by Joanna Neil
Ruby shook her head. ‘I’m used to them by now.’ She put fresh coffee into a new filter, filled the jug with water and set it on the base to heat. ‘I’m just tired because Becky had a bad night. I think she caught sight of one of her mother’s sweaters when I was sorting through the wardrobe, and it must have triggered something in her mind. After that she was inconsolable. Nothing I did would put matters right.’
She sighed. ‘And she’s teething again, so that didn’t help. She kept waking up and putting a finger in her mouth, and then she would start to sob and dribble, and it was just too awful. I ended up nursing her in my arms each time until she fell asleep. I didn’t know what to do. I tried teething gel. I tried a nice bottle of warm milk, but she was very fractious.’
She made a brief grimace. ‘Of course, this morning, when I took her over to my mother’s house to be looked after, she was sleeping serenely like a little angel.’ She pulled down a cup from the rack and sent him a taut glance. ‘So all in all I’m not in the best of moods. Be warned.’
He pressed his lips together to hide a smile. ‘What you need is doughnuts,’ he murmured. ‘Didn’t you once tell me that they were the very thing that would put a smile on the face of everyone here?’ He walked over to the fridge and drew out a box. Then he held it out to her. ‘Here you are. Help yourself to something delicious.’
She lifted the lid and stared down at an assortment of doughnuts and cream cakes. ‘Oh, bliss. Oh, joy,’ she said. She looked up at him. ‘Where did these come from? I mean, who brought them?’
‘I did.’ He smiled. ‘Haven’t you noticed that the snack trolley has been filled with goodies every day? I thought you were giving out extremely good advice, so I decided to act on it. And today, since it’s the weekend, I reckoned we all needed an extra boost.’
‘Mmm. I think I could kiss you,’ she said, glancing up at him and taking a bun from the selection. ‘I’m in more of an iced bun kind of a mood today, I think.’ She bit into it, savoured the sweet flavours, licking the cream from her lips, and then looked at him with deep affection. ‘I’m pretty sure you’re my favourite person in all the world,’ she murmured. She took another bite and then nodded. ‘Yes, I’m sure of it. I’m in love, definitely.’
‘With me or the bun?’ He laughed and went over to the coffee machine. ‘Sit down and I’ll pour your coffee,’ he said. ‘Relish it for as long as you can because, as we both know, it’s hell out there.’
She sat down and scoffed the rest of the bun while he made coffee and came to put a cup down on the table beside her. He waited until she had finished eating, watching in fascination as she licked her fingers clean slowly, one by one, and then he leaned over and planted a kiss firmly on her mouth.
‘Mmm,’ he said, drawing back eventually. ‘Delightful. Sweet as sugar and absolutely delicious, you taste like perfection to me, grumpy or not.’
She stared up at him, a dazed look coming over her face, her senses dazzled by the swiftness of that sensual onslaught, her lips on fire where he had touched them, and he laughed again. ‘I have to go,’ he said. ‘Back into the fray. Don’t let your coffee get cold.’
She drank it in a bemused state, her mind whirling in a wonderland of overwhelming sensation. She wanted to savour the memory of that kiss for as long as she could, but after he’d left the room and reality slowly began to sink in once more, she realised that life had to go on, and she had no choice but to get back out there and join the frantic race to deliver health care to the endless queue of people who were waiting outside.
Her nerves were in a chaotic state after that unexpected, delicious kiss. Sam was beginning to get to her, and she wasn’t at all sure how she was going to cope with all the frantic emotions that suddenly besieged her. Didn’t she have enough to contend with right now?
She went to the sink and splashed water over her face, then dried herself on a paper towel and ran a comb through the burnished chestnut of her hair. Feeling a little more in control of herself, she walked back into A&E and started to work her way through the list of patients still to be seen.
It was a thankless task. Noise from the waiting room erupted into the treatment rooms, and she had to battle a headache as she dealt with a succession of head and face wounds caused by various fracas, pavement falls and general wild and wanton behaviour.
She felt like shouting, ‘Enough!’ but of course that wouldn’t do at all.
