Time spike Page 6

  His blood pressure was low, 108/58. That wasn't good, but it wasn't bad enough to cause a stroke or throw him into shock. His pulse was 92, weak, and irregular. But his Sat level was 93 and that meant his blood carried enough oxygen to do its job. He would live. She set the oxygen level to the 2 lpm. mark. It wasn't much, just enough to help him out a little. He looked young and healthy, but you never knew. A conservative approach would be better. She slipped the nasal cannula in place and made a mental note to apply a little K-Y jelly to his nose when they got back to the infirmary. Using her penlight she checked his eyes. PEARL. The pupils were equal and reactive to light.

  No brain injury. "What's your name?" "Frank," the woman answered for him. "Shh. Let him answer. Frank, what's your last name?" "Nickerson," he whispered. Jenny looked at the woman and she nodded. She stroked the man's forehead. His brown skin looked a little dusky, but it was warm and dry. "Where are you?" Frank tried to sit up and she gently held him in place. "Can you tell me where you are?" "Yeah. Alexander Correctional Center. And today is Monday." He waved weakly toward the sky. "Maybe Tuesday. And I don't know who won the ball game, since I didn't get to watch the ending. I can tell you who I rooted for, though." He attempted a smile. Oriented to person, place and time.

  Good. "I guess if you can be all that cocky, you'll live. Let's get you to the infirmary so I can patch you up a little before we ship you." She motioned for the guards to bring the gurney over. "Keep him as flat as you can when you lift him. Barbara and I will keep the leg straight and pressure on the wound." Four guards lifted the man in one smooth move, placing him dead center of the cart. The move was practiced. She had seen experienced E.M.T.'s who couldn't do as well.

  These guys had had a lot of experience doing this. She steadied her breathing. "Barbara, take him to the infirmary. I'll check the prisoners." Barbara nodded and followed the guards with the gurney.

  The LPN from the afternoon shift had already checked the inmates lying inside the building and the one next to Frank Nickerson, so Jenny turned to the dead men lying on the street beneath the light. Dressed in prison issue, they were in the exact same position she had seen them when she first arrived. But she had to take their vitals. That was the only way to know for sure. "There's nothing you can do for them," Captain Blacklock said as she approached. "They're dead." "I know, but I have to check." She had put the electronic equipment on the gurney and sent it back to the infirmary. It was useless for this job. It would do nothing but beep and flash error over and over, giving her no reading. This had to be done the old fashioned way. So she started with the closest man's pulse. For a full minute she counted. Nothing. Respirations nothing. She then pulled out a manual sphygmomanometer and took his blood pressure. Again nothing. She thought about taking his temperature and decided to wait another fifteen minutes or so. He wasn't exactly warm, but he wasn't cold. Not yet. She repeated the procedure over and over until all three men had been checked. "What am I supposed to do with the bodies? The phones are down so I can't call the hospital or morgue to have them picked up." Blacklock shrugged. "We'll put them in with Lowry for tonight.

  I'll send a few guards after gurneys for transport and have them load them into body bags for you." "Thanks." The captain nodded, the gesture seeming calm and relaxed. That was part of Blacklock's reputation, from what Jenny had heard. One of those people who never lost their composure, no matter what they might be feeling inside.

  Under the circumstances, that was a quality that would be invaluable to all of them. It also made the man particularly attractive to her-and would have, no matter the circumstances. Despite the lack of physical resemblance, her husband had been the same way under pressure. It had been one of the things about Matt that Jenny had treasured. Trying to tear her mind away from these completely inappropriate matters, she almost asked how many body bags the prison kept on hand. Fortunately, she kept the inane question unspoken.

  Instead, she said, "Things don't feel right." "I know." "It's the barometric pressure. It feels sky high. And things are damp. Bone-deep damp. You get a combination like that and anyone planning to stroke, will. Same way for having a baby." "Baby?" "Yes. If the pressure goes up enough, it can cause a woman close to her due date to go into labor. It can also cause a miscarriage, if she's early on." "Oh, wonderful." Blacklock turned to Hulbert-the sharpshooter who'd just returned from his perch on the roof of David-house. "Locate Kathleen.

