The Surgeon's Favorite Nurse

by Teresa Southwick

  The sound of his name yanked him into the moment and he smiled at the directors of radiology, respiratory therapy, the emergency department and the E.R. doc, all gathered around the mahogany conference table. He was acquainted with them all.

  “Dr. Andrews was appointed Mercy Medical West’s chief trauma surgeon last night.” A hint of pink creeping into Hope’s cheeks told him she hadn’t forgotten what else happened last night. And what almost happened.

  Everyone applauded the announcement and seemed genuinely pleased at the news. It was worth the price he’d paid—all work, no play or much pay for more years than he cared to remember. Now that he was at the top, nothing was going to get in the way of his staying there.

  “Congratulations, Dr. Andrews,” Hope said. She barely met his gaze, then glanced at the agenda on the table in front of her. “Next I’d like a report from each department, in terms of how we stand in supplying trauma personnel.”

  As the directors took turns getting her up to speed, Jake studied Hope and knew she was aware of him, too. The pulse at the base of her throat beat just a little too fast. He didn’t know whether or not to be pleased about that. The timing of this—whatever it was between them—was damn inconvenient.

  “All right,” she said nodding. “Now I want to make sure we’re on the same page with identifying the levels of trauma. Mechanical injury—broken bones—is level one. Penetrating wound is level two. Head or traumatic brain injury is level three. Preliminary paramedic evaluation in the field will determine the trauma level of patients transported by ambulance. And walk-ins will have to be assessed by the E.R. doc who will determine the trauma level.”

  A murmur of general agreement followed her remarks as the directors took notes.

  “Next on the agenda is medical staff. We will apply for a level-three designation since Dr. Gallagher’s group signed on for neurosurgery and agreed to be in-house 24/7. That doesn’t mean on standby or on call. They will be physically on premises. Dr. Andrews can fill us in on whether or not we have adequate trauma surgeons signed on.”

  “I’m in the process of interviewing several surgeons right now,” Jake said. “I’ll be ready before the doors open.”

  “Good.” She was all business, the polar opposite of the tantalizing temptress of just a few hours ago. “Now for Radiology. Dr. Edwards, about the Nighthawk system…”

  Jake knew that radiology used the Nighthawk system to send nonemergency tests to Australia via the Internet for interpretation. But the state of Nevada mandated that an interventional radiologist be in-house for invasive procedures that required diagnostic imaging or guidance for tapping blood buildup in the chest cavity or other emergency situations. Edwards was a hard-ass and not receptive to change, making Hope’s job a challenge.

  The heavyset, balding doctor tried to glare her into submission. “It’s cost-effective to use the Nighthawk system.”

  “In most cases, yes,” Hope agreed. “But there isn’t a choice about this. We can’t be designated a trauma center without an interventional radiologist in house.”

  “And I need to pay the I.R., Miss Carmichael,” he said stubbornly. “They don’t come cheap. I have a budget.”

  “Don’t we all.” She glanced at Jake, her hazel eyes narrowing slightly. “But there are other ways to trim.”

  “None of them pretty.” He rested his elbows on the table. “What if there are no traumas?”

  “It doesn’t matter. We’re a trauma center and have to staff for what could happen.”

  “And I still have to pay the staff for doing nothing. My partners will not be happy and neither will I.”

  “You agreed to the terms of the contract, Dr. Edwards,” she reminded him.

  “Terms can be amended. I think hospital administration should absorb some of the cost.”

  Hope stared him down. “I understand that the tendency is for every department to become territorial and insular, but the goal is for all the parts to function as one. Just like the body which can’t sustain life without a brain, heart or liver, a trauma response relies on all the departments for a successful outcome.” She glanced at each department director in turn before saying, “But I’m sure you’re all as aware of that as I am.”

  Dr. Edwards shook his head. “When I can’t justify expenditures, it’s my reputation on the line. My ass in a sling.”

  “As is mine,” she said.

