Emergency Response

by Nicki Edwards

  “G’day, love,” he said by way of greeting as he removed his hat. “You’re the new nurse from Sydney,” he stated.

  “I am,” Mackenzie confirmed. No point denying it. News of her arrival had taken around five minutes to spread like wildfire after the emergency evacuation on her first night in Iron Ridge. “What can I do for you today?”

  “Oh it’s not me, love. It’s my wife. Bev. She had a bit of a fall in the garden and got something stuck in her leg.”

  Mackenzie sighed. Great. It would probably take less than two minutes to remove a splinter from the woman’s leg. That wasn’t going to kill time quickly enough. Hardly medically satisfying, but at least it would give her something to do. She stood to face him.

  “Can you bring her inside?”

  “Um.” He hesitated, scratching his forehead where his hat had left an indent in his weathered skin. “Probably not. Actually, I’ll need a bit of help getting her out of the car. She can’t walk you see.”

  Mackenzie tried not to roll her eyes as she got up from the desk and came around to where the man stood.

  “I’m Brian Henderson,” he said, reaching out to shake her by the hand. “The wife and I run the local pub.” He paused and looked her over before cramming his hat down on his head. “Haven’t seen you there yet.”

  “Oh, I just haven’t gotten around to it,” Mackenzie said as they walked outside into the bright sunlight.

  She had planned to get to the pub sooner, knowing it would be the best place to meet people and make new friends, but she literally hadn’t found the time. Heat radiated off the asphalt and she squinted. Following Brian to the car, parked beneath the shade of a large gum tree, she had to walk quickly to keep up with his long strides.

  “Well don’t go leaving it too long,” he called back over his shoulder, “or the locals will think you’re a snob. Plus there’s always plenty of nice young fellas for you to meet,” he said, turning to face her and giving her an exaggerated wink.

  She groaned inwardly again. There was no way she was about to admit to Brian she’d already met a “nice young fella” – as he put it – and she hadn’t had to go to the pub to do so.

  The back door of the car was open and Mackenzie made out the shape of a large woman sprawled across the backseat. She was wearing a pale floral dress, which looked as though it belonged in the 1950s.

  “I managed to get her in, but I don’t reckon I can get her out,” Brian explained nervously.

  Mackenzie looked closer and saw Bev sitting in a semi-upright position with both legs spread in front of her across the back seats. Draped across one leg was a dirty white towel. Mackenzie could see a few spots of blood had soaked through the fabric. Maybe it wasn’t a splinter after all.

  “Hi,” she said, smiling warmly at the woman. “Are you Bev?” The woman nodded. Her face was flushed, whether from the heat or something else, Mackenzie wasn’t sure. “I’m Mackenzie. How can I help you?”

  “It’s a bit embarrassing.” Bev pointed at the towel and then looked nervously up at her husband.

  The hairs on the back of Mackenzie’s neck rose. Something didn’t seem right.

  “You probably should put some gloves on, dear,” Bev said.

  Mackenzie frowned. Really? For a splinter?

  “There’s a bit of blood,” Brian added.

  “I’m sure it’s fine,” she assured them as she reached for the corner of the towel with finger and thumb.

  “You won’t pass out will ya love?” Brian asked, concern for his wife etched across his face.

  Bev shook her head. “Not now. It doesn’t hurt as much as it did at first. Just be careful dear when you lift the towel off,” she instructed Mackenzie.

  Mackenzie did as she was told, pulling the towel gently from the woman’s leg. She let out an expletive as her eyes and brain adjusted to what she was seeing. A wooden garden stake had impaled itself through Bev’s calf. One end of the blood-stained stake protruded through the back of her leg about twenty centimeters. The other end was poking through her shin, covered in soil. Blood had mostly dried black around the wound but some fresh blood was still oozing at the site.

  Mackenzie swore again. “How on earth did you do this?”

  Bev shook her head. “I don’t even remember.”

  “Does it hurt?”

  “No. Not really. Not now at least. It hurt before, but I can’t feel it now. Brian drove slowly because every time we went over a bump it hurt a bit.”

