Tears to Cheers will be available for Pre-Order in late September and released in early December.
Chapter 1 – Linda
“I can’t believe it’s already the nineteenth of December and you haven’t put your tree up,” I said to Casey Lowe, the new nursing supervisor in our ER, as we sat at the main desk and finished up paperwork.
“I know. I bought all the trimmings, but I just haven’t had time. I’ve been working so much overtime, that when I get home, I’m beat. Besides, it’s only me, why do I even need a tree?”
I stared at the side of her head, my mouth hanging open until she turned to me. “You can’t be serious? You have to have a tree. It’s sacrilegious to not have one. Why don’t you do it tonight? You’re getting off in thirty minutes.”
I laughed and waved her comment away with a quick flick of the hand, “Oh, this is nothing; it’s only a couple of inches. Drive slowly, take main roads, and be careful. You’ll be fine.” “Easy for you to say; I think I have driven in snow twice in my life, and it was an inch or two at the most,” Casey replied.
“It’s almost three, you should be home by four and you will have plenty of time to put up your tree.” I turned my attention back to my reports.
Casey sighed, “Yeah, maybe. I’ll see how stressed out I am when I get home.”
“Sounds like a plan.”
Casey had come to work for us right before Thanksgiving. From the moment she had walked through the door, we had hit it off as friends. Casey came from a much larger hospital in South Carolina, and she had a lot of great ideas that would help us be more effective in our treatment and workload. She was confident in what she was doing and great with people, including all the nurses.
She didn’t say much about her past, other than things pertaining to work. She mentioned once that she had been engaged, but that it didn’t work out. She didn’t have any siblings and her mother had passed several years ago. When I had asked her about her father, she had grown pensive and quiet, saying that they had a falling out and were no longer in touch.
I wasn’t going to pry; wasn’t in my nature to do so. Well, okay, it was in my nature, but only if it had to do with someone’s health, and then I asked a thousand questions to make sure we had all the facts and could administer the right treatments.
Casey finished up her reports, and I gave her a quick hug before she walked out the door. Little did I know that would be the last time I would see her until after Christmas.
“Linda,” Marybeth our receptionist at the desk called over her shoulder. With Casey gone, I was now the nurse in charge, so everything important came to me. If it was really important I would reach out to Casey and let her know or get her advice. “I just got word that we have a serious MVA patient coming in.”
Figures—with this weather, motor vehicle accidents were a dime a dozen. “How bad is the patient?”
“Information I received was: If they could have flown him to a trauma center, they would have. Sounds pretty bad.”
I stood and tapped my papers into a neat pile. “Okay, ETA and do we know anything about the patient?”
“ETA is ten, plus or minus, and patient is a white male approximately thirty with head, neck, and chest trauma.” Marybeth winced as I approached her. “They had to extricate him from his SUV.”
The guy certainly did need a trauma center, but I was determined we would give him the best care that we could. “Fine, give me any updates that come in and get in touch with the orthopedist, general surgeon, and neurologist on call and get them down here stat.”
Marybeth flipped a switch on the wall and a small green light came on at the top of the pole beside her station. The green light would let everyone know that we had a serious patient coming in. All of the employees in the department knew what they would need to do. I spun back around, “And get a cardiologist on standby, too, if there is chest trauma. Might as well have everyone ready if we need them.”
With the flip of the switch, the energy in the ER immediately changed; some of the staff immediately transferred patients to other nurses, especially those employees with trauma experience; assistants would know they were going to be stepping up a bit with the workload while we stabilized the patient coming in; and doctors finished their tasks at hand.
Marybeth also contacted radiology to get them on standby and called the blood bank to have some O negative brought up, just in case it was needed.
I pushed open the doors to one of our two largest rooms and shivered. This room was kept cooler than the rest as it was the closest thing that we had to a trauma room. Not only did the lower temps help the patient by cooling his core temps down slightly, it also helped the staff that would soon be filling this room to capacity while they attempted to treat the patient.
A few seconds after I entered, one of the nursing assistants rushed in behind me and began to turn on equipment. I scanned the room, doing a mental check of the machines to make sure they were all there. Nothing like realizing last minute that one of the lifesaving machines had been borrowed and wasn’t where it was supposed to be. The walls were lined with one piece of equipment, or cart filled with gear, after another—no empty spaces, which meant it was all most likely right where it was supposed to be.
“About six minutes out,” Jason, one of the other nurses in our department, stated as he entered the room and went right to the large sink to scrub up.
I joined him at the sink. “Been a while since we had a trauma,” I stated as I wet my hands and began to scrub them.
“We wouldn’t have this one either if it weren’t for the lack of visibility from the snow,” he commented back. “I just got in a few minutes ago; it is snowing harder than predicted.”
I wondered if Casey had gotten home safely but brushed the thought aside as two more people entered the room and broke open packages containing trauma clothing to help us dress.
The light blue trauma gown was being tied around my waist when we received acknowledgement that the ambulance had arrived. I slipped the mask over my face as Jason’s gown was tied behind him, and he pulled the mask over his face. Two doctors joined us and went straight to the sinks to wash up while the urgency of rushed voices headed our way.
