Patient Nurse (4 page)

“They wouldn't fire you,” he said.

“They might,” she snapped back. “I wouldn't blame them. A nurse should be in the peak of health when she's responsible for patients in an intensive care unit. I'm keenly aware of my limitations. That's why I insisted that they have another RN on duty with me, just in case.” She smiled faintly. “I didn't tell them why, of course.”

He shook his head. “You're playing a dangerous game. You could die.”

She got up from her chair. “We all do, eventually.”

He got up, too, scowling. “Don't wait too long,” he pleaded. “They love you at O'Keefe. I have patients there, so I hear all the gossip.” He studied her wan face. “You never told Cortero why you weren't with his wife when she died. Why not?”

“Because he wouldn't listen,” she replied. “And now, it doesn't matter.” She pushed back a loose wisp of blond hair. “It's easier for me if he goes on hating me. Please don't ask why.”

“I won't. But promise me you'll do something soon.”

“I will,” she agreed. She drew in a long breath. “It's
just thinking about the length of time I'll lose from work. I don't know how I'll survive.”

“There are all sorts of agencies that can help. Your aunt and uncle endowed a whole pediatric wing at St. Mary's. Surely they'd help you.”

She laughed. “They hate me even more than Ramon does,” she told him. She shrugged. “It's just as well. If I die on the operating table, nobody's going to grieve for me. Nobody in the world.”

She thanked him for his time and went out, clutching the prescriptions she'd persuaded him to give her, to stabilize her heartbeat and thin her blood, and buy her just a little more time before she had the surgery. In another three weeks, she'd have enough saved to pay her rent for two months in advance. If her insurance paid eighty percent of the hospital bill, which it was supposed to, she could almost manage financially.

 

“You look like death warmed over,” Brad Donaldson muttered as she came onto the ward. Brad was a technician, and a good one. He'd started at O'Keefe about the same time Noreen had, four years ago. He was the only real friend she had, although it was just the friendship of colleagues. Brad was eating his heart out over a young lady doctor who was working as a resident in the emergency room. She couldn't see him for dust. It made for fellow feeling that they were both dying of unrequited love, even though Brad didn't know who Noreen was pining for.

“I feel like death warmed over,” she told him.

He cocked his blond head and watched her closely. “Your color isn't very good.”

“I know.” She took a steadying breath. “I'll be all
right. The doctor gave me something to help stabilize my heartbeat.”

“Talk to me,” he said.

She smiled, and shook her head. “No. It's my problem. I'll handle it.”

“You worry me,” he murmured. “What is it about nurses that they never admit when they're sick?”

“All guts, no brains?” she ventured, and smiled. “Come on. We've got treatments to give and lunch on the way, and doctors about to make rounds. Let's get this show on the road.”

“After you,” he said with a flourish.

 

A female valve patient was brought up to the ward an hour before Noreen was due to go off duty. She supervised the porters as they got the woman to bed, and then connected the oxygen and the drip, checking the chart for any other medications that the surgeon had ordered. This was one of Ramon's patients. She knew the signature scrawled on the white form.

The woman's eyes opened. She looked white and sick and frightened.

Noreen put a hand on her forehead and gently stroked her gray hair back from the clammy skin. “You're on the cardiac ward. We're going to take wonderful care of you. I'm Noreen. If you need anything at all, just push this button.” She guided the woman's thin fingers to the button on the bed rail. “Okay?”

“Dry,” the woman croaked. “So…dry.”

“Do you have any family to stay with you?” Noreen asked.

“Nobody,” came the wan reply. Her eyes closed on a sigh. “Nobody…in the world.”

Noreen's heart ached for the poor soul. That's how she felt, and this was how she was going to be after surgery, too—all alone without even a friend to sit and hold her hand. She was going to have her surgery in Macon, to be sure that Ramon knew nothing about it. So even Brad wouldn't be there to sit with her. It was a sobering thought.

“I'll get you some ice,” she promised the woman. “It will help a little. You're due for medication, too. I'll bring that back with me.”

“Thank you,” the woman whispered hoarsely.

“It's my job,” she replied with a gentle smile. “Back in a jiffy.”

She went to the ice machine and found one of the other patient's wives there filling a bucket.

