TIME SPIKE – snippet 7:
The summons for medical caught the nurses off guard. They were locked inside the nurse’s station, with their guard outside the door, and were completely absorbed in their own problems. The three of them were in the middle of report, trying to take care of Brown, the injured guard, and do the paperwork for Greg Lowry. Two of the nurses were in a hurry, wanting to go home and get some sleep.
“Looks like baptism by fire for you, Jenny,” Lylah Caldwell said. The sixty-one year old R.N. smiled half-apologetically. “You’re going to have to go. My legs are killing me. They’re too old and I’ve been on them for eighteen hours.”
Jennifer Radford nodded and shot Barbara Ray a worried look. Ray was an LPN who looked to be in her early forties.
“Don’t panic, I’m coming along.” Ray pulled a large red leather bag from the bottom shelf of a metal cabinet. “Grab the portable O2 tank.” She nodded toward the back room then snatched up a radio and grabbed another bag from the cabinet, loading it onto a gurney. “Brown is stable, she should be able to get by with just one of us for awhile.”
The woman on the examining table moaned and reached for the I.V. tubing attached to her left arm. The saline solution was infusing at a keep open rate. Nothing more than a drop every three seconds, a precaution. If she started to hemorrhage or go into shock, her veins would close up fast, and then an I.V. could become impossible to insert. None of the three nurses were willing to risk that situation. The I.V. had to stay.
“Oh, God. Please. It hurts. Please.” The guard coughed, moaned and then tried to reach the tubing once more. The bandage on her abdomen was fresh, but already streaked with blood.
Lylah Caldwell pulled a couple of sheep skin straps from a drawer and began strapping Elaine Brown’s arms down. “There’s no sense hanging around. Everyone’s short staffed; you won’t get an escort. Get going. A guard is down.”
Jenny moved toward the back room where the O2 tanks were stored. Things were moving too fast for her to understand what was happening inside the prison grounds, but ten years of working under pressure—everything from crash sites to emergency rooms—kept her grounded.
She scooped up a small, portable tank and then grabbed a mask and a nasal cannula. There was no way of knowing which would be needed, so it was best to take one of each.
When she entered the examination area, Lylah handed her a Sat. Unit. The small device was designed to slip over a patient’s finger and read the amount of oxygen in the person’s circulatory system. “Now get moving. And don’t worry. The prisoners are on lock down and the guards have everything under control. The two of you will be safe.”
Jenny placed the tank on the gurney next to the bags Barbara had stacked in its center. She then took a clipboard filled with forms and the keys Lylah was holding out to her.
The call for medical had caused her stomach to tie into a knot. The three of them had just finished counting everything in the room. Keys, pills, injectables, bandages, scissors, ink pens. Everything and anything that could be considered contraband inside the walls. Twenty minutes straight. One thing right after another. She had been briefed on the deceased heart attack victim, Greg Lowry, being held down the hall in a small room with bars. Brown’s status had been assessed, and they were just beginning to go through the calls for the 3-11 shift when the radio announced a guard was down.
She took a deep breath, forcing herself to relax. Gunshot and knife wounds were not new to her, just something she hated seeing.
So much for moving out of the city and slowing things down.
She could hear Lylah, the R.N., talking on the two-way. She was telling someone they were leaving the building. Jenny took another deep breath. This was real. It was what the month long self-defense classes taught to state employees had been geared toward. She was on her own. And if something went wrong she had just one job. She had to survive long enough for the guards to rescue her. The average length of time for their arrival—after they knew you were in trouble—was three minutes. That was one hundred and eighty impossibly long seconds. She gave the gurney a shove. The familiar feel of the cart’s wheels wanting to turn right while she wanted to go straight helped calm her nerves.
“We better hurry,” Barbara whispered.
Jenny sped up.
“The nurses are never hurt,” Barbara said, panting a little as she worked at staying up with Jenny. “We’re the ones who give them their pills and make their appointments with the doctors. They’re nice to us. Afraid to get us mad. Afraid we won’t get them what they want.”
Jenny looked down the dark side street they were passing. The reassurances that everything was safe scared her. She could tell by the nurse’s tone of voice, Barbara’s hurry to reach the guards had less to do with the injured man and more to do with her wanting to be surrounded by guards with guns.
Jenny increased her speed. Experience had taught her that anything that has to be said over and over is usually not true.
They rounded the next corner and Jenny came to a complete stop. There were about a dozen C.O.’s standing near a man lying on the ground, his head on a woman’s lap. The woman was crying. A prisoner, a dead prisoner, lay just a few inches away. There were another three prisoners crumpled on the ground several yards away, obviously dead. A guard was kneeling next to one of them.
She took a breath of the morning air; it was warm, filled with moisture. Then she noticed the sun was rising. Surprised, she stumbled, caught herself, then kept moving toward the man dressed in blue and black.
The other man, the one checking the prisoners, had held her attention for a little longer than she liked. Even in the dim light she could see his face. It stirred up a set of emotions she still wasn’t sure how she felt about.
He was Captain Andy Blacklock. She knew his name even though they’d never spoken. She’d seen him leaving the facility as she was arriving every morning of her orientation.
