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A mothers special care, p.1

A Mother's Special Care, page 1


A Mother's Special Care

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A Mother's Special Care

  “I wanted to kiss you because you’re a beautiful woman.”

  As confessions went, it made her feel slightly better. “And what do you want to happen next?”

  “If you think about it…” He spoke tentatively. “My son’s suggestion makes perfect sense.”

  She stared at him, not bothering to hide her shock. “How?”

  “We’re practically a family now. You look after the kids after school, help them with their homework. We eat dinner together every night.That’s more than a lot of households do, or so I hear. I’d love to have a daughter like yours, and my son thinks the world of you.”

  “I think he’s a special kid, too, but marriage?” The suggestion was so unexpected she could hardly take it in.

  “It would be a good decision for all of us,” he told her. “Your daughter gets the father she wants, and neither of us will have to suffer the burden of single parenting.We’ll be a team.”

  His offer sounded good. Too good, in fact, and that scared her. But she wanted a hot and heavy love affair. She’d clung to her dream for so long that she simply couldn’t compromise or discard it so easily.

  Dear Reader,

  When my children attended elementary school, the principal initiated a program called Doughnuts for Dads and Muffins for Moms, in order for parents to drop in that morning and visit with each other and the teachers. A lot of grandparents and other significant family members would also attend if the parents couldn’t and so I started imagining….

  What if a fatherless little girl didn’t want to feel left out because she didn’t have a granddad or an uncle who could accompany her? As a mother myself, I know I’d want to give my child her heart’s desire, and the heroine I created, Lori Ames, felt the same way. So, what would she do? As I began to think about the lengths a mother might go to in order to grant her child’s wish, A Mother’s Special Care was born.

  I hope you enjoy reading how Lori and Mac’s temporary arrangement takes on a permanence that neither had initially expected as they discover that living in the present is much more rewarding than living in the past.

  Best wishes,

  Jessica Matthews

  A Mother’s Special Care

  Jessica Matthews














  WOULDN’T anything go right?

  Lori Ames checked the flow rate on her patient’s IV infusion pump and was satisfied to see that this particular unit was working properly. How fate had conspired to land her with two faulty pumps in the space of an hour, she didn’t know, but it seemed par for the day’s course.

  As a nurse in St Anne’s Post-Anesthesia Care Unit—or the recovery room as most people called it—she was used to expecting the unexpected, but this was ridiculous. Between several emergency additions to the surgery schedule, one of her colleagues calling in sick and several equipment failures requiring the skills of a biomedical technician, her cup of problems was running over.

  And that had been before she added her failure to find a temporary father for her daughter.

  She immediately shelved her personal problems for a later moment. The forty-year-old man who’d arrived in the PACU some thirty minutes ago needed her attention.

  Actually, he needed more than her attention. He needed a painkiller which, according to his chart, he shouldn’t be needing at all.

  Lori placed a PACU lollipop—a mint-flavored sponge of water on a stick—to Allen Clark’s mouth and held it for him as he sucked greedily. “It’s too soon for you to receive any morphine,” she told him in a low, soothing tone. “But I’ll let someone know you’re hurting.”

  Allen closed his eyes as he nodded, but not before she’d seen the suffering in his dark eyes.

  She strode to the nearest phone and punched in the code for Brad Westmann’s pager. He was the nurse-anesthetist responsible for Allen’s pain management and the same individual who’d administered his last dose, so Lori wanted to talk to him before she did anything. If he couldn’t solve the mystery, then she’d gladly go over his head to Rob Naylor, the orthopedic surgeon who’d repaired her patient’s torn rotator cuff, or better yet, Brad’s boss, Dr MacKinley Grant.

  Her mental picture of the tall, muscularly built Dr Grant had barely formed before he strode into the recovery room. As the chief of anesthesiology, he was ultimately responsible for the care of everyone who was touched by his service, and he took those responsibilities seriously to the point where she wondered if he ever went home. In spite of his near constant presence in the hospital, he didn’t micro-manage as some might have, and at times it was reassuring to have him nearby.

  However, as Mr Clark moaned, this wasn’t one of those times. He had an uncanny ability to spot the most minor of problems at twenty paces and even if her patient hadn’t uttered a sound, this case wouldn’t have escaped his eagle-eyed notice.

  He stopped at the foot of Allen’s bed, his gaze riveted to the last blood pressure and oxygen saturation readings displayed. Without a word, he lifted the chart out of its slot on the bed’s frame and began reading.

  She braced herself for his inevitable questions.

  “Who’s taking care of this man?” he demanded in a low voice, his eyebrow quirked in his characteristic questioning manner.

  She stepped forward. “I am.” The staff ratio in the PACU was usually one to one, but occasionally, like now, she had two patients to oversee at once. Her friend, Talia Simmons, was busy with a teenager in the next bed who’d undergone four impacted wisdom teeth extractions, so she would take on the next patient to arrive.

  “Are you aware he’s in pain?”

  His quiet tone didn’t fool her. No one spoke loudly in this unit because patients fighting through the fog of anesthesia to wakefulness could misunderstand the comments they heard. Consequently, PACU staff learned to convey their emotion without volume. Right now, the furrow on his forehead and his piercing blue-gray stare spelled trouble.

