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Wong s Essentials of Pediatric Nursing
Marilyn J. Hockenberry
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Nursing Management of Pediatric Disaster Catherine J. Goodhue
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Notices
Knowledge and best practice in this field are constantly changing As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary.
Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds, or experiments described herein In using such information or methods they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility. With respect to any drug or pharmaceutical products identified, readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of practitioners, relying on their own experience and knowledge of their patients, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions
To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any liability for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein
Debra Brandon PhD, RN, CNS, FAAN Associate Professor School of Nursing Duke University Durham, North Carolina
Terri L. Brown MSN, RN, CPN Assistant Director Clinical Outcomes & Data Support Texas Children's Hospital Houston, Texas
Meg Bruening PhD, MPH, RD Assistant Professor School of Nutrition and Health Promotion College of Health Solutions Arizona State University Phoenix, Arizona
Duke University Health System Durham, North Carolina
Patricia M. Conlon MS, APRN, CNS, CNP
Pediatric Clinical Nurse Specialist; Assistant Professor of Nursing
Mayo Clinic Children's Center Rochester, Minnesota
Erin Connelly APRN, CPNP Aflac Cancer & Blood Disorders Center; Children's Healthcare of Atlanta
Emory University Atlanta, Georgia
Martha R. Curry MS, RN, CPNP Instructor
Immunology, Allergy, and Rheumatology Department of Pediatrics
Baylor College of Medicine
Texas Children's Hospital Houston, Texas
Amy Delaney RN, MSN, CPNP-AC/P
Pediatric Nurse Practitioner
Boston Children's Hospital Boston, Massachusetts
Sharron L. Docherty PhD, PNP-BC, FAAN
Associate Professor School of Nursing; Associate Professor Department of Pediatrics; Director Center for Excellence in Cognitive/Affective Symptom Science Duke University Durham, North Carolina
Angela Drummond MS, APRN, CPNP
Pediatric Nurse Practitioner-Orthopedics
Gillette Children's Specialty Healthcare St Paul, Minnesota
Jan M. Foote DNP, ARNP, CPNP, FAANP
Clinical Associate Professor
The University of Iowa College of Nursing
Iowa City, Iowa
Pediatric Nurse Practitioner
Blank Children's Hospital
Des Moines, Iowa
Quinn Franklin MS
Manager
Child, Adolescent, and Young Adult Life Program
The University of Texas MD Anderson Children's Cancer Hospital Houston, Texas
Debbie Fraser MN, RNC-NIC
Associate Professor
Faculty of Health Disciplines
Athabasca University
Athabasca, Alberta, Canada; Advanced Practice Nurse, NICU ST Boniface General Hospital Winnipeg, Manitoba, Canada
Teri Lavenbarg MSN, APRN, PPCNP-BC, FNP-BC, CDE Nurse Practitioner Medical Center
St Boniface General Hospital; Professional Affiliate
Manitoba Centre for Nursing & Health Research; Instructor II College of Nursing
University of Manitoba e-Health Services Winnipeg, Manitoba, Canada
Kristina D. Wilson PhD, CCC-SLP
Senior Speech Language Pathologist and Clinical Researcher Texas Children's Hospital;
Adjunct Assistant Professor Division of Plastic Surgery
Baylor College of Medicine Houston, Texas
Reviewers
Sharon Anderson MSN, NNP-BC, APNG Instructor School of Nursing Rutgers, The State University of New Jersey
Brigit M. Carter PhD, RN, CCRN Assistant Professor; Project Director Health Equity Academy Duke University School of Nursing Durham, North Carolina
Enrique Chaves-Carballo MD Clinical Professor, Departments of Pediatrics and History and Philosophy of Medicine The University of Kansas Medical Center Kansas City, Kansas
Elizabeth Conoley RN, MSNEd, CPN Assistant Professor Brenau University School of Nursing Gainesville, Georgia
Ciara Culhane MS, RN-BC, CPN Professional Development Specialist Children's Hospital Colorado Aurora, Colorado
Jacqueline Sayre Dorsey MS, RN, ANP Assistant Professor Nursing Monroe Community College Rochester, New York
Patricia A. Duclos-Miller MSN, RN, NE-BC Professor Capital Community College Hartford, Connecticut
Stephanie C Evans PhD, APRN, PNP Assistant Professor, Nursing Harris College of Nursing and Health Sciences Texas Christian University Fort Worth, Texas
Kari Gali DNP, RN, CPN Pediatric Nurse Practitioner Distance Health/MyCare Online Cleveland Clinic Cleveland, Ohio
Bonnie Jensen RN, BSN, MSN Faculty
Provo College
Provo, Utah
Christine B Kavanagh RD, MSN, PNP-BC Instructor
Nursing Programs
School of Health Sciences
Pennsylvania College of Technology Williamsport, Pennsylvania
