A Nurse's Search and Rescue
‘And the others?’
‘They’re being loaded now. The driver’s OK—badly shaken but no more than a few bumps and bruises, thanks to the airbag. Her husband regained consciousness but had to be sedated. He was very combative due to his head injury.’
Matt glanced up as a fire officer stepped over Tori’s legs. ‘I need you to move a bit so we can get on with this extrication. You feel OK to stand up?’
‘Sure.’ But Tori was grateful for the assistance Matt gave her and she staggered slightly before stopping to lean against the side of the closest fire engine from where she could watch as they cut open the front of the van and used a backboard to secure and move the unconscious woman.
A new ambulance crew was ready to transport the patient and Tori wondered just how many vehicles had been deployed to this scene. The closest emergency department would be that of the Royal, where Tori worked, and that thought made her glance at her watch and groan. They would be hard-pressed to deal with the influx of casualties and she should have been at work over an hour ago.
‘Excuse me,’ she called to the ambulance officer on the end of the woman’s stretcher. ‘Are you going to the Royal?’
‘It’s the closest hospital.’ The female paramedic nodded. ‘They’re working under a disaster management code for this.’
‘I’m Victoria Preston,’ Tori told her. ‘I’m supposed to be on duty in the ED. If you get a chance, can you let someone know why I’m held up?’
‘Sure.’
‘Do you want to go with them?’ Matt had overheard the interchange. ‘The police can arrange for your car to be sorted later.’
‘Are you leaving now?’
Matt shook his head. ‘We’re on standby for the moment in case anyone gets injured, trying to clear this scene. The crane’s arriving now, too, so we’ll wait until we can check the truck driver. Not that I hold out much hope for him.’
‘No.’ Tori looked at the slumped figure in the truck’s cab, still dangling over the side of the bridge. The carnage of the other vehicles, now even more deformed by the extrication efforts of the fire service, were a reminder of how many people had been seriously injured here, and the enormity of it all really hit home. Tori suddenly felt exhausted. ‘I’ll stay for a while, too,’ she said. ‘I’m not sure I’m up to starting a shift in ED just yet.’ Taking a deep breath, she exhaled slowly. ‘I don’t know how you cope with this sort of thing on a daily basis.’
‘Big incidents like this are few and far between,’ Matt responded. He grinned. ‘And you know what we’re like in the ambulance service. Being able to do what we’re trained for on a scale like this is a highlight of the job.’
That adrenaline buzz might only be a memory now but it was strong enough to make Tori nod slowly.
‘It’s a very different ball game compared to hospital work, isn’t it? You have to be far more self-reliant. Yelling for help isn’t necessarily going to get someone who’s going to be any more able to deal with the situation.’
‘And every challenge is that little bit different. It never gets boring, that’s for sure.’
Matt’s partner, Joe, was packing away their gear but Matt seemed content to take a break. He leaned against the side of the fire engine beside Tori. ‘So, how are you?’ he queried. ‘It must be nearly six months since I’ve seen you.’
‘That’d be right. You talked me into coming to that USAR introduction course you ran last year, remember?’
‘Of course I do. You were hopping around on crutches. How’s the leg now?’
‘Good as new.’
‘Did you find the course at all useful?’
‘Absolutely.’ Tori smiled at Matt. ‘That session on triage started flashing like a neon sign in my head as soon as I found I was the first on the scene here.’
‘Really?’ Matt looked so delighted that Tori found her smile widening.
‘Really,’ she confirmed. ‘It was a great course.’
‘You should come and do some more advanced USAR training, then. We could do with some more medically qualified people on the teams.’
‘Hmm.’ Tori was enjoying the look of genuine interest on Matt’s face. His encouraging smile seemed to reach all the way to a pair of equally warm hazel eyes. ‘I might just do that.’
For a fraction of a second Matt held her gaze and Tori was reminded of a connection that had been completely buried over the last six months. A base for a friendship that had just been strengthened by what had happened this morning. A friendship she would be more than happy to build on.
Not that she’d want Matt to think she’d changed her mind about anything else, though. Tori broke the eye contact hurriedly.
‘How are all the kids?’ The reminder of just what had put Matthew Buchanan firmly off any agenda other than friendship was definitely timely.
