The Doctor's Christmas Proposal Page 3

  Dana glanced back towards the nurses’ station to where Lyle’s chart was. “I’ll get it for you.”

  “No need. I’ll get it myself.” Once she had the restraints secured, he moved away. “Be careful, will you? I don’t think the hospital administration would appreciate losing a good nurse.”

  Wow, two compliments in one shift. When was the last time that had happened? She couldn’t remember. “Thanks.” She watched him head back to the nurses’ station and caught the annoyed glance Therese, one of her peers, aimed in her direction. Therese’s expression couldn’t have been more clear. Hands off, he’s mine. Dana raised an eyebrow. She hadn’t arranged to get kicked as a way to snag Mitch’s attention. When Mitch approached the nurses’ station, Therese rushed forward with a fawning smile.

  Oh, brother. Dana turned back toward her patient. As if she cared about the guy one way or the other, except, of course, maintaining a professional rapport with him.

  Sweat trickled down her back as she fought to keep Lyle calm for the next few hours, in between making sure Jessica Kinkade’s breathing and oxygen saturation levels remained stable. Keeping busy was good as far as making the shift go by faster, but she’d hoped for a little time to get some of the ICU’s Christmas decorations out of the box hidden in the back storage area.

  “Dana?” Mitch called her name from another patient’s room.

  “Yes?” She crossed over. “Something wrong?

  “No, but there is a new admission down in the ED.”

  Bummer. She glanced around in dismay. Each of the nurses already had two patients. “What’s the diagnosis?”

  “Acute hyperglycemia.” He read the message scrolling across his pager. “I need to run down to the ED to evaluate the situation. If anything changes, I’ll let you know.”

  “Thanks.” She wasn’t used to any of the physicians communicating quite so thoroughly, but she wasn’t going to argue either. A refreshing change, being treated as a member of the team.

  “Are you making a play for him?”

  Dana turned toward Therese, who had sidled up beside her. “What?”

  “The way you’re throwing yourself at Mitch Reynolds.” Therese tossed her head, a movement that drew attention to her long wavy blonde hair pulled back in a bouncy ponytail. “You’re being a bit obvious.”

  “You would know.” Dana didn’t have time for Therese’s antics, especially when Therese had the most stable assignment in the unit. She tried to remain calm. “We’re getting a patient from the ED—acute hyperglycemia. Can you take on a new assignment?”

  Therese shook her head. “I’m already too busy. I can’t handle a third.”

  Not too busy to come over and poke her nose in where it didn’t belong, Dana thought, but bit her tongue to avoid an argument. Therese was the one nurse she had trouble getting along with, only because she seemed to care more about capturing a doctor husband rather than taking care of her patients. Therese seemed to see all single women as a threat to her personal goal. As if she could be a threat. What a joke. “Fine. Then I’ll take the admit.”

  Therese flounced off, as if worried Dana would try to force her to take the patient anyway.

  Dana crossed over to peek in on Jessica. Her interest in Mitch was purely professional, she assured herself. Her few relationships in the past had seemed to fizzle out, her boyfriends quickly losing interest in anything long term. She had no intention of going down that path again. Especially not with a guy as attractive as Mitch. He could have any woman in the hospital, and there was no reason to think he was interested in her.

  Which was just fine, because a relationship would only complicate things.

  CHAPTER THREE

  WITH ONE GLANCE, Mitch knew the patient George Jones, his new admission, was in serious trouble. He turned to the resident on duty. “How long has he been vomiting?”

  “Since coming in. He thought it was flu, but then realized something else might be going on.”

  “How long has he been a diabetic?” Mitch could detect the distinct fruity scent of ketones seeping from the guy’s pores.

  “Recently diagnosed, but probably had an underlying disease process for much longer than that.” The ED resident was well versed on the patient’s history.

  “Do you have a set of blood gases?”

  “Yes, Dr. Reynolds.” The ED nurse, a cheerful middle-aged woman whose name he couldn’t remember handed him the lab results. “He’s acidotic, running a PH of 7.15. We started an insulin drip because his glucose was over 900. We’ve also hung mini-bags of potassium and magnesium to supplement his electrolytes. I don’t like the looks of his EKG, though. I wonder if he has something else going on.”