Ann Marie McCarthy RN, PhD, FNASN, FAA Professor & Associate Dean for Research College of Nursing The University of Iowa Iowa City, Iowa
Carmella Mikol PhD, CPNP, CNE, RN-BC Instructor
College of Lake Country Grayslake, Illinois
Deborah A. Roberts MSN, EdD
Professor and Chair Department of Nursing Sonoma State University Rohnert Park, California
Nicole Shonka MS, RN-BC, CPN Professional Development Specialist Children's Hospital Colorado Aurora, Colorado
Dedication
We dedicate the tenth edition of this book to David Wilson who passed away on March 7, 2015, after a long battle with cancer David had been co-author of the Wong nursing textbooks for over 15 years He was known as an expert clinical nurse and nurse educator His last clinical position was at St Francis Health Services in Tulsa, Oklahoma, where he worked in the Children's Day Hospital as the coordinator for Pediatric Advanced Life Support (PALS).
Students and faculty have recognized David's contributions to the Wong textbooks for many years He was known as an outstanding educator and supporter of nursing students; his attention to clinical excellence was evident in all this work. Those who contributed to the books and had the opportunity to work with David realize the important role he played as a leader in nursing education for students and faculty His clinical expertise provided a critical foundation for ensuring relevant and evidence-based content was used in all the Wong textbooks. David led by example in exemplifying excellence in clinical nursing practice
Those who knew David well will miss his humor, loyalty to friends and colleagues, and his never-ending support He is missed greatly by those who worked closely with him on the Wong textbook over the years. Most importantly we miss his friendship; he was always there to support and to encourage. We have lost an amazing nurse who worked effortlessly over the years to improve the care of children and families in need David will not be forgotten.
Preface
Wong's Essentials of Pediatric Nursing has been a leading book in pediatric nursing since it was first published almost 40 years ago This kind of support places immense accountability and responsibility on us to earn your future endorsement with each new edition So, with your encouragement and constructive comments, we offer this extensive revision, the tenth edition of Wong's Essentials of Pediatric Nursing. This tenth edition continues the legacy of Donna Wong and David Wilson; our beloved colleagues We hold dear their contributions and memories of their pursuit of excellence in all they did for the Wong textbooks
To accomplish this, Marilyn J Hockenberry, as editor-in-chief, along with Cheryl Rodgers, coeditor, and many expert nurses and multidisciplinary specialists, have revised, rewritten, or authored portions of the text concerning areas that are undergoing rapid and complex change. These areas include community nursing, development, immunizations, genetics, home care, pain assessment and management, high-risk newborn care, adolescent health issues, end-of-life care, and numerous pediatric diseases We have carefully preserved aspects of the book that have met with universal acceptance its state-of-the-art research-based information; its strong, integrated focus on the family and community; its logical and user-friendly organization; and its easy-to-read style.
We have tried to meet the increasing demands of faculty and students to teach and to learn in an environment characterized by rapid change, enormous amounts of information, fewer traditional clinical facilities, and less time
This text encourages students to think critically New to this edition is a change in the format and content for nursing care plans throughout the book We have developed case studies that discuss clinical scenarios allowing the student to visualize how the care plan develops as a clinical situation evolves over time. The Critical Thinking Case Studies ask the nurse to examine the evidence, consider the assumptions, establish priorities, and evaluate alternative perspectives regarding each patient situation The Critical Thinking Case Studies support our belief that the science of nursing and related health professions is not black and white. In many instances, it includes shades of gray, such as in the areas of genetic testing, resuscitation, cultural issues, end-of-life care, and quality of life Revised evidence-based practice boxes include the latest knowledge crucial for nurses to practice using quality and safety competencies Competencies included in the evidence-based practice boxes are designed specifically for prelicensed nurses and are from the Quality and Safety Education for Nurses website.
