Deadly Diversion: A Medical Thriller (19 page)

“I’ve half a mind not to tell you the rest,” Ruby said, folding the wrapper down on the candy bar.

“Spit it out, Ruby, I don’t have all day.”

“Some’s money’s gone missing.”

“Where? Whose? What are you talking about?”

“Nurses, that’s whose.”

“If they kept it locked up, like we’re supposed to—”

“It were locked up, but that don’t make no difference to the man.”

“The man?”

“The boss.”

“Judyth?”

“Yeah, she the man around here.”

“OKAY, SPILL IT,” I ordered, cornering Max after a brief meeting administration had called to introduce the Joint Commission survey team I’d already met. Judyth and the other administrators had advised us to cooperate with them. No one mentioned Laura’s arrest from the day before.

Max glanced around as if he were looking for a way out, but I stood in front of him, hands on my hips, the door shut behind me. “What gives? You’ve been acting like you hardly know me. What’s up?”

He took a long breath. “It’s your drug test. It came back positive. For opiates.”

“What? How could it? I’ve never used drugs in my life!”

“They’re running the confirmatory tests to be certain. Monika, I didn’t want to say anything until we knew for sure.”

“Maybe mine got mixed up with somebody else’s and—”

“We maintained strict chain of custody, I told you that.”

“Well, there’s been a mistake. What could make it turn out positive, Max? You said something about how over-the-counter stuff might cause a false positive.”

“Cold medicines, cough syrup, Tylenol PM, for example. You use any of those in the day or two before?” His eyes, magnified through thick lenses, were bright with hope.

“Nothing. I hardly ever even take an aspirin.”

“I believe you, Monika. We’ve known each other too long for me to think you’d do anything like that.” He gave me a hint of a smile.

“Does Judyth know? About my test?”

“She’s the one who told me not to say anything yet. Especially with Joint Commission here.”

“That explains why she acted so funny.”

“Funny?”

“Not funny, ha-ha. Funny, strange. I went to talk to her after Laura was arrested. She just acted.. .oh, I don’t know, uncomfortable. I guess that was it.”

“Let’s just wait till we know more.”

“When will that be?”

“We should have the results by Friday. In the meantime, don’t worry about it. You know you didn’t use anything. I’m sure it’ll turn out fine.”

I started to turn away, then stopped. “Max, what about Huey’s tox screen? You hear about that yet?”

“They’re running it today. Come by after work and I should have it.”

RUBY HAD TAPED A MESSAGE slip on my office door saying that Lisa had called. I was checking my e-mail when the phone rang. It was Lisa.

“I need your help,” she began.

“Yes,” I said, trying to remember where I’d hidden the package that Huey’s girlfriend had left him.

“Will you help me?”

“What do you want, Lisa? I’m very busy.” I rummaged through my desk. It had to be here somewhere.

“I know you are, and I’m sorry to bother you, but...” Her words drifted off.

I thought I’d put it in the back of one of my drawers.

“I want my job back,” she added, her voice firmer.

“I have a question for you,” I said, switching gears.

“Anything,” she said at once.

“Last Friday you were in ICU with Bart. Did you see anyone around who shouldn’t have been there? Someone not a staff member?”

“Why? Is something wrong?”

“Probably not.”

“A patient died right after you two left.”

She was quiet.

“You thought of something?”

“No, no,” she said.

“If you saw something, tell me, Lisa.”

“Everything was normal,” she said, “or as normal as it is in ICU. Now what about a job? Can you please help me?”

“Why don’t you call Wanda? She was your head nurse. See what she can do.”

I turned back to my search. Minutes from old committee meetings, a schedule of staff-development programs from last year, scraps of paper with phone numbers of long-gone patients’ family members and one very stale half-eaten package of cheese crackers jammed the drawer.

“I heard you lost a nurse. I can work in ICU. Ask everyone. I did great when I was there.”

The bottom drawer wouldn’t open. Something was caught inside. I shoved the drawer back and forth until it pulled loose.

“Please, Monika, I really need to work,” Lisa went on.

Got it. The paper bag was torn where it had caught on the desk so I tossed it in the trash can. “I don’t know what I can do,” I told Lisa. I opened the baggie, releasing a pungent odor. I squeezed out the extra air and then zipped up the baggie, and tucked it into my lab coat pocket.

