A Nightingale Christmas Wish (4 page)

Hot shame washed over Helen. She knew she should walk away, but her legs wouldn’t move.

‘You’re only sulking because you weren’t consulted.’

‘Perhaps I am. But do you blame me? I take our work very seriously, and I resent having this – child foisted on us, just because she happens to be a Trustee’s daughter who fancies a change of scene.’

Helen tiptoed away, hating herself for her own lack of courage. If she truly were her mother’s daughter she would have barged straight in and confronted them, instead of creeping off to hide in a corner.

She returned to the Casualty hall just as the other nurses were coming on duty. There were four of them, three students and a tall blonde in the royal-blue uniform of a staff nurse. They were all talking among themselves, but stopped dead when they saw Helen.

‘Oh, hello. You must be our new Sister Cas?’ The blonde nurse greeted her with a broad smile. She was a couple of years older than Helen, long-limbed and languid, with thickly lashed aquamarine eyes. ‘I’m Staff Nurse Willard, and these are Perkins, Kowalski and French.’ She nodded towards the three students who stood, still in their heavy cloaks, watching Helen warily.

‘Would you like a cup of tea, Sister?’ Nurse Willard offered. ‘We usually put the kettle on as soon as we get in.’

‘No, thank you.’ Helen looked around her, completely wrong-footed. She had expected to walk into her department and immediately take charge, but instead she felt like a guest at a very jolly tea party. ‘I would rather you showed me around, if you don’t mind?’

‘As you wish,’ Nurse Willard said cheerfully, slipping her cloak off her shoulders. ‘I’ll give you a tour while Perkins puts the kettle on, how about that?’

Nurse Willard talked a great deal faster than she moved, Helen discovered.

‘The Outpatients’ clinics start at nine o’clock,’ she said. ‘On Mondays it’s General Medical, Tuesdays is Orthopaedic, Wednesdays is General Surgical, Thursdays is Gynae and Fridays ENT. The consultants are all monsters, of course, apart from Mr Cooper, who looks like Tyrone Power. Mr Prentiss the ENT pundit is the worst. Do you know, he threw a basinful of water at poor little Nurse Kowalski last week, just for putting the wrong antiseptic in it? No wonder no one wants to assist in his clinic. Over there is the Plaster Room, and this is the Accident Treatment Room, where we deal with minor emergencies. The Cleansing Room is through that door there. Excuse me for asking, but you’re Dr Tremayne’s sister, aren’t you?’

‘That’s right.’ Helen opened the door to the operating theatre and looked inside. Just seeing the white-tiled walls of the theatre, with its glass-fronted cabinets full of gleaming instruments, made her feel at ease. This was what she was used to, everything shining, clean and orderly.

‘I thought so. You look a lot like him. I went out with him once or twice, you know.’

‘Really?’ Helen inspected the instruments. Someone had done a good job of cleaning them, although they hadn’t been put away quite as she would have liked.

‘That was long before I met my Joe, of course. I mean, my fiancé,’ Penny Willard said. ‘He’s a policeman,’ she added importantly.

By the time they’d finished the tour of Casualty, Helen knew next to nothing about the running of the department, and everything she could possibly want to know about Penny’s wedding plans, and her personal opinion of all the student nurses.

Penny spoke rapidly, her words tumbling out faster than Helen’s brain could take them in. By the time they returned to the main Casualty hall, her head was reeling.

‘You know, I was so pleased when we found out you were going to be taking over from Sister Percival,’ Penny confided, settling herself comfortably behind the booking-in desk. ‘She was all right in her way, I suppose, but it will be so much more fun to have someone my age running the place.’

‘Fun?’ Helen said.

‘You know . . . someone I can chat to, have a laugh with. Ah, here’s the tea.’ She beamed as Perkins came in with a tray. ‘I think you’ll like it here, Sister. We’re one big, happy family.’

Helen thought of the comments she’d overheard, and said nothing.

She knew she should set Penny Willard straight, make it clear right from the start that she was in charge and not there to have fun. But she was already so disheartened by what the doctor had said, she didn’t want to make another enemy in the department.

Perhaps he was right, she thought miserably. Perhaps she was too young and inexperienced to take charge?

‘Have you got a boyfriend?’ Penny asked.

Helen stared at her, dumbstruck by the question. ‘I’m a widow,’ she said.

‘Oh, gosh, yes, of course. I remember now. That was terribly sad.’ Penny’s lips pursed in the kind of sympathetic grimace Helen had grown to dread over the past two years.

