Knight on the Children's Ward (2 page)

As she sat in handover, listening to the list of patients and their ages and diagnoses, he popped his head around the door to check something with Caroline, the charge nurse, and Annika felt a dull blush on her neck as she heard his voice properly for the first time.

Oh, she'd heard him laugh on occasion, and heard his low tones briefly as they'd passed in the corridor when he was talking with a colleague, but she'd never fully heard him speak.

And as he spoke now, about an order for pethidine, Annika found out that toes did curl—quite literally!

His voice was rich and low and without arrogance. He'd made Caroline laugh with something he said—only Annika couldn't properly process it, because instead she was feeling her toes bunch up inside her sensible navy shoes.

‘Back to Luke Winters…'

As the door closed so too did her mind on Ross, and she began concentrating carefully on the handover, because this rotation she
had
to do well.

‘He's fifteen years old, Type 1 Diabetes, noncompliant…'

Luke Winters, Annika learnt, was causing not just his family but the staff of the children's ward a lot of problems.

It was his third admission in twelve months. He was refusing to take his insulin at times, ignoring his diet, and he had again gone into DKA—a dangerous, toxic state that could kill. He had an ulcer on his leg that had been discovered on admission, though had probably been there for some time. It would take a long time to heal and might require a skin graft. His mother was frantic—
Luke had come to the ward from ICU two days ago and was causing chaos. His room was a mess, and he had told the domestic this morning, none too politely, to get out.

He was now demanding that his catheter be removed, and basically both the other patients and the staff wanted him taken to an adult ward, though Ross Wyatt was resisting.

‘“Teenagers, even teenagers who think they are adults, are still children.”' Caroline rolled her eyes. ‘His words, not mine. Anyway, Luke's mum is at work and not due in till this evening. Hopefully we can have some order by then. Okay…' She stared at the patient sheet and allocated the staff, pausing when she came to Annika. ‘I might put you in cots with Amanda…' She hesitated. ‘But you haven't been in cots yet, have you, Cassie?'

When Cassie shook her head and Caroline changed her allocation Annika felt a flood of relief—she had never so much as held a baby, and the thought of looking after a sick one petrified her.

‘Annika, perhaps you could have beds eight to sixteen instead—though given it's your first day don't worry about room fifteen.'

‘Luke?' Annika checked, and Caroline nodded.

‘I don't want to scare you off on your first day.'

‘He won't scare me,' Annika said. Moody teenagers she could deal with; it was babies and toddlers that scared her.

‘His room needs to be sorted.'

‘It will be.'

‘Okay!' Caroline smiled. ‘If you're sure? Good luck.'

Lisa, who was in charge of Annika's patients, showed her around the ward. It was, as Cassie had said, completely different. Brightly painted, with a detailed mural
running the length of the corridor, and divided pretty much into three.

There were cots for the littlest patients—two large rooms, each containing four cots. Then there were eight side rooms that would house a cot or a bed, depending on the patient's age. Finally there were three large four-bedded rooms, filled with children of various ages.

‘Though we do try to keep ages similar,' Lisa said, ‘sometimes it's just not possible.' She pointed out the crash trolley, the drug room, and two treatment rooms. ‘We try to bring the children down here for dressings and IV's and things like that.'

‘So they don't upset the other children?' Annika checked.

‘That, and also, even if they are in a side room, it's better they have anything unpleasant done away from their bed. Obviously if they're infectious we can't bring them down, but generally we try to do things away from the bedside.'

Annika was offered a tabard to replace her navy one. She had a choice of aprons, all brightly coloured and emblazoned with cartoon characters, and though her first instinct was to politely decline, she remembered she was making an effort, so chose a red one, with fish and mermaids on it. She felt, as she slipped it over her head, utterly stupid.

Annika started with the obs. Lunches were being cleared away, and the ward was being readied for afternoon rest-time.

The children eyed her suspiciously—she was new and they knew it.

‘What's that for?' A mother demanded angrily as her first patient burst into tears when Annika went to wrap a blood pressure cuff around her arm.

