’m used to a hectic pace.”
“Don’t step on my toes. I’ve been nurse manager for three years and I don’t intend to lose my job to anyone. Having Mr. Bradshaw’s approval doesn’t make you a good nurse.”
Laurel walked to the credenza. “I have no intention of going for your job or your throat. I was hired for triage and my experience in dealing with major disasters.”
Mary Karnes’ lip curled. “Everyone knows you were hired because you’re a Grantley grad and part of Megan Carter’s clique. I hear another one is coming to cut out a deserving nurse who has worked here for years. We function very well without a triage nurse.”
Laurel poured a cup of coffee. She held back an urge to mention the mishandled cases she’d heard about on Saturday. “Instead of feeling threatened, why don’t you wait to see how effective I am at the job?”
“If you ask me, but no one does, the job should have been given to one of my experienced ER nurses. Who knows what you’ve been doing since you graduated from Grantley.”
Laurel snapped. “Nothing much. My assignments included epidemics and disasters, both natural and otherwise.” She strode to the door. Coffee splashed from the cup and stung her hand.
“You’re wasting your skills here. Why settle for a small town hospital when you had the world?” Mary laughed. “Indeed, why work at all when you can whip off a check and buy a car and a house?”
Laurel swallowed. Once more, her money had cast her in a negative light.
The door opened. Three nurses entered. One, a petite black woman smiled and held out her hand. “You must be Laurel Richmond. I’m Simone Gray and your first trainee. Welcome. When do I start?”
Laurel shifted the coffee cup and shook hands. “Give me a week or two to set the system up and discover the usual flow of patients.” She turned to the other two women. One walked away.
The other hesitated and then spoke her name in a low voice. “Bette Norris.”
Laurel left the lounge and walked to the ED waiting room. A man dozed in one of the gray plastic chairs. Laurel stopped to read the sign above the glass-walled admissions desk. 1. You will be seen in the order in which you arrive. 2. Report to the admissions clerk. 3. After you provide her with the necessary information, you will be given a number. 4. Wait until your number is called. 5. There are no exceptions.
She shook her head. Talk about public relations. Once the triage system went into effect on all three shifts, that sign had to go. She surveyed the room but couldn’t find the table and equipment she’d requested. All right, Mary Karnes, she thought. She headed toward the doors to the examining and treatment rooms.
“Miss Richmond.” The blonde seated behind the glass enclosure motioned to Laurel. “Hi, I’m Trudy Greene, admissions clerk. Boy, am I ever glad to see you.”
“Thanks. I’m glad someone is.”
The blonde leaned forward. “It’s like this. Mary is upset because they hired you. She thinks they’re punishing her for the two patients who nearly died because I’m not qualified to evaluate conditions. I was on the carpet for them, but I’m not a nurse, so how was I supposed to know?”
“You’re not,” Laurel said. “Do you have any idea when my table and equipment are going to arrive?”
“They set the station up on Friday but Mary had it dismantled so as not to confuse the patients over the weekend. I’ll call maintenance for you. Mary should have done that when you came in.”
Laurel wasn’t prepared for another confrontation with the nurse manager. “Do that. I’ll run to my car for my own equipment.”
When she returned, a table and two chairs had been placed in the alcove just beyond the door. A hand-lettered sign taped to the wall informed all patients to report to the triage nurse.
The door opened. Laurel looked up and caught her lower lip between her teeth. Alex strode in. “Hi.” He handed her a vase filled with carnations. “For your first day.”
She touched one of the flowers. “Thank you. You don’t know how much this means to me.”
“Rough start.”
“Sort of.”
She wished she understood the meaning of the look in his eyes. The same expression had been there every time she caught his eye Saturday night. Her body burned with awareness.
He brushed her hand, sending waves of desire deeper. “See you soon. Good luck.”
“Thanks.”
For several minutes after Alex left, Laurel studied the flowers. What was happening? Though she knew the answer she wanted, she refused to allow herself to fall into a fantasy. She headed into the examining area. A young woman with red hair and the nurse who had ignored Laurel in the lounge sat at the counter. Laurel caught the clerk’s eye. “I’m Laurel Richmond. I’ll need some charts.”
“Here.” The clerk cracked her gum. “Trish. Let me know when you need more.”
As Laurel put the charts on her table, the outer door opened. A young woman carrying a baby rushed in. “My baby isn’t breathing right.” The child screamed and coughed.
Laurel took the infant from the mother. “Go check in with the clerk while I examine the baby. What’s her name?”
“Nancy.”
Laurel pulled up the baby’s shirt. She listened to the infant’s chest and evaluated the child’s respiratory status. Then she took the child’s temperature and checked her throat and ears. When the mother returned, Laurel asked several questions and noted the answers on the chart. “Do you have a pediatrician?”