Fortunately Penny changed the subject back to gossiping about the rest of the department. ‘You won’t have met the doctors yet, will you? There’s Dr McKay – Scottish, terribly clever. And then there’s Dr Adler. He’s a great big bear, utterly adorable . . .’

‘How very kind of you, Nurse Willard.’

Helen swung round. Two men stood behind them. One was a giant of a man, with a thick black beard and shaggy dark curls. The other was tall but of slighter build, with a sharp-featured face and keen brown eyes.

‘You’ll notice, Dr McKay, that Nurse Willard referred to me as utterly adorable, but the best she could come up for you was “clever”?’ the big man went on, his black eyes twinkling. ‘What does that say about you, do you think?’

‘I think it probably says more about you than it does about me,’ Dr McKay replied dryly. Hearing that well-spoken Scottish voice again filled Helen with fresh mortification.

She was even more mortified that she’d been caught drinking tea and gossiping with the other nurses. Another black mark against her, she thought.

But Nurse Willard seemed oblivious to any undercurrents. ‘Oh, you!’ She batted Dr Adler playfully on the arm. ‘Have you met our new Sister Cas? Sister, these are the two I was telling you about, Dr Adler and Dr McKay.’

‘How do you do, Sister?’ Dr McKay’s professional smile and firm handshake gave away none of his true feelings.

‘I suppose Nurse Willard has been telling you all our secrets?’ Dr Adler grinned. ‘How will we ever gain your respect, I wonder?’

‘I think it’s
your
respect I have to gain,’ Helen said, shooting a sideways look at Dr McKay.

If he noticed her barb he didn’t react. ‘Should we get these doors open, so we can start seeing some patients?’ he said. ‘That is what we’re here for, after all.’

NO SOONER HAD
he said it than the telephone rang, shattering the silence. Nurse Willard pounced on it.

‘That’s the emergency telephone,’ Dr Adler explained to Helen in a low voice. ‘It rings when there’s an ambulance on its way.’

Helen listened carefully, trying to piece together what Willard was saying.

‘Right, yes. A car and a motorcycle, you say? Three casualties, I see. And how bad is the head injury?’ She scribbled notes on the pad in front of her.

‘What do we have?’ Dr McKay asked, when she’d put the receiver down.

‘Traffic accident. A car went into a motorcycle on Mile End Road. The motorcyclist got away with cuts and bruises and possible concussion, but the car driver is unconscious with possible spinal injury, and the passenger has a deep cut to his thigh and an injury to his wrist.’

All eyes turned to Dr McKay. ‘We’ll send the spinal injury straight to Theatre,’ he said. ‘Dr Adler, you can look after the motorcyclist, and I’ll take care of the leg.’

‘Right you are,’ Dr Adler said. ‘Sister, perhaps you could assist me?’

‘No, she’ll be assisting me,’ Dr McKay interrupted him.

Helen caught his sharp brown-eyed stare and realised this was a test for her. The first of many, she was sure.

‘As you wish, sir.’ She turned to the student nurses, who were waiting keenly for their instructions. ‘Perkins, telephone Theatre and let them know there is a head and possible spinal injury on the way down. Organise a dresser to be sent up here, too. French, get some blood ordered – Type O, since we don’t know what group our patient might be.’

‘Forget the blood,’ Dr McKay snapped. ‘We won’t need it.’

‘But with a deep cut . . .’

‘The ambulance men didn’t say he was bleeding to death, did they?’

‘No, but—’

‘Then we won’t be needing the blood.’

He strutted off before she could reply. A shocked, embarrassed silence followed. Even Dr Adler looked a little shaken as he hurried off to his consulting room to prepare for his patient.

Helen pulled herself together quickly and turned to the students. ‘I will be acting as scrub nurse for Dr McKay,’ she told them briskly. ‘Kowalski, I want you to help me. And French, please order that blood,’ she added as an afterthought.

‘But Dr McKay said—’

‘Please,’ Helen interrupted her. ‘To be on the safe side,’ she added.

‘Yes, Sister.’

She had just finished scrubbing up when the patient arrived. Helen could hear his screams of agony from the other end of the passage.

She shouldered open the door to the operating theatre as the ambulance men were bringing him in.

‘Got a right one here!’ the driver said, rolling his eyes at Helen. ‘Been cursing like a good ‘un all the way from the Mile End Road, he has. Honest to God, you’d think he was dying!’

Helen looked down at the patient. He was young, in his early twenties. His face was the pale, translucent colour of candle wax, slick with sweat.

