A Christmas Knight (2 page)

 

Dominic took a gulp of coffee. Whatever was the matter with him? It was the poor woman's first day in the department and he'd been rude to her.

Well, not rude,
exactly
—he had at least acknowledged her and shaken her hand.

But the zing of attraction when her skin had touched his had thrown him, made him tongue-tied. Which was crazy, because he was never that boorish. Essie had even given him an opening, saying that Louisa was looking for riding lessons for her child. He could've given her Ric and Bea's number, because he knew they had a couple of spaces on their list. They'd talked about it last night, how people were cutting back on extras in the recession and riding lessons were expensive, and Bea had suggested that they should hold an open day to get people interested in the stables.

But then Louisa had said something that slammed right through him.
He wants to be a knight when he grows up.
Yeah. Been there, done that, and the absolute worst had happened.

Though that wasn't her fault and he shouldn't have taken it out on her.

He'd apologise later, and hopefully she wouldn't hold
it against him if she was needed to work with his team in Resus.

Riding lessons. For her son.

Though she wasn't wearing a wedding ring. And there wasn't a tell-tale band of pale skin on her finger to say she'd removed it for work. He'd looked. And he was cross with himself for looking.

Dominic took another gulp of coffee, needing the bitter liquid to jolt some sense back into him. Louisa Austin was gorgeous, with beautiful grey eyes and long dark hair; she'd tied it back hygienically for work, but he could imagine what it looked like loose. Like waves of shiny silk. Her mouth was a perfect rosebud, and it sent a shiver of pure desire running through him, along with an insane urge to find out how it would feel against his own mouth. It had been a long, long time since he'd felt an attraction that strong and that immediate—and that was what had thrown him most.

He knew that it would be pretty stupid to act on that attraction. He wasn't in the market for a relationship; and, even if he was, Louisa had a son. Which meant that either she was already spoken for, despite the lack of a wedding ring, or she was a single parent who'd be wary of taking any risks in a relationship, for her child's sake, and would want someone responsible in her life.

Responsible
.

Right.

Which was about as far from him as you could get: hadn't he ruined his brother's life, two years ago?

He needed to get out of here. Now.

‘No rest for the wicked,' he said, striding over to the sink and rinsing out his mug. ‘If we're to have any chance of meeting our targets today, I'd better get back out there and hope Resus stays quiet for the rest of the afternoon.
Welcome to the team, Nurse Practitioner Austin.' And he left the rest room before he could do anything ridiculous. Like asking her to have lunch with him tomorrow so they could get to know each other a little better.

 

The rest of Louisa's shift turned out to be as busy as the morning, but she managed to get to the after-school club on time to meet Tyler.

‘Hi, Mum.' He gave her the shy smile that always made her melt.

‘How was your day, honey?' She gave him a hug.

‘OK.'

‘Best bit?'

‘Lunch. We had pasta. It wasn't as good as yours, though.'

She really hoped that he hadn't actually said that to the dinner ladies. She could still remember the time they'd had Sunday lunch at her best friend's house and then, when asked if he'd enjoyed it, he'd very politely thanked Mel and gone on to tell her that her gravy was slimy and her potatoes weren't nice and crispy on the outside and fluffy in the middle like his mother's were. Luckily Mel hadn't taken it to heart, but Louisa had had to explain to Tyler that sometimes it was OK to tell a little fib so you didn't hurt people's feelings. And even after she'd finished explaining, he still didn't get it. ‘Let's go home and make dinner. Do you have any spellings or times tables I need to test you on?'

‘No. Do you want to see the horse I drew at lunchtime?' He had his sketchbook out of his schoolbag as soon as he'd put his seat belt on.

She stared at the drawing in awe. ‘It's beautiful, darling.' The horse was drawn in painstaking detail, and was incredibly realistic. Tyler really did have a talent for
art—something she could only assume came from Jack's side, because nobody in her side of the family was arty. But there was nobody to ask, because Jack's family had severed all connection with them as soon as Jack had left—and for the same reason.

Though it didn't bother her any more. She knew that she and Ty were better off without them. Her parents accepted Tyler as he was and gave him enough love for two sets of grandparents. They didn't need the Listons.

Tyler disappeared to his room as soon as they got home, and Louisa knew exactly what he was doing. Putting his drawing in a plastic wallet, labelling it and adding it to his database. One good thing about having a son who was obsessed with order was that she never had to tell him to tidy his bedroom. It was always immaculate. Smiling, she busied herself preparing dinner, and when everything was ready she called him down, careful not to let the new potatoes, chicken or vegetables touch each other on Tyler's plate.