This text also serves as a reference manual for practicing nurses. The latest recommendations have been included from authoritative organizations such as the American Academy of Pediatrics, the Centers for Disease Control and Prevention (CDC), the Institute of Medicine, the Agency for Healthcare Research and Quality, the American Pain Society, the American Nurses Association, and the National Association of Pediatric Nurse Associates and Practitioners. To expand the universe of available information, websites and e-mail addresses have been included for hundreds of organizations and other educational resources
OrganizationoftheBook
The same general approach to the presentation of content has been preserved from the first edition, although some content has been added, condensed, and rearranged within this framework to improve the flow; minimize duplication; and emphasize health care trends, such as home and community care The book is divided into two broad parts The first part of the book, Chapters 1 through 16, follow what is sometimes called the “age and stage” approach, considering infancy, childhood, and adolescence from a developmental context. It emphasizes the importance of the nurse's role in health promotion and maintenance and in considering the family as the focus of care. From a developmental perspective, the care of common health problems is presented, giving readers a sense of the normal problems expected in otherwise healthy children and demonstrating when in the course of childhood these problems are most likely to occur. The remainder of the book, Chapters 17 through 30, presents the more serious health problems of infancy, childhood, and adolescence that are not specific to any particular age group and that frequently require hospitalization, major medical and nursing intervention, and home care
UNIT ONE (Chapters 1 through 3) provides a longitudinal view of the child as an individual on a continuum of developmental changes from birth through adolescence and as a member of a family unit maturing within a culture and a community Chapter 1 includes the latest discussion of morbidity and mortality in infancy and childhood and examines child health care from a historical perspective Because unintentional injury is one of the leading causes of death in children, an overview of this topic is included The nursing process, with emphasis on nursing diagnosis and outcomes and on the importance of developing critical thinking skills, is presented In this edition, the critical components of evidence-based practice are presented to provide the template for exploring the latest pediatric nursing research or practice guidelines throughout the book
This book is about families with children, and the philosophy of family-centered care is emphasized This book is also about providing atraumatic care care that minimizes the psychologic and physical stress that health promotion and illness treatment can inflict Features such as Evidence-Based Practice, Family-Centered Care, Community Focus, Research Focus, Drug Alert, and Atraumatic Care boxes bring these philosophies to life throughout the text Finally, the philosophy of delivering nursing care is addressed We believe strongly that children and families need consistent caregivers The establishment of the therapeutic relationship with the child and family is explored as the essential foundation for providing quality nursing care.
Chapter 2 provides important information on the family, social and cultural and religious influences on child health promotion. The content clearly describes the role of the nurse, with emphasis on cultural and religious sensitivity and competent care
Chapter 3, devoted to the developmental and genetic influences on child health continues to provide the latest information on genetics and also focuses on a theoretic approach to personality development and learning
UNIT TWO (Chapters 4 to 6) is concerned with the principles of nursing assessment, including communication and interviewing skills, observation, physical and behavioral assessment, health guidance, and the latest information on preventive care guidelines. Chapter 4 contains guidelines for communicating with children, adolescents, and their families, as well as a detailed description of a health assessment, including discussion of family assessment, nutritional assessment, and a sexual history Content on communication techniques is outlined to provide a concise format for reference Chapter 4 continues by providing a comprehensive approach to physical examination and developmental assessment, with updated material on temperature measurement, body mass index–for-age guidelines, and the latest World Health Organization and CDC clinical growth charts Chapter 5 is an important chapter, devoted to critical assessment and management of pain in children. Although the literature on pain assessment and management in children has grown considerably, this knowledge has not been widely applied in practice. Chapter 6 was added to address common infectious diseases in children This chapter emphasizes the importance of infection control and review the various bacterial and viral infections encountered in childhood Hospital-acquired infections, childhood communicable disease and immunizations are also discussed.
