Deadly Diversion: A Medical Thriller (17 page)

“Of course not. You need the help, don’t you? Although,” she said, leaning forward, “his license is on the line if he abandons patients. Remember?”

“That’s a pretty big stretch, don’t you think?” I asked. “We’re understaffed and an already exhausted nurse might refuse to work a double shift. If the board started after nurses for that, they’d be investigating all of us. He got hurt, remember? Working for us.”

“Anyway,” she said, straightening her suit jacket, “we’ve got a new class of nurses in orientation. Ten or twelve, I think. You should have a replacement next week. You’ll be fine.”

“Oh, sure. We’re just dandy. A nurse marched off the unit in handcuffs this morning.” I leaned forward to make my point. “Through the hospital.”

“I told you not to let her come back after that last incident.”

“But they had no reason to arrest her. She’d never have hurt him, even unintentionally.”

“How do you know, Monika?”

I didn’t answer.

“As you pointed out, Joint Commission’s due back any time. Fortunately,” she said as if to herself, “the record will show that we are adhering to our staffing plan.” She drew herself up and looked at me. “Anyway, we don’t defend an employee in a criminal case. We don’t even have a criminal defense lawyer. She’ll have to get her own.”

I let that pass.

“And don’t talk to any reporters. You or anyone on your staff. I’ll hold you responsible if they do. I don’t want any bad publicity.” She stood. Our conversation was over.

AS I WALKED AWAY FROM her office I thought about what had happened. Judyth was right, of course. The hospital couldn’t defend a criminal case nor could they afford bad publicity. And, to be perfectly fair, Judyth had made some improvements since coming to St. T’s. More, in fact, than any of us had expected. Equipment had been repaired and what couldn’t be fixed she’d found the money to replace.

Heading toward the gift shop I noted that she’d improved it as well, adding medical products, equipment and supplies, everything necessary for patients released too soon and needing care at home. Even large medical equipment, such as wheelchairs, walkers and hospital beds, could be ordered for purchase or rental. Already the hospital had their pharmacy business because most people found it convenient to have them filled before they went home. Actually, her ideas sounded good to me. Patients’ families could go to discount stores where they might find a cheaper price, but people who are taking home sick relatives usually value the convenience.

She had made the hospital auxiliary angry, though. She’d barreled into the gift shop, which had been the purview of the auxiliary for more years than I’d been at St. T’s, and taken it over. The auxiliary members—most of them older doctors’ wives—had been miffed, and they had threatened to boycott our annual fundraising event. The banquet and silent auction, our big money-making event, was supported by Southside businesses, organizations and grateful patients. The benefit this year was going toward nursing scholarships, thanks to Judyth. Tim had said it was just a way to get on the nurses’ good side, but I wasn’t so sure. We needed more nurses and scholarship funds would help, benefiting the staff as much as administration.

She courted employees, too, by luring them into the gift shop with a ten percent discount on every item, including candy, soft drinks, greeting cards and gifts, and adding special promotions near holidays. Employees were now allowed to buy on credit, and the payments were deducted from their paychecks, a benefit that those without credit cards valued.

“Did you hear that charge nurses can’t vote?” asked a female roice from beyond the candy aisle in the gift shop. “Any nurse vho assumes responsibility for a unit or a floor when the nurse manager’s not there is ineligible. That means all of us but brand-new grads,” she added.

I was trying to decide whether to have a Hershey bar with or without almonds.

“Not so,” her companion said, her voice raised. “Another hospital tried that and the board—the labor relations board— ruled against them. They said charge nurses don’t hire and fire, so they’re not considered management. It’s just one more way they’re trying to intimidate us. Don’t listen to that.”

The speaker was Lucille Pendergast, the head nurse in orthopedics, who towered above the counter. Lucille’s six-foot height matched Judyth’s, but there the comparison ended. While Judyth looked as if she’d been pulled up tall by her head, with her body stretched thin, Lucille’s head and neck were oversize, matching :he rest of her. She wasn’t fat, she was just a big woman. I had often wondered what patients thought when they woke up after surgery to see her looming over them. But she had the back andd arm strength necessary for the heavy lifting required in orthopedics.