‘Settling in finally, I think. That’s why I kind of disappeared for a while. I took a desk job, thinking that the more regular hours would help.’
‘And did it?’
Matt shrugged. ‘Maybe. Trouble was I missed being on the road too much. In the end I decided that making myself miserable wasn’t going to help any of us in the long run. It was rubbing off on the family, no matter how much I tried to hide it.’
Tori found her gaze caught again. He would have tried to hide it, wouldn’t he? Anyone who’d been prepared to turn his life upside down and even sacrifice a long-term relationship for the sake of four orphaned nieces and nephews had to be some kind of saint. Or, at the very least, an awfully nice guy.
‘So you haven’t found anyone to help run the orphanage yet?’
Matt laughed. ‘As if! Any sensible woman is going to run screaming into the middle distance at the mention of four kids.’
‘True,’ Tori grinned. ‘You’ll just have to find someone who isn’t sensible, then.’
‘Totally mad, you mean?’
‘It might help.’ The humour was a thinner veneer than Tori felt comfortable with, however, because she knew better than most the implications of the undercurrents here.
Changing the subject was fortunately effortless enough to be perfectly acceptable. ‘Oh, look! They’ve got the cab of the logging truck onto that crane. It’s moving!’
‘That’s my cue, then.’ Matt straightened and watched for a short time as the cab containing the unfortunate driver of the truck swung slowly towards solid ground where it hovered before starting a gentle descent. Matt moved towards the ambulance. ‘I’ll grab my kit.’
‘Can I help?’ Tori’s exhaustion had mysteriously evaporated. There was, after all, the smallest chance that the truck driver was still alive.
‘Joe?’ Matt got the attention of his partner. ‘Tori’s offered to third crew for us for a bit longer. Give her the heavy stuff, eh?’
Joe was grinning as he held out the lifepack. ‘If you carry the oxygen cylinder in your other hand, it kind of balances you.’
‘Cheers.’
‘Just kidding!’ Joe put the lifepack on top of the stretcher and then added the oxygen cylinder and suction kit. ‘We’ll just take the whole bed. Pull out those handles at the end and help me lift it out.’
They had to wait as the cab was very slowly lowered to the ground. Then Matt swung himself up on the step and opened the door. Tori saw him reach to feel for a carotid pulse on the driver’s neck.
The shout, seconds later, was astonished.
‘Hey…I’ve got a pulse here. He’s alive!’
CHAPTER TWO
THIS was a life none of them had expected to save.
For the next fifteen minutes Tori found herself part of a small team working hard to stabilise a critically injured patient who had major chest and head injuries. A body splint and backboard were used, along with a team of firemen, to lift him from the cab of the truck. Matt intubated him to protect his airway and provide adequate oxygenation, and a chest decompression was necessary to deal with the pneumothorax that had caused a lung to collapse and affect his ability to breathe.
It was Tori who helped gain IV access and start fluids running to combat the shocked condition the man was now in. She kept up the monitoring of vital signs, like blood pressure, heart rate and rhythm and the level of respiratory distress, and it was Tori that found the driver’s wallet in the back pocket of his jeans.
‘His name’s Wayne,’ she told the others. ‘Wayne Judd. He’s fifty-three.’
And his driver’s licence indicated that he was listed as a potential organ donor. The wallet also included photographs of a woman and children that had to be Wayne’s immediate family. Suddenly this patient had a real identity and his willingness to help others if he could no longer be helped himself strengthened the desire Tori felt to see this man survive.
She helped load the stretcher into the ambulance and switched the tubing from the portable oxygen cylinder over to the wall connection for the main tanks.
Matt had his stethoscope on Mr Judd’s chest again. Then he glanced at the oxygen saturation reading on the lifepack.
‘He needs IPPV to get those sats up,’ he said. ‘He’s not breathing well enough on his own.’
‘I can do that.’ Tori moved to the head end of the stretcher. She picked up the bag mask and swiftly changed the connection to the oxygen supply. Swapping the mask on their patient’s face, she held the new one securely in place and waited for the chest to rise, indicating an indrawn breath. Squeezing the bag attached to the mask pushed in more air with a high concentration of oxygen that Wayne’s lungs, too damaged to inflate deeply enough, were incapable of delivering.