In the end, it was Sam who declared ‘enough’. He looked at the ever-growing list of patients and called the nurses over to the central desk. ‘We have some people who are seriously injured coming in by ambulance,’ he told them, ‘and they have to take priority, which means these people already here will be in for a long wait. I want to set up a nurse-based treatment centre in the annexe next door, so that you can work through those who have minor injuries and send them on their way. Michelle will be in charge. We’ll divide the more senior nurses into two groups—one group to work here, the rest in the annexe. The triage nurse on duty will decide which patients go to the annexe for treatment.’
He looked around. ‘Is that clear? Grab what you need from stores and take it with you, those of you who are going.’
There was shock on the faces of some of the assembled group. ‘You can’t do that,’ one of them said. ‘You’re not in charge of the nurses’ schedule. You can’t just arbitrarily decide who goes where.’
‘I’ve just done it,’ he said. ‘Take it up with your nursing manager later if you like, but right now we need you to be dealing with patients.’
‘And who’s going to deal with all the drunks and the aggressive patients, or even with their relatives? I’m certainly not doing it,’ another nurse said.
He nodded. ‘Call security if there’s a problem.’
‘A doctor should sign off on treatment,’ yet another said. ‘I’m not prepared to take responsibility if anything goes wrong. We’re not covered legally.’
Sam made a short, exasperated sound. ‘Yes, of course, that’s true. Send all the charts to me at the end of treatment, and I’ll sign them off. If there are any problems or queries, put a phone call through to Ruby or me, and if there’s a patient that you think needs to be seen by a doctor, or one who rejects nurse-based treatment, refer them back here. Anybody who really doesn’t want to take part should say so, but as to the rest, we need to start doing this now, otherwise we’ll be over-running the waiting times, and that will put our on-going status as an A&E unit in jeopardy.’
There were murmurs of dissent, but Michelle stepped forward and started sorting out which nurses would stay and which would go to the annexe. Sam began to walk away, heading towards the ambulance bay, and Ruby hurried after him.
‘That nurse was right, you know,’ she said. ‘You can’t just decide on a whim who goes where. It isn’t your place to do that.’
‘And do you really think the nursing manager is going to object?’ His tone was curt. ‘When she comes in on Monday and understands the situation, she’ll okay the measures I’ve taken.’
‘When you’ve had a chance to talk her round, you mean?’
He shrugged. ‘Maybe. We can’t stand around debating the issue when there’s a job to be done. Some patients don’t need to be seen by a doctor. They turn up at A&E with sprains or cuts that can be treated by nurses. We’re wasting resources if we insist that a doctor sees each one of them. Each of the senior nurses is trained to practitioner level. I don’t see a problem with that.’
‘The trust board might object.’
‘So let them sack me.’
She glanced at him. ‘You really don’t care, do you?’ She made a face. ‘I suppose that’s because you’re confident they won’t do that…but you could have handled the situation with a little more tact, you know, instead of upsetting the staff. You won’t endear yourself to anyone by taking a do-it-or-else stance.’
‘That’s not a problem for me. I don’t need to be universally liked. I just want to get the job done.’
She gave a sigh of frustration. ‘And you’ll succeed, I’m sure…but there are ways of doing it, Sam…more diplomatic ways.’
He sent her a rueful look. ‘So you’re standing in as my popularity gauge, are you? And it looks as though you’ve also set yourself up to assess the way I handle the running of the unit. Why do you want to do that? Don’t you have enough to contend with already with the job and everything that’s going on at home?’
‘I don’t want to see you at loggerheads with everyone,’ she said, frowning. ‘You deserve better than that. I know you’re trying to do a difficult job here, but you could make life much easier on yourself if you would just manage to tone your attitude down a little. We aren’t all here to jump through hoops that admin throw our way. We’re here because we want to do a good job, and at the same time we want to get along with the people who work alongside us.’
‘I’ll bear it in mind,’ he said. ‘But I do think you probably have other, more important, things to worry about rather than my popularity. I’m glad you came back to work, but I still haven’t worked out how you manage to do this job, with all its frustrations, and keep relatively good-natured and still cope with running things back at the farm.’