  “Yes, I am.”

  He tapped the chart. “You haven’t given him any relief.”

  “No—” she began, but before she could defend herself, he tapped the clipboard.

  “Why not?”

  She straightened her spine at his raised eyebrow, refusing to be intimidated because she’d taken the only course available to her. “He received a dose before he arrived here. About thirty minutes ago.”

  The fire in his eyes didn’t lessen as he frowned at her, but to her relief he readdressed the chart, presumably to verify her claim.

  She wanted to explain her doubts about Brad administering the dose in question but Dr Grant’s stern expression cautioned her to say as little as possible. Although this wouldn’t be the first time Brad’s actions hadn’t matched his documentation, she couldn’t accuse the nurse-anesthetist without proof. So she held her tongue and stole a surreptitious glance at the man beside her.

  Dr Grant’s light brown hair was short, and as usual, appeared on the unruly side. She’d never quite decided if his windblown appearance was due to a natural wave or his tendency to rake those strands with his fingers whenever he was deep in thought, like he was at the moment.

  He was tall, close to her six-foot brother-in-law’s height, but he was definitely more solid and more muscular than Tim. Of course, she’d never seen Dr Grant in anything but a scrub suit, but the lightweight cotton couldn’t disguise rippl
ing biceps and sinewy quads.

  She rarely saw him with a five-o’clock shadow and certainly not at two in the afternoon, but his night on call and their busy morning were most likely responsible. The beginnings of a dark gray tinge filled the slight but sexy dimple in his chin and emphasized the contours of his upper lip.

  His maroon scrub suit was rumpled, clearly as a result of the long hours he’d spent in surgery and Recovery while the rest of the world slept peacefully. The town of Redwood, in the heart of the Midwest, was large by small-town standards with its population of fifteen thousand, but the hospital hadn’t yet reached the point where the CEO could justify staffing two OR shifts. Everyone from the two anesthesiologists down to the operating room technicians rotated through the on-call schedule in order to handle those cases that couldn’t wait until morning. Long days and longer nights weren’t uncommon.

  Silently begging the phone to ring, Lori released a frustrated sigh, then inhaled a clean, woodsy fragrance. Dr Grant may have worked for nearly twenty hours, but he’d obviously found time for a shower.

  “So what were you planning to do?” he asked. “Let him suffer for several more hours?”

  “No, I’m waiting for Brad to answer my page.” Brad would have to give her a new med order or admit that he hadn’t followed through on his own record-keeping. She’d seen the disastrous consequences when nurses had gone out on a limb for him before, and she wasn’t about to get caught in the same position if at all possible. Brad didn’t mind letting someone else take the blame for his mistakes.

  On the other hand, she didn’t want to accuse him of a charting error without proof. If she was wrong, she’d be the one appearing troublesome, not him.

  Her explanation seemed to appease him, at least for the moment. “Don’t wait too long,” he advised.

  “I won’t.” She was so sure of Brad’s haphazard charting that she was tempted to administer the painkiller, but the threat of causing an overdose held her back. Of the two possible scenarios, it was far better for Mr Allen to suffer for a few more minutes than to recover from the complications of a medication error.

  “Where is he?” Dr Grant asked.

  “I don’t know.” That in itself was another strike against Brad in her mental ledger. With his propensity for disappearing without a trace, he should have become a magician rather than a nurse-anesthetist.

  The whir of the automatic blood pressure monitor on Mr Leiker, the patient in the next bed, caught her attention. Because this fellow’s TURP procedure, or transurethral resection of his prostate hadn’t gone well and he’d required multiple units of blood, she kept a close eye on him.

  Good thing, too. According to the numbers on the monitor, his blood pressure was dropping. To make matters worse, the heart-rate pattern on the screen changed to one of sinus tachycardia.

  The man was losing ground before her eyes.

  She rushed to his side and repeated the blood pressure measurement. The numbers were still low, much too low. Not a good sign.

  “Does he have a history of heart problems?” Dr Grant asked as he moved to the opposite of the patient’s bed to study the monitors.

  “No.” Lori checked Mr Leiker’s bandage and drainage tube. The pads were soaked and the tube was filled with blood. “He shouldn’t be bleeding this much.” She’d seen cardiac dysrhythmias manifest themselves in her unit before and for a variety of reasons. The cause that came to mind was the same one that Dr Grant voiced a second later.

  “Hypovolemia.” He’d apparently seen the same signs of blood loss that she had. With a low volume of blood, the patient was receiving inadequate oxygen throughout his tissues. “Is he cross-matched?”

  “He received three units during surgery. When this is empty…” she pointed to the bag hanging on his IV stand “…he won’t have any left.”

  “Call the blood bank and order four more units,” Dr Grant ordered. “Get a stat CBC and coagulation studies, too. He may have a clotting problem.”

  Lori nodded. How ironic to be grateful for Dr Grant’s presence when up until a few minutes ago she’d felt the opposite. While she knew what to do, it was nice having a physician nearby to handle whatever might happen. If Mr Leiker’s condition deteriorated without further warning or if he went into cardiac arrest, the presence of a physician could make all the difference.