Lisa went on. “You can talk to Judyth. Everyone needs help and I’ll work anywhere. I can do ICU, step-down, med-surg, anywhere, any hours, all nights even. Please,” she said, her voice pleading.

“Why don’t you ask Bart to help you? He’s in school with Wanda.”

“I can’t tell him. He thinks I’m still working there.”

“He doesn’t know? Certainly someone’s told him. And I’m sure he’d help you if you’d be honest with him.”

“I can’t tell him. He says I’m just like his dad.” Her voice choked.

“I know he cares about you, Lisa.”

She sniffed. “You don’t know him, Monika. All he cares about is his career. That’s it. That’s the Holy Grail for Mr. Bart Mickelson!” she said, her voice stronger. “One thing he’s always said though.”

“What’s that?”

“He’s not going to end up like his dad.”

Silence.

“Drunk. And dead,” she added just before I heard the dial tone.

“MONIKA,” MAX SAID, stopping me in the hall later. “Tell me if you’ve had any of those poppy-seed muffins they make in the cafeteria?”

“Not for a long time. Why?”

“It’s the poppy seeds. You could get a positive with those.”

“I had a poppy-seed bagel. Two, actually. Well, two tops. Ruby ate only the bottoms because of her dental plate, the seeds from the top half get caught, and then she has to take her plate out.”

Max grabbed my arm. “That’s it, Monika. That’s why it showed up positive. If they’d used the cutoff I recommended, yours would have been below that, but they wouldn’t listen. I’m sure your confirmatory test will bear this out.” His face lit up in a smile and he put an arm around my shoulders companionably as we made our way along the hall. “Just remember that the next time you’re going to have a urine test, don’t eat poppy seeds beforehand.”

“I’ll be sure to remember that, Max, if I get advance warning, that is.”

We waved goodbye as he turned toward the lab and then I headed back upstairs, bounding up the steps two at a time.

I WAS LATE TO THE MEETING for nurse managers to meet with Mr. Lawrence, the RN surveyor from Joint Commission, but when I got there it turned out he hadn’t yet arrived. As I looked for an empty chair I heard two nurses exchanging complaints.

“I’ll tell him straight out,” one manager said. “It’s still not safe. There aren’t enough nurses. People are being shifted to other units and working jobs they’re not really qualified for. Or they’re doubling back and working with not enough sleep.”

“I’m afraid that’s going to hurt our chances to get our accreditation status off warning, don’t you?” her companion asked.

“That’s exactly my point.”

The room was full. I took a chair in the front row as Mr. Lawrence joined us. He opened a folder on the podium in front of him. He began by congratulating us on the improvements we’d made and asked if we wanted to add anything to the written report the hospital had submitted.

There were a few murmured comments, but no one volunteered anything out loud. I looked around for Lucille but she wasn’t there. Maybe she’d resigned her management job to return to a staff nurse position so she could be involved in the union.

“I have here a list of nurses who have not provided the human resources office with copies of their current nursing licenses,” he said, pulling out a single sheet of paper. “There are some nurse managers on this list as well.”

A slight murmur rippled through the room.

“I’m sure it’s nothing to worry about. Some of the licenses are out of date, people who’ve neglected to renew them, I suspect. In one or two instances, the license in the file is from another state. If a nurse doesn’t have a Missouri license, that nurse is violating the law in addition to not meeting the standard for accreditation.”

“Can we bring in a copy?” a nurse in the back asked. “Originals, only,” he told her. “That’s the state requirement. And ours.”

“DID LISA CALL YOU?” I asked Wanda as we took our lunch trays to a table by the window.

“No, why?” Wanda asked. She put her taco salad and chocolate milk on the table and set both our trays on the chair next to her. “Was she high?”

“She didn’t sound like it. She wants her job back.”

“After what she did to us,” Wanda began. She leaned across the table and went on. “She stole our drugs, Monika. Stuff that should have gone to patients.”

“Do you know for sure she stole anything? Have you been short?” I opened my carton of milk, stuck in a straw and took a long drink.

“I’m not sure,” Wanda admitted. “We haven’t always had time to count as carefully as we should.” Wanda broke off a corner of taco shell and nibbled at it. “You hear about the results on the nurses’ drug tests?”

