THE car should not have been there.
In the small car park adjacent to the emergency department
of Ocean View hospital, yes. In the space reserved for the
ambulance, even, if the emergency was dire enough.
But three quarters of the way through the wide electronic
doors that led into the reception and triage area?
No way!
Nurse Elizabeth Dawson's astonishment rapidly gave way to
alarm. The car would have been suspicious enough tucked
neatly into an acceptable car-parking slot. An ancient,
rusting hulk of a V8. A status symbol amongst the elements
of society who preferred to simply ignore any restrictions
the law might impose on their lifestyle.
The man climbing out of the driver's seat was even more
intimidating. Clad in battered leathers with the 'patch'
of his gang emblazoned on the back of the jacket, the
heavily tattooed and menacing figure would have alarmed
even the most confident of any emergency department staff.
And Beth Dawson was far from the most confident right now.
She had started a new job in a new town only a couple of
hours ago, for heaven's sake, and everything was still
completely unfamiliar.
No. Not quite everything. The aggression emanating from
the gang member she was watching was all too familiar.
An unexpected flash of anger cut through her fear. This
type of scenario was precisely why she'd left her job in a
huge south Auckland hospital so recently. She'd had a
gutsful of dealing with violent and uncooperative patients
who took any pleasure or even satisfaction out of
demonstrating the level of skill she had attained in her
chosen profession.
The anger couldn't last long enough to fuel courage,
however, given the fact that she was alone in this part of
the department. At 1 a.m. in a semi-rural area you
wouldn't expect a full waiting room, and the only patient
who had come in since midnight was now having his chest
pain investigated in one of the two resuscitation rooms.
Beth's finger was pressed firmly against the button
summoning assistance and any trace of saliva vanished from
her mouth as she watched another two figures emerge from
the vehicle. The bizarre sight of the car under the bright
lights and filthy tyres on the spotless linoleum had
already become just a background to an unpleasant drama
unfolding. So had the rhythmic and futile attempts the
electronic doors were making to close the small gap left
around the obstacle. They touched the rear of the car and
then bounced open again. And again.
The movement of the doors did not impede two of the men
dragging the final occupant from the rear seat of the car.
Little care was afforded the potential injuries of an
apparently unconscious victim and a large smear of blood
appeared on the pale floor as his feet dragged.
Two more nurses rushed into the space behind Beth, closely
followed by the only doctor on duty, Mike Harris. Beth
could feel all three of them virtually skidding to a halt
as they caught sight of the car inside the building, but
she didn't turn her head. Her gaze was fixed on the
slumped figure being held up by the armpits. She drew back
instinctively as the gang member who had been driving the
car started walking towards them.
"Jackal's been shot."
Beth was aware of broken teeth and the smell of alcohol as
the man spoke. She was also quite well aware that the
incongruously casual tone of voice was no insurance
against the level of implied threat in his next succinct
words.
"You'd better do something."
They would be armed, Beth had no doubts about that. There
would be knives tucked inside those commando-style boots.
At least one of the men was wearing knuckle-dusters and
she was quite certain there would be more than one sawn-
off shotgun easily accessible in that vehicle.
Her breath escaped in something like a strangled laugh.
She had left a big city hospital that had protocols for
dealing with precisely this type of incident. Any number
of security personnel would be available within seconds
and a well-rehearsed police squad only minutes away. And
even that kind of back-up hadn't been enough to prevent
her best friend, Neroli, giving up her nursing career,
having been held at knife point in Beth's old emergency
department.
Beth had come to a small-town hospital near the tip of the
south island of New Zealand to find a peaceful place to
settle and refocus her life. She had barely begun her
first night duty in this tiny emergency department and
here she was, facing one of her worst nightmares. A
recurrent one, thanks to the trauma she had unsuccessfully
tried to help Neroli overcome.
Did Ocean View hospital even have security?
How far away were any police? The closest large town was
Nelson and that would be at least ninety minutes away by
road.
The tension escalated several more notches as the
spokesmen for the gang members moved. His shoulders
hunched and the fingers of one hand flexed and then
clenched. The fist was thrust towards the only male member
staff member present.
"Now!"
Just do what he says, Mike, Beth urged silently. Please!
But Dr Harris hadn't even flinched.
"Sure." Mike's face was impassive and Beth found herself
suddenly feeling slightly more confident. Well into his
fifties now, Ocean View hospital's emergency department
consultant probably had more than enough experience to
cope with situations such as this. "But I'm not going to
tolerate my staff β or anyone else β being intimidated."
There was a tiny silence as each side weighed up the
implications of non-cooperation. It was broken by a groan
from the injured gang member and the attention of
everybody present was instantly diverted.
"What's happened exactly?" 'He's been shot, man. I told
you." 'Yes, but where? And how long ago? How much blood
has he lost?" Mike was moving calmly towards the victim.
Beth looked at her nursing colleagues. Should they all
follow him? Chelsea was looking as nervous as she felt
herself, and Maureen looked grim. The older nurse tilted
her head.
"Chelsea, why don't you and Beth go and get a stretcher?