“I'm superfluous,” she told Noreen with a weary grin. “He can pour his own juice and get his own ice now, so I'm just company in between television programs.”

Noreen's eyes twinkled. “I don't suppose you'd like to feed cracked ice to the new patient down the hall from you? She has no family and she's dying of thirst.”

“I'd love to” came the reply. “Poor soul. There are so many of us in my family that we had volunteers for every hour of the day, but Saul just wants us to stop bothering him so that he can watch his soap operas.” She chuckled. “You don't know what a joy it is to see him sitting up in bed and smiling again. I thought we were going to lose him.”

“He's tough. I'm glad he came through. Mrs. Charles would be very grateful for any time you could spare to sit with her.”

“I'd love to. It will give me something to do with all my spare time.”

They filled ice buckets and Noreen took her in to introduce her to the elderly woman. They struck up an immediate friendship, as well.

Noreen went back to the circular nurses' station that she shared with the other people on her shift, pausing long enough to sip some coffee while she keyed the vital information about Mrs. Charles into the computer.

Brad paused beside her chair. “Should you be ingesting all that caffeine?” he asked so that only she could hear.

She grimaced. “I didn't think. No, I probably shouldn't.”

“You need looking after, honey child,” he teased, and laid a big hand on her shoulder as he smiled down at her.

Ramon, coming onto the ward, saw the way Brad was leaning over Noreen, saw the smile and the familiarity of that hand on her shoulder. Fury shot through him.

He stopped in front of the nurses' station and glared at Noreen, who noticed him belatedly and stopped smiling at once.

“I want to see Mrs. Charles,” he said without preamble. “If you can spare the time?” he added with a cold glance at Brad, who actually blushed.

“She's in here,” Noreen said, leading the way to Mrs. Charles's room without looking at her companion. That comment had been unfair and unkind. She worked as hard as he did. Brad was only being nice, but it wouldn't occur to Ramon that anyone wanted to treat her kindly.
He thought she was a murderess, someone without feelings of any sort.

She led the way into Mrs. Charles's room. The elderly lady smiled warmly when she saw Ramon.

“Thank you,” she said weakly, extending a hand. “You saved…my life.”

“My pleasure,” he replied, and held the hand. “I've ordered something for pain. Take it when you need it. It won't hurt you. Rest is the very best thing right now. In a day or so, we'll have you up on your feet and get you moving.” He frowned. “Do you have any family that we can notify?”

She shook her head. “All dead,” she said sadly. “But Mrs. Green feeds me cracked ice. It was this nice young lady's idea.”

Ramon glanced at Noreen. “Saving yourself some steps?” he asked in a soft, but accusing, tone.

Noreen ignored the comment and busied herself straightening the sheet over Mrs. Charles's thin body. “If you need us, just call,” she said.

“I won't,” came the kind reply. “You've all been very good to me.”

“It's easy to be kind to someone as nice as you,” Noreen replied, smiling.

Ramon checked his patient, murmured with satisfaction and called a cheerful goodbye as he went out of the room and pulled the door closed behind him.

“How dare you put a visitor in charge of nursing my patient?” he demanded with pure fury in his voice the minute they were out of earshot of the patient.

Noreen's heart jumped and ran away with an annoying lack of rhythm. She had to get her breath before she could even answer him. “I didn't,” she said. “Mrs.
Green's husband is almost ready to go home and he doesn't want her standing over him. She wanted something to do, and I don't have time to feed cracked ice to your patients every five minutes. I know my job. You don't need to tell me how to do it, sir,” she added deliberately. “Mrs. Green volunteered her time. I didn't ask her to.”

That was quite reasonable, but he was furious about Brad's intimacy with her and even more furious that it should bother him.

“I'll expect my patient's chart to be kept up-to-date constantly. If there's any change in her condition, I want to be notified. I don't care if it's three in the morning.”

“Yes, sir.” She clutched the chart against her breasts. “She has an arrhythmia.”

“She waited almost too long for the surgery,” he replied. “It was touch and go in the operating room, and it still is. Watch her carefully.”