Lisa moved quickly to stop her.

‘We don't routinely do blood pressure,' Lisa said, showing her the obs form. ‘Unless it's stated on the chart.'

‘Okay.'

‘Just pulse, temp and respirations.'

‘Thank you.'

The little girl wouldn't stop crying. In fact she shrieked every time Annika tried to venture near, so Lisa quickly took her temperature as Annika did the rest of the obs. In the room, eight sets of eyes watched her every awkward move: four from the patients, four from their mothers.

‘Can I have a drink?' a little boy asked.

‘Of course,' Annika said, because that was easy. She checked his chart and saw that he was to be encouraged to take fluids. ‘Would you like juice or milk…?'

‘He's lactose intolerant!' his mother jumped in. ‘It says so above his bed.'

‘Always look at the whiteboard above the bed,' Lisa said. ‘And it will say in his admission slip too, which is clipped to his folder.'

‘Of course.' Annika fled to the kitchen, where Cassie was warming a bottle.

‘Told you!' Cassie grinned when Annika told her all that had happened. ‘It's like landing on Mars!'

But she wasn't remotely nervous about a sullen Luke. She knew he had no relatives with him, and was glad to escape the suspicious eyes of parents. It was only when she went into the side ward and realised that Ross was in there, talking, that she felt flustered.

‘I can come back.'

‘No.' He smiled. ‘We're just having a chat, and Luke needs his obs done.'

‘I don't want them done,' Luke snarled as she approached the bed.

That didn't ruffle her either—her extra shifts at the nursing home had taught her well, because belligerence was an everyday occurrence there!

‘I will come back in five minutes, then,' Annika said, just as she would say to Cecil, or Elsie, or any of the oldies who refused to have their morning shower.

‘I won't want them done then either.'

‘Then I will come back five minutes later, and five minutes after that again. My name is Annika; it would seem that you'll be seeing a lot of me this afternoon.' She gave him a smile. ‘Every five minutes, in fact.'

‘Just take them now, then.'

So she did.

Annika made no attempt at small talk. Luke clearly didn't want it, and anyway Ross was talking to him, telling him that there was no question of him going home, that he was still extremely ill and would be here for a few weeks—at least until the ulcer on his leg was healed and he was compliant with his medication. Yes, he would take the catheter out, so long as Luke agreed to wee into a bottle so that they could monitor his output.

Luke begrudgingly agreed to that.

And then Ross told him that the way he had spoken to the cleaner that morning was completely unacceptable.

‘You can be as angry as you like, Luke, but it's not okay to be mean.'

‘So send me home, then.'

‘That's not going to happen.'

Annika wrote down his obs, which were all fine, and
then, as Ross leant against the wall and Luke lay on the bed with his eyes closed, she spoke.

‘When the doctor has finished talking to you I will come back and sort out your room.'

‘And I'll tell
you
the same thing I said to the cleaner.'

She saw Ross open his mouth to intervene as Luke snarled at her, but in this Annika didn't need his help.

‘Would you rather I waited till children's nap-time is over?' Annika asked. ‘When you feel a little less grumpy.'

‘Ha-ha…' he sneered, and then he opened his eyes and gave a nasty sarcastic grin. ‘Nice apron!'

‘I hate it,' she said. ‘Wearing it is a bit demoralising and…' She thought for a moment as Luke just stared. ‘Well, I find it a bit patronising really. If I were in cots it would maybe be appropriate. Still…' Annika shrugged. ‘Sometimes we have to do things we don't want to.' She replaced his chart. ‘I'll be back to clean your room shortly.'

 

Ross was at the nurses' station writing notes when she came over after completing the rest of the obs. He grinned when he saw her.

‘Nice apron.'

‘It's growing on me!' Annika said. ‘Tomorrow I want to wear the one with robots!'

‘I can't wait!' he replied, and, oh, for a witty retort—but there wasn't one forthcoming, so instead she asked Lisa where the cleaning cupboard was and found a bin liner. She escaped to the rather more soothing, at least for Annika, confines of Luke's room.

