Authors: Jordyn Redwood
Phillip laid a comforting hand on her shoulder. “How are you feeling today?”
“I'm not sure how much longer I'll be able to do twelve-hour shifts. Dialysis really takes it out of me.”
His hazel eyes softened, glossy. “No, I meant the other.”
Her throat swelled at the sudden threat of tears. Phillip had been the one caring for Teagan when she came off life support.
His hand fell from her arm. “I'm sorry. I shouldn't have asked. It's just that I think about her, too.”
Morgan swiped escaped tears from her cheeks. In her selfish hold of her grief, she rarely considered how Teagan's death affected others. Her husband included.
Before Teagan died, the high rate of divorce after a child's death rarely crossed her mind. Little was known to the staff of a family's welfare after a child passed. Families didn't return to the scene, and healthcare privacy laws stymied the nurses from getting follow-up information unless they had directly provided care to the patient.
Morgan hugged him. “I know. I forget that, but I never forget how amazing you were with her.”
He eased her back, his eyes searching hers. “Morgan, why do you still work here? Isn't it awful to look at her bedspace and be reminded of her death every shift?”
Phillip possessed one of the most aggravating character traits of ICU nursesâblunt confrontation. His probing was like a scalpel to her heart.
That was the question, wasn't it? Was it a form of self-torture, or a hope that during some part of the day she might feel Teagan's spirit whisper a kiss on her cheek? A lips-parted, full-of-baby-slobber kind of kiss.
“I haven't figured it out yet. Something pulls at me to be here.”
“Teagan?”
Morgan gave a halfhearted smile. “Of course I should say yes. But, no, something different. I can't explain it. An unfulfilled need. Like I haven't accomplished the thing I'm supposed to do yet.”
Phillip smiled back. “Well, let me know when that happens. Surely, there's got to be happier areas of nursing.”
“Are you thinking of leaving?”
He sighed. “Not today. I don't know about tomorrow.”
Morgan noticed three police cruisers at the front entrance now.
Maybe there's a gunshot victim in the ER, and the back lot has run out of space?
Excluding visitors from report time was meant to afford patient privacy, since the open unit allowed conversations to be overheard. After Phillip's charge nurse report, she returned to the staff lounge where her team of three nurses awaited their assignments. Typical ICU patient load was two patients per nurse. This left Morgan open to take the first admission. Once she divided the children among them, they would go to the bedside and receive report from the night-shift nurse.
The whole process generally took thirty minutes.
While the staff gave report, Morgan made the rounds to each child's bed. It was part of the process of being a charge nurse, at least her process. Getting a visual on each child to get her own impression of their current condition. Which one dangled precariously on the ledge with his or her life?
She approached Bree's crib and lowered the yellow metal rail so she could reach her. ICU cribs resembled tiny prisons more than comforting places to slumber. They were designed to keep children from climbing out, and had transparent sheeting that dropped down from all four sides to prevent curious minds from going over the top. Due to Bree's sickened heart, she didn't have the strength to attempt escape, and her upper safety components were left in the raised position.
The toddler reached up for Morgan's index finger, her grip weak as the tiny fingers encircled her larger one. “Hey, little miss sweetheart,” Morgan cooed. “How you feelin' today?”
With her free hand, Morgan swept the moist, chocolate curls from Bree's face and looked into her big, sorrowful brown eyes. Even at rest, her heart worked in overdrive to keep her alive. Being symptomatic during little activity was a sign her heart could give up at any moment. She leaned down to kiss the tiny girl's fingers, the blue hue and clubbed tips another sign of her failing organ. The child suffered from dilated cardiomyopathy, which meant her heart was huge and weak and would eventually cease beating.
The question was when.
She slid her finger down the girl's nose. “There's no dying today. Promise me?”
Morgan tried to ease a toy into her hands. Bree dropped her hand back to the bed and closed her eyes. After pulling her gown up, Morgan examined her work of breathing. Normally, a child's torso was quiet. However, with each breath, the skin between Bree's ribs pulled in, revealing the skeletal outline of her chest. Even her heartbeat was prominent to the left side where the enlarged left ventricle pushed against its protective housing. With a stethoscope at her chest, Morgan heard the distinctive crackles that proved her lungs were filling up with fluid, another sign that her heart wasn't contracting with a lot of strength.
Morgan placed gentle fingers over the girl's puffed cheeks. “Need to ask the doctor if some Lasix would be a good idea for you. Dry those lungs out a little.” She eyed the oxygen flow meter. Up to three liters. She needed to transition to an oxygen mask from the nasal cannula.
Lisa's voice carried through the unit before Morgan heard the clicking of her high heels against the tile. Time to check on her nephew.
0730, Saturday, August 11
M
ORGAN APPROACHED
S
ETH
'
S
bedside, holding the bell of her stethoscope and the ear pieces together in front of her chest, a shield against what might pop from Lisa's mouth. When she neared, she placed her free hand on his bedrail. Lucy, Seth's bedside nurse, was busy at the next bedspace assessing a two-month-old infant with meningitis who had been extubated through the night.
The pressure waveforms on Seth's monitor told a tale of a body at quiet rest. Each color represented a different parameter. The cool blue sloped waveform his oxygen level. The spiked, steady viridian green his heart's electrical conduction. The square white hills how much carbon dioxide he exhaled.
“How was his night?” Lisa asked, her voice low but sharp. That steely edge echoed everything about her sister-in-law. Her dyed, platinum hair pulled tight in a ponytail. The black eyeliner heavy on both upper and lower eyelids stark against the light blue eye shadow and garish red lips. A white blouse tucked into a wrinkle-free gray skirt with knee-high black leather boots.