  Mitch thought the same thing. “First we need to intubate him. Then I’d like to get him upstairs to the ICU.”

  “He’s breathing fine,” the resident argued.

  “Not for long, with that level of acidosis. Intubate him.” The resident shrugged, then headed over to do as ordered. Mitch turned toward the nurse. “I’m going to call upstairs to let the ICU know we’re on our way.”

  “I need to give report, too, Dr. Reynolds,” the ED nurse reminded him.

  Already dialing, he nodded. He recognized Dana’s voice when she answered and was annoyed when his heart gave a little jump. He cleared his throat. “Dana? We’re intubating Mr. Jones right now, then we’ll be up.”

  “Bring him up to bed ten, it’s our only empty bed at the moment.”

  “Great. Here’s the ED nurse to give you report on the patient.” He handed the phone over.

  Anxious, he glanced at the clock then back at the patient. The ED resident was taking his time on the intubation. Mitch shoved his hands in his lab coat pockets and watched, overseeing the procedure. He could have had the tube placed in half the time but unless it was an emergency, the residents needed to be in charge of doing procedures.

  There wasn’t a major rush to get the patient up to the ICU anyway, so why was he checking the clock every ten seconds?

  Because he didn’t have a good feeling about George Jones. He wondered if Dana would be the nurse assigned to the new patient. Then told himself he didn’t care. He wasn’t in the market for a woman. Especially not someone like Dana. If he dated at all, he’d choose someone who didn’t want anything more than simple companionship. He wasn’t ready for more. Dana was too open, too honest. She’d stolen his breath, the way she’d looked as she’d comforted Jessica Kinkade’s daughter. Which meant Dana was off limits in a big way. He hadn’t come all the way to Milwaukee to open himself up for more heartache.

  He’d experienced enough heartache to last a lifetime.

  “Dr. Reynolds? We’re ready to go.” The cheerful nurse drew his attention toward matters at hand.

  Finally. “All right, let’s move him.”

  Between the ED resident, the nurse and the respiratory therapist, they made their way up the elevator to the ICU. Dana met them at the bedside, jumping in to take over the patient’s care.

  Moments after the ED staff cleared the room, the monitor above George’s bed beeped.

  “He’s throwing lots of PVCs.” Dana frowned. “Do you want me to try a bolus of amiodarone?”

  “Yes.” He glanced down at the 12-lead EKG in his hand. There were some minor signs of a myocardial infarction, which might have been mistaken for a simple electrolyte imbalance. “You’d better get ready to cardiovert him, too.”

  Dana was already wheeling the crash cart over to the bedside. With a quick motion, she snapped off the plastic lock on the cart then opened the medication drawer.

  He noticed she never hesitated, but with smooth, competent movements she gave the amiodarone, then hooked up the defibrillator just in case they needed it.

  “What was his potassium?” Dana asked, staring up at the monitor with a frown. So far, the medication had had no effect on slowing George’s heart rate.

  “Only 2.5, but the ED has given him some potassium since that was drawn.”


  “The amiodarone may not work if his electrolytes are out of whack.” Dana began to place the large, square defib patches on the patient’s chest. “I’ll ask Pharmacy to start a drip.”

  “I’ll call for a cardiology consult.” Mitch walked over to the closest phone, right outside the room. If George had suffered an acute MI, giving fluid, the normal treatment for DKA, might put too much stress on the heart and extend the infarct. After getting in touch with the cardiology attending, he hung up the phone and returned to George’s room.

  “He’s in sustained V-tach but I still have a pulse.” Dana’s voice was calm. He was glad the patient still had a pulse because they had a better chance of converting him without sustaining too much damage to his heart.

  “Cardiovert with 25 joules.”

  “We don’t have bi-phasic defibs.” Dana spoke up quickly.

  Damn, he hadn’t realized they still used old technology here. Without the new bi-phasic defibrillators, patients required a higher amount of energy, which could possibly cause more risk of heart damage. He’d have to have a word with his new boss. “OK, then, cardiovert with 50 joules,” Mitch amended.