‘My leg!’ he screamed. ‘Jesus, my leg!’

‘Oi, stop the language! There are young ladies present.’ The driver shot Helen an apologetic look. ‘Sorry, Sister.’

‘It’s quite all right.’ Helen fixed her attention on the young man. ‘Get him on to the table, as quickly as you can, please.’

He screamed as Helen carefully removed the makeshift splint. His dressing was soaked in blood, and as she peeled it off she caught a sickening glimpse of raw, glistening muscle.

‘Making a hell of a fuss, isn’t he?’ The ambulance man grinned at her.

‘So would you, if you’d gashed your leg open like that.’ Helen peered into the wound. It was deep, and there seemed to be fragments of broken glass embedded inside, but she had seen worse. The ambulance man was right, he did seem to be in a great deal more pain than he should have been. Unless there was something else going on, something she couldn’t see . . .

She was aware of the man watching her, and smiled down at him reassuringly. ‘Don’t worry, I’ll give you something for the pain and then we’ll get you cleaned up.’

She gave him an injection of morphia and was carefully swabbing his wound when Dr McKay swept through the doors, his gloved hands raised.

His eyes looked so forbidding above his surgical mask, Helen’s nerve started to fail her. She was probably mistaken anyway. But if she wasn’t . . . She took a deep breath. ‘Doctor, I think this patient might have a femoral fracture,’ she said.

Dr McKay’s brows puckered in a frown. ‘The ambulance men didn’t mention it,’ he said shortly.

‘The ambulance men don’t have access to X-rays,’ Helen replied.

‘Neither do you, Sister.’

‘No, but I know when a patient is in more pain than he should be.’

She knew arguing with a doctor was the worst crime she could commit. Even as a sister, her job was to carry out his instructions to the best of her ability and not to question his judgement in any way. But she knew from her experience in Theatre that doctors and surgeons were only human. They could make mistakes, just like everybody else. Helen had seen patients die on the operating table because a consultant had missed something, and no one had had the courage to question them.

They faced each other across the table and for a moment Helen thought he was going to ignore her and carry on stitching up the patient. But to her relief he looked down at the young man and said, ‘Right, let’s see what you’ve been doing to yourself, shall we?’

The patient groaned, already groggy from the shot Helen had given him.

She waited tensely while Dr McKay took up his forceps and gently probed the open wound. She didn’t want to humiliate herself by being wrong, but she didn’t want to be right, either, for the poor young man’s sake.

When Dr McKay looked up it was at Kowalski, who hovered by the door. ‘Nurse, please telephone Theatre and let them know there is a fractured femur coming down. And alert the X-ray department, too.’ He glanced at Helen. ‘It seems you were right, Sister,’ he murmured.

Helen said nothing. The silence became uncomfortable as they waited for the porters to come and collect the patient.

Five minutes later, they were shifting the young man on to the trolley. ‘Be careful,’ Dr McKay warned. ‘There’s still some broken glass in the wound, which needs to come out. If a piece shifts it could sever the femoral . . .’

No sooner had the words left his mouth than a fountain of blood spurted violently from the wound. Helen grabbed a towel and started to mop at it, but the blood soaked straight through, flowing over her hands in a warm, sticky crimson tide.

Dr McKay reached for a tourniquet as Helen dropped the towel and moved to place her hands around the rim of the man’s pelvis, her thumbs pressing down on the artery, feeling the hard bone underneath. She threw her weight against it, her feet slipping on the slick of blood under her shoes.

She’d lost the feeling in both her thumbs by the time Dr McKay got the tourniquet strapped into place and stemmed the tide of blood. Then he moved quickly to ligate the wound, tying off the two ends of the artery and bringing them together.

‘How is he doing, Sister?’ he asked, not looking up.

‘His breathing is very shallow.’ Helen felt for his pulse, leaving sticky red fingerprints on his skin. His heartbeat skittered underneath her fingertips. ‘And his pulse is irregular.’

‘We’ll need some blood. Telephone down to—’

‘I’ve already got it.’ Helen nodded to Kowalski, who hurried off to prepare it.

‘How . . .?’ She saw Dr McKay’s expression change behind his surgical mask. She could see he didn’t know whether to be angry that she’d defied his orders, or grateful that she had anticipated his needs. In the end, neither won. ‘I’ll give him a shot of Vasopressin, while his blood pressure is still up to it. Then we’ll pack the wound and get him down to Theatre. They can sort him out from there,’ he said shortly.