Accidental Reunion

‘My intention is to highlight to the staff here the special needs of elderly patients in the accident and emergency department.’ Yvonne’s lilting Scottish accent forced the staff to listen more carefully. ‘Would any of you like to suggest what specific problems they might face during their time here?’

‘Missing out on their regular medication?’ Sue suggested.

‘Excellent. Their GP will have spent a lot of time educating them, insisting that they take their medication at a certain time, stressing the importance of not missing a dose. The elderly patients might suffer with dementia, might be confused, but they know that at six p.m. they have to take their blue tablet—or their insulin, perhaps. Then they come into Emergency and, lo and behold, a nurse tells them that as it isn’t prescribed they can’t have it, and, anyway, missing out on one dose isn’t going to cause a problem. It can take weeks to undo that sort of damage when in truth it could be so easily prevented. Can anyone suggest how?’

‘By getting them seen more quickly, perhaps,’ Lila suggested. ‘Even if not for a full assessment, at least a doctor could write up an interim order for their regular meds, enabling the staff to give them if required.’

She could feel Declan’s eyes on her and couldn’t help a small blush as she spoke. It felt surreal, discussing medical issues with him in the room.

‘Well done. Any other problem that comes to mind?’

Yvonne was looking directly at her now, and Lila had no choice but to make a suggestion. ‘Pressure areas?’

‘Another good point. Unlike the wards, the emergency department doesn’t have a routine as such. Emergency staff are busy dealing with the immediate and in some cases life-threatening problem that has caused the patient to present in the first place. So often elderly people lie on hard trolleys without the very basics of nursing care being addressed. By the time they get to the wards damage has been inflicted upon their frail skin. So what can be done?’

It was Lucy who responded this time. ‘Implement a system of assessing an elderly patient when they come in—if they need pressure area care then make sure it’s carried out regularly.’

‘It wouldn’t work,’ Lila said thoughtfully. ‘Maybe for a couple of weeks, but sooner or later everyone would slip back into the old ways. We could start doing four-hourly pressure area rounds, like on the wards. Anybody needing pressure area care would be treated then.’

‘A fantastic idea. What do you think, Hester?’

Yvonne turned and addressed the unit manager, who gave a thin smile. ‘Worth some thought, I’m sure,’ Hester agreed, though her tone could hardly be described as enthusiastic.

The meeting continued in the same vein. They bounced ideas off each other, trying to come up with solutions to the endless problems nursing threw up, but finally at ten to nine they were done, leaving just enough time to grab a quick coffee before the night shift started.

‘Thanks a bunch,’ Sue said good-naturedly as they picked up their bags. ‘If we don’t have enough work already, now the Horse will have us doing pressure area rounds. I came down to Emergency to escape all that!’

‘Sister Bailey, if I could have a quick word in my office?’ Hester’s voice was hardly friendly, and, forgoing any chance of a coffee, Lila turned and followed her boss down the corridor, closing the door behind her as Hester took a seat at her desk.

Anticipating a ticking off for her gymnastic display, Lila tried to keep her face impassive. Her lateness she could accept being told off for—after all, none of the staff knew the true extent of her mother’s illness. If they had she was sure they would have happily made allowances. However, Lila consistently refused to apologise for having a bit of fun now and then. Heaven knew, the staff worked hard enough in this department—between them they saw enough terrible sights to send even the most stable person searching their soul. Letting off a bit of steam at work did no harm, in Lila’s eyes; in fact, she felt it did a lot of good. It was a point she and Hester would never agree on, and one of the many reasons Lila preferred night duty. Away from the politics of days, away from the bureaucracy and the demands of admin, staff were able to get on with what they were paid to do—nurse.

But for now, at least, the waste of two hospital bandages wasn’t what Hester had on her mind.

‘I’ve been going through the applications for the night associate charge nurse position, and I see you’re not amongst them.’

As she sat down on the chair Lila’s impassive expression slipped for a moment. ‘I thought it would be a waste of time,’ she admitted honestly, after a moment’s silence.

‘Why? Don’t you want the job?’ Hester’s voice was crisp, her stare direct, but, undaunted, Lila looked her directly in the eye.

‘On the contrary, I’d love the position. However, I know that we don’t always see eye to eye on my methods of nursing—’

‘Your nursing methods don’t worry me,’ Hester interrupted. ‘I don’t doubt for a moment that you’re an excellent nurse. If I had any concerns in that area you’d have been gone long ago. What concerns me is your disregard for detail, your casual attitude to the rules, your lateness.’