Lucille reached a large hand up and grabbed a bag of cheese puffs from a rack near the cash register. I knew they needed me upstairs but I waited at the back of the gift shop, reluctant to go up to the cash register and get into a debate with Lucille, whose size, I had to admit, intimidated me. Two older women standing by the display of nightgowns watched as Lucille and her companion paid and turned toward the entrance.

“If we don’t fight,” Lucille said, raising her fist into the air, “we get what we deserve—nothing.” She spread her hand wide, flinging off invisible injustices.

I grabbed both candy bars and hurried toward the counter.

Outside I realized what had seemed confusing: Lucille was management just like me; she couldn’t vote for or against the union.

A new patient had been wheeled up from surgery by the time I got back to the unit, and I went in to check on him.

“What are you doing here?” 1 asked Bart, my tone none too welcoming.

“Just giving her report on this patient after surgery,” he said nodding to Jessie, who was checking the patient’s vitals. “I’m doing clinicals in anesthesia today and tomorrow, and this was my patient.”

The young woman groaned. Jessie swiped a port on her IV with alcohol and injected a Tubex of morphine.

Bart scooped up some syringes left on the bed and deposited them in his lab coat pocket. “I’ll take these back to surgery,” he offered.

“What are they?” I asked.

“Meds we used in the recovery room,” Bart said.

“You’d better be careful,” I warned. “They’re keeping a close check on the counts, now especially.”

“These aren’t narcotics. They’re just meds we use in O.R., but I have to return them so they can be logged out anyway.” He turned to go.

“Bart, can I talk to you a minute?”

A flick of annoyance crossed his face. “Sure,” he said, “but I’ve got to get back soon.”

I nodded toward an empty room and when we were inside 1 asked him, “That morning Huey Castle died—”

“I wasn’t here,” he said quickly. “I don’t know anything about it.” He jiggled the syringes in his lab coat pocket.

“I know that. Did you see anyone around the halls or by the elevator? Anyone who shouldn’t have been here?”

“I honestly can’t say. I was in such a hurry to get to class, 1 don’t remember. Now can I go?”

I waved him off.

“ALL SHE’S WORRIED ABOUT is our reputation,” I told Jessie later, relating what Judyth had said.

“That affects us all,” Jessie said reasonably.

“What affects us?” Serena asked. She had had an early class and had just arrived.

Jessie explained what had happened to Laura.

“Oh, no. This is just like before when they thought she—”

“Shh,” I interrupted.

Serena leaned over the counter and lowered her voice. “I know Laura didn’t do anything wrong. She cares too much about her patients. She just wouldn’t,” Serena added with a catch in her voice. “Can’t you do something, Monika? Find out what happened to Huey? Do they think he died of something other than the cancer? Can’t you find out? Can’t you get Laura back?”

“I’m not sure there’s anything else I can do, Serena. Tim’s brother said he’d have her out of jail tomorrow morning, at the latest. And we don’t even know that Huey’s death was anything but what we expected.”

She chewed her lip, fingers drumming on the counter, nails bitten to the quick.

“They’re running a tox screen for narcotics,” I said, not mentioning that it was the medical examiner’s office who was doing it.

“I know Laura didn’t do anything wrong,” said Serena again.

“So how do we cover Laura’s hours?” Tim said, returning after taking medication to Mr. Kleinfeldt. “More overtime for the rest of us? Mandatory, I suppose.”

“I have some good news, though. They’ve got a bunch of nurses in orientation and...” I stopped when I saw Tim’s face screw up in anger.

“Great,” he said sarcastically.

“It is! We need more nurses. With accreditors coming and Laura gone—for now, at least—this will help the whole hospital.”

“Don’t you know why they’re doing this, Monika?” He went on without waiting for a response. “It’s to stack the union vote!”

“We won’t even be in business if we don’t pass accreditation, Tim. We’ve got to have enough nurses to be safe.”

“Oh, yeah, we’ll be safe. But for how long? They’re getting a two-fer, you know. Having new nurses will help us pass accreditation and they’ll vote down the union. Two fer one.” He squinted. “You think new nurses, just hired by Judyth, will vote against administration?” Serena had left so he turned to a student nurse standing by the counter, “Would you?” he asked her.