  I don't want her by herself until the end of shift." Hulbert nodded.

  Blacklock turned back to Jenny. "Is there anything we can do to stop the barometric pressure from causing a problem?" She shook her head.

  Despite his outward calm, she could sense that the man was upset. The shooting and killing hadn't ruffled him, but mention of a baby being born did. Well, that was one awkward question she wouldn't have to figure out how to ask somebody. He was married. And his wife's name was Kathleen. Jenny was met at the infirmary's outer door by Barbara Ray. "Lylah and I cleaned and stitched Nickerson. It was deep, but he's all right." Her voice dropped to almost a whisper and she motioned to Jenny's nametag, which was imprinted with the initials N.P. "You're a nurse practitioner?" Jenny nodded. "Brown'snot all right. She's hemorrhaging. We're going to lose her." Jenny ran down the hall to the examination room the wounded correctional officer was in. Coming through the door to the small cubical, she glanced at the machine giving a continuous reading of several vital signs. Elaine Brown's blood pressure was down; her pulse was up. Her Sat level was an 81. Jenny knew by looking, the woman's skin would be cold and clammy. She was almost the same color as ash and her lips were black and purple. Years of training and experience made her forget she was the new kid on the block. "Heat me a blanket," she said. She looked around the room. She couldn't remember where everything was stored.

  The setup was nothing like the hospitals and clinics she was used to.

  Quick access to supplies and equipment during emergencies where seconds frequently made the difference between life and death was not the guiding principle in the storage and location of supplies and equipment inside the prison's infirmary. Staff safety and prevention of prisoners' access to anything that could be used as a weapon were the only factors. "Do we have anything I can cauterize the wound with?" Lylah's eyes narrowed. "We're not allowed to do that, the wound is too deep. Best we can do is re-sew her." "Damn." Jenny slipped on a yellow paper gown and pulled on a pair of rubber gloves. "Get me a suture kit," she said, removing the blood-soaked bandage. "First things first. Turn around," Lylah said. Jenny turned and the elderly nurse handed her a pair of latex gloves and then slipped a paper mask over her nose and mouth. "Thanks," she said. Lylah opened the suture kit. "Increase the saline to 60 and the oxygen to 6. And turn the lights up." Barbara came through the door with three warmed blankets.

  "The guards are making us more, just in case." Jenny nodded, looking at the jagged tear in the woman's skin. She had been cut from just below the umbilicus to just above the pubis. "I can't see where it's coming from," she said, rinsing the area with saline. "Damn. The stitches are all intact. This is new." She began the process of applying pressure systematically, looking for the source of the blood flow. She was going to have to open her up. "I have to take them out, get inside, see what's going on." Lylah's face was tight. "You're on your own," she said. "I've been awake too many hours. Besides, my eyes aren't any good for that type of work. Never were. And Barbara's an LPN. She's good, but she hasn't been trained for anything invasive."

  Lylah stepped away from the table and returned with a suture removal set. "Do we have anything to put her under with?" "No. Just a local, and that's not very potent. And even if we did, none of us has been trained to administer it." Jenny suppressed a groan. If the local was what was used earlier, it was almost useless for what she was going to have to do now. "I've served with the military overseas. Plus, I did missionary work in Latin America. I can administer anesthetic. I've also done surgeries under conditions much more primitive than we have here." "Surgeri
es?" Lylah Caldwell spread one of the heated blankets over the woman's chest and shoulders. "Maybe you have. But that was then and that was there. Now, here at the prison, you don't have the authority to do anything more than snip those stitches and re-sew her." Jenny looked up from what she was doing, then back down again.

  Her voice was firm, clipped. "We are in an emergency situation. This woman will die if we wait until someone with the authority shows up.

  Are you willing to have her death on your hands?" "It wouldn't be. But if I let you pretend you're a doctor and she dies, then I would be as responsible as you. Sorry, but I'm not willing to join you in prison just because you say you know how to do something. I know you're a nurse practitioner, but here, with no doctor present, you're a nurse.