  “Who’s the surgeon?” he asked.


  “Call him,” Dr Grant ordered. “He may have some repair work to do.”

  Lori moved to Leiker’s feet. “I need to—”

  He brushed her aside. “I’ll take care of it. Make those phone calls.”

  She didn’t argue. While she called the lab and paged Dr Harrington using the special code signifying emergencies in the PACU, Dr Grant elevated Leiker’s legs and administered what she assumed was epinephrine. The drug would constrict the blood vessels until they were able to correct the low blood volume.

  For the next few minutes the area bustled with activity as the lab personnel arrived and left with their precious blood sample. Dr Harrington arrived on the run and, after conferring with Dr Grant, made arrangements to return to surgery.

  The phone rang. Standing the closest to it and expecting to hear from the lab, Lori snatched the handset.

  “Hey, Lori. Talia said you’re looking for me. What’s up?”

  Brad spoke her name in a lazy bedroom drawl which irritated her no end. In his late forties, the balding CRNA thought himself a ladies’ man but he was more annoying than charming. At least he’d stopped calling the female staff pet names like “lambkins” and “sweet cakes”. After several of the more outspoken nurses had threatened a sexual harassment lawsuit, he’d modified his vocabulary.

  Lori gritted her teeth and let his syrupy tone slide by without comment. “Mr Clark, the fellow with the rotator cuff repair desperately needs pain meds, but I can’t give him any because according to the chart—”

  “Oh, yeah, I forgot to tell you—”

  Conscious of Dr Grant standing within earshot, she repeated Brad’s words. “Forgot to tell me what?”

  “I didn’t give him his dose.”

  “Why not? You took time to chart it.”

  “It’s not my fault the vial was empty when I went to draw up the dose,” he defended himself. “I got sidetracked before I could hunt down another one.”

  “It would have been nice to know that when you brought him in here,” she said. “I wouldn’t be worrying about this man and he wouldn’t be lying here, suffering.”

  “If you recall, I was being paged and didn’t have time to chat,” he said nastily. “Life in the OR isn’t exactly moving along at a snail’s pace, you know.”

  All the more reason for your charting to be accurate, she wanted to say. Clearly Brad thought that working in the PACU was simply a ho-hum routine of taking vitals and mopping up vomit. Little did he know of the stresses inherent to this unit or else he was too egoistical to think that someone else might work as hard as he did.

  Lori bit back her comment. Arguing with Brad would have to wait for a calmer moment when she didn’t have a critically ill patient on her hands. “I have to go. Mr Clark needs his meds now.” Fighting the urge to slam the receiver down, she forced herself to replace it with a quiet click.

  Idiot, she thought.

  Apparently she’d spoken aloud because Dr Grant’s voice came from behind her. “I presume that was Brad?”

  Her face warmed at least ten degrees. Calling a member of his personal staff an unflattering name wasn’t a smart way to win herself over to his good side.

  “Yes, it was.” Immediately, she hurried to Mr Clark’s side, filled a syringe with the required amount of morphine and injected it into his IV port, conscious of Dr Grant’s gaze following her every move from the time she began until she disposed of the syringe.

  “You’ll feel better in a few minutes,” she told her pain-ridden patient.

  Mr Clark managed a weak chuckle. “Pro

  She smiled down at him. “You bet. Would you like your lollipop now?”


  Once again she moistened his lips and allowed him to suck the fluid from the sponge until he declared he’d had enough.

  One problem down, one to go.

  By the time the scrub nurses appeared to wheel Mr Leiker back to the OR, the lab had telephoned with his test results and a hard copy report had arrived via their laser printer.

  “His hematocrit is low,” Dr Grant said as he scanned the printed form before handing it to the OR staff to carry to Dr Harrington. “Coag studies are normal, which is good.”

  “What do you think happened?” Lori asked Dr Grant, aware of how well they’d functioned together in this emergency—like the proverbial well-oiled machine.

  “Either Harrington missed tying a vessel or he nicked one and didn’t realize it,” he answered. “That guy was just lucky to have such a conscientious nurse looking after him.”

  Lori’s face warmed. She wasn’t used to being praised for doing her job, but to have someone of Dr Grant’s stature notice…well, that was enough to make anyone glow. It had nothing to do with the fact that this sinfully attractive man was studying her as if he were seeing her for the first time, or so she told herself. “Thanks.”

  “What was the situation with Brad?”

  She might have known that he’d ask. “He didn’t administer the dose as charted.”

  He frowned. “Why not?”

  “According to him, he got sidetracked before he could hunt down a new vial.”

  His expression didn’t change. If he wondered, as she had, why Brad hadn’t stocked his supplies before the surgery started, he didn’t comment.

  “It’s a good thing you checked on the situation so promptly,” he commented. “You saved that man a lot of unnecessary pain.”

  Two compliments in a row. This was certainly a day for surprises. “Thanks. I try to stay on top of things, especially when—” She stopped herself, unsure how to continue.

  “Especially when what?” he prompted.

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