It was mid-January and we were in the middle of a cold snap. Schools had even closed because of the sub-zero temperatures. I made sure to wear my long-sleeved Cuddl Duds under my scrubs because I got cold far too easily.
And so I was off and running first thing in the morning. To be honest, I had heard other nurses talk about the occasional lull in activity they occasionally experienced, but I felt like I never slowed down. My first patient was an elderly homeless woman with possible frostbite due to the bitter temperatures. I realized that we would likely have a steady stream of homeless folks due to the weather.
My next patient was brought in by ambulance. Her records indicated that she had just been discharged four days ago after a spinal fusion. "Hi, Joann," I greeted her with a smile. "You're not supposed to be back here," I teased. "They just let you go."
She gave me a tired smile. "Something's wrong," she said. "Of course I can't see the surgery site very well myself, and my husband doesn't change the dressings, so he hasn't been able to look at it. My daughter was going to come today to do it, but I thought I'd better come here first."
"Is it hurting more than when they discharged you?" I asked, digging for a gown in the cabinet.
"Terribly. Even the narcotics don't knock it out," she said in sarcastic laughter. "My husband should be here soon. Will he be able to find me?"
"Yep, one of the nurses will bring him right back here." I handed her the gown, but then I asked, "You'll probably need a little help with this, won't you?" Her soft yes came as I was already helping her. We quickly got her into her gown and then I pulled away the dressing to look at her sutures. They were red and swollen, just like I suspected. I could also feel that her skin was hot, even through the exam glove.
"102.5," I announced after I took her temperature. "Looks like you have an infection. Dr. Styles will be in shortly to take a closer look, all right? Do you need anything else before I go? Some ice water?"
"Ice water, please," she said as if she'd been craving it for a month. I knew better than to offer her a warmed blanket, for obvious reasons. Sometimes patients with a fever felt cold and chills, but unfortunately, we couldn't offer them a blanket even then, so I was glad she didn't ask.
I was surprised to find Bridget in the hallway. "Hey, girl, you don't normally work the day shift."
"Picking up some extra hours," she said with no further explanation.
"Well, it's fun to see your face," I said, giving her a cheesy grin. "Good luck in Room 5, by the way. Sounds like you've got a screamer."
"Great," she said playfully and headed off in that direction.
Next, I found Quinn, who had also come in by ambulance. "Hi, I'm Ellie," I said by way of introduction. "You must be Quinn. That's a fantastic name. Looks like you injured your leg?"
"Yeah," she said, gritting her teeth through the pain. An older woman stood close by, looking very concerned.
"Is this your mom?"
"No," she gasped. "Aunt."
"Aunt Frances," the woman clarified.
"I know it hurts, hon, but can you tell me exactly what happened?"
"Soccer," she said simply.
"I thought soccer season was over," I mused.
"Practice...for spring soccer."
"Ahh, I see. Tell me exactly what happened. Was another player involved, were you running, jumping?"
She did her best to describe an airborne kick and how she landed at a very awkward angle. I was already examining the knee as she told me. It was swollen grotesquely, and I could see why it hurt so much.
"Okay, hon, I'm going to get you an ice pack and something for the pain and the doctor will check on you soon." Then I turned to her aunt and told her, "He will probably order some X-Rays, at least, and then we'll go from there."
"Thank you," she smiled."
Harry found me in the hallway and whispered excitedly, "Ellie, come with me. I have to tell you something."
We got into his office and closed the door just before he blurted out, "Durand was fired!"
"What?! No way!" I was shocked. The only way to get rid of a tenured doctor was for the board to vote unanimously on the dismissal.
"Yes!" He hissed in a loud whisper. "She's facing charges for unsafe research practices because she was experimenting with drugs that hadn't been cleared by the FDA. And get this, she joined the ER committee to try to draw attention away from her misdeeds. She must have been hoping that if she had some major insight into the new ER, they'd forgive her for a fucking felony!"
Harry looked so excited, it was almost shameful to see him rejoicing so much over Dr. Durand's downfall. But I shared the sentiments, and of course, she made her own choices, so she had no one to blame but herself.
"Holy shit!" I said quietly. "That's just...wow! Okay, I have to get back. Love you!"
It was getting late in the day when I received a patient who seemed violently ill, both from the symptoms listed in her chart and from the appearance of her bright red and sweaty skin. She was trembling with chills, but I suspected a high fever would follow.
I gave my standard introduction and then met the 14-year-old patient, Jade, and her mother. "So what's been going on with her?" I asked the traumatized mom.
"She seemed perfectly fine yesterday, she went to school and ate dinner just like normal, but early this morning, she came into my room saying she had a really bad headache. I felt her and she was burning up. I have no thermometer, but I could tell the fever was high."
I turned to Jade and asked, "Can you show me exactly where your head hurts?"
She motioned to different parts of her head, but then she said, "I've just never had such a bad headache before. It feels...different."
"Can you move your head at all? Try looking down at your chest."
She tried but winced in pain. "I can hardly move it at all."
Alarms were going off in my head, but I didn't want to scare her mother, so I asked a few more questions while I finished up the vitals. As soon as I left the room, I called Harry and hoped he'd answer. This girl's situation was definitely high priority.
"Hello," he answered.
"It's Ellie. Patient in Room 17 presenting with symptoms of menin-" I didn't even finish the word when her Jade's mom cried out, "Somebody! I need help!" I threw my phone into my pocket as I raced back in to find Jade having a seizure. Bridget, another nurse, and a PCT rushed in behind me. All we could really do was to make sure she didn't hit her head on the sides of the bed until the seizure was over, which was fairly soon. I rolled her gently onto her left side and placed her right leg over her left to keep her from rolling onto her back.
