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Deadly Secret: A Tale From The Ohio Valley

By Sharon A Lavy

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Denton Community Hospital
Oncology Ward

Chapter One

Sweat beaded Sophie’s forehead. Brown hair appeared black in the damp places and stuck to the sides of her face. Her distressed coun-tenance made her appear aged and frail. “Hurts.”

Warning signals pinched Evalena Davidson’s flesh like hives. She had read Sophie’s chart and studied multiple myeloma while at home. This form of cancer weakened bones. The mildest movement could cause deep contusions for those who suffered in its grip.

Her first instinct was to lower the guardrails. But doing so presented the potential of Sophie falling out of bed in her agitation. Still, the worst danger came from the way she thrashed her limbs, which threatened fractures.
What could Evalena use to create bumpers over the rails? She re-moved a blanket from around Sophie’s feet and folded it around the closest rail.

“What hurts, Sophie?” Evalena asked as she walked around the bed to grab a pillow off the chair.

She hoped Sophie couldn't sense the urgency coursing through her own body. As Evalena bent to catch Sophie’s words, she placed the pillow against the second rail, then pushed the call button for assistance.

“All…over.” Sophie jerked again. “Please. Oh. Please.”

“When help comes, I’ll bring more medicine,” Evalena said, wrapping Velcro restraints around her patient’s wrists. She silently prayed Sophie hadn't already fractured the delicate bones.

Brown eyes sought her own.

“I’m sorry, Sophie. I know you don't like this. I only want to keep you safe, and it’s just until we get assistance.”

“What can I do for you?” a voice squawked from the intercom.

“We need help. Stat!” To lessen the force behind her order, Evalena smoothed the hair on the left side of Sophie’s forehead.

“Dr. Boone…said…home…tomorrow.” Distress shot across Sophie’s face with each attempt at speaking.

“I know. But now we'll have to get your pain under control.”

Danni Wagoner, a town girl who'd married Evelina’s cousin, entered the room and placed her hands on the shuddering bed. “Tell me how I can help.”

“Look after her while I get her another dose of morphine,” Evalena said, moving from the bedside so Danni could move close to Sophie.”

Keeping one hand on the rail, Danni placed the other on the patient’s shoulder. “Father God, we come to You—because we know You care. Surround Sophie with Your loving arms. Be with her in this time of suffering and anguish. Comfort her as only You can.”

Knowing Danni as an extraordinary nurse, and that her patient was in good hands, Evalena didn't wait for the amen. She sprinted to the nurses’ station and soon spied the top of the charge nurse’s perfectly coiffed, strawberry-blonde hair.

“We have a situation—,” Evalena said as she passed beyond the high counter. “A severe case of breakthrough pain.”

From her place at the station’s computer, Francine Elliot raised her brows. “Another crisis?”

“It’s Sophie Locke.”

Francine pushed back from the computer, moving in slow motion, standing and methodically pulling the medicine cabinet’s key from around her wrist. She moved to the cabinet as though nothing was wrong in the world, unlocked it, and placed the key on the counter.

All the while Evelina’s mind screeched hurry, hurry, hurry.
Reaching into the cabinet, Francine sorted through the bottles, and selected a vial. She held it close to her squinting eyes and checked the label before she handed it to Evalena. “When you return this, don’t forget to notify me immediately.”

“Yes. Yes,” Evalena said, snapping off the seal. She snatched up a syringe, tipped the vial, inserted the needle, pulled back the plunger to the proper dose, and watched the medicine fill the tube.

She pitched the cap into the sharp’s container, jotted her name and the amount of medicine in the logbook along with the time.

After placing the medicine into the cabinet, peace washed over Evalena and her shoulders lifted as if from a great burden. She swiveled and glanced at Francine. “Finished.”

Not one muscle on Francine’s lean frame twitched. Had she heard her? Evalena thought to speak again, but the vision of Sophie’s agony-filled features danced before her as a specter.

Her patient’s needs were too great to dawdle even a second longer. Evalena raced down the hall and re-entered the room. The smell of stomach acid hit her gut.

Danni held a basin beneath the patient’s chin. Sophie lay twisted on her side. An agonized groan escaped her throat.

With a quick prayer, Evalena continued to the bedside. “Don’t know why the last dose wore off so fast,” she muttered to Danni. “This one is from a fresh vial. I popped the seal myself.”

“Here’s your relief, hon.” Danni spoke soft words of comfort to Sophie and slipped out of the way.

Evalena reached for Sophie’s IV line and injected morphine. “It won’t be long now,” she said, throwing the syringe into the sharp’s container.

“I’ll be back shortly with fresh bedding and a clean gown,” Danni said.
Holding Sophie’s hand, Evalena prayed over her until Danni re-turned.

Fifteen minutes after the two nurses changed Sophie’s soiled bed and gown, and sprayed the room with lavender-scented air- freshener, the patient drifted off to sleep.

Evalena looked across the bed to Danni. “Thank you,” she whispered.