Morgan had always admired Lisa's fashion sense but marveled at how she could keep it going with her son critically ill. During Teagan's stay, Morgan hadn't strayed far from a comfortable set of holey sweats.
A tired ache spread through Morgan's chest.
“He did well,” she replied. “They've been decreasing his sedation through the night. The plan is to warm him back up slowly through the day and then turn off the sedation.”
Lisa's blue eyes captured her, the vulnerable fear struck right at Morgan's core. “Do you think he'll wake up?”
Morgan swallowed hard, her own grief mirrored in the sadness of her sister-in-law's face. The motherly anxious trepidation of wanting to know
if the treatment had worked paired with the weighted dread of what it meant if the medical efforts failed.
“I hope so.” Morgan reached out and ran her fingers through Seth's towhead locks, the silky threads almost as white as the starched pillowcase they rested on. The night nurse had spent time washing his hairâa difficult feat with a person in a medically induced coma.
“I didn't ask you what you hope. I asked you what you think.”
Morgan inhaled and held her breath to stem the flood of adrenaline. Lisa's anxiety shot over Seth's bed like electrified harpoon darts tagging her skin. The flesh on her arms rose as the confrontational nature of Lisa's glare fed into her body's defense. She pulled her hand from Seth and gripped the side rail with both hands.
“Lisa, though I appreciate you asking my opinion, I don't know what to expect. My prayer is that he will wake up. What I know is that the research protocol Dr. Marshall put him on is the best chance he'll have at sparing his brain from the effects of his arrest.”
Lisa leaned over the bed in Morgan's direction. “Talk to me like a mother!”
Morgan edged back from Seth's bed. She clasped her hand over the bell of her stethoscope as her mind sifted through several options.
Parental outbursts were not unusual in the PICU. Stress caused normal societal mores to fall away. When a child hovered over the cavern of life and death, all bets were off. Normally, she would round the bedside and offer tactile comfort. Sometimes the physical touch of another human being was what was needed to diffuse the situation. In response, the parent would often dissolve into uncontrolled crying, the outburst a substitute for the fear of having to make funeral plans.
However, Morgan checked that option with Lisa's icy stare.
“I'm sorry” was all Morgan could say.
“You're sorry? That's all you've got for me? What does that even mean?”
Having grown up as a single child, Morgan thought joining Tyler's happy family of so many married couples would afford her the sisterhood she longed to have. But none of them understood her, and her relatability to Tyler's clan had always been hard to come by. Especially with Lisa.
“Just what I said. I'm sorry that you're going through this. When Teagan was sick . . .”
The syllables of her child's name as they crossed her lips caused the
words to stick in her throat. The charge nurse pager vibrated at her hip. She turned without a word and went back to the nurses' station. As she passed the windows on the way, she noticed more police cars at the front entrance. Even Lisa's eyes were captivated by the action.
She dialed the number. “This is Morgan. Someone paged me.”
A harried voice punctured her ear. “Morgan, thank heavens you're in charge.”
The nursing supervisor.
“Kathleen, what's going on?”
“I need nurses with a level head today. Have you looked outside?”
“The cop cars? Why are there so many?”
“There have been reports of three men roaming the hospital. They might be military types.”
“Why is this causing concern? We're right next to a military hospital.”
“One person thought they might be carrying weapons.”
Morgan pulled over a chair and sat down. “Kathleen, it's too early for this kind of paranoia.”
“Morgan, it's serious. Clarence was found barely alive. Gunshot wound to the chest. They're trying to stabilize him in the ER right now.”
A vision of the older security guard came to her mind, his kindness well known throughout the hospital. Always a smile on his face. Even during the dark times, he was that little ray of sunshine.
Morgan blinked as Kathleen's voice continued. “We're in lockdown. I need an account of who is up there with you right now.”
Morgan scanned the unit. Lisa was the only parent in so far.
“Six patients, four nurses including me, and one family member.”
“No one in or out of your unit,” she ordered.
“Even parents? That's not going to go over so well.”
“I'm making one exception. The ER had an infant being transported from another facility. They've talked to Marshall. They're going to direct-admit her to the PICU.”
“What's the diagnosis?”
“Abusive head trauma.”
Morgan's heart sank. Shaken, just like Teagan.
0800, Saturday, August 11
R
ED FLUID TRICKLING DOWN
the infant's body pulled Drew Stipman's eyes to his patient. The transport paramedic's heart rate picked up speed as he reached forward to turn her arm over to check for the source of the bleeding.
At the space inside little Scarlett's elbow, and at each needle stick site where the community hospital had attempted to place an IV, their one-month-old tiny charge now oozed blood. Short acronym: DIC. Long name: Disseminated Intravascular Coagulation. What it meant was that Scarlett's blood no longer had the ability to clot. Some thought it was related to the actual brain injuryâthe process that happened during shaking. Others felt it was related to a build-up of acid in the blood. What it boiled down to right now was uncontrollable bleeding everywhere.
Drew cleared his throat to get his transport nurse's attention. “Emma,” he called.
She placed an X-ray back into a large manila folder. “Breathing tube is in good position.”
The father, and likely the perpetrator of the child's abuse, stepped closer to her. “Don't you need the doctor to read that?”
Her glare was like the whir of a lawnmower blade as it sliced a thin shoot of grass. “No, I am more than capableâ”