She blushed and turned to her sister to change the subject, but he spoke before she had a chance.
“Why don’t you repay me by going out with me?” He quickly glanced down at his plate and back up. “Let me buy you dinner.”
“Hey, that’s a great idea. She’ll take it,” Sierra accepted quickly on China’s behalf.
China kicked her sister’s foot and watched Sierra wither under the death look she threw her. But having finished a glass of wine, Sierra didn’t know when to keep quiet.
“It’s been a long time since you’ve had an evening out, China. There’s more to life than charity fundraising, meetings, and work. I just thought maybe you and Rick would enjoy each other’s company. He’s always good for a laugh in the ER so he’s probably a real kick on a date. Right, Rick?”
“You know I am.”
Seeing red with a combination of anger and embarrassment, China glowered at her sister, then pretended to smile for Rick. He turned on his lopsided grin and raised his brows, looking far more charming than China cared to admit.
“Just dinner.” He placed his wide palm over his heart. “I promise.”
China shook her head.
“Look,” he said, taking out his checkbook, “I’ll make a $500 donation tonight for the honor of taking you out. It’s for a good cause. What do you say?”
Once again speechless, China looked at her traitorous sister.
“Yes,” Sierra said. “She says yes.”
CHAPTER THREE
“SMILE for me,” China coaxed her fifty-something patient, the following Monday afternoon. He gave a one-sided, sagging smile. “Now lift your eyebrows.” Only one shot up. “Can you close your eyes tightly?” It looked more like a single-eyed wink.
The man, a schoolteacher, had been admitted to the ER fearing he’d had a stroke when he’d woken up with half of his face paralyzed.
“How am I going to teach like this?”
His left cheek drooped and his eye teared. The medical history China had taken revealed that no injury had occurred, and no disease process played into the condition. His blood pressure was normal, his handgrip was even bilaterally, and he had full use of his left extremities. Her biggest concern was that he might develop permanent nerve damage from what she suspected to be Bell’s palsy.
“If it’s any consolation, I can understand everything you’re saying,” she said. “And I’m sure your students will, too. But if you feel uncomfortable I’m sure you can get a substitute teacher for a few days. “
Rick strolled by the exam room.
She zipped outside to catch him. “Hey, Rick?”
He turned expectantly, holding a staple gun, and gave a pleased grin. “Ah, our date. Yes, we need to make plans.”
She sighed and rolled her eyes. “No. As a matter of fact, I was looking for Dr. Weinstein. Have you seen him?”
He shook his head.
She gestured toward the patient exam room. “Hey, since nurses aren’t supposed to diagnose and physicians’ assistants can, and the doctor is tied up with another patient, I need you to examine this guy. I think it’s Bell’s palsy. He’ll probably need a script for prednisone, but Dr. Weinstein can write that when we run everything by him.” She motioned for him to follow her.
“I’d love to, China, but first I’ve got to staple up a head wound.”
“Oh. OK.”
“Give me ten minutes, and if you haven’t found Dr. Weinstein by then, I’ll be right with you.”
A half-hour later, with prescription in hand for steroid therapy and a follow-up appointment with his personal physician, and following a crash course from Rick on eye care and muscle exercises to prevent permanent damage, the teacher was discharged and escorted out of the ER.
China smiled and handed him his insurance form, reassuring him that he’d have a good chance of spontaneously recovering from Bell’s palsy. Only time would tell for sure how long it could take.
Though he’d been unexpectedly put off work, leaving his school in limbo, she knew substitute teachers could replace him over the next month or six weeks. Being a teacher in the public school system, he had excellent medical benefits and, if necessary, he’d get disability pay.
She turned to see which patient was next; instead, she found Rick. He stood resolute, broad shoulders filling out his blue scrub top, arms folded, legs in a wide stance. With swept-back nut-brown hair and a determined stare, he looked dashing, and it irked China to no end that she’d noticed.
“It’s pretty quiet. Why don’t you take your dinner break with me in, say…” he glanced at his watch “…right now?”