He was tall and thickly built. His complexion was ruddy and his hair-color a light brown. And even though he looked nothing like her husband Matt, she couldn’t deny the attraction. That attraction had bothered her at first. After a couple of mornings, she found herself looking forward to it. Matt had been dead for almost three years. It felt good just knowing she could still feel.
She took a quick glance at her patient, and forgot about the captain. The guard had been stabbed in the groin area, just centimeters from the femoral artery. She knew the artery had been missed because he was still alive. That was the good news.
The bad news was, he had lost a lot of blood.
Jenny patted the woman holding the man on her lap, then gently lifted the young man’s head so she could move and the wounded man could be laid flat. She then applied a pressure bandage and motioned for Barbara to apply additional pressure while she checked his vitals. His blood pressure was low, 108/58. That wasn’t good, but it wasn’t bad enough to cause a stroke or throw him into shock. His pulse was 92, weak, and irregular. But his Sat level was 93 and that meant his blood carried enough oxygen to do its job. He would live.
She set the oxygen level to the 2 lpm. mark. It wasn’t much, just enough to help him out a little. He looked young and healthy, but you never knew. A conservative approach would be better. She slipped the nasal cannula in place and made a mental note to apply a little K-Y jelly to his nose when they got back to the infirmary.
Using her penlight she checked his eyes. PEARL. The pupils were equal and reactive to light. No brain injury. “What’s your name?”
“Frank,” the woman answered for him.
“Shh. Let him answer. Frank, what’s your last name?”
“Nickerson,” he whispered.
Jenny looked at the woman and she nodded.
She stroked the man’s forehead. His brown skin looked a little dusky, but it was warm and dry. “Where are you?”
Frank tried to sit up and she gently held him in place. “Can you tell me where you are?”
“Yeah. Alexander Correctional Center. And today is Monday.” He waved weakly toward the sky. “Maybe Tuesday. And I don’t know who won the ball game, since I didn’t get to watch the ending. I can tell you who I rooted for, though.” He attempted a smile.
Oriented to person, place and time. Good.
“I guess if you can be all that cocky, you’ll live. Let’s get you to the infirmary so I can patch you up a little before we ship you.” She motioned for the guards to bring the gurney over. “Keep him as flat as you can when you lift him. Barbara and I will keep the leg straight and pressure on the wound.”
Four guards lifted the man in one smooth move, placing him dead center of the cart. The move was practiced. She had seen experienced E.M.T.’s who couldn’t do as well. These guys had had a lot of experience doing this. She steadied her breathing.
“Barbara, take him to the infirmary. I’ll check the prisoners.”
Barbara nodded and followed the guards with the gurney.
The LPN from the afternoon shift had already checked the inmates lying inside the building and the one next to Frank Nickerson, so Jenny turned to the dead men lying on the street beneath the light. Dressed in prison issue, they were in the exact same position she had seen them when she first arrived. But she had to take their vitals. That was the only way to know for sure.
“There’s nothing you can do for them,” Captain Blacklock said as she approached. “They’re dead.”
“I know, but I have to check.” She had put the electronic equipment on the gurney and sent it back to the infirmary. It was useless for this job. It would do nothing but beep and flash error over and over, giving her no reading. This had to be done the old fashioned way. So she started with the closest man’s pulse. For a full minute she counted. Nothing. Respirations nothing. She then pulled out a manual sphygmomanometer and took his blood pressure. Again nothing. She thought about taking his temperature and decided to wait another fifteen minutes or so. He wasn’t exactly warm, but he wasn’t cold. Not yet.
She repeated the procedure over and over until all three men had been checked.
“What am I supposed to do with the bodies? The phones are down so I can’t call the hospital or morgue to have them picked up.”
Blacklock shrugged. “We’ll put them in with Lowry for tonight. I’ll send a few guards after gurneys for transport and have them load them into body bags for you.”
The captain nodded, the gesture seeming calm and relaxed. That was part of Blacklock’s reputation, from what Jenny had heard. One of those people who never lost their composure, no matter what they might be feeling inside. Under the circumstances, that was a quality that would be invaluable to all of them. It also made the man particularly attractive to her—and would have, no matter the circumstances. Despite the lack of physical resemblance, her husband had been the same way under pressure. It had been one of the things about Matt that Jenny had treasured.
Trying to tear her mind away from these completely inappropriate matters, she almost asked how many body bags the prison kept on hand. Fortunately, she kept the inane question unspoken. Instead, she said, “Things don’t feel right.”
“It’s the barometric pressure. It feels sky high. And things are damp. Bone-deep damp. You get a combination like that and anyone planning to stroke, will. Same way for having a baby.”
“Yes. If the pressure goes up enough, it can cause a woman close to her due date to go into labor. It can also cause a miscarriage, if she’s early on.”
“Oh, wonderful.” Blacklock turned to Hulbert—the sharpshooter who’d just returned from his perch on the roof of David-house. “Locate Kathleen. I don’t want her by herself until the end of shift.”
Hulbert nodded. Blacklock turned back to Jenny. “Is there anything we can do to stop the barometric pressure from causing a problem?”
