Disclaimer: The primary characters in this story belong to Janet Evanovich. I make no money for this work. While I work in healthcare, the names and places detailed in this story are not based on specific persons.
A/N: Thank you all so much for the reviews. I hope you like this update as well. Thanks to FairTaxGirl and Margaret Fowler for reviewing this for me.
Previously:
Ranger walked me down to the garage, giving me a soft, sweet goodbye kiss. I drove off simultaneously filled with happiness with the man in my life and dread at the thought of work.
Control Chapter 14
When I got to work, I noticed that Cheryl had waited for me in the parking lot. I walked over to meet her and we hugged and both sniffled, trying not to start crying again. She looked up and said, "Did you get the message I left you last night?"
"No, I stayed at Ranger's."
Cheryl's eyebrows rose and she said, "Don't think we're not coming back to that. I left you a message saying that the nursing supervisor called me last night and gave me a heads-up that we're all going to be called in at some point today to give a detailed report about Mr. Hamilton's treatment and our last encounter with him. They're going to do a full RCA." ***see end of chapter for note
I nodded. I had expected that. My fear, though, was that it could easily turn in to a witch-hunt. I knew a social worker at another VA that had almost lost his job during an RCA. There was absolutely nothing he could have done about the situation he was in, but the brass believed somebody had to be the "fall guy" and the social worker was it.
We walked up to the unit together, both dreading the day ahead of us. We knew there was nothing to do but wait to be called. Dr. White was waiting for us when we got to the unit. He was as upset as we were. While he had a hard time showing it, he truly did care about our patients and as the treating physician, he felt the sense of failure maybe more acutely than Cheryl and I.
We tried to go on with our normal routines, but we were all dreading being called about Mr. Hamilton. We were all afraid that we would hear that we had done something wrong and caused this terrible incident. It's a hard thing to think that something you did or didn't do caused someone to take his own life and being questioned about it is even worse.
At 10:00, Cheryl was called. At 10:15, Dr. White was called and at 10:45, I got the call to come to the Chief of Social Works office. I had so hoped Derek wouldn't be on this committee, but I guess I've had too many orgasms over the past few days and fate decided I needed some shit to go along with them, just to even out the good and bad in my life.
The chief's office is across campus, so it's about a 15-minute walk from the acute unit. I walked slowly; trying to ready myself for the questions they would ask me. I entered the office and found Derek, the Director of Nursing, Director of Mental Health, Chief of Staff, Patient Advocate and Suicide Prevention Coordinator (SPC) waiting. Derek, apparently trying to behave in a professional manner in the company of others, stood and said, "Stephanie, how nice to see you again."
The SPC, Rita, began the proceedings by explaining the reason for the meeting. "Stephanie, I'm sure you're familiar with Root Cause Analysis (RCA) Investigations?" I nodded and she continued, "The purpose of this investigation is to determine if Trenton VAMC's staff could have done anything differently or if the clinicians did everything possible to help and support Ben Hamilton. We will ask you some questions and please keep in mind that this is not a personal attack against you or the rest of the staff, it is simply an investigation into the clinical methods used in treating this veteran." I nodded again and Rita said, "First, I would like to take your statement about what you recall about Mr. Hamilton, particularly your last contact with him." The stenographer was busily typing in a corner and the noise frayed my nerves even more.
Taking a deep breath, I tried to remember everything I could about Mr. Hamilton and said, ""Mr. Hamilton had been on the acute unit several times over the past year. Typically, he would come in complaining of severe depression, difficulty sleeping and eating, feelings of hopelessness and worthlessness, etc. He did not have a good support system. When I spoke with him on Saturday, and he told me that his wife had left him and he didn't think there was any hope for reconciliation. He was obviously down, but denied any thoughts of harming himself. I asked him to see the POD before he left campus, but he said he didn't want to be admitted and would see his regular doctor on Monday. I told him to call the unit if he needed anything and asked Rita to contact him over the weekend."
Rita cut in and said, "I can confirm that I spoke with Mr. Hamilton on Sunday and he stated he was 'doing okay." He specifically denied any thoughts of suicide and stated he knew to phone the hospital or the National Suicide Prevention number if he needed help."
Derek spoke up at this point and said, "Since Stephanie is in my service line I feel that I should complete the rest of the questioning." He looked at me and said, "Did you feel that this patient would be safe left to his own devices?"
I bristled at his wording. We had NOT left Mr. Hamilton to 'his own devices.' I thought about my own wording and said, "Mr. Hamilton was not left alone. He was offered support and assistance. Rita contacted him over the weekend to check on him and offer additional support if needed. He had a doctor's appointment scheduled for Monday. We were all as available as possible to help him. No, I did not feel good about him declining admission, but it was his decision."
Derek continued, "Why did you not file an Order of Commitment?"
The ridiculous thing was that he should have known the answer to this. I supplied, "First of all, it is a physician that files an Order of Commitment, not a social worker. Second of all, there must be an overt act to serve as proof that a patient is a danger to himself or others. There was no overt act. Mr. Hamilton was depressed, but had never tried to harm himself or anyone else in the past. He denied SI at our last meeting. We can only use words and actions in a commitment, not feelings and supposition."
Derek gave me a tight smile and said, "Would you say you have your overt act now?"
I could feel my face flood with color. I couldn't believe he had said that. While I knew Derek was an asshole, I'd never imagined he could be so unspeakably cruel and callous. We were talking about a man's life and he was acting like it was a personal vendetta to accuse me of wrongdoing. The other people in the room were watching Derek with a mixture of horror and disbelief on their faces. The senior staff member in the room, the chief of staff, finally looked at me and said, "Ms. Plum, you can go for now, but we may need you back for further questioning at a later date." I nodded and left the room as fast as I could.