“I will.” It was making her nervous to know how crucial timing was to a valve surgery. What if she waited too long? She was younger than Mrs. Charles, but she had an arrhythmia of her own…

Ramon noticed the flutter of her flowered cotton jacket, a touch of color that nurses favored over strictly white pants and jacket. He frowned. “Are you all right?” he asked. “Your heartbeat is…odd.”

It was even odder, thanks to the observation. Her breath was coming too fast. “It's standing so close to you, sir,” she whispered, her voice dramatic but so low that nobody else could hear. She opened her eyes very wide. “It's so exciting…!” she said in a theatrical tone.

He muttered something in Spanish that she was glad she couldn't translate, then turned and stalked away
down the corridor. She sighed with relief. Well, she'd survived that unexpected bout of curiosity. She wondered why he noticed her heartbeat in the first place. Surely it would suit him if it stopped altogether…

T
he stress of her deteriorating condition and the pressure of work knocked Noreen flat two days later. She couldn't even lift her head, much less go to work. She called in sick, attributing her illness to a bout of flu, and she promised rashly to be back in two days. That would carry her through her day off, which would be the next day, and give her a little time to get past the weakness. She only hoped that it was overwork and not the valve getting worse.

Brad stopped by after work to bring her some soup and a sandwich from the local deli. She was so weak that she could barely walk to the door, and out of breath when she got back to her bed with Brad a step behind.

“This won't do,” he said darkly. “You're going to kill yourself if you don't give in and have the surgery.”

“I need…three more weeks to…add to my savings,”
she explained, white with the exertion and breathlessness. “Then I can pay my rent while…I recuperate.”

“You stubborn little idiot,” he muttered. “Why doesn't your family realize there's something wrong with you?”

“They never see me. They're only my aunt and uncle. My parents died years ago in an automobile crash.”

“They raised you. Don't they care at all?”

“I think they did a little, before Isadora died,” she added sadly. “I wish I could change the past. I wish so much that I could. But it's all over.”

“Poor little scrap,” he said heavily. He patted her hand. “Can you eat something? I brought soup and a sandwich.”

“Thank you,” she said. “I'll have it tonight, but I don't think I could keep anything down just now.”

“Let me call the surgeon.”

She shook her head. “Not yet. I'll be better in the morning. I know I will. And I don't have to go back in for two days. Surely, in that length of time…”

“At least stay in bed,” Brad pleaded. “Don't exert.”

“I won't.”

He stayed for a few minutes longer, then he had to go back on duty. She felt more alone than ever when he'd closed and locked the door behind him.

She didn't have the soup. She slept the clock around. And although she did feel better that afternoon, much more able to get around, she was far from recovered. Time was running out.

 

It was pouring rain the morning she went back to work. On her way out the door, she heard a pitiful mewing sound, and looked down to find a tiny kitten
under one of the hedges that flanked the walkway. It was cold and shivering, and its ribs showed right through the skin.

“Oh, you poor little thing,” she cooed, bending to lift it. It purred and purred, rubbing its head against her chin. She looked at it with a rueful smile. The apartment house didn't allow pets. But surely one little kitten…

She stuck it under her coat and went back up the stairs to her apartment, panting for breath when she reached the landing. She put the kitten in the efficiency kitchen with some milk and a little leftover meat loaf. She put a box-top lid down with a newspaper to line it and shut the kitten in the room, hoping for the best. If she got kicked out, perhaps she could find an apartment somewhere else, but she couldn't leave the kitten out in the freezing cold rain.

It would be company, she thought, and a warm glow rose in her chest as she got into her small car and tried to start it. The engine had been acting up, but she couldn't afford a tune-up. She was going to have to make do until after her surgery. But the car refused to start.

She had to sit down and rest enough to catch her breath before she went to wait for the bus. It came, and she got to work.

It was the longest day she could ever remember. She'd told her coworkers that she'd been out with flu, but now two of the nurses on her ward really were out with flu. The nursing staff was shorthanded and as a result, Noreen had to work double shift. The added hours couldn't have come at a worse time.

“This is ridiculous,” Brad muttered, watching her prop her back against a wall in the coffee room to catch her breath. “You'll collapse at this rate.”

“I have to work,” she told him, her eyes as weary as her body. “There wasn't anyone else to call, and I have had two days off, you know.”

