“He scared the bejesus out of me, and I threw up my hands in defense. The next thing I knew, he was grabbing at my arm and bit me.” She stopped talking and closed her eyes, looking frail. Sucking in a ragged breath, she continued. “I panicked and just started hitting him over the head with my wallet until he let go. He was crazy. I screamed for help and begged him to stop. He didn’t even react. Then I sped off and came straight here.” I looked over to the bedside table and saw her wallet. This thing looked more like a brick then any wallet I had ever seen. Mary caught me eying her weapon of destruction. “I have a lot of coupons, so I need a big wallet.”
I covered Mary’s arm with some saline drenched four by fours and began charting.
My nursing instructor came into the room and snatched the chart out of my hands. “Tell me about your patient,” she snapped at me. What was it about those old-school nurses? Did something strip away their humanity over the years? She always gave off this air of annoyance, like we were putting her out by forcing her to do her job.
“Mary Jennings, sixty-seven-year-old female presenting with a malodorous circular laceration to her left forearm, approximately six centimeters in diameter and one centimeter deep. The wound is not actively bleeding but is oozing purulent discharge. Patient is alert and oriented to person, place, and time. Complains of ten out of ten throbbing pain in her arm and a severe headache.” I relayed the clinical information as I’d been instructed. It always felt cold and somewhat condescending to talk about a patient like that in front of them.
My instructor stood at the foot of the bed going over the chart, nodding while she listened. “What assumptions can you make from your initial assessment?”
“Patient has been bitten,” I said at first, not believing that someone could do such a thing, but then I caught up with my instructor’s meaning. “Patient is ambulatory but complaining of dizziness and fatigue. Skin color is pale, heart rate elevated, respirations are increased, and she is hypotensive. I suspect she may be in hypovolemic shock and will require electrolyte replacement. There is a potential for transfusion, depending on her hemoglobin levels once labs are returned.” I looked at my instructor for feedback and was rewarded with a curt nod as she put down the chart and promptly left the room.
“The physician will be in to see you shortly, Mary. I’ll go check to see if your labs are back. Lay back and try to relax.” I assisted Mary to lay back, covered her with a blanket, and left the room to check on her labs. On the way to call the lab, my assigned nurse caught up with me and informed me she had already called them. Results wouldn’t be back for about thirty minutes so she suggested it was a good time for me to take a dinner break. I promptly texted Kat to meet me in the cafeteria.
“I so hate you right now,” she said while we waited in line to pay for our food. “I wish I was in the ER. I hate Ortho. It’s total poop patrol!”
After paying, we walked our trays to a table in the corner and I chuckled, glad someone else felt my misery from the night before.
“I’m loving life right now,” I gloated. “I have a wicked cool wound that I get to dress when I get back, and I may get to hang blood if her hemoglobin and hematocrit levels are low enough.” We both sat down with an audible sigh, grateful to be off our feet for the first time all night, and ate dinner while chatting about all the new and exciting things we were learning.
After half an hour of gabbing, we headed back to our respective units to finish out the last part of the night. Halfway back I heard, “Code Blue, Emergency Room,” come through the loudspeaker and hastily made my way back.
The ER was in chaos. As I got closer, I realized it was coming from my patient’s room and started running. Ollie came out of a nearby room, jogging by my side as we burst into Mary’s room to find it packed with people and Mary lying flat on the bed with a nurse already performing chest compressions. The physician pointed at Ollie, “You! Do you know how to find a femoral pulse?”
Ollie nodded her head in affirmation and was instructed to switch places with another nurse and keep checking. Every thirty compressions, the nurse stopped and the physician asked Ollie if she felt anything. She gave a negative response each time.
He turned to me and barked, “You’re on compressions, switch out.”
My nervous system’s flight or fight response kicked in, increasing my heart rate and flooding me with adrenaline. My stomach turned to ice when I noticed everyone’s gaze focused on me, and I began compressions. The first thing I felt was squish. I remember reading that it was common to break ribs while performing CPR, but I had never imagined the mushy feeling I experienced.
I was singing the Bee Gee’s song “Stayin’ Alive” in my head to keep the right pace, or so I thought. I looked up for a millisecond and caught the look on Ollie’s face. Oh. My. God. I was singing out loud.
After five minutes, the physician called it, “Time of Death, twenty-three, forty-seven.” The statement was so powerful; one could almost hear the capitalization of his words.
He came over as the nurses and aides cleaned up the patient and surroundings. I jumped when he spoke to me, too caught up in what was going on around me to notice he had even moved. “That was your first time, wasn’t it?”
“Yes.” I looked at Mary. Her skin was grey, lips blue, and eyes vacantly open, staring at nothing.
“You did fine. I had you jump in because I knew it was over. We had been at it for fifteen minutes, but I wanted you to gain some experience.”
I looked down at my hands, mind racing. A woman’s life just ended right beneath my hands. I killed someone tonight. Someone that I had been having a normal conversation with a half hour ago was now dead. That’s the experience he wanted me to have? I mumbled something akin to thank you and left the room.
Our instructor sent us home for the night. We only had ten minutes left, so no big deal if we skipped out a bit early. I felt like I was in a fog. I couldn’t put words to what I felt in those moments following Mary’s death. Walking out, I vaguely remembered saying goodnight to Ollie and got into my car drenched from the rain. I didn’t see Kat, but I assumed she was still upstairs on the Ortho floor.
There was a weight to me when I slumped into the seat. My brain felt numb. I didn’t cry, but I mourned for Mary Jennings as I sat in the parking lot for what seemed an eternity. What happened? This woman with a wound on her arm was now dead. Even though I knew it wasn’t my fault, I felt like I let her down, like I had been the one who failed to save her.
Chapter 04
Snow Day
I drove home in silence and ruminated over the events of the night. The rain came down so heavy I could barely see out of the windshield. Tropical Storm Ike made its way up the Florida coastline and closer to my little town. Looking at myself in the rearview mirror at the last stoplight before home, I realized this was a gut-check moment and pulled myself out of the stupor. “Nut up, bitch. Grow a set and stop acting like a pussy,” I said out loud.
Jake was watching the same Vince Vaughn movie when I got home. I repeated my strip down from the night before and decompressed with a long, hot shower. When I got out, my phone beeped with a new text message. It was my mother-in-law asking where I was. I messaged her back, let her know I was home, and asked why she was texting me at one o’clock in the morning. Every time she sent a late night text, another one of Jake’s grandparents’ had passed away. I braced myself for bad news and was surprised when her text instructed me to turn on Channel 4 right away.