‘Why wouldn’t I manage it?’
‘Well, for instance, you didn’t take me up on my offer to send people over to help out with your crops and your animals. How on earth are you able to keep going?’
‘My father is helping out by calling in every morning and evening, and Mary from next door said she’d keep an eye on things each day to make sure that everything was secure and the animals were safe. She’s been great with Becky too. I suspect she likes looking after her once in a while.’
‘Hmm. Well, the offer still stands for me to send people over if you change your mind.’
‘Thanks.’
She worked with him over the next hour or so, helping to stabilise a teenager who had been brought in after a fall from a bridge. He had suffered several broken bones and internal injuries, along with a hairline fracture to the skull.
‘We’ve done all we can for him for now,’ Sam said, writing up the medication chart and then checking the monitors and intravenous lines. ‘He needs to be transferred to Intensive Care.’
Ruby made all the arrangements and explained to the boy’s parents what was happening. Then she accompanied the boy to ICU, stopping there to give details of his condition and the care he had received to Jenny, the nurse in charge.
‘It sounds as though things have been hectic in A&E today,’ Jenny said, ‘more so, perhaps, than usual.’
‘Well, we’ve been having some fine weather,’ Ruby answered, ‘possibly the best we’ll get before autumn sets in. I think people are making the most of it while it lasts, so the pubs are full, and people are in high spirits in more ways than one.’
‘It always happens, doesn’t it? Still, maybe next week we can relax a bit. Sam’s holding the fund-raiser then, isn’t he?’
‘That’s right. I’ll look forward to seeing you there, Jen.’
She took a final look at the injured boy before she left. She knew she was leaving him in good hands, but she was sad to think of how much damage the fall had done to him.
Back in A&E, the relatives of the walking wounded were becoming restless. ‘Your Mr Dryden is back again,’ Olivia said as Ruby glanced in at the waiting room.
‘My Mr Dryden?’ Ruby echoed. ‘What makes you call him that?’
‘Because I suspect he’s only here because he wants to see you. He’s been asking for you to treat him.’
Ruby gave a frown. ‘What’s wrong with him?’
Olivia glanced at the triage chart. ‘A sprained wrist.’
Ruby shook her head. ‘I can’t deal with that right now. I need to go back to Sam to help with the people in resus. Say I’m not available and send him over to the annexe, will you?’
‘I will.’
They both moved off in different directions to go on with their work, but a gang of youths spilled out of the waiting room just then, arguing with the triage nurse and pushing people out of their way. Ruby went to intervene, and Olivia said hastily, ‘I’ll call security.’
Ruby nodded. ‘Yes, do that. Thanks.’
She went to stand in front of a young man who was staggering towards the resuscitation room, blocking his way. ‘You need to go back to the waiting room,’ she said.
He glowered at her. ‘I’m not going back there. You can’t make me. My mate needs to see a doctor. Look at him.’ He draped an arm around his friend, who stared at her in a blearyeyed fashion. ‘He’s bleeding from a cut on his arm, and his hand’s in a right state. He’s weak from all the blood he’s lost, and it’s messed with his head.’ He lurched towards her and grabbed at the name badge she wore on her green scrubs. ‘You’re a doctor. You see to him.’
Ruby twisted out of his grasp and turned to look at his companion. ‘Let me see your arm, please.’
The youth stuck his arm under her nose, narrowly missing her face, and then swayed with the movement, so that a waft of alcohol-drenched breath fanned her face.
She studied both the arm and the hand. His knuckles were raw from where he had been in a fist fight, and the cut on his arm was not too deep. ‘The wounds aren’t that bad,’ she said. ‘The nurse has put a temporary dressing on your arm, and you should put it back in place to keep the wound from becoming infected. Please go back into the waiting room and take a seat until a doctor’s free to see you.’
‘No, that ain’t good enough.’ His friend became belligerent and lunged towards her, pushing her with enough force so that she spun round and fell back against a wall, hitting her arm on the corner of a desk. ‘You see to him now.’