  Jake glanced in the direction of the body part in question which she was currently sitting on. From what he remembered, it was an excellently curved butt that fit nicely in his hands.

  “This is not the time or place to be discussing financial arrangements. I suggest you speak to the administrator regarding your concerns. Bottom line,” she said, momentarily glancing at Jake as if she could read his thoughts, “I need your assurance that you’ll be prepared with an in-house radiologist around the clock.”

  The radiologist stared at her for several moments, then finally nodded, albeit reluctantly.

  “Good,” she said, smiling sweetly. “And last but not least, I’d like to discuss who should respond to a code-trauma page.”

  Jake knew how he wanted it to go and was acutely interested in how she’d present this.

  After glancing at her notes, she looked around the table. “In my opinion there should be someone from the lab, Radiology, Respiratory Therapy, Admitting and an ICU nurse. Just in case.”

  “How about housekeeping and dietary?” Jake asked. “Or lions and tigers and bears, oh my.”

  “Excuse me?” She met his gaze.

  “You’re aware of the limited space in the trauma bays?”

  “I am.”

  “If you get all those people in there, it’s like an IV push of adrenaline. Looky-loos show up in droves. It will be a three-ring circus and you might as well sell tickets.”

  Around the table everyone laughed and Hope narrowed her gaze on him.

  “You didn’t let me finish, Doctor.”

  “So you were going to say that the key to an organized trauma team response is…”

  “Security,” she finished, one eyebrow raised. “Security will be trained to monitor who should and should not respond to a code trauma.”

  He nodded, more than satisfied with her response. She knew her stuff. She was a smart cookie and sexy as hell. Damn inconvenient this thing arcing between them.

  “That’s it for me,” she said, glancing at everyone around the table. She looked at him. “Dr. Andrews, it’s your meeting.”

  “Gripes anyone?” They all got a chuckle out of that, including the radiologist. It took the edge off the tension of moments before. “Any other business?” Before they could answer, he stood and said, “Hearing none, I call the meeting to an end.”

  Jake figured that everyone had had enough for today. Especially Hope. The room cleared quickly, as if they were afraid he’d change his mind and bring up something really complicated, like open-heart surgery with a cheese grater.

  He remembered Hope telling him if he was as good in surgery as everyone thought, he could get a positive outcome with a potato peeler and a watermelon scoop. That made him smile.

  “Something funny, Doctor?”

  “Nope. Not a thing,” he said. Her frown said she wouldn’t find his thoughts amusing.

  “Not even throwing me under the bus with the three-ring circus remark?”

  “It was an attempt at humor. To keep tempers in check.”

  “At my expense,” she accused.

  “Did it occur to you that they were testing your resolve? That I set you up to show these guys you know what you’re doing?”

  “Actually, no.” She folded her arms over her chest and leaned back against the table. “Did you?”

  “Actually, no.” He wished that had been his motivation. “I was testing you.”

  “You didn’t think I knew that a free-for-all in the trauma bay is a whole different kind of trauma?”

  “I only know what’s on your résumé. Not your ph
ilosophy on setting hospital protocols.” Or anything else for that matter. Part of him wanted to know everything about her and that was bad.

  “Apparently I passed.”

  Oh, yeah. His gaze settled on her mouth and the memories came flooding back. One minute they’d been on opposite sides of the money-versus-medicine debate and she’d skewered his last nerve with her stiletto. The next he had her up against the wall and both of them were breathing hard while he kissed her senseless.

  And she kissed him right back.

  Another thirty seconds and he’d have been inside her. He’d been almost grateful when his partner’s call interrupted what would have been a huge mistake. But he carried around a big fat regret that he would never know what loving Hope would feel like.

  “Yes,” he finally said. “You passed the test. Obviously you’ve been through a trauma situation with no one directing traffic.”

  She nodded. “You do the best you can to think of everything, all the medical consequences. Sometimes you forget to factor in human nature. Basic curiosity.”

  “Speaking of that—” He was so damn curious about her. If only he had internal security to direct that somewhere it wouldn’t bite him in the ass.