Joe was frowning. It was obvious that close monitoring and possibly further interventions would be necessary en route to the hospital. Providing intermittent positive pressure ventilation was all that one person could do.
‘We’ll have to try and meet some back-up if I’m driving,’ he told Matt. ‘You’ll need some help in the back.’
‘I could come,’ Tori suggested eagerly. ‘My car’s still stuck and I should be trying to get into work anyway.’
‘Cool.’ Matt wasn’t going to waste any more time. ‘Let’s roll.’
* * *
Watching pre-hospital emergency care of a critically injured patient on board a rapidly moving ambulance was a totally new experience for Tori, and she was amazed at how Matt made it look so easy. Even trying to get an accurate blood-pressure reading with the interference of engine noise would be a challenge, let alone inserting a second IV line.
Matt’s face was serious as he concentrated on his tasks, but he seemed unflappable. Swinging bags of IV fluids smacking the side of his head or keeping his footing during cornering or braking were clearly so much part of his normal working environment he barely missed a beat. He also managed to record a series of vital sign measurements and keep an eye on what Tori was doing.
‘Fantastic,’ he told her at one point. ‘You’ve got the sats well over 90 per cent now.’
Her glow of pride was out of all proportion to the task, but this was so new for Tori—an extension of the front-line medical management that was so different to her everyday job. The lack of a stable environment, limited resources and total reliance on personal skills made trying to stabilise and transport this patient a challenge that felt almost raw compared to what went on in the emergency department of a large hospital.
What would have been a terrifying responsibility if she had been on her own had become something else entirely. Matt was so confident and obviously skilled that being a part of this drama was exciting. Exhilarating, in fact. It was almost a disappointment to arrive at the Royal’s ambulance bay.
Matt had contacted the ED en route, relaying all the necessary information about the patient they had on board. They wheeled the stretcher directly into the trauma room, which had been cleared, and a medical team was waiting to take over care of the patient.
‘His name is Wayne Judd,’ Matt informed the receiving doctor. ‘Fifty-three-year-old driver of a logging truck who was trapped in his vehicle for approximately ninety minutes. When we got to him, he was status one, with chest and head injuries. He had a GCS of three, he was tachypnoeic with absent breath sounds on the left side and an oxygen saturation of 83 per cent, BP of 85 over 50 and a heart rate of 130.’
The doctor nodded. ‘Let’s get him on the bed. I’ll take his head.’ Staff positioned themselves, leaning over the bed to take a firm grip on the edge of the sheet beneath the patient. Tori lined up with Joe and Matt to lift the sheet on their side of the stretcher.
‘On the count of three,’ the doctor in charge of the airway instructed. ‘One, two…three!’
Maureen, one of the trauma team nurses, moved in to start cutting away the remains of the truck driver’s clothing. She caught Tori’s gaze.
‘You’re in trouble,’ she whispered. ‘Out playing, instead of getting to work on time.’
‘I couldn’t help it,’ Tori protested. ‘Pam isn’t furious, is she?’
‘She hasn’t had time to be.’ Maureen slipped Wayne’s shoes into a paper ‘patient property’ bag. ‘It’s been chaos in here.’
Other staff were crowding around the stretcher now and orders were being given for X-rays, CT scans and a neurology consult. Matt and Joe had pushed the stretcher out of the way and were finishing their paperwork in a corner of the room. Maureen took a swift glance at the two ambulance officers as she bundled up the rest of the driver’s clothing and put it in the bag. Then she winked at Tori.
‘I think I’d stay away and play with those two as well.’
Tori followed her out of the trauma room. It was high time she apologised to the charge nurse, Pam, got herself changed and started work. She certainly didn’t want to get caught up in one of Maureen’s conversations, which always seemed to be centred on men. Her colleague’s attention was not easily diverted, however.
‘Who’s the new paramedic?’ Maureen asked.
‘Matt Buchanan. He’s not so new. He was around for a little while last year before you started here. He’s been off the road for the last six months.’
‘You know him?’
Tori nodded. ‘I went on a weekend USAR course he ran.’
‘Do you know if he’s married?’
‘Yes.’
‘Oh.’ Maureen looked crestfallen. ‘Why is it that the gorgeous men are all taken by the time I see them?’
