were a common occurrence in a busy hospital such as this, but the summons that came was one that Freya hadn’t yet heard.
‘Obstetrics Squad to Casualty.’
Freya wasn’t a part of the Obstetrics Squad. She had been told about it during her interview, though. Each Maternity shift, a senior midwife carried a pager and would attend to any obstetric emergency elsewhere in the hospital, along with an obstetrician and anaesthetist.
New staff had to attend at least three off-unit emergencies as an observer, and then Dr Mina had to approve them before they were made a part of that team. But just because she wasn’t part of the team it didn’t mean that there was nothing for Freya to do.
She ran down to the equipment room and opened up the door, and was pulling out the emergency trolley as Stella and Kelly came running from opposite directions.
‘Dr Mina’s already down there,’ Stella informed Kelly, who held the pager for the Obstetrics Squad today. ‘Freya, go and observe.’
Freya nodded. She was nervous about this role, yet keen for the experience.
The chimes were pinging again.
‘Here...’
It was Len the porter, who had caught up and took over the other side of the trolley, allowing Kelly to run on ahead.
There was everything that might be required, including a neonatal cot, even though there would be one in Emergency. The trolley was set up for any eventuality.
As she swept into Casualty, Freya acknowledged that she was nervous but consoled herself that she was just there to observe. Even if she never made the team it would be good experience for when she went back to Cromayr Bay.
When.
There was no time to dwell on that word, though it jolted her.
Richard was at the head of one of the resuscitation beds and only briefly glanced up when she came in.
‘Next bed,’ he said, clearly knowing that she wouldn’t have been down there before. He gestured with his head to a curtained area beside him, from behind which came the sound of equipment and people, and above all that the screams of a woman.
They were terrified screams and the woman sounded in pain.
‘Thanks.’ Freya stepped in and saw there was organised chaos taking place.
Dominic, his registrar, was at the head of the bed and the trauma team were around the woman. So too was Dr Mina, tiny in green scrubs and yet authoritative all the same.
She had a Doppler on the woman’s stomach and there was the sound of a rapid heartbeat.
‘Stay back and observe,’ Kelly said. ‘You’ll be doing this yourself soon.’
There wasn’t actually room for her to do anything but observe.
An older woman dressed in scrubs was talking to the patient. ‘You’re okay, Louise,’ she said in an Irish brogue. ‘We’re taking care of you now...’
Louise had on a hard collar, and from what Freya could make out she had been involved in a high-impact motor vehicle accident. There was blunt trauma to her chest and abdomen as well as a head injury.
And she was twenty-six weeks pregnant.
‘Louise.’ Kelly moved near the head of the bed. ‘Your baby has a strong heartbeat...’
But nothing would calm the woman. Louise Eames was absolutely terrified and perhaps, after her head injury, confused too.
There were also concerns that she had abdominal bleeding.
‘I’m May, the Unit Manager in this madhouse.’ The Irish woman stepped back and spoke to Freya as Kelly took over reassuring the patient. ‘I’m a midwife myself. All looks well but, as you know, pregnant women can mask symptoms. I’m worried that she’s worse than her observations are showing.’
It was nice to be talked through it all. Most of it Freya knew, but she hadn’t actually seen the Obstetrics Squad in action.
‘I’ve told NICU to hold a cot, in case she has to be delivered.’ May said. ‘Here’s Richard now.’
Richard spoke for a moment with Dominic, and then Dominic stepped out—Freya guessed to take over the patient in the next bed.
‘Hello, Louise.’
He spoke as if they had already met, Freya thought. There was just something so reassuring about his voice.
‘I’m Dr Lewis, Consultant Anaesthetist.’
Louise screamed again.
‘No,’ he said. ‘No screaming. Save that oxygen for your baby. Now, I want to have another listen to your chest.’
‘That’s a good girl,’ Kelly said to Louise, who was quietening down—though that wasn’t necessarily a good sign.
‘We’re going to get her round for a CT,’ Dr Mina said. She and Richard discussed sedation, but Louise seemed a lot calmer now.
The CT was swift, and showed a small tear on Louise’s spleen, but everything looked fine with the baby.
‘Louise.’ Dr Mina spoke to her. ‘The hard collar can come off now and you’ll be more comfortable. The baby is doing well, but we’re going to move you now to the Intensive Care Unit, so that we can keep a close eye on both of you.’
‘Will my baby be okay?’ It was all Louise wanted to know.
‘Everything is looking fine for now,’ Dr Mina said. ‘But, Louise, if we need to deliver you, then we will.’
ICU was all ready and waiting, and absolutely the right place for Louise to be.
Freya listened as May gave a detailed hand-over to the Critical Care Nurse. It was scary for Louise to be there, no doubt, but after the noise of Emergency it was certainly a lot calmer here.
‘Thank you,’ Dr Mina said to the midwifery staff as they gathered up their equipment to leave.
Richard didn’t look up as he was already with another patient and completely focussed.
God, what a job he had, Freya thought as they headed out.
‘Poor thing,’ Kelly said, as they made their way back, but then she moved straight on to business. ‘We’ll have to check the trolley as soon as we get back,’ she told Freya. ‘Just in case we’re called again.’
‘I hope we’re not,’ Freya said.
But hope didn’t work.
Just after three the chimes went off again. Freya was taking a baby for Pat when she heard them, and they didn’t even share a glance—instead they focussed on the little life coming into the world.
Working at The Primary was, Freya thought
