sound of his name yanked him into the moment and he smiled at the directors of radiology, respiratory therapy, the emergency department and the E.R. doc, all gathered around the mahogany conference table. He was acquainted with them all.
“Dr. Andrews was appointed Mercy Medical West’s chief trauma surgeon last night.” A hint of pink creeping into Hope’s cheeks told him she hadn’t forgotten what else happened last night.
And what almost happened.
Everyone applauded the announcement and seemed genuinely pleased at the news. It was worth the price he’d paid—all work, no play or much pay for more years than he cared to remember. Now that he was at the top, nothing was going to get in the way of his staying there.
“Congratulations, Dr. Andrews,” Hope said. She barely met his gaze, then glanced at the agenda on the table in front of her. “Next I’d like a report from each department, in terms of how we stand in supplying trauma personnel.”
As the directors took turns getting her up to speed, Jake studied Hope and knew she was aware of him, too. The pulse at the base of her throat beat just a little too fast. He didn’t know whether or not to be pleased about that. The timing of this—whatever it was between them—was damn inconvenient.
“All right,” she said nodding. “Now I want to make sure we’re on the same page with identifying the levels of trauma. Mechanical injury—broken bones—is level one. Penetrating wound is level two. Head or traumatic brain injury is level three. Preliminary paramedic evaluation in the field will determine the trauma level of patients transported by ambulance. And walk-ins will have to be assessed by the E.R. doc who will determine the trauma level.”
A murmur of general agreement followed her remarks as the directors took notes.
“Next on the agenda is medical staff. We will apply for a level-three designation since Dr. Gallagher’s group signed on for neurosurgery and agreed to be in-house 24/7. That doesn’t mean on standby or on call. They will be physically on premises. Dr. Andrews can fill us in on whether or not we have adequate trauma surgeons signed on.”
“I’m in the process of interviewing several surgeons right now,” Jake said. “I’ll be ready before the doors open.”
“Good.” She was all business, the polar opposite of the tantalizing temptress of just a few hours ago. “Now for Radiology. Dr. Edwards, about the Nighthawk system …”
Jake knew that radiology used the Nighthawk system to send nonemergency tests to Australia via the Internet for interpretation. But the state of Nevada mandated that an interventional radiologist be in-house for invasive procedures that required diagnostic imaging or guidance for tapping blood buildup in the chest cavity or other emergency situations. Edwards was a hard-ass and not receptive to change, making Hope’s job a challenge.
The heavyset, balding doctor tried to glare her into submission. “It’s cost-effective to use the Nighthawk system.”
“In most cases, yes,” Hope agreed. “But there isn’t a choice about this. We can’t be designated a trauma center without an interventional radiologist in house.”
“And I need to pay the I.R., Miss Carmichael,” he said stubbornly. “They don’t come cheap. I have a budget.”
“Don’t we all.” She glanced at Jake, her hazel eyes narrowing slightly. “But there are other ways to trim.”
“None of them pretty.” He rested his elbows on the table. “What if there are no traumas?”
“It doesn’t matter. We’re a trauma center and have to staff for what could happen.”
“And I still have to pay the staff for doing nothing. My partners will not be happy and neither will I.”
“You agreed to the terms of the contract, Dr. Edwards,” she reminded him.
“Terms can be amended. I think hospital administration should absorb some of the cost.”
Hope stared him down. “I understand that the tendency is for every department to become territorial and insular, but the goal is for all the parts to function as one. Just like the body which can’t sustain life without a brain, heart or liver, a trauma response relies on all the departments for a successful outcome.” She glanced at each department director in turn before saying, “But I’m sure you’re all as aware of that as I am.”
Dr. Edwards shook his head. “When I can’t justify expenditures, it’s my reputation on the line. My ass in a sling.”
“As is mine,” she said.
Jake glanced in the direction of the body part in question which she was currently sitting on. From what he remembered, it was an excellently curved butt that fit nicely in his hands.
“This is not the time or place to be discussing financial arrangements. I suggest you speak to the administrator regarding your concerns. Bottom line,” she said, momentarily glancing at Jake as if she could read his thoughts, “I need your assurance that you’ll be prepared with an in-house radiologist around the clock.”
The radiologist stared at her for several moments, then finally nodded, albeit reluctantly.
“Good,” she said, smiling sweetly. “And last but not least, I’d like to discuss who should respond to a codetrauma page.”
Jake knew how he wanted it to go and was acutely interested in how she’d present this.
After glancing at her notes, she looked around the table. “In my opinion there should be someone from the lab, Radiology, Respiratory Therapy, Admitting and an ICU nurse. Just in case.”
“How about housekeeping and dietary?” Jake asked. “Or lions and tigers and bears, oh my.”
“Excuse me?” She met his gaze.
“You’re aware of the limited space in the trauma bays?”
“I am.”
“If you get all those people in there, it’s like an IV push of adrenaline. Looky-loos show up in droves. It will be a three-ring circus and you might as well sell tickets.”
Around the table everyone laughed and Hope narrowed her gaze on him.
“You didn’t let me finish, Doctor.”
“So you were going to say that the key to an organized trauma team response is …”
“Security,” she finished, one eyebrow raised. “Security will be trained to monitor who should and should not respond to a code trauma.”
He nodded, more than satisfied with her response. She knew her stuff. She was a smart cookie and sexy as hell. Damn inconvenient this thing arcing between them.
“That’s it for me,” she said, glancing at everyone around the table. She looked at him. “Dr. Andrews, it’s your meeting.”
“Gripes anyone?” They all got a chuckle out of that, including the radiologist. It took the edge off the tension of moments before. “Any other business?” Before they could answer, he stood and said, “Hearing
