Chapter 6
CHAPTER
SIX
Phoebe
Who knew I could request a nerve block? I sure didn’t but when I was presented with that option, I took it, knowing that the upcoming debridement would suck otherwise.
Of course, I’ve got an IV in place that’s pumping me full of a broad-spectrum antibiotic and initial cultures of the wound have been taken so that the doctor can ensure I get the correct one to ward off any infection that may have already set up in my wound.
They also drew blood to run a tetanus titer on me.
Right now, I feel rather pitiful, but at least I’m clean and my hair looks good.
“It sucks being on this side of the curtain,” I grumble, causing Ella to grin at me.
“I know, Fee, but you don’t want to ignore it and run the risk, do you?” she asks.
“No, not particularly,” I admit. “But this wasn’t on my bingo card for this assignment!”
She giggles then grows serious as she states, “It would’ve been worse if it had been Otis, especially since he’d been stuck for more than twenty-four hours, Fee. He’s older and has other health issues too.”
“I know, I just hate this is all. And how on earth are they going to close this gaping wound?” I query. “The edges are all jagged and it’s a hot mess from what I can tell.”
“We won’t,” the doctor says, coming back into the room. “We’ll get it debrided now that you’re numb and use the covering we use on burn patients because it’ll have to be done several times as it heals. We may even use a wound vac to help close it up.”
“Ugh,” I mutter, making him smile. “It’s definitely going to be one helluva gnarly scar then.”
“Unfortunately, because of how jagged it is, there’s no way to adequately stitch it closed.
Not only that, but until we know for sure what kind of bacteria was introduced, I’m not comfortable closing it completely.
A wound vac will allow it to be accessible to debride as it heals.
But just so you know, most folks in healthcare act the same way whenever they’re told what a treatment plan will be,” he admits, putting fresh gloves on.
“Now, can you feel this?” he asks as he probes the wound.
“Nope, not at all,” I reply.
“Then we can get started,” he says, pulling the tray that’s full of surgical style implements toward him.
“Ella, you need to record what he’s doing because you know Thelma’s gonna want to see the video.
Is that okay?” I ask the doctor. “She won’t show anything but your hands, I promise.
Our boss is a nurse practitioner and owns the agency we work through, so I’m positive she wishes she could’ve come with us. ”
“That’s fine. At least with the two of you being nurses, you’re hopefully not squeamish,” he says as he begins carefully cleaning the wound with the curette.
I don’t remember much from my rotation on the burn unit, but if memory serves, his objective is to ensure that there’s nothing underneath the edges.
The process is fascinating as he uses sterile saline to keep the area somewhat clean, allowing the fresh blood to flow as he slowly and carefully removes pieces of debris.
He’s wearing a headlamp with a bright light, and I notice his glasses are actually magnified so he can clearly see the affected area.
“Those are kind of cool, it’ll make it hard to miss anything,” I say, my gaze focused on what he’s doing. It’s a little bit weird watching him work on my arm since I can’t feel anything at all.
“The last thing we want is to have anything left in here that shouldn’t be there,” he says, not looking up.
I hear a commotion beyond the curtain as a female voice says, “Sir, sir! You can’t just barge in like that!”
“Watch me,” Eli growls, making me smile. How I instinctively knew he’d show up is beyond me, but what I don’t expect is what happens next as he and another man come through.
“Eddie?” Ella asks.
“Ella?” the other man questions.
“What are you doing here?” they ask in unison.
My eyes are round and wide, possibly because of the medications they’ve given me, but I think it’s because of the longing looks my bestie is giving the man who’s standing next to Eli.
I’ve got questions, so many questions! Who is he?
How does she know him? Why hasn’t she ever mentioned him to me?
Hell, she was with me every step of the way after everything went down with my ex, for heaven’s sake!
“You first,” Eddie finally says.
“I’m working a contract up here,” she replies. “Now, what are you doing here?”