‘That’s enough.’ Sam’s voice cut through the air like a whip. ‘We don’t have to put up with disrespect. You’re out of here.’ Sam strode purposefully from the resuscitation room and grabbed the youth by the collar. With one hand at the nape of the young man’s neck and another tugging his flailing arm behind his back, he marched him out of the unit and into the hands of the security team who were at that moment heading along the corridor towards A&E.
Sam returned a minute or so later and propelled the injured drunk back into the waiting room and sat him down on a chair. A security officer came to stand guard by the door, preventing any more unauthorised access into the main treatment area.
Sam came to find Ruby, who was rubbing her arm and heading towards resus. ‘Come into the treatment room,’ he said, his voice brisk. ‘You’re white as a sheet.’
‘I’m all right. It’s a headache, that’s all…too much noise, too little sleep. I’ll be fine, and we have patients to see.’
‘They’re being looked after,’ he told her. ‘You don’t need to worry about them right now. Besides, you should have gone off duty half an hour ago.’
‘Should I?’ She allowed him to usher her into an empty treatment room and submitted to being gently pushed down onto a chair.
‘Let me take a look at your arm,’ he said.
She shook her head. ‘I told you, it’s fine. I’m fine. It’s just my head that hurts.’
He nodded. ‘Okay, we can fix that. I’ll get you some paracetamol tablets. Sit there and don’t move while I go and fetch them.’
Now that she was sitting, she found she had no inclination to go anywhere, so she did as she was told and stayed where she was. When he came back a few minutes later and handed her a glass of water, along with the tablets, she meekly accepted them and swallowed them down.
‘You were terrific back there,’ she told him, giving him back the glass and rubbing her hands over her aching temples. ‘Where did you learn to handle people like that? Do you have a secret life as a security guard?’
He gave a wry smile. ‘I learned how to handle bullies at boarding school,’ he said. ‘The older ones would pick on the new recruits. It was bad enough when they tried their tactics on me, but when they started on my younger brother, I h
ad to let them know once and for all who they were dealing with. They didn’t try it again after that.’
She looked at him curiously. ‘I guess you must have been very fond of your brother. You were both a long way from home and family, so I expect you turned to one another for comfort and companionship.’
‘Yes, we did.’ He made a bleak kind of smile. ‘I’d always looked out for him from when we were very young, and it was a natural thing for me to do the same at school. Of course that was a long time ago. We’ve both moved on since then.’
‘But you’re still fond of one another?’
He nodded. ‘It goes without saying. Why do you ask?’
‘I was just wondering how much contact you have with him, now that he’s up in Scotland and you’re down here.’
He gave a light shrug, leaning back against the wall and watching her from a short distance. ‘Like I said, we’ve both moved on. It’s unfortunate that we’re at other ends of the country, but it can’t be helped, I suppose. We talk to each other on the phone now and again, and of course there’s always email…but we’re both busy people working in professions that are deeply involving and time-consuming.’
‘So you don’t get to see much of your nephews?’
He shook his head. ‘Birthdays, maybe, and Christmas. I doubt they even think of me very much. They have their own lives to lead.’
‘I think it’s very sad,’ she said, getting to her feet and studying him as he began to move towards her.
‘Are you sure you’re feeling up to walking about?’ He studied her, his brows drawing together. ‘Shouldn’t you sit for a little longer? You’re still very pale.’
‘I need to curl up in bed and have a long, uninterrupted sleep,’ she said. ‘Perhaps Mum will keep Becky overnight, and I’ll be able to do that.’ She gave him a faint smile. ‘Thank you for taking care of me. I wish I could do the same for you.’
He looked at her in astonishment, giving a small chuckle. ‘Take care of me? What can you possibly mean by that?’
She gave him a sad smile. ‘Perhaps tiredness is giving me a different perspective on life.’ Even through her weariness, she had picked up on the faintly wistful note in his voice when he spoke about his brother and his family. He might declare that he was content with his life the way it was, but deep inside him wasn’t there a yearning to be part of an open-hearted, bustling family unit? So far it had eluded him, and maybe that was why he kept his emotions in check. Perhaps it was the reason why he wouldn’t allow himself to love and be loved, for fear of losing control, or even of being hurt.