He chattered happily about horses all the way through dinner; and then it was the usual routine of washing up while he had a bath, nagging him to clean his teeth, and giving him a kiss goodnight.

Carefully, he turned the kitchen timer next to his bed to twenty minutes. ‘I'll put my light out as soon as the alarm goes off, Mum,' he promised.

And she knew he would, even if he was in mid-sentence. Tyler was one for sticking to the rules. ‘See you in the morning, darling. Sleep well,' she said, giving him another kiss.

Then she curled up on the sofa with her laptop and looked up all the local riding stables, listing them with their phone numbers in her diary. She'd start calling them tomorrow. It was a pity that Dominic Hurst had turned
out to be so formal and unapproachable—she would've appreciated some tips on choosing the right riding school. But she was used to doing things on her own, so she wasn't going to let it throw her.

And as for stray thoughts of a tall, dark, gorgeous and reserved medic with a mouth that promised sin…she'd banish them all from her head, because there just wasn't room in her life for someone like that.

Handsome is as handsome does.

T
UESDAY
went without incident in Minors, but on Wednesday Louisa was called in to help in Resus.

‘Essie tells me you're very experienced, so I'd like you to work with me, please, Nurse Practitioner Austin,' Dominic said.

She noticed again that he'd addressed her by her title rather than by her name. Was he just being like that with her because she was new, or was he like that with everyone? Then she remembered that Essie had called him by his first name. Better get things straight now, then. ‘OK, but can we spend thirty seconds now to save us a lot of time when our patients arrive?' she asked.

He frowned. ‘How do you mean?'

‘It goes without saying that I respect your seniority, but I'm used to working on first-name terms. It's quicker, easier, and less of a mouthful. Would you mind?'

He blinked. ‘OK, Nu—Louisa.'

‘Thank you, Dominic.' She used his name deliberately. ‘So what's happened?'

‘Car crash. Three casualties,' Dominic explained. ‘Both drivers are coming in with suspected whiplash, and the passenger has suspected multiple fractures. Ronnie and Sasha are going to treat the drivers, and I need you with me as lead nurse to treat the passenger—Sally will assist us.'

She nodded. ‘How long have we got to prepare?'

‘Five minutes. I'm going down to the ambulance bay now.'

She busied herself getting the trolley ready; when Dominic came back with the paramedic and their patient, the team swung into action.

‘Rhiannon, this is my team, Louisa and Sally,' Dominic said calmly. ‘They're going to help me look after you.'

‘Hurts,' Rhiannon mumbled. ‘Where's Gary?'

‘Your husband's right here,' he reassured her. ‘Ronnie's looking after him, and as soon as she's checked him over and made him comfortable, he'll be able to come and see you. And we're going to give something to help with the pain,' he said. ‘I'm going to put an oxygen mask on you to help you breathe better, and then we're going to have a proper look at you, OK?'

On Dominic's direction, Sally gently cut through Rhiannon's clothes so he could do a full body assessment, top to toe. Meanwhile, Louisa hooked Rhiannon up to a cardiac monitor, put in a second line and started taking obs.

‘Heart rate 135, respirations twenty-six, blood pressure 82/54,' she said. Tachycardia and low blood pressure pointed to major loss of blood—probably caused by internal injuries, Louisa thought.

‘We need to get some fluids in. Start with a litre of Hartmann's, and get six units cross-matched for me,' Dominic said—and looked approving when he saw that she already had the saline solution in her hand.

Dominic had given Rhiannon painkillers to make her more comfortable; but when her blood pressure didn't respond to the fluids and her sats started dropping, he glanced at Louisa. ‘Can you do ABGs for me, please, Louisa? And, Sally, I need X-rays.' He listened to Rhiannon's chest.

From the bruising on Rhiannon's skin, it looked as if she had several broken ribs. No doubt Dominic wanted to check for pulmonary contusions. There were a lot of problems that could be caused by blunt trauma at high velocity, Louisa knew; with damage in Rhiannon's chest area, there could be trauma to the heart as well as the lungs.

‘I think we need to intubate.' He held Rhiannon's hand as he explained to her what they were doing. ‘You're struggling to breathe, sweetheart, so we need to help you with that and make sure you get enough oxygen. I'm going to put a tube down your throat so you won't be able to speak, but I'm going to give you some medication first so you won't feel it and it won't hurt—it'll make you more comfortable. I know you're feeling tired and it's hard to talk, so just squeeze my hand if you're OK with that—once for yes and twice for no.' He paused. ‘That's a yes—that's my girl. We'll get you comfortable as soon as we can.'