“You'd best chart this,” Danni said. “I'll initial it if you need me to.”
Relieved by the rhythmic breathing coming from Sophie, Evalena left the room to do as Danni suggested. When she finished, Evalena passed the nurses’ station. Danni leaned on the opposite side of the counter watching Francine, who remained at the computer.

“See you both tomorrow,” Evalena said.

“Yeah.” Danni grinned at her over her shoulder. “And hope the ward’s quieter.”

Evalena’s gaze flickered to the normally locked narcs cabinet. Her heart lurched. “Why is that cabinet still open?”

“Are you finally ready to put away your meds?” Francine pushed back from her computer. Her chair rolled lazily across the floor as though she’d not heard a word Evalena had spoken.

A chill skittered across Evelina’s back. “I put the vial into the cab-inet right after I filled my syringe. Didn't you hear me say I’d finished?”

“No, I didn’t. I sure didn’t.” Francine reached for a scratch pad, then opened the ledger and placed her finger on the page. “Okay.” She nodded “You logged twenty-milligrams at ten after six.”

Francine jotted the original amount of morphine in the cabinet at the beginning of their shift, and subtracted each dose used throughout the day.

“We should have four vials left,” she said as she finished the list. She searched the cabinet again before turning her head to where Evalena and Danni stood waiting. “We only have three.”

“Did everyone remember to log their meds today?” Evalena knew it was a silly question, but misplaced medicine wasn't like a Band-Aid or piece of gauze.

“We went through a ton this afternoon.” Francine ran her finger down the signatures. “As far as I can see, everyone on this shift has signed the ledger.”

Evalena envisioned her hand reaching toward the cabinet as she placed the used vial on the shelf. She'd been in a hurry and antsy about Sophie. Had she set it too close to the edge?

“I’m thinking…I wonder if the vial fell out after I put it back.” Evalena rolled the four station chairs away from the low countertop of the workstation. She searched every inch of the flooring around them. Nothing.

She watched anxiously as Francine removed the narcotics from the cabinet one by one. Her oval face remained expressionless as she turned the labels face-forward, sorted the vials according to type, and replaced them. Only then, did she remove the key from her wrist and twist it in the lock.

“Could someone have accidentally used the wrong medicine?” Danni asked. “Used morphine instead of one of the other drugs?”

“A onetime switch wouldn’t make this large of a discrepancy.” Francine leaned against a file cabinet and exhaled in short little gusts. “And the other meds check out. Are you sure you didn't take the vial back to the patient’s room, Evalena?”

“Of course, I didn’t.” Evalena struggled to keep her tone even. Until now, she'd been on good terms with her charge nurse, and she didn't want anything to change that. “But, if you want, I’ll take a look.”

“Maybe you should. Just to be on the safe side.”

Returning to the sleeping Sophie’s room, Evalena tiptoed about, searching thoroughly. She found no medicine container on the counters, tables, or window ledge. Next, she checked under the bed and pulled out the little bedside cabinet. As she expected, not even a hint of dust wafted in this pristine hospital.

Evalena returned to the nurses’ station where Danni and Francine waited. “The vial is not anywhere in Sophie’s room.”

“Thanks for trying.” Francine’s usually soft voice sounded strained.

“If it’s any consolation,” Danni said, placing her hand on Evelina’s forearm. “I told Francine that I don't remember you having a vial in your hand when you returned to Sophie’s room. Just the syringe.”

Evalena nodded. “Thanks.” She looked down at the trashcan. “Maybe…” She picked it up, shook it, and listened for the sound of glass clicking against something hard.

White clogs entered her peripheral vision. She straightened. Oncology’s night shift charge nurse stood much too close. Ramona Kelly’s maternity smock fit tight against her blue scrub pants.

Feeling Ramona’s anger, Evalena shuffled backward. She replaced the trashcan to where it belonged, then straightened and rubbed her arms. “Ramona…”

“I hear you've misplaced some medicine.” Ramona didn't break eye contact with Evalena. Angled features that could be attractive on most people only appeared harsh under the charge nurse’s attitude toward the people under her and nearly everyone else. “This morphine loss is a problem. I understand surgery lost several vials over the past week. Now oncology is getting careless.”

“I've looked…everywhere.” Evalena's voice cracked, and she backed up another step before stiffening her spine. She unlinked from Ramona’s stare and glanced at her own charge nurse. “Francine verified that our shift tracked all the meds we used today. I only wish she’d locked the cabinet after I signed out.”

“Refresh my memory.” Francine’s right eyelid twitched furiously. “Where was I when you finished? I know I had to step away from the station for a while.”

“You were right here beside me, working on your computer. It only took me two minutes, tops.”

“Like I said, someone in our department is neglectful.”

Ramona and Evalena locked eyes again. Evalena became more de-termined that, charge nurse or not, she wasn't going to allow Ramona to bully her. They could have easily stayed that way the rest of the night, but Danni stepped between them and picked up the telephone.

“What’s sanitation’s code?” Danni asked.

“One-zero-zero.” Francine shot a worried glance toward Danni. “Even if they find the medicine in the trash, we can't use it.”

“We still need to find out what happened.” Danni punched in the number. “I've never known morphine to sprout legs and walk.”

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