I busied myself with my salad and shook my head. Had she heard about mine?

“One nurse on call in O.R. nights—she’d just started—and Lisa, of course. You think her boyfriend—that cute guy who works for you—might have taken some for her?”

“From what I’ve seen Bart’s more interested in his career than risking a drug arrest for his girlfriend.”

“Well, I couldn’t help Lisa if I wanted to,” Wanda said, dipping into the meat sauce on her salad. “If we hired her back and someone got hurt because she was high on something...”

“You could be fired.”

“And sued. What is it they call it? Respondeat superior, that’s it.”

“Supervisors are responsible for the actions of their subordinates,” I said, stressing every third word.

“Yep. I can’t take that chance.”

“Lisa will just go somewhere else. There are plenty of jobs these days.”

“Well, I certainly won’t give her a recommendation.”

“What will you say if someone calls?”

“I’d answer the only question we’re allowed to answer—would you rehire? I can’t say I would.” She broke of a piece of taco shell and scooped up some spicy ground beef, then popped it neatly into her mouth.

I cut off a bite of pork tenderloin, dipped it in mustard and tasted it.

“Say, what’s the story about the nurse on your unit they arrested?” Wanda asked. “The scuttlebutt is that she’s another one stealing drugs. Wasn’t she the one who got in trouble for abandoning the patient who died? She ended up in psych, didn’t she? As a patient. Miss Loony-tunes.”

“That’s all over,” I said, swallowing. “It was just a reaction to the trauma. She’s fine, and she’s a good nurse.”

“Well, something’s going on. I mean, they arrested her. I do have to say though, that I wondered why they didn’t just fire her, like they did Lisa.”

“Laura’s in a protected class.”

“Huh?”

“Peggy set me straight on that. Mental illness is one of the conditions under the Americans with Disabilities Act. They can’t fire her.”

“I never heard that. You mean that if someone’s been diagnosed with a mental illness we have to keep them, regardless of what they might do?”

“No. It’s just that we have to make accommodations.”

“So what kind of accommodations do you make for crazy people?”

“Wanda! You’re a nurse! You know that mental illness does not always translate into ‘crazy,’ which is not an accurate way of describing anybody, anyway.”

“Well,” said Wanda, “I heard they think she did something to the guy in ICU who died last Friday.” She lowered her voice and looked around. “Do you think she murdered him?”

“Of course not,” I said. “And, besides, the police released her this morning. I can’t imagine what motive they think she’d have.”

“Maybe they just think she made a mistake.”

“They don’t arrest people for making a mistake.”

“Well,” said Wanda, “maybe that nurse in Florida who did those mercy killings that’s been all over the news has made them jumpy.”

Peggy approached our table, tray in hand and a large book under her arm. Wanda stood, offering her chair to Peggy, saying she had to get back to work. Peggy slid the book onto the table and rubbed her arm where the book’s edge had left a dent on her arm.

“Are you going to grad school?” I asked her.

“I’m thinking about it. I thought I’d try one class and see how it goes. Abnormal psychology,” she added, tapping the book. She spread her napkin in her lap and took a sip of water. “You get those e-mails I sent?”

“No, I haven’t had time to check my mail. What are they about?”

“Nurses United. The committee that’s working to organize us. I guess he just sent them to staff nurses. That makes sense. We’re the ones can vote.”

“Who?”

“Tim.”

“Tim sent them? From home?”

“I don’t know. Why?”

“I just don’t want him getting into trouble using the hospital’s system for union organizing.”

“That already happened.” Peggy cut her pineapple rounds into tiny wedges and scooped one up with a topping of cottage cheese and took a bite. She dabbed at the comers of her mouth and went on. “Didn’t you hear about Judyth—” Peggy nodded toward administration’s offices “—going off on him? It was after a meeting for staff nurses about the union, and it took the hospital’s legal counsel to set her straight. It seems as if this issue already went to the NLRB, according to another e-mail we got this week. If your employer allows you to send personal e-mails on work time, they can’t forbid you to send any sort of organizing information in the same way.”

“When does any nurse have time to send personal e-mails?”

“That doesn’t matter. If they’ve been allowed to do it even once, administration can’t prevent them now.”