He studied her wan complexion. “You look worse now than you did at the apartment.”

“Thanks. You're gorgeous, too.”

He chuckled. “What am I going to do with you?”

“Don't you have something to do?” she murmured.

“A question I was about to ask,” came a deep voice from the doorway.

They both turned, to find Ramon Cortero glaring at them with a clipboard chart in his hand. “Do either of you work here? I want to know why my patient hasn't had his 5:00 p.m. dose of blood thinner.” He waved the chart at her.

Noreen blinked at him. Her mind was as tired as her body. She blinked. “Which patient?”

“Mr. Hayes,” he replied tersely. “It's 8:00 p.m.”

“I've been slow,” she said miserably. “I'm sorry.” She moved away from the wall. “I'll make sure he gets it at once.”

“And I'll check the charts of my other three patients while I'm doing rounds,” he said angrily. “Just to make certain there were no other…lapses.” He followed her, glaring toward Brad.

“It wasn't Brad's fault,” she began.

“Oh, I'm aware of that,” he replied, his eyes flashing. “Like most men, he's vulnerable to overt flirting.”

She closed her teeth together with a snap. “I don't flirt.”

“Call it what you like. I'll wait while you get Mr. Hayes's medicine.”

She fetched it, still grinding her teeth. He was right,
she'd been slow and it could have serious repercussions. If she hadn't been pulling a double shift after two days in bed, it never would have happened.

She gave Mr. Hayes his dose and double-checked all the other files. The vital signs were all neatly charted, but she'd forgotten to measure the urine volume on Mrs. Charles. She could have groaned aloud, for all the good it would have done her.

“I won't report this,” Ramon told her when he'd finished his rounds. “But make one more mistake, and I'll go straight to the administrator. I won't have my patients put at risk by a nurse's incompetence.”

“I'm not incompetent,” she began.

“Play with Donaldson on your own time,” he added curtly.

“I wasn't…!”

He didn't pause to listen to any more excuses. He stalked off the ward, his lean body rippling with bad temper.

Noreen had to bite back tears. He seemed to hate her more every day she lived. Nothing was going to change his mind about her; she knew that now.

Brad came out of a patient's room, having started the patient on the breathing machine for his inhalant medication.

He glanced around. “Has he gone?” he asked hopefully.

She nodded. She pushed back her hair and shook her head. “I don't know what I'm going to do. I fouled up really good. Someone could have died.”

“Not from having one dose of medicine a little late,” he said, comforting her. “I should have paid more attention. I'm supposed to be your backup.” He put an
affectionate arm around her. “Chin up, girl. You'll get through this.”

“Heavens, I hope so,” she said wearily. She glanced at the clock. “Another hour and I can go home.”

“See the surgeon,” Brad said solemnly. “You're taking a risk.”

Her shoulders slumped. “I suppose I am. Maybe that extra money doesn't matter so much after all. Do you like cats?” she added hopefully.

He shook his head and grinned. “I'm allergic to them. Why?”

“Oh. Never mind.” She still had to worry about what to do with the new cat. Perhaps she could work out something with another member of the staff. She'd have to wait and see.

She finished her work, barely, and went off duty after she'd briefed her relief nurse. It was still pouring rain and cold outside. But she heard Ramon's scathing words in her head the whole way, and never noticed the icy wetness on her cheeks.

 

Ramon came back onto the ward less than half an hour after Noreen had left it, to make one last check of his patients before he went home. He examined carefully the man whose blood thinners had been given later than scheduled and noted that his progress continued. He was vaguely disturbed with himself for his attack on Noreen. It wasn't like her to be slow with medicines or overlook notations on the charts. He wondered what had happened.

Brad was just coming out of his last patient's room with his equipment when he saw Ramon waiting for him. He squared his shoulders for a frontal assault, be
cause the surgeon looked more formidable than usual with that scowl on his lean face.

“Why was Noreen slow with the medicine?” he asked bluntly.

Brad's mouth pulled down. “Because she'd been out sick for two days and had to work a double shift tonight. Two of the RNs are down with flu.”

Ramon's face tautened. “I see.”