  Mackenzie shook her head in wonder. The woman was a martyr. “You should have called the ambulance.”

  “Oh, we didn’t want to bother them. I know they’re probably busy.”

  She pointed to the woman’s shoes. “Can you wriggle your toes?” The woman obliged, moving her foot slightly before wincing in pain. “Does that hurt?”

  “Yes, a little bit.”

  “So what happened?” Mackenzie asked again. She still couldn’t believe what she was seeing.

  “She had a fall,” Brian replied.

  Mackenzie smiled sweetly at him. “If it’s okay, Brian, I need Bev to tell me what happened, in her own words.” Mackenzie needed to assess the woman’s mental state.

  “I can’t believe it,” Bev said. Her voice was so soft Mackenzie had to strain to hear.

  “Can’t believe what?”

  “That I was so stupid!”

  “Oh love, it’s not your fault,” Brian said, reaching into the car and patting Bev’s other leg.

  “So Bev, tell me about the fall. Did you hit your head or lose consciousness? Did you feel faint or dizzy before you fell?”

  Bev looked to Brian for clarification and then shook her head. “I don’t think so. No. Nothing like that.”

  Mackenzie looked at Brian, giving him permission to speak. “Um, no. She didn’t lose consciousness. I’m pretty sure she just tripped. I was on the other side of the garden so I didn’t see it happen.”

  “So do you think that’s what happened? You tripped?” Mackenzie asked again.

  “I don’t know. It all happened so fast and I don’t remember.”

  “Any chest pain?”

  “None,” Bev confirmed.

  “How bad is your pain now?” Mackenzie asked. “On a scale of one to ten. If ten is the worst pain you’ve ever had in your life and one is a little niggle, what would you rate your pain?”

  “Um, maybe an eight when I did it, but now I can’t really feel it. It just hurts whenever I move too much.”

  “Righto. Let me get you some pain relief, get you inside and then we can examine you properly. Have you taken anything yet? Panadol, Nurofen?” Bev shook her head. “Are you allergic to anything?”

  “Penicillin,” Bev said.

  “She breaks out in hives,” Brian added.

  “I still can’t believe you didn’t call the ambulance,” Mackenzie said, shaking her head in astonishment. “Give me a moment. I’m going to go inside and get you something for the pain. Once you’ve had that we’ll move you. Are you right here for a bit?” She was glad Brian was smart enough to park in the shade and he’d left the car running with the air conditioner on high.

  “No rush, dear. I’m not going anywhere,” Bev said with a laugh.

  Mackenzie went back inside and called Charlotte and Amy. Both nurses were on call and they arrived at the same time, within ten minutes of Mackenzie phoning them. They were as shocked as Mackenzie had been to see Bev Henderson sitting in the parked car with a smile on her face.

  “Should we call Richard?” Mackenzie asked quietly. She hadn’t met the local GP yet.

  “He hasn’t come back from his weekend off,” Amy said.

  “Flying doctors then?”

  Charlotte nodded. “Obviously. But we’ll need to somehow get her inside and assess her first. It’s pointless ringing them when we don’t know what we’re dealing with.”

  “I can do an x-ray, as long as you don’t tell anyone I did it,” Amy said. They weren’t supposed to do x-rays wi
thout a doctor’s permission, even though they all knew how to use the machine. “Otherwise we’re going to have to wait for the radiographer from Tom Price. That could be hours away. And there’s no way we can transport her to them.”

  After a brief discussion, they decided to move Bev inside out of the heat, do their assessment, take the x-ray and then call the flying doctors and get them to do another assessment via video conference.

  Ten minutes later Bev had sucked away on a green Penthrane “whistle” filled with analgesia and was giggling like a schoolgirl. Between Brian and the three nurses, they somehow managed to get her into a wheelchair and inside the hospital, out of the hot sun. They helped lift her onto the narrow bed where she lay back down, completely oblivious to the concerned glances the nurses were giving one another.

  “Amy, can you get some morph drawn up please?” Mackenzie asked. “Once that Penthrane wears off and the shock kicks in, I reckon she’s going to be in heaps of pain.”