  “All clear?” She waited for everyone to step back, then delivered the shock.

  “Still in V-tach with a pulse.” Dana glanced at him. “Do you want to repeat the same level?”

  “Yes. Cardiovert again with 50 joules.”

  “All clear?” Dana pushed the button and delivered the second shock. For long seconds they stared at the monitor. “He’s converted back to normal sinus rhythm.”

  “Good. Although I’m not sure how long his rhythm will hold.” Mitch didn’t want to take any chances. “Let’s get the amiodarone going and keep replacing his electrolytes.”

  Dana nodded in understanding. Noreen, the pharmacist on duty, brought in the requested medications.

  “Be careful with the fluids,” Mitch warned as Dana filled another mini-bag. “Let’s not stress his heart any more than we have to.”

  “I understand.” Dana hung the medication then handed him the chart. “Write your own orders. I need to go and check on my other patients.”

  Mitch couldn’t help grinning. Dana’s blunt tone delegated him to the level of a green, first-year resident, but he couldn’t take offense. Not when she’d been quick to recognize the defibrillator issue during the cardioversion.

  When the cardiologist arrived at the bedside, he agreed with Mitch’s assessment. “Once you get his electrolytes under control, we’ll take him for a cardiac cath. I don’t want him to arrest on the table.”

  Over the next hour they made enough headway with George’s labs that the cardiology team felt comfortable enough to take him down to the cath lab. He noticed Dana didn’t relax once she’d transported the patient, but disappeared into Jessica’s room.

  “Of course I’ll call your children,” he overheard her say. “I’m sure they’d love to say goodnight. Just give me a few minutes to clean up my other patient, all right? I’ll be back as soon as I can.”

  He understood Jessica’s concern about her children. Parents never stopped worrying about their children. He shied away from the painful thought. The hour was late, well past the time he should have been heading home. Not that there was anything to hurry home to.

  Although staying here to watch Dana run back and forth between patients would drive him nuts. She had more energy than anyone he’d ever known. And, technically, he owed her a favor. He stopped her outside Jessica’s room. “Dana, is there something I can do to help?”

  “No, thanks.” Dana flashed him an absent smile then stopped, and came back. “Actually, there is. Will you call Jessica’s kids? She wants to say goodnight.”

  “Ah…well, I don’t know.” He wished he’d just kept his mouth shut. Maybe he should go home after all. The residents could handle things here.

  “I have the number.” Dana must have been trained in the military by a drill sergeant, the way she thrust the clipboard holding Jessica’s mother’s phone number into his stomach. “Use the phone in her room, so she can talk to them.”

  She was gone before he could blink. Staring down at the number, he wished he had just minded his own business.

  Communicating with Wendy and Chad had been more difficult than he’d thought. He’d managed to avoid almost all contact with kids over these past two years. Not because he didn’t like them, but because seeing them hurt. Watching Jessica interact with her children had brought long-buried feelings rising to the surface. The happy family atmosphere was a devastating reminder of what he’d lost.

  For a moment he pictured with sudden clarity the moment of Jason’s birth. The awe and absolute miracle of bringing a child into the world. For two glorious months they’d been a happy family. Then the day before Christmas his wife had walked into the nursery to find Jason wasn’t breathing. She’d screamed for help and he’d run in to perform infant CPR, but to no avail.

  The pediatrician had deemed the cause to be SIDS, sudden infant death syndrome. They’d done everything right according to the latest research. They hadn’t put any blankets or stuffed animals in the crib with Jason, they’d put him to sleep on his back, they’d used a baby monitor. But still their precious son had died.

  After that, things had gone from bad to worse. Instead of coming together after the tragedy, he and Gwen had been torn apart. He’d buried himself in his work. He had to admit he hadn’t been completely surprised when she’d asked for a divorce.

  In the space of a few short months, he’d lost everything.

  Moving forward with his life had been the most difficult thing he’d ever had to do. Work kept him busy, maybe too busy. He still had a small box of Jason’s things packed away. Maybe it was time to give them away, to the Salvation Army or someplace that would put the things to good use.