  Nothing more." Lylah stepped back from the table. "You will lose your license and get at least ten years if you do anything more than re-sew her. That is practicing medicine without a license." Barbara Ray, the LPN, gave Jenny a sad look then turned toward the older R.N. and said,

  "Lylah, you're right, practicing medicine without a license is illegal." She draped an arm across the woman's shoulder. Her voice was soft, almost a whisper. "We won't do anything we shouldn't. Relax."

  She reached across the table and handed her a set of keys. "Go on break. You need it. You've been here too long. Take a pillow and a blanket, go to the records room and lie down on the desk or the counter and go to sleep. I'll take care of this." The older woman's eyes lost their cold, angry look and filled with tears. "I can't; I'm exhausted. You understand that, don't you?" Barbara nodded. "I know that; we both are. And Jenny is no fool. She understands the rules.

  You go get some sleep, and we'll do what we can here." She motioned toward the C.O. standing outside the open door. "Glasser, how about helping her with the blankets and pillows." "Sure. No problem." The guard gave the R.N. a quick hug and said, "When you wake up I'll have coffee waiting for you." With no one in the room but the two nurses, Barbara handed Jenny the tools she needed to cauterize the wound. "We have just about anything you need for emergencies. It's the comfort measure materials we have trouble getting." Jenny looked at the gleaming metal tip and inwardly winced. This was going to be rough on the woman. The anesthetic was completely inadequate. But she would hemorrhage to death without it. The procedure took less than five minutes. Twenty-five minutes after they started, Brown's bandages were in place and the woman was asleep. When Jenny finally sat down at the desk it was Barbara who spoke first. "I have to get some sleep. I've been awake for over thirty hours. I'll be in the break room on a table." She grinned. "That was some mighty nice work you did. Half the doctors we have here are druggies, doing community work to stay out of the slammer. They couldn't have done it." "Thanks. For the compliment, and the warning about the docs. I didn't know that. I thought they were hired by the state." "Some are, but some aren't." Jenny nodded and made a mental note to nose around and learn which was which. "For a woman with no training in invasive procedures, you didn't do so bad either." Barbara Ray's smile was replaced by a look of worried concentration. "Yeah, well, Lylah was just talking. Working here, as short as we are and as violent as some of our emergencies get, you stay up on your skills. And you wind up stepping out of your area of official expertise fairly often. You just don't talk about it. Not if you're smart." Jenny picked up on the hint and decided it was time to change the subject. "How many of the psych docs are here as part of a plea bargain?" "None. They're here because they want to be." Barbara shrugged. "They have to think they're helping. It can't be for the money. The state doesn't pay enough for that." "How's Brown?"

  Blacklock asked Jenny as she walked out of the examining room and into the wide hall that doubled as a reception area and rest stop. "I think she'll be okay. I've started her on I.V. antibiotics. That room is not exactly sterile. If I don't give her something, she'll get a hellish infection." She sat in a chair next to the door. "How long until the phones are working?" "I don't know." "This is the craziest thing I've ever gotten myself into," she said ruefully. "No wonder you guys can't keep nurses." The captain chuckled. "It's usually not this bad.

  Honest." He looked at Hulbert. "I've never seen anything like that… quake. Have you?" Hulbert shook his head. "I just hope we don't get hit with an aftershock." Five minutes passed. "I'm really out of my element and I'm betting you guys are, too." Jenny pulled the rubber band from her hair and started reapplying it. "What's up with the sun? And the barometric pressure. And that quake. And the way the sky looks. I have never seen such a blue sky." Neither man answered.

  They were looking at the floor, their brows creased, their elbows on their knees and their hands dangling between their legs, still and calm. Jenny slumped in her chair. Exhaustion, caused from the tension of the last-she looked at the clock-four hours, washed over her. She had hoped this job would be easier than her last one. That, obviously, was not going to be the case. She glanced to where Frank Nickerson was lying. In spite of the light and the noise, he was sleeping soundly enough that a soft snore could occasionally be heard. His gurney was parked in the hall, since there was no place else for him. At least no place convenient enough for a staff of one to keep a close eye on him.

