The Baby Emergency

‘Then you’re better off without him.’

Shelly looked up with a start. There was no pity in his voice or in his gorgeous blue eyes, just the cool sound of reason.

‘So everyone keeps telling me,’ Shelly sighed. ‘And they’re all probably right. But is it better for Matthew? Surely he needs a father?’

‘Not that sort,’ Ross said quickly, his voice strangely flip, a defiant jut to his chin. Suddenly he looked older than twenty-seven. He certainly didn’t look like the carefree backpacker she’d built in her mind. He looked every bit the man he was. ‘Children need to feel loved, safe and wanted, which are the three things Neil can’t give him, so if you ask me, Matthew’s better off without him. You, too, so I’m not going to make small-talk, passing on my condolences about the demise of your marriage when your divorce obviously agrees with you. You look the happiest I’ve seen you in a long time.’

‘I am,’ Shelly said slowly, the words a revelation even to herself. The divorce had hurt, but her grief had been expended long ago. The tears she cried now when she thought about the end of her marriage weren’t for herself and what she’d lost but for her little boy, a two-year-old child whose father simply didn’t want to know. Yet for all the angst, for all the struggle, both financially and emotionally, for all the responsibility of being a single parent, for the first time in over two years Shelly actually realised just how much she had moved on.

That she was finally making it.

Not happy exactly, but definitely getting there.

As Melissa stood up Shelly picked up her notepad. ‘I’d better go and get the handover. I’ll catch up with you later.’

‘No doubt about that.’

Her cheeks were burning as she took handover, her mind flitting as she desperately tried to concentrate, tried to ask intelligent questions and make sure she had all the drip rates and drugs due diligently written down in her usual neat handwriting as Annie, the sister in charge of the late shift, told the night staff about the patients on the ward. But there was no chance of that. Her mind was saturated with Ross, going over and over their brief but long-awaited exchange. Still, when Annie gave the details of the latest admission, Shelly’s ears pricked up and all thought of Ross flew out of the window, momentarily at least.

‘We’ve got a new patient direct from Theatre—Angus Marshall, twenty months old with a spiral fracture of the femur.’

Shelly’s eyes shot up as Annie continued. A spiral fracture in a child was an injury that sounded alarm bells and Shelly’s were ringing, but Annie quickly shook her head to dispel any worries.

‘The staff in Emergency are happy with the story—they don’t think it’s a non-accidental injury. Apparently he’s just started walking so the injury could have happened when he fell.’

‘Could have?’ Shelly questioned, knowing that injuries like that were sometimes caused by an abusive parent.

‘They’re not sure how it happened, there’s a big sister and a new baby at home so it’s obviously a busy house. Apparently Angus was very grouchy and reluctant to weight-bear and his mum noticed the swelling so she took him to their GP who sent them over to us. They’re nice people, the child’s beautifully looked after.’

‘That doesn’t mean anything.’ Melissa’s stern voice matched Shelly’s thoughts exactly.

‘I’m going on what I’ve been told. They’ve been interviewed extensively by Dr Khan down in Emergency and he’s satisfied that it was a simple accident, so it’s not up to us to go jumping to conclusions.’

‘Nobody’s jumping,’ Shelly said in a calm voice, trying to diffuse the undercurrents. ‘But with an injury like that, child abuse has to be considered.’

‘Which it has been,’ Annie answered stiffly. ‘And it’s been discounted.’

‘So, how many beds does that leave us with?’ Shelly asked when she realised the discussion was going nowhere.

‘One bed and two cots,’ Annie said, closing the folder she was reading from. ‘But Emergency just rang and they’re probably going to be sending up a three-month-old boy with bronchiolitis, which will leave you with just the one cot.’

‘Probably?’ Shelly checked.

‘He’s quite sick, they’re still deciding whether or not to transfer him to the Children’s Hospital in case he needs an ICU cot as our intensive-care beds are all taken. Ross is just heading off down there to see him.’

‘Well, I hope Ross takes into account there’s only three night staff on and Nicola’s only a grad,’ Melissa said with a warning note to her voice that had Annie again ducking for cover. Melissa was a straight talker and didn’t care who got hurt along the way. Feelings didn’t come in to it when she was dealing with her beloved babies. ‘It’s not like on days where staff are falling over themselves. One critical baby is bad enough but there’s a couple more here that could go downhill quickly.’

‘Ross knows all that,’ Annie said defensively. ‘But this baby has been down in Emergency for eighteen hours now, and there’s hardly a paediatric intensive care cot left in Melbourne, so someone’s going to have to take him. Anyway, Emergency just had a big multi-trauma come in and they need to start moving some of the patients.’

‘Well, maybe you should have thought of that earlier,’ Melissa carried on, without even blinking. ‘You know as well as I do that we’re going to get this baby. He should have been admitted and settled by now while there were enough staff to do it comfortably, not left till Emergency’s bursting at the seams and there’s no choice but to move him.’ And without another word she headed out onto the ward, leaving the rest of the staff chewing their lips and rolling their eyes.

‘Good luck with her tonight,’ Annie said with a grimace. ‘She’s in a right old mood.’

