Free The Nurses: A Year of Secrets, Drama, and Miracles with the Heroes of the Hospital by Alexandra Robbins Page A

hadn’t evaluated the patient at all; she based the order on the patient’s initial behavior alone.
    Finally, Molly spoke to the woman, who was again trying to escape her chair. She gently put her hand on the woman’s arm. “May I please speak to you for a couple of minutes?” she asked. “Everyone else, can y’all please leave the room so I can talk to my patient?”
    The nurses shrugged and left Molly alone with the woman. Molly’s green eyes softened. Occasions like these were important, to nurses and to patients—the moments of exchange with another person on a human-to-human level.
    Just because a patient wanted to leave didn’t mean the hospital could allow her to go. Where would she go? Who would make sure she got home safely? Molly wanted to learn the woman’s story to give her a chance to explain why she was in the ER and whether she would be safe if she were discharged. “So what’s going on?” Molly asked. “Why are you so angry?”
    The woman sat down and calmly told Molly that her neighbor had taken her to her doctor’s office. The doctor told her she was in heart failure, needed new medications, and should probably move into a nursing home. When she rejected the plan, the neighbor drove her to the ER and left. “I’ve lived a full life,” the woman said. “I’ve outlived my husband and most of my friends. My doctor said I’d die if I didn’t take his advice. I’m fine with that. I’ve lived in my home for forty years. I don’t want to leave it. I have help. I don’t need doctors telling me what to do. I’m ready to go.”
    Molly nodded. “That makes complete sense to me.”
    Molly found Dr. Baron in the hallway and relayed the discussion. The doctor barely looked at her. “She’s not competent,” she said.
    “We just had a very lucid conversation. She wants to go home and let nature take its course,” Molly replied.
    “She can’t make her own decisions,” the doctor insisted.
    “Come back to the room with me,” Molly said.
    Dr. Baron followed her and addressed the patient. “What is today’s date?” she asked. To determine whether a patient was clearheaded, it was standard practice to ask the patient’s name, the date, and the name of the current president of the United States.
    The patient was frustrated. “I don’t know or care what the date is.”
    She knew her name and the president’s, but Dr. Baron said, in front of the patient, “She is not competent.”
    “You’re so pretty,” the patient suddenly told the doctor.
    Molly laughed. “Well, I guess you’re right,” she said to the doctor. Dr. Baron turned on her high heels and went straight to the nurses station to order a psychiatric consultation and a variety of lab tests. Luckily, Dr. Baron’s shift ended soon afterward. When the next physician, Dr. Ward, arrived, Molly explained the situation. She liked Dr. Ward. He took the time to listen to the nurses. Molly had seen the doctor respect even a new nurse’s input when she knew that a rhythm change on a heart monitor signified that something was wrong, though she couldn’t pinpoint exactly what was amiss.
    Dr. Ward sat down with the patient to hear the same story she had told Molly. The doctor called the patient’s son, who confirmed that the woman was entirely competent and able to make her own decisions. He let Molly put the woman in a cab twenty minutes later.
    “If I hadn’t advocated for her, she could have ended up being committed to the psych unit for observation while they prolonged this woman’s life against her will,” Molly realized. “I think a lot of ER docs forget that not everyone wants to—or needs to—be saved.”
    A few days later, a patient came in with a bad bone infection in his foot. While at home, he had broken his foot by merely putting weight on it, and the already infected area began to bleed. Paramedics bandaged his foot and brought him to the ER. By the time he arrived, the bleeding was controlled but his blood