about midnight. Cassie Blake’s come in with a temp of 39.5 and a productive cough. Most of you know her, I think. Twelve-year-old with ALL.’
Lynne interrupted, ‘Do you know what that stands for, Tracey?’ She directed her question to the student nurse who had started on the ward the day before. The girl blushed.
‘Acute…er…lymphoblastic leukaemia,’ the girl amended.
‘Well done. Sorry, Barb, go on.’
‘No problem.’ Barbara smiled and refocused her attention on the pile of patient folders. ‘She’s halfway through induction chemo as an outpatient and responding well. Chest X-ray’s clear but she’s on IV antibiotics and two-hourly obs. Temp’s come down to 37.9 already. The physio will see her this morning and she’s to have another blood count.’
Joanna became aware of the presence of a late arrival in the small nurses’ station. By the hint of aftershave she knew the person was a male and he was standing directly behind her. She began to feel embarrassed that he had a full view of her recently shorn skull and as she moved sideways he leaned towards her and whispered, ‘No need to move,’ as casually as if he’d never met her before. ‘I’m just eavesdropping.’ Then he addressed the whole group.
‘Don’t let me interrupt, ladies…’ he glanced apologetically at Grant, the only male nurse on for the shift ‘…and gentleman. Just thought I’d get a head start on the ward round by listening in. Hope you don’t mind.’
‘Of course not, Dr Howell.’ Barbara beamed. ‘I was just about to say that you would be seeing Cassie this morning to assess her.’ She addressed the group again. ‘You’ve all heard Dr Howell is starting his clinical duties today as medical oncologist, taking over from Dr Price.’
All eyes turned towards the man standing behind her. Joanna sensed the rush of warmth and felt certain her whole scalp was glowing. This kind of reaction was so out of character. She was embarrassing herself and behaving like a teenager.
‘Thanks, Barbara, but please go on. Pretend I’m not here.’
Easier said than done, Joanna thought as she forced herself to concentrate on the remainder of the handover. It was no easy task with the man she had shared the most traumatic time of her life with standing so close she could feel his thigh touching her hip and the warmth of his breath on her neck. She didn’t want to draw attention to herself by moving again, though.
Barbara was finishing. Joanna cleared her throat but her voice still sounded husky.
‘What’s happened to Tye?’
Barbara laughed and Joanna thought she detected a hint of a wink. ‘Even the prospect of his favourite nurse on duty today couldn’t keep him here. He left last night, straight after his treatment finished.’ She looked around the room. ‘Anything else, any questions?’
There was an impatient silence. They were all ready to embark on another busy day’s work.
‘Great, I’m out of here, then. Have a good day.’
* * *
Richard’s aim had been to get the feel of the staff attitude, the atmosphere of the ward and a rundown on the patients from the nursing point of view before his morning ward round. He’d had no idea whether Joanna would be working a morning shift so, when he saw her in all her close-clipped glory, he mentally rearranged his schedule.
She’d blushed at the mere sound of his voice; her breathing had quickened and he’d detected the slightest trembling of her hands when he’d accidentally touched her. He’d have to make an opportunity to speak to her alone, not only to reassure her that the last thing he wanted to do was to upset her but also to offer her an olive branch and let her know he wasn’t about to intrude on the life she now had…unless she wanted him to.
He leafed through the case notes while Lynne allocated patients and duties to her staff for the day.
‘Joanna will be coming with us, if that’s okay with you, Dr Howell?’ Lynne interrupted his train of thought. He didn’t look up, but gathered the files and put them on the trolley.
‘Fine by me.’
‘She’s the only nurse who gets to know all the kids on the ward and their families.’ She chuckled. ‘And a few of their secrets they won’t share with anyone else.’
Now, why didn’t that surprise him?
Joanna was again looking embarrassed, as if she wasn’t comfortable with compliments—an unusual personality trait in an experienced, capable and obviously respected nurse. Richard dismissed the thought that his presence was the reason and focused his attention on what the charge sister was saying.
‘We’ll see Cassie, our most recent admission, shall we?’ Lynne said as she guided them into the small room next to the two single rooms set aside for the special care of patients with severely compromised immune systems or serious infections that might be a threat to the fragile health of other sick patients on the ward. They all dutifully rubbed sanitising gel onto their hands.
‘Cassie’s been isolated as a precaution until we get confirmation of the nature of her infection. With your okay, Dr Howell, we’ll move her into the general ward as soon as we can.’
Joanna entered the room first and Richard noticed the girl’s face light up at the sight of her. Cassie’s mother, though she looked as if she’d had little sleep the previous night, also managed a smile.
Joanna held up her hand in a high-five gesture.
‘Love the new look, Jo,’ the twelve-year-old said with a cheeky grin as their hands touched. Both mother and child were behaving as if Richard and Lynne weren’t in the room. Their attention was entirely on Joanna…and they weren’t the only ones. She had transformed on entering Cassie’s room: she was now confident, charismatic even and seemed to have an aura of optimism hovering around her.
‘Can’t have you getting all the attention on the ward. I did it purely out of jealousy,’ Joanna said.
Cassie smiled and then finally acknowledged that Joanna wasn’t the only one who had entered the room.
‘Who’s that?’ she said with the typical forthrightness of the young. ‘Is he the new doctor?’
‘Where are your manners, Cass?’ her mother said as she stood to introduce herself. ‘I’m Kerry.’ She extended her hand.
‘Dr Richard Howell. I’ve taken over from Dr Price and will be looking after Cassie for the rest of her treatment.’ He turned to the girl and smiled. ‘Hi, Cassie. I gather you’re doing well with the chemo but you’ve had a setback. What’s happened to bring you back to hospital?’
The girl looked at her mother then began to cough. It was a rasping, throaty cough and, combined with Cassie’s good spirits, he doubted she had a serious infection.
‘You tell him, Mum,’ she said, slightly breathless from the exertion of coughing.
‘Her brother had a cold last week. Cassie caught it, just a runny nose and a bit of a dry cough and I thought she was getting over it. She’s in the middle of the cycle so I thought her neutrophils would be coming up and she’d be okay. But then last night—’