  “Yes?” She tilted her head and her hair swung sideways, revealing the smooth expanse of sexy skin on her neck.

  “Edwards is a pain in the butt. I’ll speak to him and make sure he backs off.”

  “Why would you do that?”

  Good question. He hadn’t planned to offer his help. Watching his own back had been top priority for a long time. “I know him. It might help.”

  “Thanks. But it’s my job to deal with him.”

  He nodded. “Okay, then.”

  She was right; not his responsibility. Since when did he run interference for anyone? That was way too easy to answer. Hope Carmichael had tripped the switch on his protective instincts. There was something fragile about her that made him want to keep her safe when she should be dead last on his priorities list.

  He hadn’t worked his ass off and scraped out a living all his life just to let sex with a tempting coworker derail his career plan.

  “Okay, then,” she echoed. She straightened from the table and started to walk away. “I have work to do and I’m pretty sure you do, too.”

  “Wait, Hope…”

  She stopped and looked up. “Yes?”

  “We need to talk.”

  Something flickered in her eyes. Heat? Awareness? Regret? “I really have to go, Jake. You’re the one who ended the meeting because there was no other business.”

  “It’s not about the hospital.”

  She tucked a silky strand of honey blond hair behind her ear. “Then this must be about last night.”

  She’d blamed herself, but he’d been a more-than-willing participant. He hadn’t meant for it to happen. He’d told her common sense was highly overrated, but that was lip service. No pun intended. Common sense had gotten him to where he was now. His career trajectory was right on target.

  “Yeah. About last night—” He pushed his suit jacket aside as he rested his hands on his hips. Kissing Hope came under the heading “Seemed Like a Good Idea at the Time.” They’d even agreed that kissing common sense goodbye was a very bad idea. Then they’d turned the bad idea on its ear and went for each other again.

  It was time to clarify the mistake, clear the air and put the personal behind them. Get back on a professional footing because he had a lot at stake.

  “Our priority needs to be getting the hospital open and running smoothly. At a profit,” he added, bracing for her reaction.

  “You’re absolutely right,” she said.

  “Anything of a personal nature between us would distract attention from that goal.”

  “I agree completely.” She nodded so eagerly that it made his head hurt.

  “This is important for the community.”

  Not to mention himself. Success equaled power and security. Only someone who’d been powerless and insecure could understand how vital those intangibles could be.

  “I’m really glad you brought this up,” she said seriously. “It’s like lifting a heavy load from my shoulders. What happened was a momentary, involuntary, reflexive, impulsive, spontaneous, inconsequential, insignificant—thing.”

  “Agreed.” And yet her qualifying it to the size of something you could only see under a microscope was starting to tick him off. He’d spent a lot of time and energy worrying about how to handle this. “So we’ll just forget it ever happened.”

  “Right. I so don’t need any problems in my life. Already forgotten. Thanks, Jake.”

  Could she be any happier to be done with him?

  He wanted to stop her when she walked to the door. He wanted to take back his words, but she might claim it was such a nonevent that all memory of their lips touching and sparks flying had been completely removed from her memory bank.

  And how perverse that erasing it had been his goal in bringing up the subject. Talking about the elephant in the room was supposed to make it go away. He felt as if the effort had been a complete failure to meet the objective he’d had in mind.

  Not only could he not forget about kissing her, but he was also annoyed that she could. Being frustrated at the success of his strategy was too stupid for words.

  Chapter Three

  “How many traumas would you guess come into this E.R. in a month?”

  Hope put the question to Dr. Cal Westen, a pediatric trauma specialist, and Dr. Mitch Tenney, the E.R. doc on duty. They were Jake’s partners in the trauma practice. Both worked at Mercy Medical Center’s main campus and they stood with her in a hallway just outside the emergency room.

  Mitch thought about the question for several moments. The dark-haired, blue-eyed hunk was dressed in green scrubs. He was on duty but had taken a few minutes to answer her questions after waiting patients had been triaged and sent to rooms where they’d be seen in the order of symptom severity.

