The little girl took a shuddering breath. ‘Arm.’ She shrank away from Holly who nodded sympathetically.
‘I won’t touch it, sweetheart, not until you’re ready. What we need to do is make it nice and clean and have a good look at it. There’s a special room here for that sort of thing. And there are some lovely toys...’
She crossed her fingers that her predecessor had kept toys in the nurse’s consulting room. Surely she did. Everyone did.
Holly turned to the receptionist, her smile friendly. ‘If I could just use the treatment room, we don’t have to make these poor people travel all the way to the Infirmary.’ She turned to give Helen’s mother an explanation. ‘I’m the new practice nurse and technically I haven’t started yet, but I can’t see anyone minding if we sort Helen out.’
The set of the receptionist’s mouth indicated that she minded a great deal. ‘We’re not an accident and emergency department.’
‘No,’ Holly agreed quietly, her voice firm, ‘but if we’re capable of giving the care required, without the patient having to make a long trip to hospital, we should give it. I’ll assess the bite and clean it up, and hopefully by then one of the doctors will have arrived back from their calls and they can write up some antibiotics. Is there a white coat I could borrow, please? My uniform is still in my suitcase.’
Her shoulders stiff with disapproval, the surly woman marched out from behind the desk and walked down a carpeted corridor. Making a mental note to have a word with Mark about the attitude of his receptionist, Holly gestured to Helen’s mother to follow her.
‘This is the room you’ll be using.’ The receptionist flung open the door and turned to leave. ‘I’ll phone the senior partner to let him know that you’re here.’
And try and make trouble, no doubt, Holly thought uneasily, watching the woman leave. Oh, bother. She didn’t need that sort of aggravation in a new job.
‘Take no notice of Caroline Duncan,’ Helen’s mother said, rolling her eyes. ‘Her bark is worse than her bite.’
Holly wasn’t convinced, but she gave the woman a smile. ‘I do apologise for the fact I’m not in uniform, Mrs...?’
‘Brown. But call me Alison, and I don’t care what you’re wearing as long as you can sort my Helen out.’
‘Well, I’m just going to dig out a white coat and then I’ll have a look at it,’ Holly promised, glancing round as the door opened sharply and Caroline entered, carrying a white coat.
Holly thanked her warmly. ‘Oh, and, Caroline, presumably I can access the notes on the computer?’
Caroline frowned as she turned to leave. ‘Our computer system is very complicated. I expect you’ll need to be trained before you can use it.’
Holly, who had been using computer systems all her working life, smiled easily, still doing her best to be friends with the woman. ‘I’m sure I’ll be able to muddle through. Thanks, Caroline.’
She slipped on the white coat and then spotted a basket of toys under the examination couch. ‘Oh, look at these, Helen!’ She dived under the couch and retrieved the basket. ‘Have a little look at those for me and tell me what there is because I’ve never seen them before.’
The little girl delved into the basket and finally a small smile appeared as she pulled out a bright yellow helicopter with blades that spun round. ‘There’s a helicopter! I love helicopters.’
‘I had one like that when I was small,’ Holly chatted away, calming and distracting the little girl until she felt the time was right to look at the damage. ‘Can I just take a look at that arm now, sweetheart?’
Helen nodded, still intent on playing with the helicopter.
‘Is it awful?’ Alison Brown bit her lip as Holly unwrapped the makeshift bandage she’d used to stop the bleeding. ‘It bled such a lot.’
‘I’ll just take a look. How did it happen? Did the dog have an owner?’
Alison sighed. ‘Yes, it belongs to Mrs Ellis, the librarian. It was Helen’s fault really. I’ve warned her not to touch dogs she doesn’t know, but she will go up to them and make a fuss—you know children.’
‘I do indeed,’ Holly agreed sympathetically. ‘Don’t tell me—this wasn’t a cuddly type of dog.’
‘Not at all,’ Alison shuddered. ‘It was tied up outside the supermarket and Helen was over there and patting it before I could stop her. To be honest, I didn’t think about stopping to have words with Mrs Ellis after it happened. I just sprinted over here in a panic.’
Holly dropped the bloodstained bandage in the bin and examined Helen’s arm carefully.
‘Actually, it isn’t very deep at all,’ she said finally, walking across the room and rummaging through the cupboards until she found a dressing pack. ‘The biggest risk from animal bites is infection, so what we need to do is clean it really carefully and then give Helen some antibiotics. How old is she?’
‘She’s five,’ came the reply and Holly nodded as she ripped open the dressing pack.
‘And is she fully immunised? Did she have all her childhood jabs?’
‘Oh, yes.’ Alison nodded vigorously. ‘I really believe in immunisations. She had everything going.’
‘Good. Then she won’t need a tetanus injection. Helen, I’m just going to clean your arm. It might sting a little bit. Fancy you liking helicopters. Do you know that in one of the hospitals I worked at, we had our own helicopter?’ Holly chatted away as she cleaned the wound, knowing that thorough cleaning was as important in the prevention of infection as the antibiotics.
‘A hospital had a helicopter?’ As she’d planned, the little girl was so interested in her story that she virtually ignored the pain in her arm.
‘That’s right. I worked in London, and as it’s such a big place with lots of traffic, they have a helicopter to go and collect people who need to see the doctor in a hurry.’ Satisfied that the wound was as clean as it was going to get, Holly inspected the edges, deciding that it was better left to heal on its own without sutures. ‘I’m not going to stitch this, Alison, because it would be distressing for Helen and, to be honest, after a bite like this it’s better, if possible, to leave the wound open so that any infection can drain away.’
‘I know this sounds like a stupid question...’ Alison blushed and pulled a face ‘...but there’s no risk of rabies, is there?’
‘No.’ Holly shook her head. ‘Rabies isn’t endemic in this country. We’d only consider taking preventative measures against rabies if she was bitten abroad or if the dog was imported. But seeing as you know the owner—’
‘Yes, I do.’ Alison’s mouth tightened. ‘And I’ll be having words with her, believe me. Helen was wrong to have touched it, but Mrs Ellis shouldn’t be leaving an animal like that in a place where children are tempted to touch him.’
Holly taped a sterile dressing in place and helped the little girl put her T-shirt back on.
‘Did you go on the helicopter?’ Helen’s eyes were like saucers and Holly smiled at her.
‘Not usually. I worked in the accident and emergency department, so we used to take care of the people after the helicopter had given them a lift. But I did go out on it a few times.’
‘Wow!’ The little girl hardly noticed as Holly carefully dressed the bite. ‘Was it very high up?’
‘Oh, very!’ Holly’s green eyes twinkled as she secured the dressing firmly. ‘The people looked like dots and I could see into everyone’s gardens. Now