She shook her head. Despite his outward calm, she could sense that the man was upset. The shooting and killing hadn’t ruffled him, but mention of a baby being born did.
Well, that was one awkward question she wouldn’t have to figure out how to ask somebody. He was married. And his wife’s name was Kathleen.
Jenny was met at the infirmary’s outer door by Barbara Ray. “Lylah and I cleaned and stitched Nickerson. It was deep, but he’s all right.” Her voice dropped to almost a whisper and she motioned to Jenny’s nametag, which was imprinted with the initials N.P. “You’re a nurse practitioner?”
“Brown’s not all right. She’s hemorrhaging. We’re going to lose her.”
Jenny ran down the hall to the examination room the wounded correctional officer was in. Coming through the door to the small cubical, she glanced at the machine giving a continuous reading of several vital signs. Elaine Brown’s blood pressure was down; her pulse was up. Her Sat level was an 81. Jenny knew by looking, the woman’s skin would be cold and clammy. She was almost the same color as ash and her lips were black and purple.
Years of training and experience made her forget she was the new kid on the block. “Heat me a blanket,” she said. She looked around the room. She couldn’t remember where everything was stored. The setup was nothing like the hospitals and clinics she was used to. Quick access to supplies and equipment during emergencies where seconds frequently made the difference between life and death was not the guiding principle in the storage and location of supplies and equipment inside the prison’s infirmary. Staff safety and prevention of prisoners’ access to anything that could be used as a weapon were the only factors. “Do we have anything I can cauterize the wound with?”
Lylah’s eyes narrowed. “We’re not allowed to do that, the wound is too deep. Best we can do is re-sew her.”
“Damn.” Jenny slipped on a yellow paper gown and pulled on a pair of rubber gloves. “Get me a suture kit,” she said, removing the blood soaked bandage.
“First things first. Turn around,” Lylah said.
Jenny turned and the elderly nurse handed her a pair of latex gloves and then slipped a paper mask over her nose and mouth. “Thanks,” she said.
Lylah opened the suture kit.
“Increase the saline to 60 and the oxygen to 6. And turn the lights up.”
Barbara came through the door with three warmed blankets. “The guards are making us more, just in case.”
Jenny nodded, looking at the jagged tear in the woman’s skin. She had been cut from just below the umbilicus to just above the pubis. “I can’t see where it’s coming from,” she said, rinsing the area with saline. “Damn. The stitches are all intact. This is new.”
She began the process of applying pressure systematically, looking for the source of the blood flow. She was going to have to open her up.
“I have to take them out, get inside, see what’s going on.”
Lylah’s face was tight. “You’re on your own,” she said. “I’ve been awake too many hours. Besides, my eyes aren’t any good for that type of work. Never were. And Barbara’s an LPN. She’s good, but she hasn’t been trained for anything invasive.” Lylah stepped away from the table and returned with a suture removal set.
“Do we have anything to put her under with?”
“No. Just a local, and that’s not very potent. And even if we did, none of us has been trained to administer it.”
Jenny suppressed a groan. If the local was what was used earlier, it was almost useless for what she was going to have to do now. “I’ve served with the military overseas. Plus, I did missionary work in Latin America. I can administer anesthetic. I’ve also done surgeries under conditions much more primitive than we have here.”
“Surgeries?” Lylah Caldwell spread one of the heated blankets over the woman’s chest and shoulders. “Maybe you have. But that was then and that was there. Now, here at the prison, you don’t have the authority to do anything more than snip those stitches and re-sew her.”
Jenny looked up from what she was doing then back down again. Her voice was firm, clipped. “We are in an emergency situation. This woman will die if we wait until someone with the authority shows up. Are you willing to have her death on your hands?”
“It wouldn’t be. But if I let you pretend you’re a doctor and she dies, then I would be as responsible as you. Sorry, but I’m not willing to join you in prison just because you say you know how to do something. I know you’re a nurse practitioner, but here, with no doctor present, you’re a nurse. Nothing more.” Lylah stepped back from the table. “You will lose your license and get at least ten years if you do anything more than re-sew her. That is practicing medicine without a license.”
Barbara Ray, the LPN, gave Jenny a sad look then turned toward the older R.N. and said, “Lylah, you’re right, practicing medicine without a license is illegal.” She draped an arm across the woman’s shoulder. Her voice was soft, almost a whisper. “We won’t do anything we shouldn’t. Relax.”
She reached across the table and handed her a set of keys. “Go on break. You need it. You’ve been here too long. Take a pillow and a blanket, go to the records room and lie down on the desk or the counter and go to sleep. I’ll take care of this.”
The older woman’s eyes lost their cold, angry look and filled with tears. “I can’t; I’m exhausted. You understand that, don’t you?”
Barbara nodded. “I know that; we both are. And Jenny is no fool. She understands the rules. You go get some sleep, and we’ll do what we can here.” She motioned toward the C.O. standing outside the open door. “Glasser, how about helping her with the blankets and pillows.”
“Sure. No problem.” The guard gave the R.N. a quick hug and said, “When you wake up I’ll have coffee waiting for you.”