“Aha!” moments. Smart, hard-working people gather data, ponder for however long they’ve got, and then act. Time is always of the essence.
Speaking of time, I look at my watch. How did it get to be 9:30 a.m. already? And I didn’t call home. I used to make a point of always calling home in the morning before the kids left for school. I loved hearing their little soft voices, imagining the bustle of lunches being prepared, backpacks being loaded and zipped up. They usually didn’t have much to say to me, but I wanted to let them know I was thinking about them. It seemed important.
Paradoxically, once I got more experience under my belt I stopped calling home in the morning. If I think about it I have to admit that not calling is actually easier. A call makes home, my actual home, too real and thinking too much about home might make me vulnerable in ways the job doesn’t really accommodate. It’s the patients who get to be emotional and unpredictable, not the staff, or at least that’s the ideal. I need to be in control at work, so I don’t call home unless I have to. I stick the chart for Susie’s patient back in the circular rack and one of our social workers pulls it out immediately. “Is he your patient?” she asks, hopefully.
“No—Susie, down the hall,” I point. Many hands make light work and that’s good, because the sickest patients need a team of people to look after them.
Sheila’s thin intern is talking on the phone and I overhear her. “Chardash was fine? Oh, that’s good. Just a problem with his oxygen?” Sheila continues to wait for a full consideration of her health status, but I feel relieved that Chardash, a patient I’ve never heard of and know nothing about, has been rescued from whatever trouble seemed to be heading his way.
CHAPTER 4
Worries
R
apid response team
” comes over the PA system and I wait, holding my breath, to find out where. “
Medical Oncology.
”
Shit! Our floor? Which room? “It’s here! It’s Mr. King!” I hear Nora. She’s in the pod next to mine.
I walk back to her, fast, and see Susie coming down the hall, fast, too, with Randy behind her. Nora has already pulled the crash cart into the room and I see, quickly, Mr. King, a patient most of us have known for over two years, lying in bed not moving with a thin stream of blood running from his mouth down his chin onto his chest.
My focus narrows to what’s right in front of me: the portable defibrillator is on the bed next to Mr. King. I grab the small plastic instrument we use to measure oxygen saturation and stick his finger into it.
“What’s his pulse-ox?” asks Nora.
“Waiting.” The machine registers a horizontal line as it calculates Mr. King’s oxygen level. “Seventy-five percent.”
“I’m cracking the cart, getting out a non-rebreather.” That’s Randy.
I hear Susie say, “What happened to him?” as I wrap the blood pressure cuff around his arm and start the machine so we can get his pressure.
Nora says, “I dunno. I walked in and found him like this. Here—you can record.” She shoves a clipboard at Susie. “Write down everything that happens on this form.”
Susie’s eyes widen, but she takes the clipboard and clicks her pen open.
Suddenly the room floods with people: an ICU doc, nurses from the ICU, a respiratory therapist, an anesthesiologist. The code team has arrived.
This intensivist, Matt, is a friend. Despite not being any older than I am he’s world-weary, but also whip smart with a well of compassion hidden beneath his hard edge. He stands by the opposite side of the bed, across from me, and our eyes briefly meet. Then he raises his voice above the loud buzz in the room. “What’s up with this patient? Who’s the nurse?”
Nora’s good in codes. She rolls the information out like she’d memorized it. “Day one hundred – plus of a mud transplant, patient has GVH of the lungs and a fungal pneumonia, with increasing needs for oxygen. Alert and