UNIT THREE (Chapters 7 and 8) stresses the importance of the neonatal period in relation to child survival during the first few months and the impact on health in later life In Chapter 7, several areas have been revised to reflect current issues, especially in terms of the educational needs of the family during the infant's transition to extrauterine life as well as the recognition of newborn problems in the first few weeks of life Current issues that have been updated include proactive measures to prevent infant abduction; hospital-based, baby-friendly breastfeeding initiatives; choices for circumcision analgesia; newborn atraumatic care; car safety seats; and newborn screening, including universal newborn hearing screening Newborn skin care guidelines have also been updated, and choices for newborn umbilical cord care are discussed Chapter 8 stresses the nurse's role in caring for the high-risk newborn and the importance of astute observations to the survival of this vulnerable group of infants. Modern advances in neonatal care have mandated extensive revision with a greater sensitivity to the diverse needs of infants, from those with extremely low birth weights, late-preterm infants, and those of normal gestational age who have difficulty making an effective transition to extrauterine life. This chapter also includes the latest information regarding the detection and management of inborn errors of metabolism.
UNITS FOUR through SIX (Chapters 9 through 16) present the major developmental stages outlined in Unit One, which are expanded to provide a broader concept of these stages and the health problems most often associated with each age group Special emphasis is placed on preventive aspects of care The chapters on health promotion follow a standard approach that is used consistently for each age group. Chapter 10 has been streamlined in regard to nutritional imbalances and continues to focus on the influence of nutrition in early childhood as it impacts health status in adulthood The sections on colic, sudden infant death syndrome, and car seat safety in infancy have been updated as well. The influence of nutrition in preschool-age and school-age children (especially decreasing fat intake) in relation to later chronic diseases such as obesity and hypertension is also discussed The importance of safety promotion and injury prevention in relation to each age group is included as well Chapter 14 contains updated information on bullying.
The chapters on health problems in these units primarily reflect more typical and age-related concerns The information on many disorders has been revised to reflect recent changes Examples include sudden infant death syndrome, lead poisoning, severe acute malnutrition, burns, attentiondeficit/hyperactivity disorder, contraception, teenage pregnancy, and sexually transmitted infections The chapters on adolescence include the latest information regarding substance abuse, adolescent immunizations, and the impact of adolescent nutrition on cardiovascular health
UNIT SEVEN (Chapters 17 and 18) deals with children who have the same developmental needs as growing children but who, because of congenital or acquired physical, cognitive, or sensory impairment, require alternative interventions to facilitate development Chapter 17 reflects current trends in the care of families and children with chronic illness or disability such as providing home care, normalizing children's lives, focusing on developmental needs, enabling and empowering families, and promoting early intervention. This chapter highlights common fears experienced by the child and family and includes discussion of symptom management and nurses' reactions to caring for dying children
The content in Chapter 18 on cognitive or sensory impairment includes important updates on the definition and classification of cognitive impairment Autism is discussed in this chapter to provide a cohesive overview of cognitive and sensory impairments
UNIT EIGHT (Chapters 19 and 20) is concerned with the impact of hospitalization on the child and family and presents a comprehensive overview of the stressors imposed by hospitalization and discusses nursing interventions to prevent or eliminate them. New research on short-stay or outpatient admissions addresses preparing children for these experiences Chapter 19 provides updated information on the effects of illness and hospitalization on children at specific ages and the effects on their development. The increasing role of ambulatory and outpatient settings for surgical procedures is also discussed. Chapter 20 includes numerous revised Evidence-Based Practice boxes that include QSEN competencies and are designed to provide rationales for the interventions discussed in the chapter A major focus in this chapter is the evidence related to preparation of the child for procedures commonly performed by nurses. Recommendations for practice are based on the evidence and concisely presented in Evidence-Based Practice boxes throughout the chapter.