Brad searched the taller man's eyes. “You really should take a good look at Noreen,” he replied quietly.

“What do you mean?”

Brad wanted so badly to tell him. But it was Noreen's secret, not his. “Never mind. It's not my business.” He nodded and went on his way.

Ramon recorded his notes, and then drove himself home. But even as he pulled into his garage, he knew he wouldn't be able to sleep until he'd apologized to Noreen. With a sigh of resignation, he reversed the car out of the garage and drove the few miles to the apartment house where Noreen lived.

She sounded shocked when he rang the buzzer in her apartment, but she did let him in the front door. She was waiting at her door when he came up the flight of stairs. It was a modest apartment house, with only four occupants, but it was clean and not too spartan.

“What do you want?” Noreen asked, clutching her blue checked housecoat close at the throat. She was barefoot and disheveled, as if she'd been in bed. Surely not; it was barely nine-thirty.

“Donaldson told me you'd been pulling a double shift,” he said shortly. “I didn't know.”

Her eyebrows arched. “Would it have mattered?
I can't think why. Jumping to conclusions about me seems to be your main form of entertainment.”

His brows drew together. “All the same, I don't like berating you for…” He paused as he heard a soft sound in the apartment. “What's that?”

She grimaced, quickly looking up and down the hall and toward the staircase. She pulled her housecoat closer and stepped back. “Please come in.”

He stepped into the small combination living and dining room and she quickly shut the door, just as a tiny ball of fur came trundling out of the kitchen mewing.

He gaped at it. The tiny thing was smaller than her foot, barely weaned by the look of it, and half-starved to boot. She bent and picked it up, cuddling it under her chin. It purred and purred.

“I'm not allowed to have pets,” she explained. “But I couldn't leave it out in the cold rain. It's so tiny.”

That was when he really began to have doubts about Noreen's part in Isadora's death. He couldn't drag his eyes away from the tiny kitten in her arms. She had a soft heart. People were forever imposing on her, because she was a sucker for a sob story. Her aunt used to complain about the number of stray animals Noreen would bring home, which had to be properly treated and then given to good homes. Her aunt and uncle didn't approve of pets, so Noreen was never allowed to have any. But that didn't stop her from rescuing the downtrodden of the animal population.

What bothered him about that memory was what it told him about her. She wouldn't even abandon a stray kitten to its fate, so what in the world ever made him think that she'd sacrifice a cousin whom she loved?
It was so out of character that he was amazed at how easily he'd blamed her for Isadora's death.

She noticed the sudden paleness of Ramon's face under his swarthy tan and she clutched the kitten closer.

“What do you want?” she asked with accusing eyes. “I'm very tired and I want to go to sleep.”

He studied her through different eyes. Her face was wan and there were bright patches on her cheeks. Her breath was erratic, quick. He could see her heart beating against the fabric of the robe, erratically. Something was wrong here.

“Have you seen a doctor?”

“For a virus?” She laughed, bluffing. “Why would I bother a doctor with something that will wear itself out?”

“I have my bag down in the car,” he began.

Her already erratic heart went wild at just the thought of having him listen to her chest. “I have a doctor of my own,” she said through her teeth. “And why do you think I'd let you examine me, even if I were dying?” she added bitterly. “I'd never trust you with a scalpel in your hand. The temptation might be too much for you!”

His sharp intake of breath was audible. “How dare you!” he said through his teeth.

She was too sick to be intimidated by that black glare. “I'm tired,” she said, backing up a step. “Would you please go away and let me sleep?”

He hesitated. Something was wrong, and she didn't trust him enough to tell him what it was. He was suddenly less self-assured. He felt guilty, though God knew why he should. He looked at her with open curiosity, seeing the thinness of her, the dark circles under her eyes.

“You're ill,” he exclaimed softly, as if just realizing it.

“I'm tired,” she repeated. “I got out of bed too soon after a viral infection, and I did too much. I'll be fine tomorrow. I don't need a doctor to tell me that, either.”

Her cheekbones were high. She had a lovely mouth, just the right shape and size. Her skin was creamy and faintly flushed. He noted that her hair was in a long pigtail down her back, and he wondered again what it would look like if she freed it.

“Please go,” she repeated nervously.