They paused at the nurses’ station where two identical-looking dark-haired women stood in civilian clothes, waiting to be introduced to Eliza. Another younger woman came up to the desk as introductions were started. They all shook hands and smiled but Eliza had the feeling they were measuring her against Mary. Height wasn’t the only thing they were measuring.
Mary continued as her comforting self. ‘We have four wonderful enrolled nurses who rotate as the second person on for each shift.’ She gestured to a dark-haired young woman. ‘This is Vivian, who will be on with you for the rest of the day.’
Eliza smiled at Vivian. A patient call bell rang and Vivian said, ‘Nice to meet you.’ Then scooted away to answer the summons.
‘Rhonda and Donna are our dynamic duo. One of them is your night sister while the other is on days off. They also do the two days on call to cover when you’re off. The rest of the week you’re the third pair of hands if needed at night.’
Both women nodded and smiled so Eliza gathered she’d passed muster, at least today. ‘I’m going home to bed,’ Donna said. ‘Nice meeting you.’
‘I’m off, too. Ditto.’ added Rhonda, and they hugged Mary and left.
Mary watched them go and she smiled. ‘I’m going to miss this place.’ She sighed and then blinked mistily at Eliza and moved on.
Mary cleared her throat. ‘Across the hall we have our admissions office and medical records, and in here we have our small emergency room.’
Mary entered the neat mini-theatre and treatment room. ‘Of course, very occasionally we have larger emergencies and sometimes use the wards if we need more space.’ She gestured to the labelled shelves. ‘I’m a big believer in labelling so you shouldn’t have any trouble finding things.’
‘This is going to be great.’ Eliza leant across and rested her arm briefly around Mary’s shoulder in a spontaneous gesture of comfort. ‘I know I’ll love it here, Mary, and you’re not to worry. I’ll take good care of your hospital until you come back.’
A bell rang overhead and they both glanced up.
‘What’s the bell for?’ Eliza asked, and then frowned as Mary stopped and rested one hand low on her stomach.
‘That’s the casualty bell. At least I’ll get to run you through an outpatient card.’
Eliza inclined her head towards Mary’s stomach. ‘I’ll do this. If you’re going into labour I’ll write a card for you, too.’
‘The tightness will go.’ Mary smiled ruefully but didn’t deny she had some discomfort as she gingerly led the way round the corner towards the main admissions desk, where a young mother leant on the desk with her frightened daughter by her side.
‘Asthma,’ the clerk said. ‘I’ll do the admission without her.’ She gladly handed over her charges, along with a dog-eared card.
Eliza glanced at the name. Mia Summers. A good choice by the admissions clerk, Eliza thought as she helped the woman up the hallway until she met Mary with the wheelchair. They wheeled Mia into the assessment room where Eliza sat her on the edge of the bed. Mary hovered at the door, ready to help if Eliza needed her.
At least the woman had been able to stand and hadn’t fallen unconscious in the car. It hadn’t been that long since Eliza had been present at a young man’s tragic death from asthma, and that had been in a big city emergency department with more doctors than they’d needed, but it hadn’t been enough. Asthma was a killer if people didn’t take the early warning signs seriously enough, and Eliza was on a crusade for education of patients at the moment because of that.
‘Hello, Mia. I’m Eliza. Have you got your Ventolin on you?’
Mia opened her mouth to answer but was far too breathless to talk.
‘Mummy’s puffer is here but she can’t seem to breathe it.’ The little girl prised the small cylinder from her mother’s clenched fist.
Eliza glanced at the label of the puffer and nodded as she slipped the pulse oximeter on the woman’s finger and noted the low oxygen saturation of the woman’s blood. She suspected Mia wasn’t far from unconsciousness.
‘What’s your name?’ Eliza asked the little girl as she reached up into the cupboard to pull down a Ventolin mask.
‘Kristy. I’m eight.’
‘I’m Eliza. I think you’ll make a great doctor or nurse one day, Kristy, the way you’ve looked after Mummy. Where’s Daddy?’
‘Daddy’s in the far paddock and Mummy said we had to go now. I left a note.’
‘That was clever and Mummy was right.’
While she was talking, Eliza’s hands were busy. ‘This mask gives Mummy oxygen and makes the stronger asthma drug into a fine mist and that helps Mummy to breathe.’
Eliza broke open the plastic ampoule, squirted the pre-mixed drug into the chamber of the nebulising mask and fitted the now misting mask over Mia’s face.
She continued talking to the little girl but really she was talking to the frightened young woman beside her. ‘Inside Mummy’s lungs, all her little breathing tubes are blocking up with thick slime. This medicine helps the slime get thinner so Mummy can cough it out of the way and breathe better again, and the oxygen makes mummy feel better.’
The little girl nodded and Eliza rested her hand on the woman’s shoulder. ‘Just close your eyes, Mia, and let the medication do the job.’ Eliza fitted the blood-pressure cuff around the woman’s arm and began to pump it up. ‘Do you have an asthma plan sheet and a spacer?’
Mia shook her head tiredly and Eliza nodded. ‘We’ll talk about it later because I think it would help a lot in your case.’
Eliza glanced at Mary. ‘She needs IV access, cortisone and probably IV salbutamol. Would you like to ring Dr Dancer to come around? I’ll pop a cannula in to save time.’
Mary nodded and reached for the phone on the wall while Eliza swiftly prepared her equipment. ‘I’m going to put a little needle in Mummy’s arm. It looks like it would hurt but it’s really not much more than a mosquito bite. Mummy needs some other medicine that works really quickly if we put it in through the needle. Do you want to look away when I do it?’
Kristy shook her head. ‘I’ll hold Mummy’s other hand.’
‘You have a wonderful daughter, Mia.’
Mia nodded as she started to cough. Already her oxygen saturation had improved. Eliza glanced at Kristy to see if she was upset by her mother coughing.
‘So the slime in Mummy’s lungs is getting thinner, isn’t it Eliza?’
‘Yep.’ Eliza slid the cannula into Mia’s arm and taped it securely. Then she began to assemble the flask and line and draw up the drugs in preparation. ‘Next time Mummy’s fingers go this blue or she can’t talk, she’d better come in the ambulance because they can give her this medicine in the mask and put the needle in on the way to the doctor. Do you know how to ring an ambulance, Kristy?’
Kristy nodded. ‘I ring 000, or 911 in America or 999 in England.’
‘Wow. Even I didn’t know that.’ Eliza felt like hugging the little girl. ‘Tell them Mummy can’t breathe and then answer all the questions.’
When Jack arrived he could see that Eliza had everything under control. Mia could manage a few words, and after he approved the intravenous drugs Eliza had ready, Mia was stable enough to go by ambulance to Armidale, where she’d have to stay overnight, at the very least, for intensive observation.
‘Rhonda’s