Tori had actually meant that she possessed the information but having opened her mouth to correct Maureen’s assumption, she promptly closed it again. Matt was probably more than capable of looking after himself, even as the prey of a determined man-hunter like Maureen, but Tori felt absurdly protective. Even more strangely, she took considerable pleasure in extending Maureen’s disappointment.
‘He’s got four kids, too.’
Maureen sighed heavily. ‘Well, that’s that, then, isn’t it?’
‘Yep.’ Tori saw Pam coming out of a cubicle on the other side of the department and moved to intercept her boss and apologise for her lateness. She passed Matt and Joe coming out of the trauma room with their stretcher, and smiled in response to Matt’s grin.
‘Catch you later,’ she said. ‘Don’t work too hard.’
‘We won’t,’ Matt assured her. ‘Sure you don’t want to come and third crew with us for the rest of the shift?’
‘I’d love to…’ Tori grinned ‘…but I don’t think it would make me any more popular around here.’
They could all see the frown on Pam’s face as she watched Tori approach.
‘Want me to put in a good word for you?’ Matt asked softly.
‘Pam’s OK. She’s just stressed.’ Tori waved them through the automatic doors to the ambulance bay. She couldn’t help one last glance over her shoulder before moving to appease the charge nurse. Matt and Joe were laughing as they loaded the stretcher, and even from this distance Matt’s smile was contagious. As Maureen had said, having four kids ended any possibility of a relationship more than friendship but friends were important, weren’t they?
A friend like Matthew Buchanan could quite possibly be the best available. He was a very likable person and now that he was working on this side of town, Tori would be seeing a lot more of him. The thought was enough to buoy her spirits considerably.
‘I’m so sorry, Pam. I got caught up in the accident. There really wasn’t any way I could have got here earlier.’
The charge nurse nodded then sighed. ‘We’re short-staffed as it is, and with everyone possible shoved back into the waiting room when we went on code, it’s going to be hours before we get back to normal. Get yourself changed and I’ll assign your patients. Are you able to stay on a bit later tonight?’
‘Sure.’ Tori glanced through the doors to the ambulance bay on her way to the locker room and saw the beacons being activated on the ambulance now out on the main road. The sound of the siren kicked in a second later and Tori smiled. There was a bright side to be found here.
The longer she was on duty in the ED, the more chance she had of seeing Matt. And the more she saw of Matt, the more likely it was that they would become friends.
Matthew Buchanan had a lot of responsibilities. He probably had very little time to have fun these days but he seemed like someone who would be very good at it, given the opportunity.
Tori was good at finding opportunities. If they didn’t come along by themselves, she was quite capable of engineering them, given an incentive. And the thought of seeing that smile on Matt’s face at frequent intervals was an excellent incentive.
* * *
But it proved frustratingly difficult to get anything more than brief snatches of conversation with Matt, however hard Tori tried.
The turn-around time for an ambulance crew delivering patients to the emergency department was generally rapid, and Matt and Joe seemed slicker than most. The times they were held up for some reason— by a queue waiting for triage or a bigger than usual clean-up operation before being available for a new job—were invariably the times that Tori was tied up with patient care and could do no more than smile or wave across a busy department.
Happily, Matt seemed as determined as she was to renew their acquaintance. Over the first few days after the incident with the logging truck, both Matt and Joe were keen to get updates on the progress of the accident victims. Tori made sure she kept in touch with what was going on.
Chloe had been the first to go home.
‘She got a bright pink cast on her arm,’ Tori told Matt the next day. ‘She was delighted with it.’
A day later her siblings were allowed to go home with their father.
‘Mum’s still in ICU but she should go through to a ward later today or tomorrow. She’s doing well.’
The male passenger of the car had been transferred to a spinal unit.
‘He had a fracture at C6-7,’ Tori relayed. ‘I’m so pleased I got someone to sit there and hold his head. He’s had surgery to stabilise the fracture and he’s not showing any neurological deficit.’
The truck driver wasn’t doing so well, still in a coma a week after the accident.
‘I went up to see him.’ Tori shook her head. ‘He looks awful! His eyes are completely black and his face is so swollen it’s unrecognisable. His wife is in there with him most of the time and she’s so grateful for what was done on scene. She tried to thank me but I told her it was you guys who deserved the praise. I’m sure she’d love to say hello to you.’
‘We’ll try and pop in later maybe.’