UNITS NINE through TWELVE (Chapters 21 through 30) consider serious health problems of infants and children primarily from the biologic systems orientation, which has the practical organizational value of permitting health problems and nursing considerations to relate to specific pathophysiologic disturbances The most common serious diseases in children are reviewed in these chapters Important revisions include discussions of hepatitis, cardiopulmonary resuscitation, blood disorders, cancer, respiratory illnesses including influenza, acute lung injury and respiratory syncytial virus, tuberculosis, asthma, cystic fibrosis, effects of second-hand smoke exposure, seizures, acquired immunodeficiency syndrome, and diabetes mellitus The information on orthopedic and muscular injuries in childhood as a result of sports participation or other injuries has been revised to reflect current treatment modalities Chapter 28 includes focused attention on type 2 diabetes and the most up to date information on insulin preparations and types of glucose meters
UnifyingPrinciples
Several unifying principles have guided the organizational structure of this book since its inception These principles continue to strengthen the book with each revision to produce a text that is consistent in approach throughout each chapter.
TheFamilyastheUnitofCare
The child is an essential member of the family unit We refer to parents in this book as a mother and/or father but recognize parents include of a variety of individuals and do not undervalue the importance of any parent role or family structure.
Nursing care is most effective when it is delivered with the belief that the family is the patient. This belief permeates the book. When a child is healthy, the child's health is enhanced when the family is a fully functioning, health-promoting system The family unit can be manifested in a myriad of structures; each has the potential to provide a caring, supportive environment in which the child can grow, mature, and maximize his or her human potential. In addition to the integration of family-centered care into every chapter, an entire chapter is devoted to understanding the family as the core focus in children's lives including the social, cultural, and religious influences that impact family beliefs Separate sections in another chapter deal in depth with family communication and family assessment. The impact of illness and hospitalization, home care, community care, and the death of a child are covered extensively in additional chapters. The needs of the family are emphasized throughout the text under Nursing Care Management in a separate section on family support Numerous Family-Centered Care boxes are included to assist nurses in understanding and providing helpful information to families.
AnIntegratedApproachtoDevelopment
Children are not small adults but special individuals with unique minds, bodies, and needs No book on pediatric nursing is complete without extensive coverage of communication, nutrition, play, safety, dental care, sexuality, sleep, self-esteem, and of course, parenting. Nurses promote the healthy expression of all these dimensions of personhood and need to understand how these functions are expressed by different children at different developmental ages and stages Effective parenting depends on knowledge of development, and it is often the nurse's responsibility to provide parents with a developmental awareness of their children's needs. For these reasons, coverage of the many dimensions of childhood is integrated within the growth and development chapters rather than being presented in separate chapters For example, safety concerns for a toddler are much different from those for an adolescent Sleep needs change with age, as do nutritional needs. As a result, the units on each stage of childhood contain complete information on all these functions as they relate to the specific age In the unit on school-age children, for instance, information is presented on nutritional needs, age-appropriate play and its significance, safety concerns characteristic of the age group, appropriate dental care, sleep characteristics, and means of promoting self-esteem a particularly significant concern for school-age children. The challenges of being the parent of a school-age child are presented, and interventions are suggested that nurses can use to promote healthy parenting Using the integrated approach, students gain an appreciation for the unique characteristics and needs of children at every age and stage of development.
In a pediatric nursing text, a focus on illness is expected Children become ill, and nurses typically are involved in helping children get well However, it is not sufficient to prepare nursing students to care primarily for sick children. First, health is more than the absence of disease. Being healthy is being whole in mind, body, and spirit. Therefore, the majority of the first half of the book is devoted to discussions that promote physical, emotional, psychosocial, mental, and spiritual wellness Much emphasis is placed on anticipatory guidance of parents to prevent injury or illness in their children Second, health care is more than ever prevention focused. The objectives set forth in the Healthy People 2020 report clearly establish a health care agenda in which solutions to medical and social
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“She is from Havana,” said a Frenchman, who was at hand, working.
“The Raven, Captain Sudlip.”
“Captain Sudlip!” came from several of the boys.
“Was his full name Jason Sudlip?” questioned Professor Strong, with equal interest.
“Yes. Then you knew him?”
“We did. But we didn’t know he was captain of a schooner like this.”