Her mom was understandably hysterical and I could hear Bridget trying to calm her. "She has a high fever; seizures sometimes happen with a high fever, so let's just wait to see what the doctor has to say."
Harry came dashing in, having heard the commotion. Seizures weren't usually a reason to call a code blue, but a lot of people usually showed up when something like this happened, just to make sure the bases were covered.
"Fourteen, high fever, stiff neck, seizure lasted about 30 seconds," I barked out to him, knowing that was all he would need to begin assessing her. I took over with Jade's mom while Bridget and the others went back to work. Harry completed his exam quickly, asked her mother a few more questions, and then told her that he was going to admit Jade and start an intravenous antibiotic immediately.
"What happened?" Her mother asked with a horrified look on her face.
"I'm not 100% sure, but it looks like meningitis. I know that's a scary word, but if it's bacterial, the antibiotics should start working right away, and if it's viral, it should clear up on its own. The best place for her is here where we can take care of her until she's feeling better." Harry's voice and demeanor were so calming, and he had such a gift for explaining something potentially terrifying in a way that made it seem not so scary.
I left to begin the process for admitting Jade to the hospital. Glancing at my watch, I noticed that I had just under three hours left and I was so eager to get home since this was mine and Harry's last shift before a four-day break. With the long list of patients under my care, I took a deep breath and braced myself for three more hours of chaos.
Joann, the spinal fusion patient, had been admitted and and elderly man with stroke symptoms took her place. Quinn had torn her ACL and was none too happy to find out that she might not play in the spring. After her leg was braced, she was sent home with crutches and instructions to consult with a surgeon. And Jade was admitted very quickly, in an effort to get her treatment started as soon as possible. But it seemed that for every patient discharged or admitted, two took their place.
I stopped by my station for a drink of water and a deep breath. Harry walked by looking very strained and said, "Ellie, my office, now!"
What the hell? It had only been an hour since I'd seen him. What was his bizarre change in attitude? I actually thought maybe he was joking around, but when I stepped into his office, he slammed the door, I knew from the look on his face that something very serious had happened.
"Ellie, I...I..." he said, trying to control his rapid breathing. He was panicking.
"Harry, just calm down. What's going on?"
"I'm going home."
"What? Right now?" I asked in surprise. "Are you sick?"
"No, baby, no," he said as he sat down and put his head in his hands.
My heart started thumping violently against my chest. "Harry, you're scaring me. What's going on?"
"Baby, please, please don't get mad," he said, still not looking at me. His voice sounded tight, distraught. I began to feel nauseous. "They put me on administrative leave," he said through gritted teeth.
Shit! My first thought was that Durand had somehow fabricated one last lie to try to pin something on Harry before she was ousted. However, when he spoke, I actually wished that it had something to do with Dr. Durand.
"They're putting me on administrative leave," he re-stated, squeezing back tears and panic. His voice became so small that I could hardly hear him. "Because they caught me drinking on the job."
I felt like he had punched me in the gut. "What?" I asked, shaking my head and hoping I heard him wrong, but knowing I hadn't.
"I'm so sorry, Ell," he said, no longer holding back his tears. "So sorry."
How was I supposed to process this when I still had to take care of my patients and finish up my shift? "I don't know what to say. I just...just get a cab and give me your keys. I'll see you when I get home." I took his keys and walked out of his office, completely numb.
The remaining portion of my shift was torture, trying so hard to keep my mind on my patients, since their lives depended on me doing my job well, and trying not to think about Harry.
I had one last patient to check up on before I could get ready to clock out. Her name was Maria and by looking at her chart, I learned that she had fainted at the United Center while waiting for a concert. "Hey, Maria," I said cheerfully as I entered her room. There were three other girls with her, all looking extremely worried. "I see you brought some friends." They laughed and the concern on their faces eased slightly.
"Why don't you explain what happened?"
"Well, we had tickets to sound check for the concert and, well I just got my period," she said, rolling her eyes. "And my cramps suddenly got really, really bad. I was going to try to find some Motrin somewhere because none of us had brought any. I had only taken a few steps when I passed out."
"She was lucky she kind of fell into another group of people," one of her friends said. "They caught her and then laid her down on the floor while we ran to get help."
"Which concert were you going to see?" I asked.
"5 Seconds of Summer!" Said another friend excitedly.
"Oh, I like their music," I replied. "Let me get your vitals, Maria, and then the doctor will probably want to do some blood tests." I did the vitals quickly and everything looked good. "How are your cramps now? Do you still need some Motrin?"
She nodded and then asked hopefully, "Will I still be able to make it to the concert?"
I looked at my watch. 6:56 PM. "What time does it start?"
"8:00," said her third friend.
"And is there an opening act?" I questioned further.
"Yeah, some band named Augustana."
"Well, I'm not making any promises, but if the doc doesn't find anything serious, and if your cramps are under control, you might be able to make it. I would guess 5SOS won't even take the stage til almost ten. But, don't get your hopes up, all right? If you were my little sister, I would say no way! We're worried more about your safety than getting you to the concert, even though it sounds like fun. But we'll wait and see what Dr. Sty-, I mean what the attending doctor says."
I left as Maria was trying to convince her friends that they should go for sure, even if she couldn't go. I quickly went through Maria's details, along with all of the other patients I was handing off to Lynda for the night shift.
Then I clocked out, got into Harry's car and drove home, having no idea what I would find back at the apartment.
* * * * *
Thanks to @mariaburns, @NiallersPrincess413, @qspringer, and Joanngibson2194 for being my pretend patients today!
Love you guys! <3