China frantically searched for a reason to get out of it, but there wasn’t even one new patient chart lined up in the cubicles by the triage nurse’s station. A rare occurrence in the ER. China feared she’d been dragged into a subversive plot master minded by her evil sister, whom she still hadn’t forgiven. She nervously scanned the half-empty ER and found Sierra, who waved and smiled at her from across the clinic with a clipboard in her hand.
China launched a couple of angry missiles at her with a quick squint. Sierra stuck out her tongue. Fighting the desire to return the favor, she recovered and instead made a diffident smile for Rick.
“Sure.” China shrugged it off. May as well get it over with. “Dinner right now, why not?”
“Well, in that case, let’s go.” He wrapped his strong hand around her arm and led her through the ER door, calling over his shoulder on the way out, “We’re on break.”
China nibbled at her hospital cafeteria salad, mostly moving it around on her plate. Her vegetable soup had gotten cold. Despite her desire to find Rick otherwise, she discovered his casual banter to be light-hearted, witty and, yes, much to her dismay, fun.
“So this psych patient says to me, ‘I’m being stalked by my next-door neighbor, Mr. Boots. Everywhere I turn he’s there—in my living room, on the hood of my car, under my bed.’ I’m thinking to myself this guy’s either really got a problem or he’s totally paranoid and needs to get back on his meds, quick.” He scratched his long, straight nose and smothered a smile. “When I asked him to describe the neighbor to me, I finally figured out he was talking about a cat.” Rick grinned and shoveled some meatloaf into his mouth.
China laughed, and let go of another layer of tension. OK, so he knew how to entertain. But he still had all the markings of a cad. Several nurses in the cafeteria had gone out of their way to get his attention. She’d suspected that he’d probably dated most of them but, in his favor, he ignored them, concentrating solely on her.
A sense of dread about how much gossip she’d have to endure for being seen with Rickk made her tense up again. The other nurses were probably wondering what in the heck he was doing with plain old China.
Not that she wasn’t wondering the same thing.
Trying to keep the conversation going, she asked, “Have they interviewed you for the ER supervisor job yet?”
He shook his head.
“Don’t they usually reserve it for a nurse practitioner?”
“It’s about time they changed that, don’t you think, China?”
He had a point. She weighed the issue. PA? Or RNP? Both required advanced degrees. One trained by nurses and the other trained by doctors. The best person should get the job. She lifted a noncommittal shoulder. “I guess the suits will decide.”
“Undoubtedly.”
“So how come you didn’t want to become a doctor, like your father?”
He raised an eyebrow. “Let me ask you this, have you ever wanted to be like your mother?”
Cass Seabury’s cherubic face and Rubensesque shape came to mind. Her mother, the rich trust-fund child, spoiled teen, and unconventional adult who’d lived life exactly the way she’d wanted. A woman who’d never looked back, regardless of the damage she’d done. Her mother was one of a kind.
“Oh, hell no.” China took a bite of her sourdough roll, shivering at the thought of being anything like her mothe
r. No, unlike her mom, she chose to hold her regrets close to her heart, like dear old friends that she never wanted to let go. Old friends she could torture herself with whenever guilt took hold. And in life, according to China, guilt was abundant.
He nodded. “You see? I rest my case.”
Their knees touched under the table. China quickly moved hers, but not before an electric message snaked up her leg. She furrowed her brows and looked at Rick. The moment hadn’t been lost on him either.
The hint of a smile crossed his lips before he continued talking. “I wanted to see the world and have some excitement, instead of burying my nose in textbooks for ten years.”
“You were in the services, right?”
“Yep. I went into the army right out of high school and became a medic. I got most of my clinical training in the field, though.”
Rick was well respected for his knowledge of trauma medicine. It made sense that he’d learned what he knew on the front line.
“And I gotta admit it was kind of sweet to join up and stick it to my father at the same time.” His signature mischievous grin appeared. “Instead of packing up for a dorm room the year after my mother died, I got shipped off to barracks. By choice.”
