His Baby Bombshell

“I thought you’re supposed to attend orientation this morning,” Sabrina said, irritated because she had to share her first morning in the ED with him. As a floating nurse, it usually took her a day or two to fall back into the rhythm of her new assignment and she didn’t want Adrian finding fault before she’d re-established an efficient routine.

“I am, but the session doesn’t start until eight. I thought I’d orient to my own department before I learned about the rest of the hospital. So what’s up?” He glanced at the board where all the current patients were listed, along with their preliminary diagnoses.

“As you can see, we’re empty at the moment. This might be a good time for Hilary, our nursing supervisor, to give you the grand tour.”

He grinned. “I already asked. She sent me to you.”

“Oh, really?” Sabrina wasn’t convinced.

“Yes, really. If you like, you can confirm it with her. She’s in her office, mumbling about the schedule and sounding quite ferocious about staff hours and budget cuts.”

“What about Dr Beth?”

“She’s breakfasting in the cafeteria, or so I’ve been told.”

In the time it took Sabrina to talk her way out of this little task or find someone else for the dubious honor, she could be finished, so she gritted her teeth and vowed to give him the fastest orientation in the ED’s history.

“As you can see, this is the trauma room, complete with everything you could possibly need.” Her gaze landed on the crash cart within easy reach.

“Our second trauma room is next door.” She led him into the corridor. “And it can accommodate three patients, too. We also have six cubicles for walk-in patients and two that are set up for pediatrics.

“We have electronic record keeping, so all your reports can be found by accessing the hospital information system. I’m sure someone from IT will assign your password and explain how to navigate the software.”

By the time she’d answered his questions, referred those she couldn’t to Hilary and showed him around the entire department, it was time for his orientation session.

As soon as the double doors closed behind him, Sabrina sank bonelessly into a chair behind the nurses’ station and rubbed the tense muscles in her neck. She’d known that working with Adrian underfoot would be tough, but these past two hours had been more difficult than she’d imagined. Not because he’d been rude or sullen or looked through her as if she didn’t exist, but because he’d done the complete opposite! She didn’t want him to be congenial, polite, or study her thoughtfully from under his incredibly long eyelashes.

She grabbed the receiver out of its cradle and prepared to dial her director of nursing when she suddenly hesitated. Asking for a transfer was like admitting to fear, and she wasn’t afraid. She was anxious, wary, and cautious, perhaps, but she had faith in her abilities even though she had to work with a man who upset her composure just by standing in the same room. She would simply grit her teeth and suffer his presence for the next 3 weeks. After all, it wasn’t for ever.

“You chose a good day to start in the ED,” Hilary remarked as Sabrina joined her at the nurses’ station.

Sabrina glanced at her supervisor, grateful that the woman was a congenial sort whose interest in her patients and staff was sincere. “How so?”

“It’s a slow morning, our new defibrillator is on its way down from our bio-med department, and we have a new, handsome doctor in our midst.”

“Oh, yeah. Right.” Immediately, Sabrina felt Hilary’s gaze rest upon her.

“You don’t think the new guy is handsome?”

“Beauty, or handsomeness, is only skin deep,” Sabrina returned.

Hilary chuckled. “You’re too young to be so cynical, girl.”

Sabrina grinned. “I am, aren’t I?” Then, because she didn’t want to discuss Adrian McReynolds, she asked, “Is there anything new I should know about?”

“Nothing I can think of at the moment, but feel free to read through our department manual.”

“I will,” Sabrina told her. She would do whatever was in her power so Adrian wouldn’t find fault with her performance.

As it usually happened, their slow morning turned into a busy day and Sabrina could only spare those manuals a longing glance. A patient with a kidney stone was followed by a man who needed stitches after trying to sharpen his lawnmower blade by himself. After that came a chest-pain case, a teenager with strep throat, and an elderly man who’d fallen out of his bed at the nursing home and broken his hip.

Just as Sabrina was about to slip into the lounge and eat her late lunch, or early dinner, depending on how one described a mid-afternoon meal, a well-dressed woman in her sixties rushed through the emergency room doors, dragging two young children with her.

“Please, you have to help us,” the woman begged as soon as she saw Sabrina.

Sabrina pushed aside her plans to put up her feet and enjoy her carton of yogurt. “What’s wrong?”

“These two grandsons of mine…” the woman shook the arms of the two boys who stared at their surroundings with wide eyes “…got into my purse and ate my digoxin pills.”

Sabrina immediately ushered them toward the pediatric trauma room, then flagged down the passing ward clerk. “Send Dr Beth, stat,” she murmured before following them into the room where she hoisted each of the boys, approximately three and four years old, onto a bed. “How many did they swallow?”

“I just came from the pharmacy to refill my monthly prescription. There are only five left. Between the two of them, twenty-five are missing.”

“And you’re certain the boys ate them.”

The woman nodded, her eyes frantic with worry. “They were playing doctor. I don’t know what possessed them to take the bottle from my purse. What’s so awful is that I’ve always asked the pharmacy to use snap-on lips instead of the childproof caps for my pills. You see, I live alone and my arthritis makes those lids difficult to open.” She sniffled. “This is all my fault. I should have moved my purse or put my pills in the cupboard where they couldn’t reach.”

“Kids can get into trouble in the blink of an eye,” Sabrina said.

The woman nodded, then squared her shoulders as if drawing on her emotional reserves. “As soon as I saw how many they’d eaten, I brought them straight here. If anything happens to Corey and Casey, I’ll never forgive myself.” Her voice cracked and her lips trembled. “I’m Edith Gilroy, by the way, and I’m watching my grandsons because my son and daughter-in-law are attending a funeral in Oklahoma City.”

“We’ll do everything we can,” Sabrina told the trio as she began taking vital signs, noting the absence of any abnormalities.

“They look so healthy. Maybe those pills won’t hurt them?” Edith asked hopefully.

“They will, I’m afraid. An overdose of digoxin will produce cardiac toxicity which manifests itself in a number of ways, depending on the amount ingested. If we can get those pills out of their system before the drug is absorbed, they’ll be fine.”

Sabrina watched the two closely for the less serious symptoms of nausea, vomiting and a headache, hoping they could prevent the more severe ventricular tachycardia or fibrillation. So far, these two looked more scared than ill, although the time for symptoms to develop could be anywhere from thirty minutes to hours. Regardless, those pills had to be removed. By the time these two went home, they would never play doctor with their grandmother’s medicine again.

“Should I have just gone to the drug store and given them syrup of ipecac?” Edith asked.

“No,” Sabrina told her. “Vomiting can make any abnormal heart rhythms worse, which is why in cases of digoxin poisonings we often do a procedure called a lavage where we rinse out their stomach contents with fluids. Then we give activated charcoal to adsorb any of the drug that may have gotten into the bowel.”