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The hair on Rikki Johansen's neck prickled. She chalked it up to internal radar as she always knew when a certain doctor came to the orthopedic ward. The fact she had a teeny tiny crush on him was beside the point.
Dr. Dane Hendricks didn't look pleased, and the scowl on his face proved something was wrong. His agitated demeanor flashed a warning, and made her wish she could hide. With his broad shoulders squared, and an IV piggyback in his hand, his intense green eyes scanned the nurses' station for a victim. He hadn't spotted her yet. She ducked her head.
"Which nurse is taking care of room 416?"
Rikki had just started her shift that Thursday morning, and couldn't avoid him. She glanced at her clipboard. Yep, she was the lucky nurse about to get chewed out. Dr. Henricks's no-nonsense glare made her wish she could swap patient assignments with someone
"Over here." She nonchalantly raised her hand and pretended to be distracted by more important business, thumbing through a chart. She leaned back in her chair. She was damned if she'd let him know how much he and his demanding, perfectionist ways scared her.
His long strides echoed off the linoleum. Each step closer brought a twinge of dread. Rikki clenched her jaw, preparing for the worst.
He shoved the empty secondary IV under her gaze. "Whose name is that?"
"James Porter?" she read from the small plastic bag. Had she passed the test? She glanced upward into his dead-serious eyes, trying her hardest not to blink.
"Correct. So why did I find this hanging on, Patrick Slausen's IV?"
Uh-oh. She jumped up from her seat, and almost bumped into his chest. He stepped back, training his no-nonsense stare on her.
At 7:15 a.m., not about to start making excuses about how she'd just come on duty and hadn't assessed her patients in room 416 yet, she opted to keep things short and to the point.
"I'll see to this immediately, sir, and write an incident report. Did you notice any adverse reaction from the patient?"
His glower sent a shiver down her spine. She tensed, waiting for the worst.
He adjusted his trendy glasses. "Lucky for you, he's fine." He turned. "I'm going to have a little conversation with your supervisor while you check things out," he said over his shoulder, digging his heels into the lime-tinted floor.
Great. Two months on the job at Los Angeles Mercy Hospital, not even off probation yet, and he was going to complain to her boss about her. What did it matter that it wasn't her fault? She was damned if she'd grovel to the self-assured orthopedic surgeon. She knew how to take a setback. Hell, her whole life had been one challenge after another. He wouldn't get her down.
Not tomorrow. That is, if she still had her job tomorrow.
At least the patient was OK. It could be worse.
Though rare, medication errors did happen in hospitals, and as an RN it was her job to see that they didn't. But no one was perfect, and nurses needed to feel it was safe to come forward and admit when they'd made mistakes without losing their jobs. The right thing to do was to immediately report the error to the nursing supervisor, fill out an incident report, and notify the patient's MD. This time Dr. Hendricks had beaten the nursing staff to the task. The outgoing nurse could not have noticed what she'd done. No one did something like this on purpose.
The best line of defense was always to check and double-check medications with the med sheet. Never rush. Allergic reactions from wrong medications could be fatal. Rikki knew that as well as she did her own shoe size.
What had they drummed into her head in nursing school? Check for the right patient, the right drug, the right dose, the right time, the right route, and then do it all again, and again, before giving a patient anything. Obviously the night nurse had been distracted, but that was still no excuse.
Rikki rushed into 416A, to Mr. Slausen, a total hip replacement, and began her head-to-toe assessment while taking vital signs.
"Good morning, gentlemen," she said to both patients. "Get any sleep last night?"
They both grumbled from their day-old whiskered faces something about how the night nurses never left them alone. If she hadn't been so distracted, she'd have teased them to brighten up their day, like she usually did with her patients. Oh, come on. Those poor night nurses get bored. They have to keep waking you up to give them something to do. But making a joke was the last thing on her mind this morning.
She noted on the chart that patient Slausen's antibiotic was to be given every six hours. The last dose had been given one hour before her shift had begun. Thank heavens James Porter, his roommate in bed B, was on the same dose of antibiotic for his below-the-knee amputation. The error had been the right drug, the right route, the right time, and the right dose, but the wrong patient. A careless mistake. And there was no antibiotic hanging for Mr. Porter, which meant he'd missed a dose. Not acceptable.
She handed Mr. Slausen his bedside Inspirometer after listening to his breath sounds. "Here you go. Deep breathe. See how far you can raise the balls." He'd sounded a little too quiet in his left lung. "Try for the smiley face area. We've got to re-expand your lungs."
She glanced at Mr. Porter, watching and waiting for his turn for vital signs. "Do yours, too. It's very important after surgery." He reluctantly reached for the plastic contraption that bore a silly happy face that elevated to various levels with each deep inhalation. She knew it might be uncomfortable for a post-op patient to do, but it lessened the chance of pneumonia.
Rikki didn't let on anything was wrong but, in her opinion, Dr. Hendricks had every right to be upset.
Janetta Gleason sat quietly while Rikki explained the mixup with the medicine and the patients. She'd quickly learned she had a friend in her supervisor. Fair and just, Ms. Gleason never jumped to conclusions. The silver-and-black-haired lady smiled with kind gray eyes from behind her cluttered desk. Rikki bet she'd worn that same close-cropped tight Afro hairdo since the 1970s.
"I told Dane
I mean Dr. Hendricks
it wasn't your fault. I told him I'd talk to Rita from nights."
