Emergency: A Marriage Worth Keeping

Had.

CHAPTER THREE (#u7969a1a8-fb96-50e0-8f17-742f38a13702)

‘THIS is Isla Ramirez,’ Jayne Davies, the charge nurse who had interviewed her, introduced a blushing Isla to the rest of the early shift. ‘And before you ask, yes, she is related to the great man himself. This is, in fact, Sav’s wife. No doubt some of you have already met her at some of Emergency’s dos.’

The rather vague interest in the new nurse upped a notch then, and Isla blushed even more as not only did the gathered throng of nurses stare rather more closely but a couple of doctors, who were writing their notes at the nurses’ station, looked up, clearly interested to see what the woman behind the great man looked like.

‘Anyway, I’m sure Isla doesn’t want her marital status to interfere with anything, so now we’ve got that bit of gossip out of the way, we’ll let Hannah get started on the handover.’

It might not have been the most sensitive of introductions, but it was probably the most sensible.

Over and done with.

Yes, she was Sav’s wife, but here she was just another nurse and that was exactly the way Isla wanted it.

The handover was fairly short, as the department was practically empty. Unlike the wards, where Isla had done the occasional shift over the last few years, an emergency room handover didn’t involve sitting in an office with a mug of coffee, writing down every patient’s ailment and treatment, because Emergency was a constantly evolving process so most of the handover was spent staring at the massive whiteboard which Hannah updated as she spoke, wiping out names or adding various treatments a doctor had ordered.

‘The waiting room just has a few people in it, mostly waiting for X-Ray to open. B-bay only has two patients. Mrs Ivy Dullard, 82 years of age, fell at home yesterday onto the coffee table and lay on the floor for approximately eight hours until her neighbour stopped by. She arrived in the department at 10 p.m. last night. A cantankerous old girl.’ Hannah grinned. ‘Thinks we’re all out to steal her savings or rob her of her “last shred of dignity”—Mrs Dullard’s words, not mine. Anyway, our main concern was her acute abdomen, but she’s had a CT and that shows a small splenic haematoma, which the surgeons just want to observe.’

‘In English for the students, please,’ Jayne broke in.

‘Sorry.’ Hannah grinned again. ‘Mrs Dullard has a small collection of blood on her spleen and possibly a small tear. There is a chance that could extend, which would mean she’d need surgery, but at this stage she’ll be observed.’

‘Thanks.’ Jayne nodded. ‘What else?’

‘Her other major problem on arrival was a shortened, externally rotated left leg. X-rays confirmed that she’d sustained a fractured neck of femur. She’s nil by mouth on a six-hourly IV, we’ve given her morphine for pain, but she’s still a bit agitated. We’re hoping to get her up to Theatre soon….’

‘How soon?’ Jayne asked perceptively. ‘She’s already been here over nine hours now. She should be waiting on the ward, where she’d be more comfortable.’

‘There isn’t…’ Hannah started, giving a rueful smile as the whole entourage chimed in with the final two words—‘a bed’.

‘Fair enough.’ Jayne shook her head. ‘But let’s hope that Theatre rings down soon. You know how Sav feels about the emergency department being used as a holding bay. What are the Orthos doing now?’

‘They’ve been operating through the night. We had two multiple injuries from a traffic accident last night. To be honest, I wouldn’t be surprised if they wait for the next shift to perform Mrs Dullard’s op. One other thing. She had a blood alcohol reading of nought point three when she came in, which isn’t much, but given she’d been on the floor for quite some time, no doubt alcohol was a contributing factor to the fall. Still, she’s fairly settled now, hopefully she’ll be off to the ward soon.’

‘Any relatives?’ Isla asked automatically, and then snapped her mouth closed. But no one seemed remotely bothered by her assertion. In fact, Hannah gave a grateful nod.

‘Good point. Sorry. Just the neighbour. She came in with Ivy and seemed very concerned, but Ivy made it very clear that we weren’t to give her any information and sent her packing within the hour.

‘Anyway, moving on. In Resus we’ve got Mr Jack Campbell, forty-six-year-old with central chest pain. No previous history. Ross Bowden, who’s on for Cardiology, is looking at him now. He’s had some morphine and Maxalon and for now at least he seems pretty comfortable—and that’s your happy family.’

Isla stood uncomfortably as Jayne allocated the staff to their various areas before turning her attention to the newest recruit.

‘Feeling nervous?’

‘Surprisingly, no.’ Isla grinned. ‘And considering how terrified I was this morning, it’s hard to believe. Now I’m here, it feels as if I’ve never been away. There’s still the age-old problem of finding beds and theatre space…’

‘You did a fair bit of emergency work, didn’t you?’

Isla nodded. ‘I did my grad year in emergency, and then I did the advanced trauma course at the trauma centre. Not that I’ve put it to much use. I fell pregnant midway through it.’