It was disgusting.

In the short time he had been in the room he had accumulated cups and plates and spilt drinks. There were used tissues on the floor. His bed was a disgrace because
he refused to let anyone tidy it, and there were loads of cards from friends, along with all the gadgets fifteen-year-olds seemed to amass.

Luke didn't tell her to leave—probably because he sensed she wouldn't care if he did.

Annika was used to moods.

She had grown up surrounded by them and had chosen to completely ignore them.

Her father's temper had been appalling, though it had never been aimed towards her—she had been the apple of his eye. Her brothers were dark and brooding, and her mother could sulk for Russia.

A fifteen-year-old was nothing,
nothing
, compared to that lot.

Luke ignored her.

Which was fine by Annika.

‘Everything okay?' Lisa checked as she finally headed to the kitchen with a trolley full of used plates and cups.

‘All's fine.' The ward was quiet, the lights all dimmed, and Ross was still at the desk. ‘Do you need me to do anything else, or is it okay if I carry on with Luke's room?'

‘Please do,' Lisa said.

Luke wasn't ignoring her now—instead he watched as she sorted out his stuff into neat piles and put some of it into a bag.

‘Your mum can take these home to wash.'

Other stuff she put into drawers.

Then she tacked some cards to the wall. All that was messy now, Annika decided as she wiped down the surfaces in his room, was the patient and his bed.

‘Now your catheter is out it will be easier to have a shower. I can run it for you.'

He said neither yes nor no, so Annika headed down the ward and found the linen trolley, selected some towels and then found the showers. She worked out the taps and headed back to her patient, who was a bit wobbly but refused a wheelchair.

‘Take my arm, then.'

‘I can manage,' Luke said, and he said it again when she tried to help him undress.

‘You have a drip…'

‘I'm not stupid; I've had a drip before.'

Okay!

So she left him to it, and she didn't hover outside, asking if he was okay every two minutes, because that would have driven Luke insane. Instead she moved to the other end of the bathroom, so she could hear him if he called, and checked her reflection, noting the huge smudges under her eyes, which her mother would point out to her when she went there for dinner at the weekend.

She was exhausted. Annika rested her head against the mirror for a moment and just wanted to close her eyes and sleep. She was beyond exhausted, in fact, and from this morning's assessment it seemed it had been noticed.

Heather would never believe that she was working shifts in a nursing home, and the hardest slots too—five a.m. till eight a.m. if she was on a late shift at the hospital, and seven p.m. till ten p.m. if she was on an early. Oh, and a couple of nights shifts on her days off.

She was so tired. Not just bone-tired, but tired of arguing, tired of being told to pack in nursing, to come home, to be sensible, tired of being told that she didn't need to nurse—she was a Kolovsky.

‘Iosef is a doctor,' Annika had pointed out.

‘Iosef is a fool,' her mother had said, ‘and as for that slut of a wife of his…'

‘Finished.'

She was too glum thinking about her mother to smile and cheer as Luke came out, in fresh track pants and with his hair dripping wet.

‘You smell much better,' Annika settled for instead, and the shower must have drained Luke because he let Annika thread his T-shirt through his IV.

‘What are you looking so miserable about?' Luke asked.

‘Stuff,' Annika said.

‘Yeah,' Luke said, and she was rewarded with a smile from him.

‘Oh, that's
much
better!' Lisa said, popping her head into the bathroom. ‘You're looking very handsome.' Annika caught Luke's eyes and had to stop herself from rolling her own. She sort of understood him—she didn't know how, she just did. ‘Your mum's here, by the way!' Lisa added.

‘Great,' Luke muttered as Annika walked him back. ‘That's all I need. You haven't met her yet…'

‘You haven't met mine!' Annika said, and they both smiled this time—a real smile.

Annika surprised herself, because rarely, if ever, did she speak about her family, and especially not to a patient. But they had a little giggle as they walked, and she was too busy concentrating on Luke and pushing his IV to notice Ross look up from the desk and watch the unlikely new friends go by.