The Pregnant Midwife. Fiona McArthur

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       CHAPTER TWO

      KIRSTEN’S first shift as a night neonatal nurse started off quietly, if you could call the beep of two dozen heart monitors and the hiss of several ventilators breathing for tiny infants quiet. It was strange but good to be back in an Australian hospital and she glanced around at her workmates. In Dubai, the eclectic mix of nationalities was always fun but she had missed the twangy accent and dry wit of the Australians.

      Kirsten was rostered to start at MIRA headquarters on Monday morning, but for tonight it would be good to have a chance to see what had changed on the home front. Around midnight, though, her leisurely check was cut short.

      Twenty-eight-week twin girls were rushed in from the delivery suite with very little warning, and Kirsten was actually happy to see Hunter follow them in.

      Kirsten took over the care of one child, Kinny Baker, and her coworker, Patricia, took the other sister, Carla. Weighing in at just eight hundred and fifty and nine hundred grams respectively, Kirsten spared a brief thought for the long road the girls and their parents had ahead of them as the tiny infants were placed in the humidicribs to keep warm.

      Hunter had already intubated the girls in the delivery suite within a few minutes of birth and the babies had been hand-ventilated with tiny resuscitation bags by delivery-suite staff until they could be transferred to the nursery and connected to the ventilators. Kirsten attached Kinny’s three leads to the heart monitor and clipped the pulse oximeter to her tiny foot to check peripheral oxygen saturation. The capillary oxygen saturation in an infant, or sats, was a good indication of how the respiratory system was coping.

      Silently, Hunter appeared beside Kirsten and she could feel the warmth from his body beside her as he attended an initial physical examination while Kirsten was establishing baseline observations.

      ‘Hello, little one,’ he murmured to Kinny as he moved to listen to her heart and lungs. Then he examined her tiny body for any abnormalities. Kirsten checked the endotracheal tube was secure now she was hooked up to the ventilator.

      She tried to ignore the seeping heat that burned into her hip from his nearness and her chest ached with unwilling sadness. She watched Hunter deftly insert a tiny intravenous cannula into Kinny’s arm and together they splinted the little girl’s tiny forearm to safeguard the line. They’d done this for so many infants in the past. Tonight it was all achieved without speaking.

      Kirsten found she could still anticipate Hunter’s treatment plan and the thought brought a pang to be shrugged off as she considered what they’d achieved. Airway was secure, breathing was controlled via the ventilator and circulation didn’t seem to be a problem. Kinny looked good.

      The IV would avoid the need for feeding until Kinny’s condition had stabilised and provide immediate access for antibiotics and any other drugs the premature infant would need.

      Kinny’s arm, smaller than Hunter’s little finger, emphasised the extreme fragility of their tiny charge. Next to Kinny’s shiny, transparent skin, Hunter’s brown hand looked like carved stone. A little like his face whenever he needed to look at her, Kirsten thought dryly.

      Kinny’s dad, Ken Baker, arrived from the delivery suite and his eyes misted at the sight of his tiny daughters as they lay pink and fragile amidst the technological paraphernalia. Attached to each baby, a network of leads snaked out through a port in the side of the humidicrib and connected to the digital monitor beside Kirsten’s and Patricia’s work area around the cribs.

      Hunter’s voice was quiet as he spoke to Kirsten. ‘Now that we have them connected, if you want to get the surfactant from the fridge, I’ll have a quick word with their dad.’

      Kirsten nodded and turned to go, but Hunter stopped her. ‘We can use half an amp for each baby down the tube—that will be plenty.’ She dashed off and Hunter gently steered the babies’ father closer to the cribs so he could watch their progress.

      He shook Mr Baker’s hand. ‘It must look pretty daunting to you but both girls are doing really well.’ As an opening line it must have worked, Kirsten thought as she returned, because Ken seemed to sag a little with relief at Hunter’s smile.

      She carried a tiny feeding tube to help ensure the hormone reached well into the little girl’s lungs.

      Hunter went on. ‘Your daughters are sedated to allow them to rest while the ventilator expands and deflates their lungs for them. The tiny amount of liquid that Sister is squirting into their breathing tubes is a hormone to help stop their lungs from sticking together, which means less pressure is needed by the ventilator to expand their lungs.’ Ken nodded that he understood and Hunter went on.

      ‘Less pressure from the ventilator is a good thing because it means less long-term damage and less chance of a hole in the lung occurring.’

      Kirsten listened to Hunter explain the humidicribs to the babies’ father with a small smile. ‘It’s like a miniature rainforest in that crib,’ he said, and his hands illustrated his point. ‘All premature babies around your daughters’ gestation are about eighty to ninety per cent fluid and they need moisture or they’ll dry out, a bit like chips.’

      The father blinked at the graphic image and Kirsten turned away to hide her smile. Hunter was right but a less graphic description might have been better.

      Ken shook his head at all the technology. ‘So how long do they stay here?’

      ‘This young?’ Hunter looked at the girls thoughtfully. ‘They stay on average the time it would have taken for them to come to term naturally. So about twelve weeks! If all goes well, we’ll wean them off the ventilator in about a week and even start them on maybe a few drops of breast milk every four hours in a few days. But they won’t get anything to eat till then.’

      The girl’s father rubbed his stomach in sympathy. ‘But they get what they need out of the drip, right?’

      Ken looked as though he couldn’t take much more information.

      ‘That’s right,’ Kirsten said. ‘I think you’re doing really well with the day you’ve had. Did you want to get back to your wife? You know you can come back any time.’ Ken nodded with relief. She handed him two instant photos of his tiny daughters which she’d taken while she and Patricia had weighed the babies earlier. ‘Take these with you. Please, let your wife know she’s welcome to come down and see your daughters any time.’

      Kirsten showed him how to get back to the delivery suite and when she returned, Hunter was beside Kinny’s crib, looking in. ‘Dry out like a chip?’ she said, and shook her head.

      Hunter had the grace to look embarrassed. ‘Well, they do dry out.’

      ‘The poor man will worry that his babies will be crinkled when he comes back.’ Kirsten laughed and sat back on her stool to do the next round of observations and for the briefest moment they both seemed to forget the past as they shared a smile. Then they both looked away.

      It was after three a.m. before Hunter decided he could leave his charges in the NICU staff’s СКАЧАТЬ