“It was a new command for him. At the last moment the regular captain of the Raven was taken sick and Captain Sudlip took his place. Poor fellow, it was a fatal trip for him.”
“Is Captain Sudlip dead?” questioned Darry.
“Not dead, but horribly burnt. They have taken him to the hospital at Roseau, on the island of Dominica, but the doctors say he cannot live.”
The Frenchman resumed his work, and the craft containing our friends moved off down the coast. For some minutes nobody spoke. Then Darry heaved a long sigh.
“It’s horrible!” he murmured. “Horrible! Captain Sudlip wasn’t our friend, but I pity him.”
“And so do I pity him,” put in Sam. “I trust his case isn’t as bad as reported.”
This was all that was said, but nobody forgot the matter until a long time after. It may be as well to state here that the captain was in a very bad way and that he died inside of the week.
It was utterly impossible to think of going ashore at St. Pierre, and fearful of another eruption which might cost them their lives, Professor Strong procured passage on a little ferry steamer which had formerly run regularly between the fallen city and Fort de France.
Turning southward again made the hearts of Mark and Frank sink like lead within their bosoms. Their thoughts were constantly on their
parents.
“I can’t give my father up—I simply can’t!” said Frank to his chum, in a choking voice. “It’s too awful to think of!”
“I feel exactly the same, Frank,” answered the older youth. “But what more can we do?”
“I am going to make more inquiries when we reach Fort de France.”
“Oh, I shall do that, too.”
On the way down the coast they fell in with many vessels, all going to St. Pierre to give aid to those who, alas, were beyond human needs. These craft moved along silently, nobody feeling in the humor to even discuss the situation.
As soon as they landed at the capital city they started for the postoffice, to learn if anything in the shape of a letter had been left for one or another of the party. They found the streets crowded with people of all nationalities and for the first time learned how Fort de France had received a shower of dust and stones, and how everybody had been terrorized and business brought to a standstill.
“It’s a fearful state of affairs,” said Sam. “They won’t recover from this for years.”
“St. Pierre will never recover, Samuel,” returned the professor. “The eruption has——”
Professor Strong stopped short, for a cry from Mark had interrupted him. The youth was pointing up a street to their left.
“See! see! There is a crowd of negroes and they are beating a white man! If somebody don’t help the white fellow they will kill him!”
They started forward, and were soon on the edge of the crowd which numbered fully a dozen colored men. In the very midst was the white man Mark had mentioned. His hat was off, his collar and tie loose, his shirt torn, and he was fighting desperately. One cheek was bleeding from a long cut and his left arm hung limply at his side.
“It is Dan Markel!” ejaculated Darry. “Dan Markel, the fellow who once swindled Hockley!”
The crowd around the man was yelling fiercely and striking at every available opportunity. Dan Markel was yelling in return, but nobody appeared to listen to him.
“We must do something, or he’ll surely be killed,” said Frank.
By this time Professor Strong was close to the crowd. “Stop!” he called out, in French. “Stop! What does this mean?”
“He is a rascal!” said one native, wrathfully “He is not fit to live!”
“He robbed the dead,” said another. “We saw him doing it—up at the Ladarosa plantation.”
“Let me go!” screamed Markel, in English. “It’s all a mistake.”
By this time the crowd was growing larger, and the shouting continued, until to make out what one individual was saying was impossible. Those nearest to Markel continued to strike at the man from Baltimore, until he went down from a blow on the head, and several in the crowd fell on top of him.
It was at this critical moment that several gens-d’armes appeared. They were doing police duty in that neighborhood, and at once set to work to restore peace. But it was not without great difficulty that they succeeded in quieting the negroes, who insisted upon it that Dan Markel be arrested.
“He is a looter—a robber of the dead,” said one of the natives. And then he explained that he was an assistant foreman on the Ladarosa plantation not far from St. Pierre. The master of the plantation had been killed, along with several others of the household, while the negroes had fled to a rocky cave for safety. On returning to the house two days after the first eruption they had found Dan Markel there and in the act of stealing the silverware and jewelry. Markel had escaped them but they remembered his face well.