“Came to bring my brother here an RV so he didn’t have to sleep on the ground. He’s getting too old to do that shit,” Eddie states.
I watch Ella move so Eli can sit by me and take my unoccupied hand in his, being careful of the IVs. Leaning in, he whispers, “Not too old, but a bed will be a welcome addition. How are you holding up, sweetheart?”
“Good so far now that they’ve put in the nerve block to numb my arm and administered some pain meds,” I admit. “But before that, it was an exercise in survival because I was hurting so bad I wanted to puke.”
“But you took the time to take a shower?” he asks incredulously.
“Eli, I smelled like sewage,” I chide. “I figured it would be more difficult to get one after all of this is done.”
“I understand, sweetheart,” he says. Keeping his voice low, he asks, “How do the two of them know each other?”
“I don’t know,” I reply. “I’m definitely in the dark right now.”
Thankfully, the doctor keeps working. The funny thing is, the four of us are pretty much silent right now as we all watch what he’s doing, even Eli and his friend, Eddie. I’m sure he’s got a road name, but I don’t know it off the top of my head.
“What happens once you’re done cleaning it?” Eli suddenly asks the doctor.
He glances at me and at my nod, he replies, “We can’t close it because the skin was torn away and the edges are too jagged, so she’ll have a wound vac put on which will help heal the area while keeping it open so it can be checked regularly for infection and healing, plus additional debridement as needed. ”
Eli’s head snaps to me and I see the horrified look on his face. “You’re going to have to have that done again?” he asks, pointing to the doctor.
“Probably won’t have a nerve block each time,” I admit, “but the meds will be good because it’s one of the most painful procedures that can be done since nerves and all that jazz are exposed.
They’ll also likely use topical lidocaine to help numb the area.
It’ll be okay, Eli, I’m made of pretty tough stock, I promise. ”
I see the doctor smirk, even though he’s wearing a mask, his eyes crinkle slightly, so I know he’s listening to Eli. “The first few times, she actually might have a nerve block because of how deep it is,” the doctor finally says. “It’ll depend on who she sees for follow up appointments.”
“I’m here for two more weeks,” I reply. I see Eli is about to protest, so I squeeze his fingers. “Eli, I’ll help triage and won’t be out in the field. I made a commitment and I’ll honor it, okay?”
“I don’t have to like it,” he grumbles, which has me giggling a little bit. I’ll blame it on the morphine because I hate that he’s upset.
“I’m not particularly crazy about it myself,” I tell him. “But I’m glad it wasn’t our patient who had this happen since he’s a senior citizen. I’m young, relatively healthy, and will have Thelma and Ella right there in case anything happens.”
It’s not too much longer before the doctor is finished.
He places a specialty bandage across the whole wound and says, “I’m putting an order in for the wound vac now, then will check the bloodwork to see if we need to change your antibiotics.
A radiologist will be down shortly to put in the PICC line because I definitely want you on a round of IV antibiotics and there’s no reason for you to be admitted to the hospital for those given where you’re currently working.
I also want to say that I appreciate you and your employer coming up here to help those who have been stuck.
The patients we’ve seen that came in that y’all found so far were well taken care of before they arrived. ”
“I’m glad to hear that since we didn’t really have a way to check on them,” I say. “I’ve been a bit worried, to be honest.”
“Tell your boss that we especially like the form y’all filled out for each person. It made it easier to know at a glance what y’all’s observations were while in the field,” he adds.
“I’ll let her know, Doctor. Her goal in developing those was to make sure that further care wouldn’t be delayed for the patient since sometimes, they’re in rough shape,” I reply.
“Alright, young lady, you just sit tight while I put those orders in,” he advises. “You’ve got a few more hours here.”
I flop back, suddenly tired. “Oh, joy, I can hardly wait.”
Ella giggles then tells the doctor, “She’s a crappy patient.”
He doesn’t throw me under the bus, thankfully. Instead, he says, “Most people in healthcare are, from what I’ve seen over the years. Myself included.”