Rikki relaxed and studied a wall filled with pictures of the woman's young grandchildren and thought how one day she wanted to have several children of her own.
"Thanks. I'm not sure he likes new nurses, and that mix-up didn't help matters."
"Yes, well, he does like things just so." She rolled her eyes. "In a perfect world
Rikki handed the incident report across the computer. As she'd listed Dr. Dane Hendricks as first to notice the error, he'd have to sign it. She hoped Janetta would take it to him so she wouldn't have to face him again.
She had her hands full with a fresh hip replacement. Not to mention teaching Mr. Porter and his family how to care for his amputation stump in order to get him fitted for a prosthesis. Then across the hall she had the lady in traction with a fractured pelvisa very demanding patient who was constantly on the call light. Thank goodness her roommate was more reasonable to deal with. Though that patient's compound fracture of the femur with metal rod placement looked much worse. It resembled Frankenstein's head, with hardware and screws protruding from the flesh, but suspended with traction in a lamb's-wool-lined canvas sling. Not a pretty sight.
The only thing she had to look forward to today was the first-of-the month party in the nursing lounge where they celebrated for anyone who had a birthday. November was her month, and on Saturday she'd turn twenty-six. Being raised in the foster-care system, special days like birthdays sometimes got overlooked. Today at work it was a given, her name was on the cake. For some dumb reason it made her happy.
Janetta read the incident report thoroughly and nodded her head in approval. "I'll pass this information on to Dane and counsel Rita."
"Thank you. Dr. Hendricks is the last person I want to see again today."
"He's actually a very nice man. He's been through a lot the last few years."
"Oh." That had never occurred to her. Hadn't she cornered the market on challenges?
"How are things going with your foster-kid?"
"Brenden is doing great. Thanks for asking. How about you? Have you signed on to replace that empty nest you're sitting on?"
"Actually, I've attended all of the training classes. They assessed my home, made sure I had appropriate space and childcare arrangements, and issued me a license. So I'm good."
"Great. I'll see you in the childcare center soon, then."
"Right. Hey, wasn't it you who transferred here because of our family care center?" Janetta asked, while she nonchalantly signed the paperwork.
Rikki nodded. "Yes. That and the fact Mercy pays better, so I could afford my two-bedroom apartment and still have two dimes to rub together at the end of the month. And the childcare center has been a godsend with Brenden."
"We've always been progressive here, so we finally had to listen to our working mothers."
"I only wish they'd had it when I was raising my kids."
"Yeah, but someone had to be the trailblazers." Janetta laughed. Her smile brightened her eyes. "And I'll finally get to take advantage of it when I start foster-parenting."
"See? There is justice in the world."
Janetta's face grew solemn. Her gaze drifted somewhere deep within as if remembering something special.
"Since Jackson died, I just feel like I need to give more back to the community." She forced another smile. "You seem to do a lot of that."
"Nah. But every little bit helps."
"And I commend you for volunteering."
"What goes around comes around. You know?"
"More like the golden ruledo unto others
"Whatever your reasons, I'm impressed. Now, get back to work," Janetta said with a kind smile and a swish of her hand. "And don't forget to have some cake, girl!"
Dane knew what he had to do. He stripped off his specially made prescription OR goggles and placed them in the sterilization bin. He removed his blue paper cap, mask, and gown, and disposed of them.
An apology was in order.
He scrubbed his hands and threw some water on his face. After standing for three hours during surgery, he needed to shake out his legs. The nursing supervisor, Janetta Gleason, had explained the circumstances of his patient's medication error, and he'd realized he'd accused the wrong nurse.
Emma had had another upset tummy last night, and he'd spent two hours pacing with her in his arms. He knew the girls missed their mother, yet they never talked about her. Instead, they'd take turns with odd little ailments or aches that only a good long hug could cure. Unfortunately for him, too often it was in the middle of the night before his scheduled surgery days.
He loved holding their little sparrow-like bodiesso fragile and innocent. They were the best things to have ever happened to him, and since their birth four years ago, medicine had run a distant second on the priority scale.
He shook his head. Normally, he'd check out his data before leveling a full-on attack at a colleague, but he'd been tired and irritable, and then, damn, he'd found the wrong patient's medicine on his other patient's IV. Was it too much to ask for proper patient care? He'd jumped to conclusions and blasted the wrong nurse as a result. Well, he couldn't let his mistake lie. He slipped on a white coat over his scrubs.
Rikki. Yeah, that was her name.
He and the enchanting little nurse had made eye contact on several occasions on the hospital ward. She'd always offered a friendly though shy smile. He liked her huge brown eyes and glossy, butterscotch-colored hair. Not that he'd spent a lot of time noticing or anything, but she had an enticing piercinga tiny diamond chip or crystal or something that looked like a sparkly, sexy mole just above her lip. At first he'd thought it was a fake stick-on thing, but over time he'd realized it was always in the same place.
It made him wonder what it would be like to kiss her.
Would he feel it if he pressed his lips to her soft, sexy mouth? What was that about? He'd been too busy to ask anyone out on a date for months, let alone make out. Why think about it now?
He threw more water on his face and headed out the door. I've been working too damn much.
As soon as he wrote the post-op orders and notified the surgical patient's family that the knee replacement had been a success, he'd go back to the fourth floor and seek Rikki out. He owed it her to make things right.
Dane glanced at his watch. Too late. She'd already be off duty and he needed to pick up his daughters from child-care and take them for dinner at Grandma's. His apology would have to wait until tomorrow.