Louisa was just drawing up the ampoules of anaesthetic when one of the drivers who'd been brought in came over to them, his face ashen. ‘Oh, my God, Rhi! I'm so sorry. I couldn't avoid him—he just pulled out on me and there was nothing I could do.' He looked distraught as he stared wildly at Dominic and Louisa. ‘I can't believe I've come out with just bruises, and Rhi's so…so…' His voice caught.

‘Gary, isn't it?' Dominic said, somehow managing to divide his attention and eye contact between his patient and her husband.

‘Yes.'

‘She was asking for you.'

‘Can I hold her hand?' At Dominic's brief nod, Gary curled his fingers round his wife. ‘Honey, I'm here, and I love you, and I'm so sorry.' He dragged in a breath and looked pleadingly at Dominic. ‘Is she going to die?'

‘Not on my shift,' Dominic said, ‘though it might be
easier on you if you wait outside. There's a vending machine just round the corner. I promise we'll come and find you as soon as we've got her stable and let you know what's going on, but for now we need to concentrate on Rhiannon here and treat her.'

Gary shook his head. ‘No. I need to stay with her.'

‘Unless you're a trained medic, it can look very worrying in here,' Dominic said gently. ‘Especially as we're just about to intubate her to help her breathe. Trust me, we're going to do everything we can for your wife, but it will be much better on your nerves if you go and get yourself a hot drink and leave us to it for the next few minutes.'

‘I'll come and get you as soon as there's any news,' Louisa promised. But she noticed that Gary was staring at his wife, looking stunned. In shock, she thought—not the medical kind, but the emotional kind. They needed to get him out of here. ‘Do I have two minutes, Dominic, to show Gary where everything is?'

‘Two minutes,' Dominic confirmed; the expression in his eyes told Louisa that he knew exactly what she was doing and approved. Which was a huge relief: he was much easier to work with than she'd expected. And he was sensitive with patients and relatives. Maybe she'd just caught him on a bad day on Monday.

‘Come on, I'll show you where the drinks machine is,' Louisa said, slipping her arm through Gary's and guiding him out of Resus.

‘I was coming down the hill. I wasn't speeding. I could see the other car approaching the junction, but he wasn't even indicating! And then he just pulled out in front of me. It was as if it all happened in slow motion. I could see we were going to crash, and I couldn't do anything to stop it. I slammed on the brakes, but it wasn't enough.' Gary shivered. ‘We hit him and the car spun round. Rhi's side of the
car was squashed against another one. And…' He covered his face with his hands. ‘She
can't
die. We celebrated our twenty-fifth wedding anniversary last week. I can't… Not without her…'

Louisa got him a cup of hot, sweet tea from the vending machine—even if he didn't normally take sugar or drink tea, she knew it would help—and settled him in a chair. ‘Gary, it wasn't your fault, and the staff here are really good,' she told him gently. ‘We're going to do our very, very best. Now I have to go back and help Dominic treat Rhiannon, but I'll be back as soon as I can with any news.' She squeezed his shoulder. ‘I know waiting's hard but hang on in there, love.'

‘You're so kind. Thank you. And please—' Gary's face was stricken ‘—please, don't let my wife die.'

By the time Louisa got back into Resus, the medication had taken effect, and Dominic started to intubate their patient. She'd seen it done before, but never with this calm, confident efficiency—and he was amazingly quick.

Dominic Hurst was a superb doctor, she thought. And she liked the way he'd made time to talk to his patient and her husband, clearly aware of how important communication was as a way of bringing down stress levels.

He blew up the cuff on the tube and turned to the other nurse. ‘Sally, are they ready for us in Radiology?'

‘Yes.'

‘Great. Thanks for that. Can you bleep the orthopods, please, and let them know we have a patient with suspected flail chest? I want to have a look at the X-rays, so I'm going down to Radiology with Rhiannon.'

‘Do you want me to give ITU a call, to put them on standby?' Louisa asked quietly, so Rhiannon couldn't hear her and start to worry. In her experience, it was best to involve the intensive care unit as early as possible, because
cases of pulmonary contusions often led to ARDS—adult respiratory distress syndrome. And if there were multiple broken ribs, she'd need careful monitoring.

