Undercover At City Hospital

She was investigating!

Every now and then Bella felt as if everyone must surely know, as if surely there was some massive sign above her head telling everyone the real reason she was here, but for a moment or two Bella realized it had seemed as if the clock had turned back, as if she really was just another nurse on a busy Monday morning listening to handover.

Heath Jameson.

Summoning details to mind, Bella stared apparently nonchalantly as Hannah gave the handover.

Recently divorced, massive custody issues with his ex-wife over the children and a hint of partying rather too hard since being reluctantly made single, though apparently in recent weeks that had all calmed down. With the promotion to Acting Consultant, it would appear that Heath had settled down and decided to concentrate firmly on his patients and career. Certainly, from the way he was chatting to Mrs Adams, he was doing a good job, taking some time to reassure the anxious woman instead of merely rushing off.

‘Charles woke this morning at five a.m. with central chest pain, radiating down his left arm. His wife Celia decided it would be quicker to drive him in than wait for the ambulance!’ Hannah’s raised eyebrows told everyone the unfortunate lack of wisdom behind that decision. Patients with chest pain could collapse very quickly and with no warning—and this, it seemed, had happened to Charles en route to the emergency department. ‘Now, I should warn you at this point, just so that you’re prepared, that there’s no telling Celia what to do. She’s read every article on the internet about her husband’s condition and as I speak is no doubt suggesting to Heath what blood tests he runs. I tried to tell her that next time her husband gets chest pain, assuming that her husband survives this event, she should call an ambulance because next time there might not be a police car travelling behind her. Thankfully, on this occasion the police officers realized she was in trouble and forced her to pull over so they could assist. He went into VF just as the paramedics arrived.’

‘Lucky,’ one of the student nurses commented, and Hannah nodded.

‘Very lucky! The paramedics shocked him once and he reverted to sinus rhythm.’ She gave a small grin. ‘And gave him some IV lignocaine as ordered by Celia! They basically got an IV bung in and scooped and ran, then brought him in, where he’s carried on misbehaving! He was just about to be given some morphine and promptly suffered another VF episode. Heath’s in with him now…’

‘Why aren’t Cardiology in with him?’ Jayne asked. ‘The man’s had two cardiac arrests after all. Surely they should be down here.’

‘Because they’ve had as bad a night as we have,’ Hannah sighed. ‘They’re stuck on ICU with another chest pain who’s had a full, extended arrest and a teenager who took every last one of her grandfather’s heart tablets. Heath is looking after him till they can get here.

‘Problem,’ Hannah said as a rather anxious-looking Trish returned.

‘There’s an ampoule of morphine missing!’

If Bella had felt conspicuous before, she felt as if she were glowing now, scarcely able to believe that after only half an hour in the department drugs were already missing. But her internal excitement was somewhat dampened by Hannah’s response.

‘Damn!’ she cursed, instantly putting her hand up. ‘That was my fault! We wasted the morphine Mr Adams was supposed to have prior to his arrest. Bethany and I signed for it but the patient got restless again as soon as he came round and Heath decided to go ahead and give the morphine but we’d already thrown it out. Bethany and I got a fresh ampoule but we were so busy we didn’t have time to sign for it at the time. She’s off duty now; I can ask Heath—’

‘Who checked the drug?’ Jayne broke in.

‘Bethany and I.’

‘So why would you get Heath to sign for something he didn’t check?’ Jayne’s voice was crisp, her stare direct. ‘Hell, Hannah, you know the trouble the department’s been in with drugs going missing, you know we have to do things by the letter. You’ll have to ring Bethany at home and tell her to come in and sign for it.’

‘But she’s got her driving test,’ Hannah protested.

‘And I’ve got a department to run,’ Jayne clipped back. ‘Now, I’m sorry to do this, Hannah, I know you’ve got the kids to get to school, but before you go off duty I need you to fill out an incident report.’

‘What?” Hannah’s voice was incredulous. ‘It’s a non-event, Jayne. You’re completely overreacting. I really can’t stay. I need to have a couple of hours’ sleep before I bring Ken back here for his outpatients appointment at eleven…’

‘Sorry to interrupt, but could I have a hand in here, ladies?’ A rather snobbish, very deep, very laid-back drawl halted the bickering, and Bella’s eyes widened as she turned around. The reading on the heart monitor that had been blipping along slowly but regularly had reverted to the wiggly line of VF and Heath was laying Charles Adams down before he even passed out, before his wife had even registered that there was something really wrong. As Trish dashed over and led her away, Heath was applying fresh pads to the patient’s chest as Jayne quickly pressed a button to charge up the defibrillator. The machine whirring into action was a sound Bella hadn’t heard for ages, but as instantly memorable as a dentist’s drill.