  Jenny didn't think he was in any danger, but medical emergencies had a tendency to occur when you least expected them. Barbara was in the break room catching a nap. Lylah was asleep in the records room.

  Glasser had said the R.N. fell asleep as soon as she lay down. She had also said tonight was the woman's third double in a row, and that she was usually very caring and giving. Very reasonable. Jenny had been assured that when Lylah woke up she would be a totally different human being. She would be glad Brown was fixed, and would go to bat for Barbara and Jenny if she had to. She was loyal to her nurses. Jenny hoped so, but she wasn't really too worried about what she had done.

  She hadn't donemuch more than she was licensed in the state of Illinois to do. Plus, she was actually pretty good at the art of C.Y.A., covering your ass. She could do it without lying or stretching the truth. It was a matter of how and what you charted. She just hated the fact that she had needed help, and that need had put Barbara on the hot spot right along with herself. Brown's vitals were stable. The knife had, by some miracle, missed the intestines. That gave her a good chance of avoiding peritonitis, and just as good a chance of being back on her feet in a week or two. It would be at least a month before she'd be back to work, though, maybe as much as six weeks. But with a little care, the woman should do all right. Jenny had to suppress a small smile. Brown was one of those black beauties who made most women jealous, including white women. She had the high cheekbones, huge black eyes, and full lips that were money in the bank for magazine models. Which she probably could have been, except she was too short and curvy. And according to the Barbara Ray, the C.O. was as good as she looked, too. She sang in the church choir, helped with the food pantry and spent every Thanksgiving cooking for those who would normally not eat that day. Prison guard or not, she was a kind-hearted sweetie. Jenny sighed. Now that things were beginning to settle down, she found herself wanting to look at Andy Blacklock. She actually had to work at not staring at him. Finally, she caved in and gave him a quick glance-and discovered he was staring at her. "How's your wife doing?" she asked. It was her way of reminding him not to look too much, and remind herself not to enjoy his looking. "Wife?"

  "The lady having the baby." "Oh. Kathleen." He seemed flustered by the question. "She's… just Kathleen. Not my wife. One of the midnight C. O's. She's got a husband and three other kids." He shrugged. "She's fine. I offered to let her wait this out here, in the infirmary, but she didn't want to. She said she was too big and clumsy and this place was seeing too much action. She felt safer in the communication center. So I sent Keith Woeltje over. He threw his knee out, so he's not much good right now. He'll call if she runs into trouble." Jenny nodded, hoping he wouldn't be able to read her feelings. Not his wife.

  Not his baby. Just Kathleen. She straight
ened in her chair a little, then pushed the feelings that had surfaced back down. This was business. A job. You don't date men you work with. It complicates things. You dated Matt. She stood up and stretched. It was time to start pulling the meds for the morning drug pass. It took well over three hours to set the meds up, and another hour to pass them.

  According to the sun, she was way behind schedule. But the clock told her, if she hurried, she might get it done before day-shift arrived.

  If they arrived. She was starting to have her doubts about that.

  Less than one hour after Jenny entered the large room with its three, twelve-foot long combination work table/medicine cabinets, Andy Blacklock slid open the metal door slot and said through the small rectangle, "Unlock the door. I've sent for Barbara. She'll have to finish setting up for the morning med pass. I need all department heads in the administrative building for a meeting, stat. Joe is back." Jenny turned just in time to see him leave. Department heads?

  Joe was back? Jenny was the new nurse, not the head of the department.

  True, it was technically the midnight shift, and she was the only midnight nurse on duty, but that was just a technicality. In charge.

  She sighed. She had always been the one in charge. Even as a new grad working an emergency room at a free hospital smack dab in the middle of the inner city. Years ago, she had given up fighting the situation.

  Back then she was naive enough to believe she hated being the one others looked to for orders. She had thought she preferred to follow.