‘Why don’t you go up now?’ Joe suggested. ‘Control wants us to wait for a patient coming down from plastic Outpatients for a rural transfer. I can go and get her by myself.’
Tori wasn’t going to lose this opportunity. ‘I’m due for a break,’ she informed Matt. ‘I’ll come with you.’
It was a satisfyingly long trip up to the intensive care unit after they bypassed the lifts and took the stairs.
‘This is good,’ Tori announced, pushing open the fire stop door. ‘I really needed to get out of the department for a few minutes.’
‘It didn’t look overly busy.’
‘More like boring today. I’ve had two abdo pains, a ninety-three-year-old with a rectal bleed and a sprained ankle so far. I’m on the trauma team but nothing’s come in yet.’
‘My apologies,’ Matt grinned. ‘I’ll see if I can arrange a good crash or a nice medical emergency for you.’
‘Awful thing to wish for,’ Tori admitted. She gave Matt a stern look over her shoulder as she led the way up the stairs. ‘I’m blaming you for how tame work seems to be lately.’
‘Hey, it’s not my fault if people are staying healthy and happy.’
‘No, but if I hadn’t enjoyed helping at that crash scene so much, I wouldn’t have started to notice how ordinary my job is most of the time.’
‘So join the ambulance service,’ Matt suggested calmly. ‘We get our share of boring, though, believe me.’
‘Yeah, but when it’s not boring, it’s really not boring.’
‘True.’
The easy conversation was interrupted for the short time they spent in the ICU. Mrs Judd was delighted to have the opportunity to thank Matt. She was also a lot happier than the last time Tori had seen her because Wayne was showing signs of regaining consciousness.
‘They’re keeping him sedated because he still needs the machine to breathe properly, but he opened his eyes this morning and I know he recognised me. He even squeezed my hand.’
‘That’s great to hear.’ Matt smiled.
Colleen Judd had a lot of questions she wanted to ask Matt about the accident and Wayne’s rescue, but Tori found her attention wandering. Her nursing career had led very directly to the area she had most wanted to work in and her position in the emergency department represented the goal she had been aiming for.
A career change that might take her in a completely new direction—onto the front line even—had never occurred to her. Until now.
‘I might think about what you said,’ she told Matt as they made their way back downstairs. ‘I could do with a new life.’
‘Really? You not happy with the old one?’
Tori could have sworn she read real concern in Matt’s eyes and she bit back the denial leaping to her lips.
‘It’s been a weird few months,’ she admitted. ‘I’m not enjoying anything right now as much as I used to.’
‘What happened to change things?’ Matt not only slowed down on the stairs, he paused on the landing. Tori stopped as well.
‘It’s your fault again,’ she said with a grin. ‘It was that USAR course that did it.’
Matt raised his eyebrows in both a silent protest and question.
‘You remember that cyclone that was happening in the Pacific then?’
Matt nodded but then frowned. ‘But USAR didn’t get activated for that.’
‘They sent a medical relief team, though, and thanks to doing that course, Sarah got called. I couldn’t go because my leg wasn’t up to it, but she went.’
‘Sarah’s your sister, yes?’
‘Foster-sister really, but we’re very close. We were both still living at home and we looked after Mum for ages before she died last year.’
‘I’m not quite following how this is my fault yet.’ Matt’s attention was fully focused on Tori and the sensation was far from unpleasant.
‘I went to that course and dragged Sarah along purely for your benefit, you know.’
‘Really?’
Tori nodded firmly. ‘I’d decided you two were perfect for each other.’
‘We were?’
Tori nodded again. ‘She loves kids and you’re running a private orphanage.’
Matt laughed. ‘Hardly. They are family.’
‘Yeah. And you were just too nice a guy to say no.’
‘That’s me.’
‘Modest as well.’ Tori grinned. ‘I’m actually quite disappointed you’re not going to be my brother-in-law.’
‘I haven’t had a chance to try,’ Matt protested. ‘Where’s Sarah? Not that I’ve proposed to anyone for a while, but I’m prepared to give it a shot.’
‘I’ve been trying to tell you,’ Tori growled. ‘Sas went off to help with that cyclone relief team and she never came back.’
‘What?’
‘She got kind of involved with someone there. She’s living in London now but they’re going back to Fiji to get married in a couple of months.’