Heath was supremely calm, an utter contrast to Bella who could feel her heart fluttering almost as much as the patient’s—watching in awe as Heath pulled the paddles out of their trays.

‘Everybody back.’

Another memorable noise, listening as 200 joules were delivered to the patient, watching as his body spasmed, then turning to the monitor.

‘Still VF. Charge to 360 and could someone put out a code?’

On the wards a code would have been called immediately, but events like this were more commonplace in emergency and they had the equipment and expertise to deal with it. Once Charles’s heart had failed to respond, however, it was time to call for the team.

Heath’s hands were on his patient’s chest now, commencing cardiac massage as he called for drugs that would hopefully work on the irritable heart before they shocked him again.

‘Bag him, please, Bella.’ Jayne’s order was sharp and to the point.

Hell, she hadn’t even been shown around the department, but Bella knew that with the RN badge dangling from the cord around her neck she was responsible now, not an undercover cop but an emergency nurse, and a life was on the line.

An ambu-bag was already connected to the oxygen, lying on the head of the trolley beside the patient thanks to his previous episode. Bella checked the man’s airway to make sure it was clear before extending the neck and placing the mask firmly over his face, delivering oxygen as the machine charged and Heath pumped on.

‘OK. Everyone back,’ Heath ordered, then addressed his patient. ‘Come on, Charles. I’ve just finally managed to arrange a bed up on CCU for you. Don’t let’s waste it.’

As soon as Jayne delivered the shock, Bella took her position again, holding the bag tightly over Charles’s airway, ready to commence immediately. Suddenly she felt resistance, the uplifting sound of the monitor bleeping, the unmistakable feel of the quiet tension that had been present seeping out of the room as Charles started thrashing his head around. Bella replaced the ambu-bag with an oxygen mask, letting out the breath she had been holding before finally looking up.

‘It’s OK, Charles.’ Heath’s voice was still calm, and he lowered his head and spoke into his patient’s ear. ‘You’re back with us now. You just had another small turn.’

Which was one way of describing it, Bella thought, blowing skywards the hair that had escaped as she let out another deep breath.

‘Fun’s over, guys!’ Heath grinned as the crash team started skidding into the room. ‘This is Charles Adams, the patient I’ve been babysitting for you. He’s just had his third episode of VF in the last three hours and this time he had to be shocked twice before he reverted. Can we get him out of here now please and onto CCU?’

‘Good job, everyone.’ Heath nodded to the staff, then addressed Bella. ‘I assume from the way you reacted, you’ve done emergency before.’

‘Not for a long while,’ Bella admitted.

‘Well, you did great.’ He held out a hand. ‘I’m Heath Jameson, the very new acting consultant.’

‘Bella Gray.’ Bella smiled. ‘And I’m the very new nurse.’

‘Welcome aboard.’ Very green eyes smiled momentarily at her, but his face grew more serious as he looked away, nodding to the group to step outside Resus and addressing Hannah and Jayne.

‘If you have to argue, could you do it well away from Resus next time?’

‘I’m sorry, Heath.’ Jayne blushed darkly. ‘But you know the problems we’ve been having with drugs.’

‘So does half the department now,’ Heath retorted sharply. ‘Is Bethany on duty tonight?’

Hannah nodded.

‘Well, she can sign for the drug then and do an incident report when she comes in. I don’t want my nurses half-asleep on the job, which is what she will be tonight if we drag her back here now to fill in a blessed incident report just to appease the powers that be. That’s when real mistakes start to happen.’ He turned to Hannah. ‘If you can come in fifteen minutes early tonight, you can fill yours out then.’

Hannah gave a grateful nod but Jayne was far from appeased.

‘Heath, this is a nursing-related issue and given that I’m the most senior nurse in the department…’

‘This is a staff-related issue,’ Heath corrected. ‘And I’m the consultant. Sorry,’ he added before Jayne could. ‘Acting consultant.’