‘With the twins?’ Jayne smiled. ‘So you’ve been away from nursing for seven years.’

‘A long seven years,’ Isla admitted. ‘I’ve been on the wards occasionally, but I haven’t set foot in Emergency in all that time. I struggle to keep up with the television shows sometimes.’

‘You’ll be fine.’ Jayne laughed. ‘There’s new equipment, new drugs, new treatments and more politics, of course, but the patients are pretty much the same. You’ll soon be back in the swing of things.’

‘I hope so.’

‘So what made you decide to come back?’

Isla gave a small shrug, consoling herself that for the most part she was talking the truth. She was hardly in a position to tell Jayne the real reason for her return. ‘I’ve always loved emergency nursing, I’ve always missed it, and now the boys are at school it seemed like a good time.’

‘It’s a great time.’ Jayne gave her a wide-eyed look. ‘Believe me, an emergency nurse with your skills, however much they need updating, is more than welcome here. Now, how do you want to play this, Isla? A gentle start in the clinics or straight in the deep end out here with me?’

Isla hesitated, but only for a second. ‘The deep end sounds good.’

‘Great.’ Jayne gave an appreciative nod. ‘That’s the best way, in my opinion. Kerry’s in Resus today. If anything good comes in, you’re more than welcome to go in and watch.’

Isla nodded, even managed a wry smile at Jayne’s choice of words. ‘Good’ to an emergency nurse meant dramatic, gory or life-threatening—preferably all three.

‘Now, a quick run-down of the doctors on this morning. Garth’s the intern, new, eager, hasn’t a clue, but doesn’t mind being told. Heath’s the registrar, thinks he knows everything.’ Jayne rolled her eyes, and Isla did the same. ‘In fairness, he’s pretty on the ball, just doesn’t like to be told…’ Her voice petered out and Isla understood why as a rather good-looking blond man waltzed past and gave a brief wave. ‘Morning, Heath!’ Jayne called, and Isla’s forehead furrowed as she tried to place his vaguely familiar face.

‘He looks familiar. I must have seen him when I’ve called in to see Sav.’

‘No doubt you’ve heard about him,’ Jayne added in a low whisper, and Isla gave a small nod. ‘Still, it seems to have all settled down, but just bear history in mind, especially when Heath finds out that you’re Sav’s wife. Which brings me to the man himself. I’m sure you don’t need to be told what a great guy he is—on the ball, easygoing, great to work with…’

‘The real version, please, Jayne.’ Isla grinned. ‘I’m not his wife here, remember?’

‘I’m giving you the real version,’ Jayne replied, oblivious to the small frown starting to pucker Isla’s brow. ‘Of course he can let rip with that gorgeous Latin temper every once in a while if things aren’t moving along as they should be, but he’s such a honey, we all forgive him.

‘Right, I’m going to ring Theatre and see what’s happening. Maybe you could run a set of obs on Mrs Dullard and then I’ll give you a guided tour.’ As Isla made to go, Jayne called her back. ‘Isla, if anything comes in, anything that you feel…’

‘I’ll be fine, Jayne,’ Isla answered softly, knowing what Jayne was referring to and grateful to her for raising the difficult subject. ‘At least I hope I’ll be fine. I suppose I won’t really know till it happens.’

‘Look, if you weren’t Sav’s wife, I wouldn’t know about Casey, we wouldn’t even be having this conversation. Maybe I shouldn’t have raised it—’

‘You were right to,’ Isla broke in. ‘I’m actually glad that you did.’ She took a deep breath before going on. ‘I’ve only done the occasional shift on the wards since I had children, but since Casey died I haven’t worked a single shift. All I know is that emergency nursing is what I’m good at, what I’m trained to do, and if I don’t come back to it now then I never will.’

‘I’m here.’ Jayne gave her a small smile. ‘I know you’ve got Sav here and everything, but sometimes it’s nice to unload on someone who’s not so directly involved. So if something upsets you or you feel you’re not coping just let me know.’

‘Thanks.’ Isla didn’t look up, tears stinging her eyes.

‘I’ve upset you,’ Jayne said, but Isla shook her head.

‘You haven’t upset me at all. In fact, I’m grateful to you for bringing it up. I’m sure there will be times…’ Her voice trailed off and Isla gave a small shake of her head. ‘Let’s just leave it there, but honestly, Jayne, I do appreciate you talking about this with me.’

It did feel as if she had never been away. OK, the blood-pressure cuffs were all automatic now, and glass thermometers seemed to have been relegated to museum pieces, but from her stints on the wards the equipment was for the most part familiar, and Isla felt her confidence increase as she accepted a few new patients from Triage and attempted to chat to Mrs Dullard while she recorded her half-hourly observations. A frail, emaciated-looking lady she might look, but there was a fire in her eyes that Isla instantly warmed to, a wary, proud defiance that Isla found endearing.