I'll stay and help Mike." She turned as she spoke so that
her back was towards the gang members. "Call the police,"
she whispered faintly, her lips barely moving. "Fast."
Chelsea's nervousness seemed to wear off the moment she
was assigned a task. She even grinned at Beth as they
hurried from the triage area.
"Here we go," she said almost cheerfully. "Again!" Beth's
heart sank to a new low. "You mean you get this type of
incident on a regular basis?"
"We do get bit of trouble from gangs now and then."
Chelsea paused as they entered the main section of the
emergency department and she reached for the wall
phone. "You'd be used to it, though, wouldn't you? Didn't
you say you've been working in south Auckland?"
"Yes, but I didn't expect..." Beth's words trailed off as
Chelsea started speaking to whoever was on the other end
of the phone.
"We seem to have a code yellow in ED," she said briskly.
She listened for only a few seconds. "Cool...thanks."
Beth grabbed the tail end of the stretcher and she and
Chelsea headed back the moment the phone was replaced.
"What's a code yellow?" 'Trouble with gangs."
Good grief! So it happened often enough to have its own
code? "What happens on a code yellow?" 'Sid will get here
first. He's our night orderly cum security guard. Then one
of the local cops who lives just down the road will come
in." Chelsea was looking almost excited now as she glanced
back at Beth. "If he thinks it's necessary, he'll call
Nelson and they'll chopper in the armed offender squad to
help out."
"But there's only one patient!" 'So far." Chelsea gave
Beth a questioning glance now. "This really bothers you,
doesn't it?"
"I'm OK." Beth wasn't about to demonstrate any inadequacy
on her first shift. "Like you said, I'm used to it.A bit
too used to it, maybe.A friend of mine had a knife held to
her throat by a gang member not so long ago."
Chelsea looked horrified. "Was she hurt?" 'Not physically.
She's given up nursing, though, and gone to work in her
sister's coffee-shop in Melbourne."
"Was that why you decided to move as well?" 'Partly." Beth
smiled wryly as they turned the corner. "I was rather
hoping I'd be getting away from this kind of thing by
moving down here."
Chelsea's quick smile was sympathetic. "I hope it wasn't
the main incentive for the shift, then."
"It wasn't."
Beth's words were lost as they entered the front of the
department to find the stretcher was now superfluous. The
injured man's colleagues had dragged or lifted him as far
as the bed in the empty resuscitation area.
"I said don't cut his leathers, man!" 'We've got to get
his jacket off so I can assess his breathing." Mike was
still managing to sound calm but Beth could see that his
frown lines had deepened perceptibly.
Maureen was plugging the tubing attached to an oxygen mask
onto the overhead outlet. "I'm just going to put this on
your face," she warned their patient.
The stream of obscene language made Maureen look even
grimmer than she had on first spotting this patient.
"Airway appears clear,'she told Mike dryly. Stepping back
as two silent gang members unceremoniously stripped the
leather jacket off the now groaning man, she noticed the
return of the younger nurses.
"Perhaps you two could clear Resus 2.'She and Mike seemed
practised in trying to keep the atmosphere as casual as
possible, but the undercurrent of urgency was easy enough
for Beth to detect.
And no wonder. The man in the adjacent resuscitation area
was looking alarmed and his wife was terrified. It was
just as well that the chest pain he was having
investigated had been deemed to be angina rather than a
heart attack because otherwise the anxiety caused by the
arrival of the new patient might have made his condition a
lot worse. He probably didn't need admission but he
certainly needed to be moved.
It took a minute or two to disentangle the patient from
the ECG electrodes and other monitoring equipment
anchoring him to the area. Beth looked over her shoulder
as she pushed the foot end of the bed clear of Resus 2.
The injured man in Resus 1 was alone with his medical
attendants now. The other gang members had vanished. A
second later they all heard the roar of an unmuffled
engine as the car blocking the doors was restarted.
"Our first job is to clear the department of any other
patients if it's possible," Chelsea told Beth as they
manoeuvred the bed along the corridor separating the
emergency department from the rest of the hospital. "We
close the department to any arrivals that could be seen by
a GP as well." She shook her head. "There was a major riot
in the department a few years back apparently, and a
bystander in the waiting room got stabbed. That was when
code yellow came into force."
Their patient's wife was clutching her handbag in both
hands as she trotted beside the swiftly moving bed. "Did
you hear them say they were going to deal with whoever did
the shooting? Where's it going to end?"
"At least most of them are out of the department for a
while," Chelsea responded. "It'll give the police time to
deal with them before there's any real trouble here."
There was a curious calm in the emergency department when
Beth and Chelsea returned. Mike was doing an ultrasound on
the exposed, tattooed belly of their patient. Maureen was
setting up a new bag of IV fluids.
A burly man wearing an orderly's uniform was standing with
his arms folded by the head of the bed, and an equally
solid man in police uniform stood in an identical pose at
the foot. They both gave Beth a curious stare.
"Gidday," the orderly said. "You're new here, aren't you?"
"This is Beth," Chelsea told them. "It's her first shift
tonight. Beth, this is Sid and that's Dennis."
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