The man from Baltimore tried to deny this story, saying he had reached Fort de France from La Guayra that morning, but on being searched some jewelry which the negroes identified was found in his pockets. He was at once marched off to the local jail, there to await
trial, the natives following the gens-d’armes to see that the prisoner did not get away.
“It will go hard with Markel,” said Darry “Robbery under such circumstances becomes a double crime.”
“In some countries such looters would be hung,” answered Professor Strong. “You may depend upon it that Markel will get the full penalty of the law.”
“This will please Hockley,” came from Sam. “He was always sorry the rascal got away. I wonder if Hockley is still up at the hotel?” he continued.
“I shouldn’t be surprised if he got out of Fort de France when that shower of dust and stones came,” returned Mark. “He was scared to death as it was.”
A short while later found them at the post-office asking for letters. Owing to the general disorder it was half an hour before any mail was handed out.
The first communication proved to be from Hockley, and was addressed to Professor Strong. It was short, and had evidently been written while the youth was in an excited frame of mind. It ran as follows:
“D P : It looks now as if this island was doomed and I don’t propose to be burnt up or be drowned. There is a steamer sailing from here to Port-of-Spain, Trinidad, and other ports in South America, and I have secured passage. If I stop off at Port-of-Spain you can look for me at the hotel at which we stopped before, and if I go further I will leave word in a letter at the post-office. Have cabled my father to send necessary money.”
“I knew Hockley wouldn’t stay,” said Darry. “I’ll wager he was almost paralyzed with terror.” And he was right. Hockley had acted so thoroughly scared that he had made himself the laughing stock of all, both at the hotel and on board the steamer on which he had secured passage. It was to be some time before they would see their tall traveling companion again.
CHAPTER XXXIII
A HAPPY MEETING—CONCLUSION
T letter from Hockley read, they waited patiently until some mail matter which had just come in should be sorted out. This took the best part of an hour—a wait which to Mark and Frank seemed an age.
But at last the little window was opened once more and the crowd surged forward. Professor Strong was well to the front and presently they saw him turn from the window with half a dozen communications held aloft.
“Letters!” cried Frank. “Oh, if only they bring good news!”
The professor was soon beside them. There were letters for all, but just then the interest was concentrated on a communication addressed to Mark and another addressed to Frank. Both bore the postmark of Kingstown, St. Vincent.
“My father’s handwriting!” cried Mark, in a trembling voice.
“And this is in my father’s hand!” came from Frank, falteringly. His hand shook so he could not open the envelope. “Yo—you read it, professor.”
Professor Strong did so. The communication had been written the day before and ran in this wise:
“M F :
“I am writing this in the hope that you are safe despite the fearful volcano eruptions which have taken place in this quarter of the globe. I know you were bound for St. Pierre, but I have learned that by the goodness of an all-wise Providence the Vendee escaped the eruption that destroyed St. Pierre and all the shipping in that harbor.
“Mr Robertson and myself have had a narrow escape from death, and we do not yet know if we are entirely safe, for the volcano on this island is now as active as that on Martinique. We were within four miles of Mont Pelee when the eruption of May 8th occurred. We escaped by what was little short of a miracle, and were lucky enough to get on a trading vessel bound for this port. I had my lower limbs and feet considerably burnt, and Mr. Robertson suffered from burns on his feet and on his left arm. But none of the burns are serious, and we are resting here quite comfortably. If we were well enough we would set out in search of you, but as it is neither of us can do any walking at present.
“I am sending this letter in duplicate to half a dozen ports in this territory, and Mr. Robertson is sending similar letters addressed to Mark. As soon as you receive a letter let me hear from you, as both of us are anxious for news. And also send word home if you are safe. Address me at the Windsor Hotel, Kingstown, Island of St. Vincent.”
“Oh, how glad I am that they are safe!” murmured Frank, and then he looked at Mark, who had been reading his own letter. There were tears in the eyes of both and that look meant more than any words of mine can tell.
“I must go to Kingstown at once,” said Mark. “I can’t be satisfied until I see for myself just how they are faring.”
“And I will go with you,” answered Frank. “Perhaps the burns are worse than we imagine. I know father. He wouldn’t want to worry me.”