China had noticed a strained silence between father and son any time they were in the same vicinity, and had wondered why. Rick always seemed cautious around Dr. Morell. And Dr. Morell seemed flat out dismissive of Rick. Maybe Rick’s choice of the army over college explained their behavior toward each other.
Their beepers went off simultaneously. China checked hers, already knowing who it was. With no need to explain to each other where they were headed, they rushed a couple more bites of dinner into their mouths, grabbed their cafeteria trays and headed for the ER.
Nurses and doctors bustled around the drab, institution-green linoleum floors, darting in and out of several glass cubicles encased by pale gray walls. An attempt to brighten up the place with prints of seascapes had fallen flat. The familiar antiseptic odor made its presence known, along with a few demanding patients calling out from the numbered rooms that circled the central nurses’ station.
Within only thirty minutes the ER had changed from being quiet and half-empty to filled to capacity with patients, loud banter, and an occasional groan. And from the looks of the triage station, there were more people waiting.
Upon their arrival, the charge nurse pointed in the direction they were needed. Two firemen were in the midst of transferring a young man from a gurney to an ER bed. The kid let out an pain-filled yell when they lifted and moved him on the count of three.
Rick stepped up to the bedside, eyes scanning the patient. “Hey, champ. What’s up?”
The teenager groaned.
“Don’t worry. We’re gonna take good care of you.” He placed his big hand on the patient’s thigh, and though it looked as if he was just being friendly China knew he was starting his initial assessment.
China checked and retaped the IV that had been started in the field, and picked up the chart and read his name and age. The boy was only eighteen. She hooked him up to the blood-pressure machine on the unaffected arm, and pushed the button.
“Chad fell off the roof, helping his dad clean the gutters after school,” the first fireman said. “No spinal damage, but his shoulder is probably shattered.”
“How far did he fall? Did he hit anything on the way down?” Rick asked, continuing to assess his patient.
The other fireman spoke up. “About eighteen or so feet. Straight fall. Nothing in between.” A saddened look appeared on his big swarthy face. “He’s the quarterback at Valley View High School.”
China wanted to get the poor kid some immediate relief from his pain. “Are you allergic to any medicine?”
The kid grimaced and shook his head. She wrote down his elevated blood-pressure reading, noting it was probably due to his discomfort. She’d watch for signs of shock once his adrenaline rush wore off.
“Draw up 75 milligrams of Demerol,” Rick instructed.
“Write it down,” she said, handing him the green doctor’s orders, knowing she’d have to get it cosigned later by the ER doctor that Rick was assigned to. She headed for the med room for some Demerol, stopping only long enough to call the X-ray tech for a portable X-ray of the shoulder.
The firemen had left, the anxious parents had arrived, and Rick examined his patient’s shoulder. He’d had to use bandage scissors to remove Chad’s shirt rather than make him move when he knew lifting even one millimeter would hurt like hell. Bruised and swollen, the shoulder was oddly shaped, and the humerus was most likely fractured. The clavicle looked broken, too. Suspicious that more than a simple shoulder dislocation was the culprit, he continued examining the patient and palpated his chest, sternum, ribs, liver and abdomen for damage. So far, things had checked out all right.
The mother whimpered in the background. The father wrapped his arm around her and drew her close. Chad bit his lower lip and said, “I’ll be OK, Ma.” Tears brimmed in his eyes.
Rick’s heart wrenched at the sight, but he didn’t let on. His mother had died when he’d been a teenager, and he still missed her dearly. As for him and his father, well, there was no love lost there. Mom had had cancer and Dad had withdrawn. Enough said.
“Can you move your fingers?” He began his neurological assessment. The teenager wiggled them cautiously, moaning with the effort. Rick touched Chad’s fingertips with a pin. “Can you feel this?”
He nodded.
The nail beds on the affected side were a bit dusky, but when he pressed them, they blanched and the capillaries quickly refilled with pink blood. If his prediction was right, there was no nerve or deep vessel damage and his shoulder had taken the brunt of the fall.