  “Sure,” Amy said, heading with Charlotte toward the locked safe where the drugs of dependence were stored. Two nurses had to countersign all “DDs.”

  While her colleagues were preparing the morphine, Mackenzie wrapped a bright blue tourniquet around Bev’s upper arm and placed the things she needed to insert a cannula in Bev’s vein onto the stainless steel trolley. She palpated Bev’s skin until she found a suitable vein and then cleaned the area thoroughly.

  “This will feel like a sharp scratch,” she informed Bev.

  “I’m sure it’s not going to hurt at all,” Bev answered. “Not after this,” she added, pointing to her leg.

  Mackenzie laughed. “Probably not!”

  Mackenzie inserted the needle into the vein and as soon as she saw the small flashback of blood, she slid the rest of the plastic cannula in and withdrew the needle, discarding it in the yellow sharps container attached to the trolley. “All in, but keep still while I secure it.”

  “Didn’t hurt one little bit,” Bev said.

  Mackenzie withdrew enough blood to send for pathology, attached a small line and then flushed normal saline into it. She taped the cannula in place and covered it in an occlusive dressing. Amy showed Mackenzie the labeled syringe of morphine – ten milligrams of morphine in ten milliliters of normal saline – before she injected two and a half milligrams into the cannula followed by a flush of normal saline.

  “This is just morphine,” Amy explained to Bev as she delivered the drug. “It’s pretty fast acting but it will also wear off quickly so you let us know if you need any more.”

  “We should give her some Maxolon too,” Charlotte said, “in case the morph makes her sick.”

  “Good idea. Now, Bev, let’s get this leg looked at then, shall we?” Mackenzie gently undid the woman’s shoelaces and slid the shoe off. Next came the sock.

  While Mackenzie worked, Charlotte took the woman’s temperature, pulse and blood pressure and reported everything was normal. Mackenzie was staggered the woman wasn’t in much pain and was actually smiling and joking with them. The inhaler and the morphine had done their job.

  “Can you feel me touching here?” Mackenzie ran her fingers over the woman’s lower limb and foot. Bev confirmed she had full movement and sensation. “Neuro-vascularly intact,” Mackenzie said, looking up in amazement at Charlotte and Amy. “I can’t believe it, but somehow I reckon she’s managed to miss both bones and all the nerves.”

  After sending the x-rays to the flying doctors for review, Mackenzie sat and documented everything while she waited for the report. Half an hour later, they confirmed the wooden stake had missed bones, tendons and nerves, slicing straight through the muscle. They wanted Bev to be airlifted to hospital, where surgeons would remove the stake under general anesthetic. If everything went according to plan, she would make a full recovery and be back gardening again before Christmas.

  It was almost three hours later before the flying doctors retrieval team arrived and took Bev and Brian to Perth. When the three nurses convened back at the hospital, they discussed it over cups of coffee, unable to believe how lucky Bev was. One millimeter in the other direction and she could have lost the whole limb.

  By four o’clock Mackenzie was back at home, had showered and was planning what to cook for dinner when her phone rang. She glanced down and smiled. It was Nathan. As she swiped her finger across the screen to answer the call she asked herself why her heart was beating so erratically.

  Chapter 10

  Two hours later Mackenzie pulled on a white cotton halter-neck sundress ready for her first big night out in town. She was only going to the pub for a counter meal with Nathan, and was probably overdoing things in the fashion stakes, but she didn’t care. She hadn’t had a chance to wear anything other than shorts and T-shirts or scrubs since she’d arrived and it felt nice to dress up for a change – even if her version of dressing up simply meant a cheap Target dress and a pair of rubber flip-flops on her feet.

  After looking after Bev and Brian Henderson earlier that day, Mackenzie was now looking forward to checking out their pub. Known by the locals simply as “Hendo’s,” the Center Pub was one of three busy hotels in town. Not ironically, it was located in the central part of the town.

  Mackenzie had fond memories of hours spent during university in an English-style pub in Sydney. She and her fellow nursing students spent most nights at the pub, eating cheap counter meals, drinking beer and playing endless games of pool to pass the time instead of studying.