  “Dr. Reynolds?”

  He glanced up, giving the nurse who’d called his name a blank stare. “Yes?”

  “Is there something you need?” The blonde nurse put a comforting hand on his arm. He resisted the urge to shake it off. The sensation was akin to that of nettles getting under your clothing, irritating your skin.

  “I’m fine.” He glanced down at the clipboard in his hands, remembering he still needed to make Jessica’s phone call. He considered asking the blonde to do it for him, then realized he was being ridiculous. This wasn’t a game of hot potato. He tightened his grip on the clipboard and searched his memory for the nurse’s name. Her name-tag told him it was Therese. “But Dana could use a hand, getting caught up with her work.” Then she could make her own darned phone call.

  A flash of irritation crossed Therese’s face. “Actually, I have a tiny problem with one of my own patients. Will you come and take a look at Mrs. Simmons in room one? She’s running a fever and I think her lungs sound worse.”

  He glanced down at the phone number again. Not a priority in the big scheme of things, but then again his residents were supposed to be involved in problem-solving patient care. How else would they learn? “Where’s Dr. Emory? Isn’t she assigned to Mrs. Simmons?”

  Therese’s annoyance deepened. “I think I heard something about Dr. Emory being tied up with another patient. But if you’re too busy, I’ll wait for Dr. Emory to finish.”

  “No, I’m not too busy.” He set the clipboard down, then headed over to Mrs. Simmons’s bedside. She didn’t feel hot, her temp was only one hundred point six. He listened to her lungs, thinking it was possible the patient had come down with hospital-acquired pneumonia. After a few minutes, though, he thought her lungs sounded about the same as they had earlier that morning during rounds. He took the stethoscope out of his ears and looked at Therese, taking a subtle step back when she hovered close, invading his personal space.

  “Let’s repeat a chest X-ray, just to be sure. Also, let’s do a set of blood cultures and sputum cultures.” He glanced back to where Dana was still busy wrestling with Mr. Tanner. “Have you made sure Mrs. Simmons is doing her coughing and deep-b
reathing exercises?”

  “Of course.” Affronted, Therese tossed her hair. “I just have a bad feeling about her.”

  Nurses’ bad feelings weren’t to be taken lightly. Mitch didn’t say anything more as he scribbled the orders on the chart. “Call Dr. Emory when the chest x-ray is completed. I’d like to know what she thinks of it.”

  Turning away, he forgot about Therese. There was no sense in avoiding the task any longer. A simple phone call. Heaven knew over the years he’d called many family members at home and since he wasn’t giving bad news, this shouldn’t be any different just because he was calling children.

  But it was.

  He strode back out to the nurse’s station, picked up the clipboard and marched into Jessica’s room. She must have been waiting for him, because her eyes lit up when she saw him.

  “Will you help me?” Her speech was garbled a bit through the bi-pap mask. “I want to talk to my kids.”

  “Of course.” He took a deep breath, picked up the phone and dialed. When Chad answered, he was almost grateful since the kid was mature for his age. “Chad? This is Dr. Reynolds from Trinity Medical Center. Nothing is wrong,” he said quickly, in case Chad panicked. “Your mom wants to talk to you.”

  “Just a minute. I’ll get Wendy.”

  “No, wait—darn it.” Chad had already handed the phone over.

  “Hello?” Wendy’s sweet voice made his stomach clench.

  “Hi, Wendy. Your mother would like to talk to you.” He held the phone up to Jessica’s ear.

  “Hi, honey,” Jessica spoke slowly and loudly in an effort to be heard beyond the constraints of the bi-pap mask. “I wanted to say goodnight. Sweet dreams. Be good for Grandma. I love you.”

  “I love you, too, Mommy. Here’s Chad.” Mitch could hear the childish voice through the handset even though he held it up to the patient’s ear.

  Jessica went through the same ritual with Chad, then raised her eyes to his. “Thank you.”

  His throat ached with pent-up emotion, but he nodded, then replaced the phone in the cradle. “You’re welcome.”