‘I don’t blame her,’ Shelly said quickly, and to the other staff’s obvious surprise. ‘That baby should have been admitted ages ago, not just left for the night staff.’

Minor bickers like this were uncomfortable but commonplace on a busy ward. Even though Shelly hadn’t done a stint on nights for ages she knew how busy it was, and also knew that as much fun as Annie was to work with she was also very good at putting things off for the next shift to deal with. Melissa had been right to say something and Shelly was only too happy in this instance to defend her. As the day staff departed Shelly gave a comforting smile to a nervous-looking Nicola.

‘When Melissa said you were “only a grad” she wasn’t aiming it at you personally, just pointing out the staff levels,’ Shelly said, moving straight to the point.

‘I know that. It’s just that she seems so fierce. I know I haven’t worked with Melissa but I’ve seen her in handover and it’s enough to put anyone off. I’ve been dreading coming on nights.’

‘You haven’t worked with Melissa yet,’ Shelly pointed out. ‘You’ve only seen her in here. She’s nothing like that out there.’ Shelly gestured to the ward and gave Shelly a reassuring smile. ‘Any bad feeling stays in the handover room, that’s an important rule on the children’s ward. The patients pick up on bad vibes otherwise. Anyway Melissa’s as soft as butter really. Once the day staff are gone you’ll see that for yourself. As fierce as she can be, Melissa’s also the best nurse here, you can learn a lot from her. There’s nothing about sick children Melissa doesn’t know. She’s been doing this job for more than thirty years now, so if there’s anything you’re worried about don’t sit on it, just tell her, OK?’

‘OK.’ Nicola nodded but Shelly could see the poor girl was still terrified.

‘It will be fine, you’ll see.’

It was fine. The obs and drug round went smoothly. Even the raucous older children, some bored from weeks in traction, seemed fairly settled, exhausted from too many visitors and computer games and a day spent good-naturedly teasing the nurses.

Melissa was in charge so she worked both sides, overseeing all the patients and keeping a watchful eye on Nicola as she settled the children and did the late round. Shelly took the cots, which consisted of eight airy rooms all surrounded by glass, which meant at any given time she had an uninterrupted view of her patients but they were all effectively isolated so as not to spread any infections. Six were occupied and Shelly checked each child carefully, smiling to herself as she did so, taking in the little bottoms sticking up in the air, thumbs tucked into mouths, the babies sleeping on blissfully as Shelly watched over them. A couple of the cheekier babies had extensions on their cots to stop them climbing out, but for now they all looked like cute little angels.

Angus was sleeping and Shelly roused him gently, carefully checking his observations and the little toes sticking out of the damp plaster, making sure the circulation to his foot was adequate. Annie was right, Shelly thought as she flicked on the cot light and checked him more closely, Angus was beautifully kept—his little nails short and clean, his hair soft and shiny, no rashes or bruises, nothing to indicate he was anything other than loved and cherished.

‘Is he all right?’ Mrs Marshall’s anxious face appeared at the end of the cot. ‘I was just getting a coffee.’

‘He’s fine,’ Shelly reassured her. ‘He’ll probably sleep soundly for the next couple of hours. He was given a strong painkiller so he’s quite comfortable. Would you like me to get you a camp bed? We can set it up beside the cot.’

Mrs Marshall shook her head. ‘Thanks, but no. The day nurse, Annie I think her name was, already offered, but I’m going to go home. I’ve got the other two to sort out and it’s been an exhausting day.’

‘I’m sure it has. We can always ring you if there are any problems, if he gets too distressed,’ Shelly said.

‘Of course.’ Mrs Marshall gave a tired smile. ‘But he normally sleeps right through.’ The mobile telephone ringing in her bag made them both jump and Shelly waited patiently as Mrs Marshall took the call.

‘That was my husband, Doug. He’s come to pick me up.’ Walking over to her son, she gave him a tender kiss and stroked his little lock of hair. Shelly knew she should mention that mobiles were supposed to be turned off on the ward, given her little lecture about the interference they could cause with the equipment, but she didn’t. Trying to put herself in Mrs Marshall’s place for a moment, she figured it could wait for the morning.

Shelly had always been a quick worker and was grateful for the chance to make up a few bottles for when the babies inevitably awoke and to prepare some jugs of boiled water and change the sterilising solutions. Happy she was on top of things, Shelly set up an oxygen tent for the inevitable new admission and prepared the sterilising equipment and nurses’ gowns along with some literature on bronchiolitis for the undoubtedly anxious parents.

‘How’s it going?’ Melissa popped her head in the darkened room and smiled as she saw Shelly setting up the room. ‘Finally, someone who doesn’t have to be told! How are they all?’

‘Settled. I’ve put the new admission in here so it’s nearer the nurses’ station, but cot six needs an eye kept on—she’s still a bit wheezy even after her nebuliser. Cots two and four are due for a feed at eleven so I’ve left their obs till then. Their mums aren’t staying, so if they wake up at the same time I might need you or Nicola to feed one of them—their bottles are all ready.’

‘Good.’

‘How’s Angus?’

‘Fine.’

‘And the mother?’