Which was a backhanded compliment if ever Lila had heard one. Biting back a smart reply, she kept her voice even. ‘Which is why I didn’t apply for the job.’

Hester didn’t answer immediately. Instead, she flicked through the pile of résumés on the desk in front of her. ‘All of these are from external applicants. While I don’t doubt that their credentials are excellent, and while I agree I don’t always see eye to eye with you, Lila, I do think you’re a good nurse. I’m also paid to have foresight, and I can’t see it going down too well with the rest of your colleagues if I employ an outsider for a job you’re effectively already doing.’

Hester had a point there. Since Jane Church had left, more often than not Lila had been in charge of the department, and the rest of the night staff had been pushing endlessly for Lila to apply for the position permanently.

‘Now, I’m certainly not going to hand you such a senior position on a plate, but I definitely would seriously consider you if you decided to go ahead and apply. Who knows? When it’s you handling the stock-ordering and budgets, maybe a measly couple of bandages might take on a greater importance.’

Lila managed a faintly sheepish grin as Hester continued. ‘The applications close tomorrow at five p.m. It’s up to you whether your name’s amongst them. I’d better let you get back to the unit.’

Making her way back to emergency, Lila shook her head in disbelief. Hester suggesting she apply for the position was the last thing she had been expecting. Correction, Lila thought as she rounded the corner and saw Declan standing by the whiteboard, studying the patient list. Declan Haversham strolling back into her life as, of all things, the newly appointed emergency registrar was the last thing. How on earth was she supposed to deal with this?

As she approached the huddle of nurses taking the handover, painfully aware of his eyes on her, Lila took a deep breath. It was going to be a long, long night.

Once the handover was completed, as the nurse in charge it was up to Lila to assign the nurses their various roles for the night. It was quite a complicated task. Assessing the patients who were in the department, along with nurses’ capabilities, was a constantly evolving juggling act.

‘Sue, you take the obs ward, if anyone gets admitted, otherwise stay down in section A with me. For now start shifting some of the patients up to the wards,’ Lila said, writing swiftly on the whiteboard as she did so. ‘Lucy and Amy, you stay in section A with me, and help Sue. We’ll all cover Resus together. Gemma, perhaps you could close section B now and bring the patient list up here. And, girls,’ she added, calling back the dispersing group, ‘remember your para-training.’

‘Will do, Lila.’ Sue grinned. ‘Hey, what did the Horse want?’

‘What do you think she wanted?’ Lila said lightly. She certainly wasn’t about to divulge the real reason for Hester’s little chat. It would be bad enough not getting the job, without every one knowing about it! ‘You do realise I cost the hospital four dollars tonight, teaching you Neanderthals the finer points of gymnastics.’

‘And a real treat it was, too.’ Lila pointedly didn’t look round as Declan came over.

‘I never knew you were such a talented gymnast.’ She could hear the familiar dry humour in his voice, but still she didn’t look. ‘But then what would I know? I never even realised you were a nurse.’

Sue gave them both a quizzical look. ‘I’ll get cubicle four up to the ward, then,’ she said, leaving them to it.

For the longest time they stood there, both pretending to study the whiteboard. It was Declan who finally broke the silence. ‘So you were serious about nursing after all?’

Lila gave a curt nod. ‘It looks that way.’

‘I guess you must have got over your weak stomach?’

‘Not in the slightest.’

He looked up at her wry chuckle. ‘But you work in Emergency!’ His voice was incredulous, but Lila was used to shock when she admitted her weakness. Her response was well rehearsed.

‘Name one person who loves every aspect of their job.’ When he didn’t immediately answer Lila jumped right in. ‘See, you can’t! Emergency isn’t just about blood and gore—that’s just one aspect of it…’

A smile was twitching on his lips, and those smoky dark eyes were crinkling in that endearingly familiar way.

‘What?’ Her voice was defensive, an instinctive reaction to his response. She still read his face so well, almost knew what he was thinking.

‘You’re still as passionate as ever.’ He cleared his throat, as if realising the faux pas he had just committed. ‘I mean…’ His voice trailed off.

Passionate. The word hung in the air between them, conjuring dangerous images of long ago.

Images best forgotten.

Finally he found his voice. ‘How on earth do you cope?’

She swallowed hard. ‘Red cordial helps.’ Her words were light and glib, a deliberate attempt to lighten the increasing tension.

‘Red cordial?’