‘So you’re pulling rank now, Heath? According to the records there are drugs missing…’

‘There’s a single vial of morphine that hasn’t been signed for,’ Heath broke in, instantly diluting Jayne’s accusation. ‘And if anyone has a problem with the incident reports being filled in tonight instead of this morning, they can discuss it with me. I am not having a simple mistake turning into a drama, and if it means pulling rank then I’m up for it. I am not going to walk around panicking about things and feeling guilty when I’m not, and neither do I expect the rest of the staff to. Now, can I have a nurse to come in to speak to Charles’s wife with me?’

And turning on his heel he stalked off, leaving everyone, especially Bella, standing blushing and open-mouthed.

Jayne because she’d been put down.

Hannah because she’d been backed up.

And for the rest of the nurses standing there, including Bella, it was entirely due to the fact that they were female.

CHAPTER THREE

CELIA was inconsolable.

Sobbing in a chair, a massive overcoat over a fluorescent nylon nightdress, pulling tissues out of a box, she stood up and let out a wail of terror as Heath and Bella walked in.

‘Please, don’t tell me…’

‘He’s not dead,’ Heath said quickly, taking her elbows and lowering her back into the chair. Bella could only admire him. Instantly he’d quelled Celia’s greatest fear without giving false hope. How many other doctors would have walked in and quickly said that Charles was OK, that the drama was over when, in fact, it had barely started.

‘This is all my fault.’

‘It’s no one’s fault.’ Heath attempted to soothe her. ‘Charles has had a heart attack, and unfortunately these types of events often occur afterwards. He suffered another cardiac arrhythmia,’ Heath explained. ‘His heart effectively stopped again. However, we got it started.’

‘And he’s OK?’ Celia begged, but Heath held back.

‘He’s critically ill, Celia, but we’re moving him up to the coronary care ward and we’ve given him some drugs which we hope will calm his heart down. The next forty-eight hours will be—’

‘Critical,’ Celia whispered through chattering teeth. ‘I’ve read all about heart attacks on the internet.’

‘Quite.’ Heath flashed a brief smile, clearly not impressed with her cyber-knowledge. ‘For now, though, I need you to tell me what happened.’

‘It’s all my fault,’ Celia said again. ‘I should have listened to him when he said he wasn’t well enough—’

‘Did Charles have chest pain last night?’ Heath asked, but Celia shook her head.

‘He was fine last night. I made him a special dinner. I told him to forget his diet for a night, we had a bottle of nice red wine and everything was fine until this morning. Oh, God, what have I done?’

‘This isn’t your fault,’ Heath said firmly, then softened it with a smile. ‘Some doctors actually recommend red wine for cardiac patients and I can assure you, Celia, nothing in last night’s meal would have caused this…’ Clearly he’d said the wrong thing as her sobbing grew louder. Bella pulled out another wad of tissues as Heath struggled to say the right thing, his eyes meeting hers over the woman’s heaving shoulders in a silent plea for help.

‘It’s OK, Celia,’ Bella said soothingly. ‘I’m just going to have a word with the doctor and we’ll be right back.’ Gesturing to the door, she walked outside and waited till he joined her, a quizzical look on Heath’s face, clearly surprised that Bella had pulled him out at such a sensitive time.

‘She’s very upset.’

‘Very,’ Bella agreed, nibbling on the skin around her thumbnail. ‘Extremely upset, in fact.’

‘Well, I guess that’s to be expected.’ Heath shrugged, his frown deepening as Bella’s eyes met his. ‘Why did you call me out?’

‘Because I think you were making things worse in there.’ She heard him suck in his breath, clearly irritated that this very new nurse was pulling him up. But as a tiny smile wobbled on her lips as she tucked back a strand of hair behind her ear over and over, Heath finally joined the party, a smile of his own starting, eyes crinkling around the edges as he waited for her to elaborate.

‘What am I missing, Bella?’

‘The sexy night attire under her coat for starters.’ Bella grinned, blushing as he did, too. ‘The romantic dinner for two, the fact she’s feeling impossibly guilty…’

‘They’re allowed to have sex,’ Heath said gruffly. ‘Just because they’re in their seventies—’

‘He’s a cardiac patient,’ Bella broke in.

‘So? Just because he’s got a heart condition it doesn’t exclude him from having a healthy sex life.’

‘Of course not,’ Bella agreed, ‘but you’ve seen the medication he’s on at home. It wouldn’t be surprising if he was having some difficulties with…’ Clearing her throat, Bella attempted to squash her embarrassment. ‘Maintaining an erection.’