The gurney rolled into the room accompanied by five people: two ambulance personnel, a medic, a nurse from the ER, and a nursing assistant. Thank God the medic was Scott Allen. He had worked with us for years and was a trusted and valued paramedic. The ambulance personnel lifted the patient from the gurney to another one via a backboard, his head held straight and still by blue cushions and straps. Scott whipped off the sheet that lay over him to protect him from the elements, and the sight sucked the breath out of my lungs.
“Shit,” muttered Jason as he pushed past one of the ambulance personnel to go hands on by removing some of the field dressings.
“You can say that again,” I said softly as I approached the patient from the other side. “Okay, let’s get the rest of his clothing off, please. Tina, take the bottom half, get those shoes and socks off.”
Before I could say anything further, Tina, another of our nurses, began to cut the denim jeans off his legs, and Scott began his field assessment report: “I arrived on scene to find this thirty-one-year-old male patient trapped in his vehicle. The SUV appeared to have rolled over several times before coming to rest on its roof against a tree. Speed on the icy road most likely caused it. Single occupant, restrained with seatbelts, no airbag deployment noted. Patient was semi-responsive in a hanging position in the driver’s seat.” Scott shifted out of the way to make room for us. “He was extricated, placed on a board with cervical collar as you note. He has an eighteen-gauge with normal saline running in his left antecubital space and another in his right antecubital. He has swelling and bruising to his face, with bleeding from several small lacerations, and his chest is intact, abdomen is soft non-tender, pelvis intact, and extremities are normal with some abrasions with lacerations on the arms, chest, and shoulders. Patient became unconscious and was having trouble maintaining his airway, so he was intubated with a 7.5 ET tube and ventilated using BVM.”
As my hands flitted over his body, I briefly wondered where to even begin. His shirt had already been cut off and three large gauze bandages had been taped in random places, all of them covered in blood as the injuries underneath continued to seep through the protective covering. This guy was in for a serious number of stitches.
“I heard the police mention they think his vehicle rolled at least three times. BP has been steady but high at 145/95 since we boarded him. Pulse is in the one-tens. Left pupil is blown, but the right is reactive, but slow.”
I began to pull the bandages off his torso and shoulders, checking his assessment and finding each laceration, long and bleeding, but not life threatening. “Jason, put butterflies on these for now,” I stated and shot a peek over my shoulder, “thank you, Scott.”
One of the doctors spoke up, “We need to get the X-rays done. I want a skull series, chest, abdominal, and pelvic. Once those are done, let’s get him straight to CAT scan and make sure we don’t have any brain bleeds.”
I glanced toward the face of the patient, but between the cushions supporting his head and the blood covering his skin, I couldn’t see much.
“X-ray technicians are here,” Tina called out as she pushed open the door to bring them in.
The doctor called out to the technician, “He might have a skull fracture on his left side, and it looks like the zygomatic bone in his left cheek might be fractured. His ramus and mandible could be cracked also. Make sure we have clear films of those.”
“Sounds like he hit his head on the side window or door pillar,” Jason deduced as he removed another bandage covering a laceration, so he could put a butterfly over it.
The doctor replied to Jason that he most likely had. As Jason finished up with the third laceration, Tina finished drawing blood from the IV already in place and handed the vials off to an assistant who would put a rush on them for the lab.
The patient’s blood pressure was still high, but stable, and so was his pulse. His blood oxygen level was a bit on the low side, but nothing to be worried about, most likely because he was breathing shallowly. More forced oxygen into his lungs would help that.
The X-ray technicians went to work, and most of the people stepped out of the room. I helped to remove the foam holding his head still, but kept the straps on his forehead and chin. The man had strong facial features and the left side was extremely swollen.
When the technicians were ready, I stepped out of the room after one final glance at the monitor to confirm that he was still stable. Outside the room, the team huddled, waiting to be let back in to prepare for the next step.
I glanced at the assistant who was talking to John Pointer, one of Celebration Township’s police officers, “Is someone trying to notify the family?” she asked him.
“His license said he is from Bryn Mawr, which I think is down by Philadelphia. Thad is trying to contact someone down there to try and make a notification.”
“Officer Pointer,” he nodded as I approached him and asked, “What is the patient’s name?”
John glanced at the small notepad he held in his hand, “Ian Dugan, age thirty-one.”
All eyes landed on me as the gasp left my lips. “Ian Dugan? Is his birthday April twenty-fifth?”
“Yeah? Why? You know him?” John queried back.
I glanced back at the door, “Yeah, I know him.”
“Damn, sorry about that, Linda. How long has it been since you’ve seen him?” Jason asked from beside me.
Memories of my sophomore year of high school flashed to the front of my mind like a strobe light. Ian’s light green eyes and boyish smile as he grinned down at me when I said I’d go to his junior prom with him filled my mind.
I’d been enthralled with his eyes, with the smile that could light up a room along with the deep voice that commanded attention, even at that young age.
“I haven’t seen him since I was sixteen, no one around here has.”
I stared at the door as the voices around me faded. Ian Dugan was the man I had fallen head over heels in love with in high school, the one I had lost my virginity to on his prom night. He was also the one who disappeared out of my life two days later. He not only vanished from my life, but from our school and our town as well. Shortly after he had left, I had resolved to never fall in love again.