‘Yes, please. And could you tell Gary I'm taking her to X-Ray? Not because he should worry himself sick, but because it means I can see the X-rays straight off and it'll save us some time. Tell him I'll come and talk to him as soon as we know more.' He smiled at her. ‘Thank you, Sally. You've done a really good job. You, too, Louisa. Even though this is the first time we've worked together, it's felt as if we've been on the same team for years. Your old department must really be missing you.'

The compliment made her feel warm all over—especially as she hadn't expected it from him. And it was good to work with a doctor who appreciated the nursing staff rather than taking them for granted, especially one who bothered to give a student praise where it was due. She smiled back at him. ‘Thanks.'

While Dominic went off to X-Ray with Rhiannon, Louisa contacted the intensive care unit to put them in the picture, then went in search of Gary to let him know what was happening.

‘Is she going to be all right?' he asked. ‘I'll never forgive myself if anything happens to her. And that stupid guy who tried to get into a gap that wasn't there, just to save a few seconds…' He was shaking, clearly near tears.

Louisa put her arm round him. ‘I know, love. You said yourself there was nothing you could do, so don't blame yourself. The police will deal with the other driver.' Who'd also walked away without a scratch, according to Ronnie, but that wasn't something Louisa intended to share. ‘We'll know a lot more when the X-rays are back, and Dominic will talk you through what Rhiannon's injuries are and how we're going to treat her. But for now we're keeping
her comfortable. Try not to worry—and, yes, I know that's a lot easier said than done.' She gave him a sympathetic smile. ‘Is there anyone we can call for you?'

‘I… No.' He shook his head. ‘I'd better call our daughter myself. She'll be devastated.' He dragged in a breath. ‘I can't use a mobile phone here, can I?'

‘In the corridors, you can,' she reassured him. ‘The phone won't interfere with equipment there.' It wasn't the only reason the hospital preferred not to have people chatting on mobile phones—loud conversations disturbed other patients, and some ringtones sounded eerily like alarms on equipment. The blanket ban on mobile phones throughout the hospital had been relaxed, except for critical-care areas such as the emergency department, the coronary care unit and the special care baby unit, where equipment could be affected by electromagnetic interference.

‘Thank you.'

When Dominic came back from Resus, he looked serious but calm. ‘Gary, I've seen the scans and I'm sending Rhiannon up to Theatre where the surgeons can help her. She's got four ribs broken in two places, pulmonary contusions—that's a bruise on the lung and you often get that with broken ribs—and what looks to me like a cut to her liver.'

‘So the surgeons can fix her ribs?'

‘They might decide to let them heal without fixing them,' Dominic said. ‘But the contusions are going to make it a bit hard for Rhiannon to breathe, so she'll be in Intensive Care afterwards until they heal—they can keep a close eye on her and make sure she's comfortable.'

‘You mean she's going to be ventilated?' Gary's eyes widened. ‘Oh, my God.'

‘It looks and sounds a lot scarier than it is. It's going to be the best treatment for her,' Dominic reassured him.
‘We're taking her up to Theatre now, and if you'd like to you can come with us, as far as the doors. There's a waiting area there, and one of the surgeons will come out and talk you through what's happening. The staff at the ICU—the intensive care unit—are lovely, and they'll be happy to answer any questions you have.'

They headed up to Theatre, Gary holding his wife's hand all the way.

‘I'm so sorry, Rhi. I love you,' he said, clearly trying to hold back tears.

‘They'll take care of her,' Louisa said gently, putting her arm round his shoulders as Rhiannon was wheeled through the doors to Theatre. ‘Is your daughter coming?'

‘She's on her way.' He bit his lip. ‘And I'm keeping you from your work.'

‘That's OK.' If necessary, she'd work through her lunch hour to make sure that the targets were hit. People came before admin, in her book, and always would; and if she had to explain herself to the bean-counters, so be it. Nursing was about people, not numbers. ‘I'll wait until she gets here.'

When Gary and Rhiannon's daughter arrived, Louisa explained what had happened and what would happen next, made sure they both had a hot drink, then headed back down to the emergency department. She was back in Minors as nurse practitioner for the rest of her shift, and her lunch break consisted of two minutes to bolt a sandwich so that she could catch up with the delay in treating her patients. When it was clear that she was still running late, she made a quick call to her mother to ask if she could pick up Ty from after-school club, and continued working steadily through her list. After she'd seen her last patient, she headed for Resus, hoping that Dominic would be there and that he knew how Rhiannon was.

‘Shouldn't you have been off duty half an hour ago?' he asked.

She shrugged. ‘It happens. I just wondered if you'd heard anything from the ICU about Rhiannon?'