  Dr. Tenney had a reputation for passionate intensity, but had been eager to help when she’d explained she had staffing questions regarding the soon-to-open hospital.

  “In a month we probably get ten to twelve level threes,” Mitch said. “Those are usually head trauma from MVA—motor vehicle accidents. Or GSW—gunshot wounds.”

  “How many children?” she asked the pediatric specialist.

  Cal Westen was no less super-hot than his partner, but his coloring was different. Dark blond hair and blue eyes made him look more relaxed, but his skill and rapport with kids was well-known.

  “We probably get twenty-five kids a day,” he said, sliding his stethoscope over the back of his neck, letting the ear tips and circular chest piece dangle. “Fever is the most common complaint followed closely by wheezing—a level-one nebulizer.”

  Hope jotted down a few things in a small notebook. “I’m guessing that those kinds of issues are seasonal?”

  Cal nodded. “Spring and fall pick up because of allergies. And we get a surge when kids go back to school. In large groups the germs spread faster. They get colds and flu. Wheezing is a secondary complication.”

  “As far as staffing we need to take that into consideration.” She’d been an E.R. nurse, but every hospital had its way of doing things. It was her job to observe Mercy Medical’s procedures and improve on them with the new campus. If possible. “What’s the work flow like? What happens when patients hit the door? Where do they go?”

  “Sometimes we sit around and twiddle our thumbs. Sometimes it’s saturated.” Mitch rubbed a hand across the back of his neck. “We assess everyone right away. If we’re really busy, the least severe cases see a nurse. Next would be E.R. doc. Me. The level threes are evaluated by the trauma surgeon.”

  “That would be Jake.” When both doctors looked at her she said, “We’ve met.”

  Especially their lips and bodies from chest to thigh had met. The memory made her hot all over even though she’d enthusiastically agreed with h
is suggestion, just yesterday, that they forget all about that meeting.

  “I understand Jake was with you the other night when he was appointed to chief trauma surgeon.” There was a gleam in Cal’s blue eyes.

  “I did see him. Right after Congressman Havens made the public announcement.”

  She remembered Jake’s gruff, curt responses when he’d answered his cell that night. Probably Cal had been on the other end of the call. He’d be curious because the appointment would impact their practice. Did he also know that he’d interrupted an intensely personal moment? If he didn’t, she certainly wasn’t going to confirm. All business. She and Jake had agreed.

  “So,” she said, looking from one hot doc to the other. “You both put in a lot of hours here in the hospital?”

  “Yeah.” Cal checked the pager at the waist of his scrubs. “We’re in the process of looking for another pediatric specialist and E.R. intensivist for the practice. Both of us are married and want to spend as much time as possible with our families.”

  “You have children?” she asked.

  “I have a little girl,” Cal said, a proud smile curving his mouth. “Almost two.”

  “And I have a son.” Mitch’s smile was pleased. “Going on a year.”

  So hospital gossip was right. Two of the trauma docs were no longer single. All evidence pointed to the fact that they couldn’t be happier about losing their playboy position to Jake.

  “Is it hard,” she said, “seeing sick children when you have little ones of your own?”

  “It was hard even before I became a father,” Mitch answered. “I went through a cynical phase and had to work through some issues. A lot of patients come in for things that could easily have been avoided. I had little tolerance for that. It was my wife who helped me mellow.”

  “Really?”

  “Yeah,” Cal said. “Jake and I are incredibly grateful to Sam for this kinder, gentler Mitch.”

  “Bite me,” his partner said.

  “Seriously,” Cal continued. “I don’t see my daughter in every child I treat. But I do understand now how parents feel and try to be more sensitive to that.”

  “I see.” Hope saw a nurse in the E.R.’s doorway signaling to the doctors. “One last question. Stryker gurney or Hill-Rom? Hospital administration has a contract with the latter. We get a rebate after a certain number ordered. But I like Stryker.”