He lifted his eyebrows. If Chad had landed a couple centimeters one way or the other, he could have broken his neck and wound up paralyzed or, worse yet, dead. Worst-case scenario, a pulverized shoulder joint could be wired together and dealt with in this day and age of titanium and joint replacements if need be.
Regardless of what the X-rays revealed, how would he explain to an eighteen-year-old quarterback that he wouldn’t be throwing a football the rest of the season?
China whisked into the cubicle like a fresh healing breeze, and smiled at the teenager.
“Relief,” she said, displaying the filled syringe. “I’m going to use your thigh so you won’t have to roll onto your side.”
“Thanks,” Chad said, apprehension disappearing from his eyes.
Rick admired China’s easygoing manner with patients. Her calm attitude helped relieve her patients’ worst fears, even if only for a minute or two. He also suspected that Chad, though wrung out with pain, noticed how sexy she was. And a nurturing woman could always make any situation better.
Rather than dealing with his belt and jeans, and wanting the medicine to affect his patient a lot quicker, Rick made a suggestion. “Why don’t you titrate the Demerol IV push?”
Procedural sedation in the ER was still a sticky subject with hospital administration, unless a doctor was at the bedside, but his patient’s comfort came first. And theoretically there were several doctors nearby. He nodded to China to go ahead.
She nodded back and worked quickly to connect Chad to the heart monitor for added observation, and finished by placing an oxygen saturation meter on the nail bed of his finger. Then she switched the long needle for an IV tubing friendly lever-lock plastic one, and swabbed the rubber port with alcohol. She crimped the tubing and expertly delivered 25 mg of Demerol into the IV over the next minute, followed by another 25 mg over another minute or so. When Chad showed no signs of being nauseated and started to look sedated, she glanced at Rick. He nodded to indicate that 50 mg IV of the painkiller was enough. He watched her waste the remaining 25 mg of Demerol then dispose of the needle in the sharps container. She checked the IV machine, and looked satisfied that all was well.
A normal sinus rate and rhythm on the monitor once again p
roved the resilient powers of youth.
The X-ray technician appeared like a bumper car with his noisy, portable motor operated-machine, forcing his way into the room. Now was as good a time as any to clear out.
Rick escorted the parents toward the waiting room and asked the ward clerk to order a routine pre-op lab panel. If the X-ray revealed what he suspected, a shattered joint head and a fractured humerus, Rick might have to notify the on-call orthopedic surgeon for emergency surgery. Hopefully, that wouldn’t be necessary, it would be better to stabilize Chad, drug him up and make him comfortable for the night. A well-rested surgeon was imperative, too. Rather than adding on a case after a long day, he’d wait for the X-ray results, then suggest they wait until bright and early the next morning for surgery.
If it turned out to be a mere shoulder dislocation, though, he’d reduce the joint a.s.a.p. to prevent permanent nerve or circulation damage. Either way, the surgeon promised to come by and examine the patient after the X-rays were in. They’d go from there.
Rick planned to stabilize the joint with a shoulder immobilizer, keeping the arm flush to Chad’s chest. The less movement, the less pain the patient would feel, until morning when he’d get sent to surgery for open reduction and internal fixation. In the meantime, Rick would send him to the holding area.
His eyes wandered across the clinic and found China, pert and concentrating on making chart entries. Her shiny ink-colored hair was pulled tightly back into the usual French twist, except for her short fringe of bangs. She wore a white scrub top and string-tied pants, and clogs with thick, colorful athletic socks, yet she still managed to look sexy. If he squinted, he could almost see the outline of French-cut panties through her scrubs. Too bad she didn’t treat him like a patient. He’d appreciate some of her easygoing bedside manner instead of the nurse from hell routine.
He’d made some progress during their break. After all, he’d actually made her laugh. And who knew what he could accomplish with a little more time?
Her L.A. Knight Page 3