why the patient feels faint. If a person faints, they automati-cally lower their head and make gravity at least push blood to their brain. That’s why I raised the foot of the bed for Mel’s feet to be higher than her head.’
Georgia saw that they had the concept and moved on. ‘Or you can have a woman go back to her room and bleed quietly in a steady trickle until she is in just as much trouble. They’re usually the ones who buzz because they feel faint when they get up to go to the toilet.’
‘We had a lady do that…’ Gerry nodded soulfully ‘…at my training hospital back in the bad old days. When we went to make her bed she’d trickled steadily under the covers over a couple of hours and we nearly had a fit when we went to help her get up. She nearly died.’
Flo’s mouth formed an ‘O’ of surprise. ‘So that’s why we check postnatal women for the first four hours, just like a post-operative patient gets checked in Recovery.’
Georgia nodded. ‘But remember it’s not normal for a healthy woman to do that. The body has mechanisms to prevent it, but some women don’t know they are in trouble. Basic observation is very important. Rapid emergency treatment can save lives, and that’s where having everything ready to go is so important.’
Georgia removed the haemorrhage tray from the cupboard. ‘Let’s have a look at the tray we have here. You obviously need your IV fluids, a tourniquet, your cannulas to insert into the vein for access, and connection tubing for administering the fluids. You both remember Doctor connecting these to Mel. Then there are the drugs that can help with contracting the uterus.’
Georgia held up a sheet of paper in a plastic sleeve. ‘This is the order and dose of the drugs you would need, and that can be very helpful if no one has time to repeat what they asked for.’
Gerry snorted. ‘Typical. I wish I’d known that was there, even though I did manage to get them all in order.’
Gerry acknowledged she’d worried the previous day and Georgia was glad they were talking about it again. She realised Gerry had probably been rehashing the events and needed this discussion to debrief after Monday’s excitement.
‘An emergency is a stressful time. Extra reminders are always helpful. These trays save everyone from running to find different things, too.’
Flo nodded enthusiastically. ‘Boy, do I know what you mean. Every emergency I’ve ever been in I seem to be hunting for things other people want.’
Georgia smiled. ‘The most important thing to get is help. Even the kitchen lady to write down what you gave and when and what steps you’ve taken can be good if you are short-staffed. That’s why the pad and pen are here.’
She held up a pen with a long cord attaching it to the pad. ‘We all find it difficult to get the time drugs were given exactly right even if we record an event immediately afterwards.
‘The beauty of recording events at the time is that we can make fine adjustments when we go over our treatment and actions and review later.’
Gerry snapped her fingers in enlightenment. ‘Is that what a critical review is? I thought it was when you were critical of what people did or when they’d done something wrong.’
‘No. It’s feedback to make the next situation run even more smoothly. Max is going to sit down with us later today and we’ll go over it together and see if we missed anything.’
‘I don’t think there was anything anyone could have done better,’ Gerry said dryly. ‘I thought you guys were amazing.’
‘We were a team and you and Flo were an important part of that. I think you both were pretty wonderful, too.’
On Thursday Max was called into Maternity just as he was about to go home for the evening meal and he didn’t return until after Georgia had gone to bed. They’d had a sick baby with congenital heart problems and Max had waited for MIRA to arrive to stabilise and take the baby to Newcastle Hospital with her mother.
He’d rung and let Georgia know he’d be very late and she’d sat in the dining room by herself and had then gone to bed early. She couldn’t believe how much she’d missed his company for that one evening.
She had geared her day off to when Max came home. Things she’d planned to tell him. An article she’d thought he might be interested in. And the extra time she’d taken with her appearance.
These were all warning signs that Max was assuming a larger part of her life than she’d promised herself she’d let him be.
ON GEORGIA’S third morning shift the day dawned cold and damp, with thick fog that engulfed the mountain and the road on the way to work. Georgia had left fifteen minutes early to be on the safe side and still only arrived as the clock hit seven.
Minutes after the night staff had departed a young woman hobbled miserably into the ward with her friend. She stood at the nurses’ desk with her hand cupped protectively around her small belly and her lips pressed tightly together.
Georgia came back from the medical end of the hospital at the sound of the buzzer and something about the young woman’s stance sent alarm bells ringing.
‘Can I help you?’ The young woman nodded but didn’t speak.
‘She’s having contractions,’ Her friend said, ‘and you need to stop them.’
Georgia blinked. OK. This was different. ‘I’m Georgia, the midwife. Would you both like to come through to the observation room and we’ll see what’s going on? Then I can ring the doctor.’
The spokeswoman nodded. ‘I’m Shannon and this is my friend, Del. She’s got eight weeks to go.’
Georgia glanced at the silent Del and her heart rate picked up. They’d have to fly her out if she was in labour—they couldn’t handle a baby that size here. Even the base hospital wouldn’t take her at that gestation.
Shannon went on. ‘She’s having twins.’
Georgia’s eyebrows rose. They’d have to fly her out urgently, which would be interesting with the fog. A twin pregnancy was even more likely to progress to a premature delivery.
Del froze as she went to sit on the bed and she grabbed Georgia’s hand and squeezed it as her contraction mounted. Georgia slid her other hand down to gently feel Del’s belly through her shirt, and it felt rock hard against her fingers.
Georgia reached for the buzzer and pressed for assistance. She glanced at Shannon and although Shannon looked scared, at least she could talk. Del certainly wouldn’t be talking for a minute. ‘How long has Del been having contractions?’
‘It took us an hour to get here and an hour before that.’
Two hours shouldn’t be too advanced in labour for a first baby, Georgia thought hopefully. ‘Is this your first pregnancy, Del?’
Shannon came to the rescue when all Del did was shake her head. ‘Her third. The last one took two hours.’
Georgia smiled at Shannon. ‘I’m glad you came