The mother shook her head. “We go to the clinic and there’s a different doctor every time. It’s only open on Thursday.”
Laurel rose and carried the baby inside. Simone Gray emerged from a curtained cubicle. “Back again. Hi, Nancy.” She took the child and the chart.
Laurel returned to the waiting room. Eric’s idea for an outpatient clinic staffed by nurse practitioners might be an invaluable service to the community.
A short time later, a well-dressed man pushed through the doors. He pulled a boy who seemed to be a little older than Johnny behind him. “My son has a nose bleed and I can’t stop it.”
Laurel opened a wheelchair and asked the boy to sit. She pulled an instant cold pack from her bag and broke the seal. “What’s your name?”
“Rob.”
“Hold this on your nose.” She studied the boy’s face and didn’t like the redness and swelling around his right eye. “How did this happen?” she asked.
The boy opened his mouth. Before he spoke, the father answered. “He was horsing around instead of getting ready for school. He tripped.”
Something about the way the boy’s shoulders stiffened alerted Laurel. “Does he have a lot of accidents?”
“Just what are you inferring? For your information, I’m the new assistant district attorney, Paul Sobekel.” He scowled.
“We need this information to rule out a number of conditions that can contribute to clumsiness. Who is your son’s doctor?”
“He’s in the city. My wife...she didn’t want to change doctors when we moved here.”
Laurel nodded. “I’ll take Rob in to be examined while you give the information to the clerk.” She hit the button to open the doors and pushed the wheelchair inside. “How old are you, Rob?”
“Seven.”
At the desk, Laurel signaled to Bette Norris. “This is Rob Sobekel. He’s seven and has a nose bleed and a swelled right eye. Pediatrician’s in the city. Do a thorough body check and note your findings.”
“Do you think...” Bette slapped her hand over her mouth.
“We can’t afford to take the chance, can we?” Laurel wrote her observations on the chart and handed it to Bette. “I’ll talk to the father.” She smiled at Rob. “I’ll send your father back soon.”
“Okay.”
Mary Karnes grabbed Laurel’s arm and pulled her down the hall. “Don’t look for trouble. Do you know who the father is? Bette, I’ll take over.”
Laurel sucked in a breath. “Just remember, a child could be in jeopardy.”
“Don’t tell me how to do my job.”
Laurel left and caught Mr. Sobekel just as he finished at the admissions desk. “Rob is being seen by the ED doctor. You can go back in a few minutes. I need some information for his chart.”
She asked the routine questions about medications, allergies and known medical conditions. “Did you see the accident?”
He shook his head. “I was in my study when I heard my wife screaming at Rob.”
“Has he been treated here before?”
“I don’t know. I’m not home much. Susan usually handles these things.” He shook his head. “I brought him this morning because he didn’t want to come with her.”
Laurel rose. “Thanks. I’ll show you where he is.”
A steady stream of patients moved through the ED. At three, Laurel packed her bag, cleared the table and took down the sign.
Trudy motioned to her. “Congrats. Twenty minutes waiting time. On Friday, it was forty-five. Word is going to spread about our improved service.
*****
On Thursday, the newly placed phone on Laurel’s desk rang. “Triage, Miss Richmond.”
“State Trooper Perry. Three ambulances on the way. Six patients. Van accident. ETA fifteen to twenty minutes.”
“Injuries?”
“Cuts, possible fractures. Multiple injuries.”
“Thanks.” Laurel hung up and stopped at Trudy’s desk. “Call me if anyone comes in. Three ambulances on the way. Six patients.” Moments later, she repeated her information to Mary Karnes. “I’ll help you set up. You might want to let the Nursing Office know and find out what nurses can be pulled from other units.”
Mary Karnes made a face. “Good thought. We’re down one today. Trish, call the Nursing Office.” She turned to Laurel. “How bad?”
“Multiple injuries.” Laurel grabbed Simone Gray. “We need to set up for six motor vehicle victims.” She reeled off a list of supplies that should be available in each cubicle.
Just before the ambulances arrived, Mary Karnes called Laurel over. “You were right about the Sobekel boy.”
“What’s being done?”
“Social Service is involved. Mr. Sobekel was shocked to see the list of healed injuries.”
A siren wailed. “See you.” Laurel hit the doors and stepped into the outer hall. She took report from the ambulance attendants and directed the stretchers to the various cubicles.
“Any doctor in the house report to the ED immediately.” The announcement blared over the speakers.
Jenessa hurried past. “Where do you want me?”
“Check with Mary.”
Eric and two of the supervisors arrived. Eric grabbed the end of one of the stretchers. “Having fun?” he asked. “Challenge number two.”
“Four,” she said.
When the last of the ambulances arrived, Laurel returned to the triage desk. Fortunately only one patient had arrived during the time she’d been absent. The woman wanted to be seen by her doctor. Laurel called his office.