‘I’m not with you, Bella.’ He gave her a rather wide-eyed look and made to go back to the room, but Bella stilled him with a sentence. ‘She’s an internet junkie!’ Heath was frowning now, two vertical lines appearing on the bridge of a very nice nose as Bella continued. ‘I’d suggest that Celia’s guilt has nothing to do with the eggs she put into his soufflé or the wine she served, but more to do with the little blue pill she served up instead of after-dinner mints.’

‘No!’

‘Yes.’ Bella nodded, her smile widening as Heath blushed to his impossibly blond roots. ‘If you ask me, there’s a very good reason Celia’s feeling guilty, and you insisting that it wasn’t her fault isn’t exactly helping matters.’

‘Do you think she drugged him?’

‘Oh, please.’ Bella laughed. ‘I’d say she just nagged him to death more likely!’ As Heath opened his mouth, Bella got there first. ‘Pun entirely intended. Look, it’s just a hunch, but if I am right, maybe you need to alter your line of questioning a bit.’

‘Line of questioning!’ Heath gave her a slightly startled look. ‘We’re in Emergency, Bella, not down at the local police station!’

‘Of course,’ Bella responded quickly. ‘I meant—’

‘I know what you meant.’ Heath gave a grateful nod. ‘And you’re right, if Celia’s been ordering drugs from the internet, then my line of questioning was way off track. How the hell am I supposed to broach this with her?’

It was more a statement than a question, and Bella watched as he raked his hand through his superbly cut hair.

Danny was blond.

At a totally inappropriate moment the thought popped into her head.

There was absolutely no comparing the two.

Danny had been the surfy, sporty type, with shaggy blond hair that had always been in desperate need of a cut, living his life in bathers and board shorts, whereas Heath was the epitome of cool sophistication. No doubt his wardrobe was full with variations on the superbly cut suit he was wearing now, just an occasional glimpse of subtle but expensive jewellery but wearing enough aftershave to asphyxiate from fifty metres.

There was no comparison, Bella concluded, except for the fact they were both blond.

‘Hell, they never prepare you for this type of thing in medical school,’ Heath moaned, staring directly at her.

And except for the fact they both had beautiful eyes.

‘Or nursing school,’ Bella agreed, heading back towards the interview room, frantically trying to clear these ridiculous thoughts from her head.

‘How did you work it out?’ Heath asked, catching her arm lightly and pulling her back. ‘I mean, how did you guess what was going on?’

‘Just incurably nosy, I guess.’ Bella shrugged but she lost her audience as a red-eyed Hannah brushed past, clearly in tears.

‘Hey!’ Heath called her back. ‘Jayne didn’t make you stay and write that report?’

‘No!’ Though visibly upset, Hannah forced a smile. ‘Just another stupid mistake I made last night—I left my car lights on.’

Heath gave a groan of sympathy.

‘I’ve called the roadside assistance number but it would appear I’m not the only one. There’s a two-hour wait.’

‘Get a taxi,’ Heath suggested, ‘and then pick your car up when you come in for Ken’s outpatient appointment. Shirley on Reception can tell roadside assistance where your car’s parked.’

Raking her hand through her hair, Hannah gave a nervous nod. ‘I guess. It’s just…’ Her voice trailed off, but Heath picked up the silence with efficient calmness.

‘You’re probably entitled to a cab charge. Why don’t you check with Jayne?’

‘I was just about to.’ Hannah gave a pale smile and started to go, and only then did Bella really understand. A cab charge might get her home but she’d have to pay for a taxi back, and if funds were short perhaps the twenty or fifty dollars it would take hadn’t been factored into this week’s budget, let alone a new car battery and callout fee. But it wasn’t Bella’s place to say anything. She was the very new girl here, so instead she stood in polite silence, pretending not to watch this exchange.

‘Hannah?’ Heath called her back. Maybe he had understood, Bella realized as he dug in his jacket pocket and pulled out a very flash-looking keyring. ‘Take my car.’

‘Sorry?’ Hannah looked completely dumbfounded as her weary face turned around.

‘You’re over twenty-five, I assume?’

‘Way over.’

‘Then take it.’ Heath shrugged. ‘Jayne’s pretty tied up, you’ll have to wait for ever for her to go into the office and find the forms. Just take my car.’

‘Heath—’

‘I’m not going anywhere,’ Heath groaned. ‘Just don’t smoke in it.’

‘I’ve run out.’ Hannah grinned, the first real smile Bella had seen from her breaking over her exhausted face.

‘Then there’s no problem.’

And except for the fact that under all the bravado, both Danny and Heath were as soft as butter.

