4. Marcus
4
MARCUS
T he charge nurse—I glanced at her ID quickly, Hernandez —hovered as I flipped through the chart in my hand.
“I told you, we follow standard documentation protocols,” she said.
“If there’s one thing I’ve learned in my years of working in different hospitals, it’s that there is no such thing as a standardized protocol. Hell, even field hospitals under different commands have variations in procedures.”
“We’ve got incoming!” one of the nurses at the station said as she hung up the phone.
I handed the chart back to Nurse Hernandez. “What have we got?” I asked.
“Triage will be updated when the EMTs arrive.”
“What, exactly, do you mean?”
“Triage will debrief us, usually on an incoming case,” Hernandez started to explain, not the nurse who had cut me off. “If we’ve got incoming, the emergency crews give us as much information as they’re going to bother to give us. And the intake nurse waits until the entire team is gathered so she only has to explain things once.”
“Oh.” I shrugged. That made perfect sense. Otherwise, she was constantly having to repeat herself, not something that was useful in an emergency situation.
“You make it sound like we don’t necessarily know what’s coming,” I said.
Nurse Hernandez shrugged. “Sometimes, we don’t. Sometimes, they just let us know who’s coming in and what shape they’re in. Sometimes, they’re able to give us all kinds of details. A lot depends on the condition of the patient and the crew on the ambulance. Let’s be honest, if they’re busy working on that patient, they don’t have time to tell us much more than approximate age, if they even know that, and what kind of trauma we’re expecting to come in. If it’s an easy case, we’ll get the full rundown.”
I nodded. It was not unlike working in a field hospital where communications tended to be minimal, and the emergency medical team was often too busy securing the patient for transport.
I tagged along behind her like some puppy expecting a reward in the form of a treat or a pat on the head, like the new kid on the block, as if I had never had a job before. But I guess that was pretty much the case, seeing how this was technically my third day at this location. Instead of learning policies and procedures and the administration’s expectations of me on the first day, I had been thrust right into the deep end of the trauma pool—something I was slightly more familiar with.
Every organization wanted their staff to make reports, fill out forms, and document everything. Nobody wanted their documents completed the same way, which was what Nurse Hernandez was so condescendingly going over with me when the call came in.
“Okay, I’m here. What’s up?” Dr. Emma Chen jogged in and came to a halt.
The station nurse who had taken the call looked around. I guess she was taking a headcount, making sure everyone she expected was present.
“We got a call on a couple of kids who either jumped or fell from their apartment patio. Both male. Child one is stable. Child two is not stable. Reported as unstable en route—multiple abrasions and fractures, possible head trauma.” She finished her assessment with a curt nod.
“Okay. Trauma bays are prepped and ready. We have no ER overspill, so we should be good to go.” Dr. Chen stepped in and took charge, designating who went where.
“I’ve got experience with spinal and head trauma. Do you want to give me that one?” I asked.
Her dark eyes flashed at me as if I had dared to speak to her.
“Fine,” she snapped. She pointed to the second trauma bay. “You’re there. Get yourself ready.”
I nodded and stepped away to prepare. Once these kids came in, I wasn’t going to have time to make sure I had everything I needed. I didn’t need to be told twice. Still, I couldn’t shake the sense of being dismissed—all along the line, from the intake nurse through Dr. Chen. This was not a situation where my ego needed to get in the way. However, better communication was definitely needed.
The first ambulance arrived, and the trauma team jumped into action. They were a well-oiled machine, smoothly transitioning the patient from the ambulance crew to the hospital staff. Everyone spoke in quick, clipped words. There was no yelling, no flailing about.
The second ambulance pulled up, and the EMT practically launched out of the back with the bright yellow gurney. In a few steps, I was by the EMT’s side, getting all the detailed information they had for me. I quickly realized that the spinal and head trauma patient was on the first ambulance and therefore was now Emma Chen’s patient. That was the kind of information I felt could have been better communicated earlier.
Instead of preparing for neurology, I was faced with multiple and compound fractures. The trauma nurses at Manhattan Memorial were exceptional, and we fell into a smooth pace, even though our work was rife with tension. My patient was stable upon arrival, and we were able to maintain that stability throughout treatment. I released the child into the general care of the hospital.
I peeled off my gloves and stepped out of the trauma bay to find Nurse Hernandez. I wanted to speak with the child’s adult guardian but didn’t want to just randomly approach one of the stressed out couples in the waiting room. She directed me to a small Hispanic woman curled up and quietly crying to herself in the corner.
“This is the children’s aunt,” she told me.
“Where’s the mother?” I asked.
She shook her head. “I don’t have that information. I just know she’s the adult here with them.”
The woman lifted large, dark eyes, bright with tears, up to my face. Her lower lip quivered.
“I’m Dr. Walker. I treated one of your nephews.”
Her head dipped in a barely perceptible nod.
“He was treated for multiple contusions. We set the broken limbs. He’s in for a long recovery. He’ll be in some pain, but as far as I could tell, he didn’t sustain any internal injuries.”
“And the other one?” she asked.
“He is still being treated by another team. I did want to let you know you’ll be able to go in and see your other nephew in a few minutes. I believe they want to get him settled into a room. He’ll be scared.”
“I want him to know I’m here,” she said.
“He’s currently under sedation and asleep. When he wakes up, a nurse will make sure you’re there.”
“And you’ll let me know about the other one?” she asked.
“I will, or the doctor treating him will come and update you,” I assured her.
She looked less panicked as I left. I returned to the first trauma bay to observe Dr. Chen and her team. The trauma bay had a mobile X-ray machine. I loved those devices since I didn’t have to wait to send a critical patient across the hospital to another department. Dr. Chen, however, grumbled about it.
“I just can’t get a clear enough picture. I hate this thing,” she said as the tech switched plates. “It’ll be a few minutes for processing.”
“I admit, they’re not the best for the torso, but they’re great for ankles and wrists,” one of the nurses said.
Emma gave a curt nod. “It definitely shows us a good, clear break. I want a full scan on this kid. Neurology is going to want it anyway. Let’s stabilize the ankle and leg. The swelling will have to come down before we can consider surgery.”
The team worked efficiently to stabilize the patient before transferring him to another department for further imaging. I observed as Dr. Chen updated the aunt. She was cool and detached, even when the woman collapsed in tears.
While I wanted to continue observing Dr. Chen’s methods, I had other patients to attend to. Before long, my shift ended, and it was time to go home. It felt like the day had passed quickly, but when I stepped inside the brownstone that was now home, I realized how long and exhausting it had been.
I found Jason in the living room, playing the video game his sister had been adamant about limiting his time on. Only this time, she wasn’t harassing him, and instead of blasting the volume, he wore a set of sound-dampening headphones. I left him to his game and headed to the kitchen.
Grabbing a beer out of the fridge, I peered through the lid of the crockpot to see what Lily had been making for dinner before heading upstairs to check in with her. Since moving to the city, she had taken on a lot of responsibility, and I knew it hadn’t been easy.
When I tapped on her bedroom door and didn’t get an answer, I gently pushed it open. Lily sat at her desk, wearing a pair of those same sound-dampening headphones. Instead of playing a game, she was lip-syncing to her music, her head bobbing in time, while she appeared to be doing homework. Smiling to myself, I quietly closed the door so as not to disturb her.
The next morning at the hospital, I searched for Dr. Chen. When I finally found her, she glanced up at me, raising an eyebrow.
“What do you mean, you’ve been looking for me?” she asked.