She was about to return to the treatment area when the doors opened. Bob Karnes walked to her desk. “My chest.” His skin bore a gray pallor. Sweat covered his forehead. Remembering what Alex had said about the man’s blood pressure, she opened a wheelchair. “Sit. I’ll take you right in.” She stopped at the admissions desk. “Trudy, call Dr. Alex Carter. Tell him Bob Karnes is here and complains of chest pain.”
Laurel pushed the wheelchair around the portable X-ray machine, waved to the lab technician and found a vacant cubicle and a monitor.
“What happened?” Bob Karnes asked.
“An accident.” Laurel helped him onto a stretcher and attached the EKG leads. She found a nasal cannula, helped Bob Karnes fit it into place and started the oxygen flowing. She was relieved when some color returned to his face.
“Tell me about the pain. When did it start? Is it sharp or dull? Was it sudden or gradual?”
“Sharp. Sudden. Like a knife.”
“Miss Richmond, Dr. Carter’s on the line,” the unit clerk said.
Laurel checked the cardiac readout and went to the phone.”
“Dr. Carter, about Mr. Karnes.”
“What’s going on?”
“Sudden onset of sharp chest pain, dyspnea relieved by nasal oxygen, EKG strip shows tachycardia.”
Alex rattled off a series of orders that Laurel jotted on the chart. “I’m on my way,” he said.
She handed the order sheet to the unit clerk. “Patient’s Bob Karnes. Grab the lab tech and have her draw the blood stat. Call respiratory for blood gases. Dr. Carter’s on the way.”
She heard a gasp and turned to see Mary Karnes. “What’s wrong with Bob?”
“Chest pain. Tachycardia.” Laurel bit her tongue before she voiced her suspicions that this was more likely a pulmonary emboli than a heart attack.
The nurse manager slumped against the desk. “I don’t think I can handle this.”
“Why don’t you sit with Bob until Dr. Carter arrives. After I start an IV, I’ll check on the progress of the accident cases.”
Mary’s grateful smile spoke volumes and gave Laurel the hope that she and the nurse manager would be able to solve their differences. Laurel strode across the hall and started the intravenous. She exited the cubicle and went to check the waiting room and then to make sure the accident cases were being handled smoothly.
She moved from one treatment area to another. In one cubicle, she stepped in to assist the surgeon while Simone went for supplies. Laurel had just stepped into the hall when she saw Alex walking toward her.
“Thanks for your quick action.” He took her hand. “With the accident and all, Bob might have sat in the waiting room for hours.”
The warmth of his touch encompassed her. She looked up and saw something in his eyes that brought all her hopes welling to the surface. With a soft sigh, she pulled her thoughts from dreams. “How is Mr. Karnes?”
“On his way to ICU. Pulmonary emboli.”
She nodded. “That was my first choice.”
“Have you considered becoming a practitioner?”
“I have the information from Grantley.” She moved away. “I have to get back to my station.”
“And I have a full office waiting for me.” He held the door for her. “Would you have dinner with me tomorrow night?”
She turned. “I have a date. Johnny called yesterday and asked me to come for dinner.”
He frowned. “I didn’t...I meant...Just the two of us. What about Saturday night?”
“If we make it an early evening. I work Sunday.”
“We’ll plan the details tomorrow.” He walked to the door. “See you.”
Laurel watched him walk away. She refused to allow her hopes to soar.
*****
When Alex returned to his office, he found a log jam of patients waiting to be seen. Though he wanted to call the Cove and make reservations for Saturday night, Laurel hadn’t agreed to go. He pulled himself from thoughts of filling her amber eyes with joy and plunging his hands through her sun-streaked brown hair. Later, he thought. After he saw his last patient and left the office, he would make the reservations. He inhaled and thought he smelled jasmine.
Finally, his nurse handed him three charts. “These are the last. Your son called earlier.”
Panic gripped him. “Why didn’t you let me know?”
She stepped back. “Hey, you were with a patient.”
Alex reached for the phone and called home. “Sarah, is Johnny all right?”
“Excited. Brady called and asked if Johnny wanted to go to Mountain Park with them Saturday. I told him you’d call back.”
Alex frowned. He hated to disappoint his son, but he had planned a special evening with Laurel. Courting was impossible with a child in tow. “See you later.” He hung up and went to see a patient.
*****
On Friday, Laurel left the hospital feeling like she’d won a war. Though she and Mary Karnes would never be pals, they would be able to work as a team to improve the reputation of the Emergency Department. This afternoon, she had earned a grudging compliment from Johnny’s pediatrician and a lavish one from Alex. She smiled. Perhaps he’d begin to see her as a person rather than a walking bank account.