As Hannah happily made her way off, jangling Heath’s car keys in her hand, Heath rolled his eyes heavenwards. ‘Why me?’ he groaned.

‘I’m sure she’ll look after it,’ Bella ventured, referring to his car, but that, it would seem, was the least of his problems.

‘I couldn’t give a damn about the car. Why, out of all the doctors in the building, do I get the geriatric nymphomaniac to deal with?’

And except for the fact that they both made her laugh!

‘Is everything OK, Doctor?’ Celia jumped up as they entered, terrified eyes dragging between the two. ‘Nothing has happened to my Charlie, has it?’

‘No.’ Heath gestured to the chair and waited patiently as Celia sat down, clearing his throat and staring at the floor for an endearing moment before assuming a bland expression and looking down at the woman. ‘Now, Celia, for Charles’s sake, I really need to know what happened last night. I need to know about any medications he might have taken, anything unusual that’s happened recently…’

‘There’s nothing!’ Celia said quickly, too quickly Bella thought, and clearly so did Heath.

‘Celia, this is an emergency room. No one’s here to judge either you or Charles. We just want to give your husband the best treatment possible and to do that we need all the facts. So if there’s anything you can think of that might help, anything you’re holding back, now might be a good time to tell me about it.’

‘What about…?’ Celia gave a nervous swallow. ‘I mean, if I’d done something wrong…’

‘I’m a doctor, Celia. My only concern is to see Charles gets the appropriate treatment.’

‘And I won’t get into trouble?’

Heath shook his head. ‘I just need the truth, Celia.’

CHAPTER FOUR

‘CAN I grab you for a moment, Bella?’ Jayne clicked off the hands-free telephone as Bella came out of the interview room. ‘I need to check some pethidine.’

‘Sure,’ Bella replied easily, walking towards the drug room with Jayne.

‘How’s Mrs Adams?’

‘Better. Heath’s still in with her. She’s still upset, though. Oh, that’s what I came out for. Where do I get tissues? There aren’t any spare boxes in the interview room.’

‘I’ll get Tony onto it for you,’ Jayne answered, swiping her ID on the drug-room door and waiting for the access light to turn green.

‘The domestic?’ Bella checked. ‘Don’t worry, I’ll ask him. I actually want him to service the room while he’s in there, it looks as if a bomb’s hit it.’

‘I’ll speak to him about it,’ Jayne said, fiddling with the drug cupboard keys then giving a rather weary sigh as she opened it. ‘Remember to smile for the camera!’

‘So it is true, then?’ Bella asked innocently. ‘Drugs really are going missing?’

‘I’m afraid so. I’m sorry you had to find out that way but, with the way gossip spreads in this place, it’s just as well that you know and can understand why everyone seems to be acting a bit strange at times. No one likes being under suspicion and until they catch whoever is responsible we’re going to just have to live with it. It’s awful, isn’t it?’ Jayne added. ‘That’s why I came on a bit strong out there. We have to be more careful, have to,’ she reiterated. ‘It’s all very well for Heath to say I’m overreacting, but he isn’t the one signing his name at the beginning and end of the shift in the drug records.’

‘And there are really cameras in there?’ Bella peered inside, staring at the neat rows of drugs and pretending to try and locate a lens.

‘Not in there.’ Jayne laughed. ‘At least, not that I’ve heard. Up there.’ She gestured to a small black box on the ceiling. ‘It’s supposed to be hidden, but everyone knows it’s there.’

‘Gosh.’ Bella stared upwards, resisting a childish urge to wave to her colleagues.

‘Anyway, it’s nothing for you to worry about. Just make sure you check things carefully and don’t be rushed. It’s just common sense really.’ Pulling out a box of pethidine, she opened the drug book. ‘Pethidine, 100 milligrams. There should be nineteen ampoules.’ Swinging the ampoules around in the package so the drug name was visible on each, she waited patiently while Bella checked. ‘I’m taking one, which leaves eighteen.’ They both signed off the drug book and safely locked everything away then Jayne collected a kidney dish and syringe as Bella watched. ‘This is for a Mr Benjamin Evans, a forty-eight-year-old who was trying to put the roof on a pergola this morning and forgot to secure the ladder. He’s hurt his back.’

‘Ouch.’ Bella grimaced.

‘He’s had X-rays and Jordan, the registrar, has had a look. The damage is muscular, so we’re going to give him this and send him home in a couple of hours for a few days of bed rest.’