in report, yet here she was, clearly in distress. Rikki needed to figure out what to do.
“Are you all right?”
The woman nodded her head and fussed with the sheets on her bed, trying to adjust her position but unable to move much with the traction holding her in place.
As it was the beginning of the shift, Rikki took vital signs. Mrs. Turner had an elevated temp and her pulse rate was close to one hundred. She breathed as though she was anxious, short and shallow. There was no obvious sign of infection at the surgical site.
Something caught Rikki’s attention when the woman tugged on the neck of her hospital gown. A sprinkling of small purplish spots dotted the surface of her chest. Rikki peeked inside the loose short sleeve of the gown, where more spots could be seen under her arm and on the side of her breast. It wasn’t a rash. A mental red flag went up.
“May I look in your eyes, Mrs. Turner?”
The agitated woman nodded.
Rikki gently pulled down the lower lid and discovered a few more of the same sort of spots inside the eye membrane. Another red flag.
“I need to call your doctor, but in the meantime I’m giving you some oxygen.” She pulled the two-pronged plastic tubing out of the bedside bag and connected it to the wall oxygen, then fitted it inside the patient’s nose. “I’ll be right back.”
She rushed past the roommate, thanking her on her way out while dredging up well-learned data from nursing school.
Fat embolism was a complication that sometimes occurred with severe multiple fractures, especially of long bones. Mrs. Turner had a fractured femur. Fat globules could be released from the fracture into the bloodstream and act the same as blood clots, which could migrate to the lungs, heart, or brain. If not dealt with immediately, they could prove lethal.
Rikki grabbed the patient’s chart, remembering Dr. Hendricks was her doctor. Flipping quickly through the hospital phone book, she found his private line and dialed. She’d try calling him before the on-call doctor.
“Dr. Hendricks,” he answered gruffly on the first ring.
“Doctor?” She was surprised he was in his office on a Saturday instead of in surgery. “Mrs. Turner in 408B has developed petechiae across her chest and inside her eyes. She’s restless and her temperature and respirations are elevated. I’m worried it might be fat embolism. Can you take a look at her or shall I call your on-call resident?”
“I’ll be right there.” He hung up before Rikki could explain why she hadn’t thought to call the doctor on duty—because she’d become flustered and her mind had gone blank when she’d seen whose patient Mrs. Turner was. Rikki rushed back to the patient’s room to check the oxygen saturation, which to her relief was in the normal range.
Dr. Hendricks appeared out of nowhere, winded and ready for business, as though he’d taken the stairs from his first-floor office rather than wait for the notoriously slow elevator. His sandy dark blond hair looked disheveled, and his white doctor’s coat wasn’t buttoned.
“Mrs. Turner.” He slowed his pace and had a calm smile on his face, though his breathlessness gave his sprint away. “How are you feeling today?”
“OK, I guess.”
As he casually questioned his patient, he looked under her lids and peered down the neck of her gown, confirming what Rikki had told him. “Are you having any chest pain or trouble breathing?”
Mrs. Turner shook her head. “I’m just antsy. You know, anxious, because I’ve been stuck in this bed too long.”
“I’d go a little stir-crazy, too, if I were you.” He nodded at Rikki while he listened to Mrs. Turner’s lungs through his stethoscope. “Take a deep breath,” he told the patient. “Does it hurt when you breathe?”
“No, I just feel like I need to cough.”
“Let’s get a blood gas, stat,” he said to Rikki. “How is her urine output?”
“Um…” Rikki hadn’t thought to check her intake and output, and Mrs. Turner hadn’t asked to use a fracture pan yet that morning.
He didn’t wait for her response. “Get some IV fluids going—normal saline, 125 cc an hour. Get a urine sample to check for fat globules. I’ll order a stat CT scan of the brain and lungs, and we’ll start heparin therapy after the blood gas has been done. Page me as soon as the results are back.”
Rikki flew out of the room and paged the respiratory therapist for the blood gas test, then rushed to the supply closet for what she’d need to start the intravenous line. She glanced over her shoulder and saw Dr. Hendricks scribbling on a green doctor’s order sheet, and blanched when he glanced up and caught her. When he smiled and nodded, she flushed and scuttled back to the patient’s room, trying not to feel flustered under his smoldering gaze.
In the midst of setting up the IV bag and tubing, Dr. Hendricks appeared in the doorway again.
“Here’s my beeper number.” He handed her a small piece of paper.
She snatched it with an unsteady hand. He didn’t let go of his end of the paper, forcing her to tug and look up at his teasing eyes. He gave her a casual smile and said, “Good catch. This could have gotten ugly. Oh, and I’ve ordered IV steroids.”
“You’ll be fine.” He called out to Mrs. Turner. “Rikki here will keep tabs on you until I get back.”
He nodded again, and smiled in a naturally sexy way that made her toes curl, then left.
She stood quietly, shaken. Why did she let him have such power over her? Damn, denial was useless—she had a crazy crush on the man. There was no getting around it.
Thankfully, she had something to distract her, something much more pressing to attend to than Dr. Hendricks’s make-your-knees-knock smile. She had a sick patient to care for.
Dane had finished his weekend rounds and discharged several patients. Mrs. Turner’s computerized tomography revealed early evidence of fat embolism in her lungs, and she needed to be transferred to ICU and intubated until her condition came under control. If Rikki hadn’t been on the ball, the patient’s prognosis could have been much worse.
He put his hands in his pockets, deep in thought, and walked to his car in the doctors’ parking lot. He glanced up to find a captivating vision before him. Rikki’s hips swayed with a mesmerizing rhythm as she walked quickly to her car. She’d unwound her bun and, as if a pendulum, her ponytail kept counter-time to her strut in a most alluring way. He rushed and caught up with her.
“What’s your hurry? Hot date?”
She spun around, looking surprised. “Oh.”
He could get used to that wide-eyed liquid brown gaze of hers.
She’d changed into baggy camouflage pants and a tight T-shirt, revealing a modest chest. Her backpack matched the pants. Not exactly the sexiest outfit he’d ever seen, but on her it worked. The fashion statement was further evidence that he couldn’t deny: he was a good ten years her senior. Could they possibly have anything in common? At least she wasn’t wearing combat boots, just brown high-top canvas sport