At home, she showered and changed into jeans and a bright green tee shirt. Then she headed to Alex’s house.
Johnny ran across the lawn. “I knew you would come early. Mrs. Rodgers thinks you would wait for Daddy.”
“And miss the chance to spend some time alone with you?” She ruffled his hair. “I’ve missed you.”
“Then come and live here.”
She smiled. “I have my own house now. Let’s ask your father when you can come and sleep over.”
“Tonight?”
“What about next Friday?”
“Okay.” He tugged on her hand. “Come and see what Daddy buy me. Want to go to Mountain Park with me and Daddy tomorrow?”
Laurel frowned. Had Alex changed his mind about dinner? Johnny skipped ahead of her to the house. She marveled at the changes in him since she’d come to stay. Though she wanted to believe she was responsible, the real reasons were time and security. She entered the family room and saw Johnny perched on the back of a huge pillow shaped like an elephant.
He laughed. “Neato, right. Don’t need one of those howdy things to ride him.”
“He’s terrific. Does he have a name?”
“Saggy. Like the one in your story.”
Laurel moved to the door. “Let me tell Sarah I’m here.”
“Then we can play on the swings and wait for Daddy. Maybe he’ll be happy now. He’s sad a lot since you go.”
Laurel gulped a breath. She couldn’t afford to build another fantasy. Dreams led to heartbreak.
A short time later, she pushed Johnny on the swing. A sleek gray car drove slowly past. When the car returned and once more crawled past, Laurel frowned. Was it Alex’s father-in-law?
At five fifteen, Alex’s car pulled into the driveway. Johnny ran across the lawn. Alex scooped him into his arms. Laurel started toward the laughing pair. The gray car appeared. She shaded her eyes. Though she tried, tinted glass kept her from identifying the driver.
“Is something wrong?” Alex asked.
“That’s the second time I’ve seen that gray car this afternoon.”
“Damn,” Alex whispered.
“Daddy, that’s naughty.”
“What is it?” Laurel asked.
“I’ll tell you later.” He hoisted Johnny to his shoulders. “Right now, I’m starved.”
Laurel tucked her curiosity away and followed them to the house. How much had Alex told the Rodgers? Was it safe for Johnny to play outside alone?
After dinner, she and Alex played a board game with Johnny. Laurel watched Alex’s strategy to lose and silently applauded.
After the third game, Alex rose. “Time for bed.”
Johnny reached for Laurel’s hand. “Will you tell me a story?”
She looked at Alex. He nodded. “Which one?”
“Saggy Elephant for mine.”
When she finished the story, Johnny threw his arms around her. “I love you.”
“And I love you.”
“Will you be here when I wake up?”
“Not this time. Next Friday, I’ll come for you after I finish work. We’ll have supper at the Hot Doggery and then come back for popcorn and a video.”
“And ice cream?”
“Why not?” She ruffled his hair and retreated into the hall while Alex said his good nights.
Several minutes later, he joined her. “Let’s take a walk.”
“I’d like that.” As she and Alex walked downstairs, she asked about the gray car.
“Richard Cooper.”
“How much have you told the Rodgers?”
He opened the front door and stepped outside. “Not much.”
“Is that wise? They’re with Johnny every day.”
“Sarah knows not to let Johnny go off with anyone, even Dad or Megan without checking with me first. That’s always been the rule.”
A gentle breeze stirred the air and carried the scent of roses. Laurel entered the gazebo and stood looking toward the woods.
Alex sat on one of the benches. “Brady obtained a restraining order that forbids Richard from coming on my property or approaching Johnny except in my company.”
“Will he obey the order?” Laurel sat across from him.
“Since he believes rules are for others, I doubt it.” He pressed his hands against his thighs. “He’s threatened to hide Johnny so I can’t find him. He has enough wealth to do just that.”
Laurel started to speak, but closed her mouth. She could offer Alex enough money to keep Johnny safe, but he wouldn’t accept such a gift from her. “If I can help, let me know.”
He clasped her hands. “Thanks.”
For a time, they sat in silence. Laurel’s body thrummed with awareness of Alex. She breathed deeply. The aromas of the night blended with Alex’s scent. Before she made a fool of herself, she had to leave. “I’d better go.”
“I’ll walk you to the car.” He retained his hold on her hand. “Do you mind going to the amusement park instead of a quiet dinner for two?”
She laughed. “We’ll have fun. It’ll be a new experience for me.”
He put his arm around her shoulders. Their strides matched. Laurel remembered her first night here and the first searing kiss. Would there be a repeat performance? At the car, he kissed her lightly, yet she felt a searing promise. “Tomorrow at eight,” he said.
“I’ll be ready.” She started the car and drove home. She would find a way to help Alex solve the problem with Richard Cooper. If necessary, she would use all her assets to protect Johnny and Alex.