The man in bed three smells terrible. A potent mixture of alcohol, urine, and feces. Heather wishes she could roll his entire hospital bed into a shower. She did not have such a sensitive nose until nursing school, but these days she uses her nose almost as much as her stethoscope and blood pressure cuff.
"Good morning, sweetheart. How was your date?"
"Good morning, Dr. Melzner, how is your wife?" Heather whips right back. Most of the doctors are nice enough on this ward, but Heather can't get used to being called 'sweetheart'. Still, she immediately regrets bringing up his wife. As she prepares a dose of lorazepam for the quivering woman in bed nine, she tries to think of a way to apologize.
"Ouch. Wrong side of the bed again? Either that or he stood you up. You know, everyone says nurses are supposed to be caring." Dr. Melzner pours himself a cup of coffee and begins to flip through charts.
"My date was perfectly fine. He arrived on time and brought flowers and everything." Heather flips her blonde ponytail defiantly.
Dr. Melzner's booming laugh fills the unit; he signs some orders and flips the chart closed. "Flowers, eh? People still do that? How old is this guy?" He ironically strokes his trim but entirely grey beard. "I hope you're not going on a second date with this guy."
Heather looks around for bed four's chart, wondering who could have taken it. "I just might. Why do you care?"
Dr. Melzner, for a moment, stops what he's doing and makes eye contact. "Because you deserve better than 'perfectly fine', and don't let anyone tell you different." And with that he hooks his stethoscope around his neck and ducks behind the curtain in bed six. Heather can hear him greeting the patient: "Mrs. Villaneuve, what brings you here today? Can you tell me where the pain is?"
"So how was your date last night?"
Heather turns around to see Sam, her fellow nurse and best friend, washing her hands in the sink. Her dark brown ponytail matches her large brown eyes, accented by her olive green printed scrubs which fit her slim figure as well as scrubs possibly can.
"Tell me everything, spare no details. Was he tall? Dark? Handsome? Good kisser? Good in bed?"
"Ambulance ETA 5 minutes. Sam, this one's for you," Lucy calls from the desk.
"Saved by the bell," Sam winks. "This isn't over. Every detail." She goes to the desk to get report on her patient.
Heather breathes a sigh of relief and goes to assess her lady in bed nine. She draws the curtain behind her. "Hello, Mrs. McKay, how is your pain doing?"
According to her chart, Elanor McKay is seventy-nine. Her hair is nearly white, blending into the pillow beneath it. Her skin is thin and wrinkled, but tan, and she appears wiry but strong. An intravenous line sprouts from her left arm, a bag of normal saline slowly dripping into her veins. Heather takes a quick listen to her chest, stomach, and back. Her breathing is clear and regular, good air entry, her bowel sounds are active. Her feet are warm, which means circulation is good. Her pupils are equal and react to light. Her pulse and blood pressure are elevated, and respiratory rate is a little high. So is her temperature.
"It's okay" Mrs. McKay answers, in response to the pain question. But when Heather touches the left side of her abdomen, she jerks and moans.
"Can you give me a number out of ten? 10 being excruciating, zero meaning no pain."
The patient considers a moment, fingering the hem of her blue hospital gown. "Maybe an eight."
"Have you had this pain before? Does it come and go or is it constant? Is there anything that makes it better or worse? Is it just in your stomach or does it radiate somewhere?"
Mrs. McKay answers the questions to the best of her ability. Heather runs diagnoses through her head. Appendicitis: unlikely, as the appendix is on the right side. Bowel obstruction: bowel sounds were normal, but it is possible. Renal colic: would explain the pain radiating to her back. Gynecological cause: her chart said she's had a hysterectomy - unlikely.
"Okay, Mrs. McKay, I am going to give you this lorazepam, which will help make you feel more calm, and then I will bring you some more morphine for the pain. Is there anything else I can do for you?"
She opens her mouth to respond, but is interrupted by a shout on the other side of the unit, echoed by a voice over the PA.
"Code Blue trauma bay, Emergency. Code Blue, trauma bay, Emergency."