The matter was talked over by all, and in the end Professor Strong agreed to see about passage to St. Vincent. Darry and Sam wanted to keep with Frank and Mark, and the whole party sailed southward the next morning at sunrise.
The run to St. Vincent, past the Island of St. Lucia, which, strange to say, had entirely escaped the eruptions on both sides of it, was
made without anything unusual occurring. While still some miles north of the island for which they were bound they could see the smoke of La Soufriere and through the marine glasses took note of some of the terrible damage done.
“It is very fortunate that no large city was located near this volcano,” said Professor Strong. “No living thing could have escaped such an outburst as has taken place here.”
When the vessel reached Kingstown harbor the boys could scarcely wait to get ashore. They learned that the Windsor Hotel was in a suburb, and hired a carriage to take them to the hostelry
“There is father now!” cried Frank, as they entered the beautiful grounds, and he pointed to a figure reclining in an invalid chair on the veranda.
“And my father is there, too!” exclaimed Mark. In another moment they were out of the carriage and rushing up the veranda steps. As they came closer both Mr Newton and Mr Robertson sat up to greet them.
“My boy!” cried Mr Newton, and flung his arms around Frank. “My own boy!”
“Mark!” came from Mr. Robertson, and his face broke out into a warm smile of welcome. “We were just talking about you and wondering if we would get a letter.”
“You don’t know how glad I am to see you, even like this, father,” answered Mark. “We were afraid you had been burnt up.”
“Yes, and we went on a regular search for both of you,” broke in Frank.
“And they came pretty close to losing their own lives in that search,” came from the professor, as he shook hands.
“Then you went ashore—” began Mr. Newton, in wonder.
“Yes, we went volcano exploring,” said Darry.
“And we climbed Mont Pelee,” finished Sam. “I don’t believe we’ll ever want to do it again.”
“No,” finished Mark. “Once was enough. Now we are all safe away from it, I never want to see the island of Martinique again.”
And the others agreed with him.
Let me add a few words more, and then we will bring to a close this tale of sight-seeing and adventures in the West Indies.
What Mr. Newton and Mr. Robertson had written in their letters concerning their injuries was true. Although painful, none of the burns were serious, and they were both doing as well as could be expected. In a few days each was able to walk a little, and inside of a month both were practically as well as ever.
For the time being all business in Martinique, and a good part of that in St. Vincent, came to a standstill, and this being so nothing could be done regarding the dyewood scheme the two gentlemen had had in mind Consequently the pair returned to the United States at the first available opportunity.
“Take good care of yourselves in the future, boys,” said Mr Robertson, on leaving.
“And let the active volcanoes alone,” added Mr. Newton.
And all of the party agreed to heed the advice.
During the time spent in St. Vincent the boys made one trip northward toward La Soufriere. But though they inspected the great volcano from a distance they took good care to keep out of the zone of fire.
“It’s a fearful spot,” said Mark. “Worse even than around Mont Pelee. It’s a regular Inferno on earth,” and the others said the same.
At last came the day for the young explorers to leave St. Vincent. Anxious to learn what had become of Hockley, who had not answered a letter sent to Trinidad by him, Professor Strong engaged passage on a vessel bound for Port-of-Spain.
“Hurrah, we are off at last!” cried Darry, as they set sail. “Good-bye to the West Indies.”
“After all, the trip through the islands wasn’t so bad,” said Sam. “We saw lots of interesting things.”
“I guess we shall see even more interesting things in the future,” came from Mark.
“Of course, our sight-seeing isn’t half over yet,” added Frank. He was right, and what the immediate future held in store for our young friends will be told in the next volume of this “Pan-American Series.”
In that book we shall meet all our boys and the professor once more, and learn of many things as interesting, curious, or exciting as those related in these pages.
But for the present we will leave them, and also these ill-fated islands of the Lesser Antilles, the fate of which even to-day seems uncertain. Our friends made a happy group as they steamed rapidly southward, and here let us say good-bye.
THE END
TRANSCRIBER’S NOTES:
Obvious typographical errors have been corrected. Inconsistencies in hyphenation have been standardized.
Archaic or variant spelling has been retained. New original cover art included with this eBook is granted to the public domain.
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