The Nurses: A Year of Secrets, Drama, and Miracles with the Heroes of the Hospital by Alexandra Robbins Read Free Book Online Page A

Charlene told her, “We have another LOC [loss of consciousness]. Room 18. Brain injury.”
    Hurrying down the hall, Juliette saw that Room 8, which was directly in front of the nurses station, was empty. Andrea, the nurse assigned to that zone, was idly surfing the Web.
Why is Charlene giving me so many critical patients when Andrea has none?
she thought. Suddenly, the monitors started beeping from Room 18. The new patient was crashing, unable to maintain his vitals.
    When Juliette entered the room, she saw a neurological physician’s assistant frantically attempting to insert an IV into the brain injury patient. “I can’t get IV access,” the PA said. She had to prepare the patient for a central line, an IV line going into the major vein near the groin. Sometimes central lines could be difficult to place.
    Charlene had overloaded Juliette with critically ill patients as if the preceptee were an assistant, rather than extra work for Juliette. Trainees were supposed to be learning directly from a preceptor, not thrown into the deep end as full-fledged nurses. Quickly but gently, Juliette instructed Noelle how to help. “Go check on the patient with the cardiac drip. Ask him if he’s having any further chest pains, and then check to see if the cardiac drip needs to be titrated based on his chest pain. Check on Room 16’s level of abdominal pain. Then come back here to see what else we can do for this brain injury patient before we assess him again.”
    The PA tried again to insert the IV, but couldn’t. The pressure was getting to her. “Get me an ICU nurse! We need more people in here,” she hollered.
    Juliette rushed to the hall to ask Charlene to check on Noelle and Juliette’s other critical patients. Charlene was nowhere to be found.
    Scatterbrained and prone to favoritism, Charlene spent much of her day gossiping in her office, rather than making sure that patients received proper attention. She was hard on Juliette for coming into work five or ten minutes late when traffic was particularly bad, but said nothing to clique nurses who arrived half an hour late without explanation. She was overly focused on getting patients out the door as quickly as possible, so she could bring in more patients and increase hospital profits. And she certainly didn’t prioritize the overall safety of the ER. Recently, when a loud bang sounding like a gunshot occurred near the nurses station, Charlene shoved another nurse out of the way and bolted out the front door. For weeks, the nurses made fun of her for abandoning staff and patients to save herself, especially because the noise turned out to be a harmless equipment malfunction.
    Charlene thought she was part of the clique. The nine nurses kissed up to her so that she would give them the plum assignments, and the ploy worked: Charlene blatantly favored Andrea and the other dominant clique members when it came to scheduling. But Juliette had heard them laugh about Charlene behind her back. The childishness of this behavior exhausted Juliette, who did not want juvenile social maneuverings taking up brain space that she hoped to devote to patient care.
    Juliette’s patient was now completely unresponsive. His Glasgow Coma Scale, a range from 3 to 15 used to measure consciousness, was a 3: He was not opening his eyes to painful stimuli, talking, or moving any extremities. Without the central line dispensing medication, he couldn’t be intubated.
    Finally, the tech got the line in. Juliette immediately started the medications to prepare the patient for intubation.
    When the respiratory tech arrived to take over, Juliette and Noelle made sure their other patients were stabilized. Then Juliette stripped off her gloves, sanitized her hands, and found Charlene at the nurses station, where Andrea was still shopping online. “I’m done. I’m going to minor care for the rest of the day,” Juliette said. “I’ll meet you there,” she told Noelle.
    “Okay,” Charlene said.