  Since arriving in Iron Ridge, even though she’d barely stepped outside in the sun for longer than the five minutes it took her to walk between the hospital and home or home and the shops, she’d somehow acquired a fabulous tan. She’d also lost weight with all the walking she was doing, and against the white of the dress, her shoulders actually looked fabulous. She couldn’t ever remember feeling so good about her appearance. She pulled her long straight hair out of the elastic band and let it fall loose around her shoulders. Dabbing her favorite Estee Lauder fragrance behind her ears, she stared at herself in the mirror. When was the last time she’d gone to so much effort for a guy?

  *

  “You look hot,” Nathan said when Mackenzie walked through the front doors of the pub seven minutes later.

  She felt hot. “It’s still stifling out there.” She tucked a strand of hair behind one ear and touched the nape of her neck. She should have worn her hair up.

  Nathan leaned in closer so he didn’t have to shout over the sound of the music blaring through the pub’s sound system. “I meant you look hot, hot,” he said. “It’s nice to see you wearing a dress.” He inhaled deeply. “And you smell nice too.”

  He leaned in and kissed her on the cheek and something fluttered deep in her belly. No guy had ever called her hot or made her insides go mushy like that. She shook her head. She had to stop reading things into every comment he made. If she didn’t do something to make this infatuation with him stop, it would lead to disappointment.

  While she tried to think of a smart comeback, a group of men appeared. One of them slapped Nathan on the back. His bushy beard, tattoos and yellow high-visibility shirt pegged him instantly as a miner. “Mate! So this is your new girlfriend, eh?” he asked.

  Nathan glanced at Mackenzie but she wasn’t sure how to interpret the look he gave her. In the back of her mind she vaguely registered the man’s question. Had they referred to her as Nathan’s girlfriend? Mackenzie’s stomach flipped and flopped back over itself again.

  “Ah, yeah guys, this is my sister’s friend Mackenzie,” Nathan said. “She’s one of the new nurses at the hospital.”

  Disappointment went through her, landing like a stone in the bottom of her stomach. He hadn’t introduced her as his friend. She pasted a smile on her face and greeted the men pleasantly in return. At least now she knew where she stood with Nathan. He was only being friendly because she was one of his sister’s friends so there was no point getting her hopes up.

  Another man spoke up. �
��Nurse, eh? So you would have heard about Hendo’s wife? Bev?” All the others turned to look at him. “Apparently she got flown off to Perth today after a massive fence post went through her leg.”

  Eyes widened as the man embellished the story with details he was making up on the spot. Nathan glanced at Mackenzie and she shook her head.

  “A fence post might be exaggerating the story slightly,” Mackenzie interrupted. They all turned to look at her then and she blushed, feeling uncomfortable being the center of attention. “She’s fine. A garden stake went through her calf but it looks worse than it is. She’ll have surgery in Perth and be back here before you know it.”

  “Just as bloody well,” another man said. “The pub wouldn’t be the same without Brian and Bev runnin’ it.”

  “Who’s cookin’ tonight then?”

  “Dunno. As long as they whack a heap of chips on the plate with my steak, I don’t care.”

  “You ready to order then?”

  The men wandered off toward the bar, leaving Mackenzie and Nathan standing in the middle of the pub.

  “Are you hungry?” Nathan asked.

  “Not especially.” Mackenzie stared at him. For some reason he looked pale. “Are you all right?”

  “I’m fine. Just all that talk about Bev makes me feel a bit queasy.”

  She touched him gently on the arm. “Oh Nathan, she’s fine.”

  “Well I’d feel better if I didn’t have to picture her with a fence post sticking out of her leg.”

  Mackenzie laughed. “I promise not to mention it again.”

  “Have you ever played pool?” he asked, changing the subject.

  She shrugged. “A few times.”

  He glanced behind her. “The table’s free. Want to play before we eat?”

  “Sure. How about loser pays for dinner?” she suggested with a smile.

  Nathan chuckled and instantly looked more relaxed. “Sounds like a challenge to me. Are you sure you’ve got enough money, because I’m a growing man and I’m starving! I could eat a horse!”