Crime Unsolved

"Hailey, there is a code blue trauma coming in. ETA for the bus is five minutes out. They've managed to intubate the patient, bagging them and continuing CPR. Bay 9 work for you?" I glance up from the computer. It's the first time I have sat down in seven hours. I just need to put in this bed request for the DKA in room five.

"Yeah fine." I wave off the nurse and get back to my bed request. It's been a busy day, and it's not even the busy time of the year. Summers are busy here when the elderly folk who spend their winters elsewhere come home, and then it's like Grand Central Station up in this place. For some reason, it's only March and we are busting at the seams.

"Hailey, Kevin needs you in room four." The unit secretary is relentless. She sits back in her chair, tapping her nails on the countertop. As I'm about to rip into her, the phone rings and she snatches it off the hook. "Emergency Department, Jenna speaking, how can I assist you." I roll my eyes and stand up after hitting submit on my bed request.

Being the charge nurse in a busy emergency department is not glamorous. It's not fun, it's not easy. It is however, one of the most rewarding jobs I've ever had. Why? Because I get to help the nurses and techs around me to save lives, even if it does take every ounce of my energy, on the daily, to not tell people to fuck off. Maybe I'm bitter. Maybe it's time to go work up on the floors again, take a break from the chaos. Maybe I should be an operating room nurse, that sounds downright boring. Who am I kidding? I need the busy of this emergency department in order to stay sane. Literally, the insanity keeps me sane. I chuckle as I walk over to room four.

"Kevin?" I say as I lean against the door frame. "You need help?"

Kevin is a newer nurse, and it appears he is struggling to insert an IV. The patient is an elderly man, probably in his seventies, beads of sweat on his forehead. His eyes are squeezed tightly shut as he winces in pain.

"Can you help me with this Hailey? He keeps moving and I can't thread it through." I look at the man and he hasn't moved anything except his face, the entire time I've been standing there. Shrugging, I walk in and squeeze between Kevin and the gurney. I move the patients arm just a fraction and hold traction on the vein.

"Now try it," I say, while holding the vein taught. Kevin advances the IV catheter, blood flashes into the chamber and then it slides it. With a grin, Kevin lets the tourniquet loose, attaches the tubing and gives the IV a slow flush. Winner, winner. I step back and he dresses the IV. I barely hear his muttered thank you as I walk out into the hallway, just in time to watch our code roll in from the ambulance bay.

I make eye contact with one of the firemen who is helping guide the gurney down the hallway while the others continue to conduct CPR. "Bay 9". I wait for his nod that he heard me and make my way towards bay 9. What a day.

I need to pee, my bladder hurts. I have a headache coming on and my stomach has been growling for the last hour. It's a typical day at work for me, and again it makes me think that maybe it's time to change my specialty. I can't retire, I'm only thirty-four, but I sure feel sixty. I've seen too much, watched to much death in this job, watched to many people fall apart, their lives in shambles. My own life included fell to shambles in this department. Trauma Bay Three. I can barely stand to walk past it, and everyone knows it. When I work, I don't assign patients to Trauma Bay Three, because I can't force myself to walk into that room and watch another person die. It's just that room. The memories of what happened in there haunt me. It's been eight years and still, I see it like it was yesterday. I feel it, like it was yesterday.

I swallow down a lump in my throat, wondering why I've even thought of that event at all. Maybe it's the fact that the crew that brought in this code today, half of them is the crew that brought in that disaster five minutes before my shift ended, eight years ago. A disaster that no one should have to witness, especially when that disaster is your husband.

Seeing Mark, the Fire Captain is what does it to me. I can still see the sympathy and pity in his eyes when they all realized who the man on the gurney was, the moment when they connected the dots and the room went pin drop quiet for three long seconds. Three seconds and then my scream of terror, as I saw the man I loved bleeding out in my emergency room, right in front of me. You can't take that back. It's just not possible.

"What do you got for us?" I ask the paramedic who's jotting down information on his clipboard.

"Hey Hailey, uh it's a fifty-eight-year-old female, apparently riding her bike and then her daughter said she suddenly fell over unconscious. Appears to have been cardiac arrest. We intubated her in the field, gave 2 of morphine, she's had two amps of bicarb and some epinephrine. It's all on my form here. We got her back once and then two minutes later she coded again." I nod at his brief report and walk into the room. The doctor is already there barking orders and there is a rhythm on the screen. She's back.

"And the trauma piece?" I ask.

"She probably had a broken arm and a laceration to her right eyebrow. Maybe needs a CT scan," answers the paramedic.

"Call the cath lab, her EKG looks awful. She's got some infarcts, active MI (Myocardial infarction) occurring. Probably needs stents." Today we are lucky to have on a doctor who is all business and doesn't mess around. Sometimes we have the ones who are kind of lazy and just want to see the easy patients so that they make sure they don't have to stay late. "See if we can get her to CT following the cath," he adds.

"On it," I walk to the desk and call the cath lab, we are told to draw labs and the Cath lab tech and a nurse will be up to help get the patient down to the lab for a possible stent.

I look at the clock, it's five p.m. It's now officially twelve hours since I used the bathroom and eleven since I've had anything to drink. The clock isn't the only thing telling me this, the spots dancing in my eyes tell me that I better go get a little hydration in my system. I tap the counter, "Jenna, I have to use the bathroom. If you need help, ask one of the other nurses." I give the unit secretary a look that says I'm serious and bolt to the employee lounge. I don't know why they call it a lounge, nobodies lounging in there. Ever. It's too busy.