She backed up and didn’t answer.

He went on. “They won’t know how bad it is here. Then we won’t get representation—that’s what a union can do—and nothing will change.” He turned on his heel and marched back into Mr. Kleinfeldt’s room.

The student scooted away.

I’d have to broach the overtime issue with Tim soon, but not now. Not when I couldn’t predict what he’d do or say with patients, visitors and staff all listening.

BJ WAS LATE. Not for the first time, I worried. I knew that cops, like nurses, often spent more time documenting what they did than doing it. But police work was more dangerous than working in a hospital, even though we had had our share of violent patients and their visitors. I also knew BJ would no more think of being anything but a cop than I would think of leaving nursing.

“Where’ve you been?” I asked her, my irritation concealing my fear.

She straddled the stool, smoothed loose strands of her blond hair back and smiled. “I’m happy to see you, too,” she said, tapping the bar for a beer.

We were meeting at our favorite hangout, Hauptmann’s, the corner tavern in our old neighborhood. Hauptmann’s remained a working man’s (and woman’s) bar, but the clientele was more diverse than it had been when we grew up there. Back then the patrons were mostly of German heritage and worked at the brewery nearby, faithful to the Busch brands of beer.

“That your dinner?” BJ asked, nodding at the bag of chips I was rapidly devouring.

“Uh-huh,” I mumbled, my mouth full.

“Come right from work?” BJ asked with a grin.

It had been too late to go home and change so I was still dressed in my green scrubs, which, thankfully, were only slightly soiled, with what I didn’t want to think about.

I wiped my hands on my pants and grabbed a drink of beer. “I didn’t want to be late,” I said to make my point.

We were there to watch the election results. The polls had just closed and the announcers, with no results yet to discuss, were rehashing the election. Democrats had controlled the mayor’s office since 1949 so the primary election would decide the winner. The city was strictly divided along racial and economic lines. The north side was mostly black and poor, the south side was white and, while few Southsiders could be considered wealthy, they were more likely to be financially comfortable. The central corridor, which consisted of the regenerated areas, was racially mixed and more socially liberal. The candidates reflected these differences. A black man from the northside was opposing a white man from the south.

Both factions had been successful at city hall in the past, although the first African-American mayor had not been elected until 1993. In this election, however, a white woman, who represented the central corridor, was garnering as much support as the other two. According to the most recent poll the three were in a dead heat, but only one of them would be the Democratic candidate and, thus, the next mayor of St. Louis.

I asked BJ if she knew anything more about Laura’s arrest.

“Isn’t she the one ditched that patient a few months ago? Left her to bleed to death?”

“Well,” I said. “Laura couldn’t have saved her no matter what.”

“I thought she lost her license over that. Nursing license.”

“She’s on probation. She can still work, and she’s done fine. Until now. I’m sure Judyth will report her arrest to the board of nursing, and what they’ll do I don’t know.”

I waited until the bartender left and went on. “Maybe not, though. Judyth’s so worried about publicity and our accreditation. Maybe she’ll wait and see what happens. She wouldn’t let me report Bart, the guy who let Guardino die.”

“Wasn’t that different? Guardino was about to die.”

“So was Huey. Just not so soon. Or so we thought.”

A man approached the bar, noticed BJ’s uniform, and took a seat at the end away from us.

“Why’d they arrest Laura, anyway?” I asked her. “Have you heard anything?”

“Don told me that ever since McNeil made detective he’s been trying to rack up scalps. I told you he was a hot shot. But he’s in a shit-load of trouble now.” She smiled and took a long swallow of beer. “We call it ‘jumping the gun.’”

“Sounds like a cliché.”

“Well, cops ain’t the most imaginative.”

“In the meantime, Laura’s sitting down there in jail.”

“What time did you say they arrested her?”

“In the morning. I think it was about ten. Why?”

“They can only hold her twenty hours without charging her with something.”

I checked my watch. “It’s been almost twelve hours now. You mean they’ll keep her overnight?”

“Probably.”

“Poor Laura.” I rolled my beer bottle around on the bar, leaving a pattern of wet circles.