I stopped in the garden before heading back to the acute unit and walked around for a while. This was one of my favorite places on campus. It was cool and calm here and the sound of the water fountains always made me relax. I felt someone approaching and looked up to see Michael stalking toward me.
I shot up and turned to head towards the doors, but Michael grabbed my arm before I could get two feet away.
Michael snarled at me, "Jesus, Stephanie. I just want to talk to you. Why do you have to act so crazy?"
Trying to pull my arm away, I said, "I don't have anything to say to you. Let me go, now!" I realized in that instant that I didn't have the panic button that Ranger had given me. It was in my purse, in my office. I could only pray that someone passed by and saw what was happening. Just as I had that thought, I heard someone calling my name and turned my head enough to see Isaac wheeling his chair towards us. He looked at my arm and looked at Michael and said calmly, "You need to let Ms. Plum go before you get her hurt."
Michael sneered at him and said, "What the fuck do you think you're going to do about it, roll me out of the way?" He laughed and said, "Get out of here old man, before you're the one that gets hurt."
Isaac looked at me and tried to let me know with his eyes that he would go for help. I prayed that he would be in time. I watched him go, thinking that even if he couldn't help, it would have been nice to have a friendly face here.
I looked back at Michael and he began dragging me into a corner of the garden, secluded between buildings. He pushed me into the concrete wall hard enough that my head slammed against the rock, bouncing me forward. I felt pain explode through my head and thought that Michael was crazier than any of us had given him credit for. I felt nauseous and knew that I had at least a mild concussion. I struggled to stay standing, not wanting to give him an even greater advantage by falling or passing out.
Michael grabbed my head, one hand on either side and put his face inches from mine. "Now, you're going to listen to me. I told you that we weren't done and I meant it. I don't know what you think you're doing running around with that fucking thug, but it stops now. You will withdraw that restraining order and we'll start seeing each other again. If you do that, I can be very nice. I can be the perfect gentleman and the man your family wants to see you with. If you don't do what I say…"
I didn't hear the rest of what Michael was saying because I saw bright colors. Bright colors connected to a very baldhead that was sneaking up behind Michael. Cal. Cal was here. I felt such sweet relief that my eyes welled up with tears. Cal's eyes met mine and in the next instant his arm was wrapped around Michael's neck, dragging him backwards. Michael had released me with the shock of someone grabbing him and I sunk to the ground.
I watched as Cal threw Michael on the ground, put his arms behind his back and cuffed him. He leaned down and said something in his ear that made Michael go completely still. In the next second, I heard Isaac screaming, "She's back here" and the garden was filled with VA police and several other veterans who had apparently come to watch or help. Cal released Michael to the police and turned towards me. He approached me slowly and knelt down beside me. He put a hand on my shoulder and said, "Stephanie, are you okay?"
I looked up at him, nodded and promptly collapsed into him.
When I came to, there was a nurse leaning over me, taking my blood pressure and checking my pulse. Cal was kneeling beside me, looking worried. The nurse said, "Young lady, did you head get hit?" It took me a few moments to think of the answer, I couldn't quite get my brain and my mouth to work together. I nodded and said slowly, "He hit my head against the wall."
The nurse said, "The doctor will need to see you, but I'm sure he'll want to get an x-ray of your head. Do you hurt anywhere else?"
"My arm hurts where he grabbed me, but I don't think it's anything but a bruise."
The nurse nodded and said, "Okay. We need to get you up to radiology to get x-rayed. I'll go get a wheelchair for you." She walked off quickly, promising to be right back.
I looked at Cal and remembered that this man who had rescued me was fighting his own demons. "Cal, are you okay?"
He gave me a tight smile and nodded. "Do you want me to help you sit up?" he asked.
"Please." He eased me up gently and I could feel the nausea return as I struggled to sit up. Cal saw it and eased me back against him, so that I was partially sitting up, but had some support.
At that moment, I looked around and saw the crowd part to let someone through. It was Ranger, running towards me. He stopped dead a foot in front of me and dropped down on his knees. He took my hand and said, "Babe, are you okay?"
Seeing him released the pent up emotions and I began sobbing. He gently eased me off of Cal and picked me up into his arms. He carried me to radiology and waited beside me as they did the x-ray. I did have a minor concussion and the doctor advised that I not be alone for 24 hours and not sleep more than two hours at a time. He offered to admit me to the local hospital for observation, but I declined. Despite the fact that I worked in a hospital, I didn't want to be admitted to one. Ranger told the doctor that he had a medic on staff and I would be staying with him and would be well taken care of.
When we were finished with the doctor, I insisted on walking, so Ranger sent Cal to get his car and bring it to the entrance of the building. Ranger kept his arm around me and eased me into the car when we got there. We drove to his building in silence, my head throbbing. When we got up to his apartment, he eased me into his bed and got me an ice pack for my head.
"Babe, you can rest for awhile, but I'll have to wake you up in two hours." I nodded and was just about to drift off when I felt his hand tenderly brush my hair out of my face and his lips place a gentle kiss on my forehead. I heard him whisper, "I'll make sure he never touches you again," before I drifted into sleep.
A/N: RCA or Root Cause Analysis is used by many corporations and public service agencies to identify problems and the causes of them. The belief is that if the cause of a problem can be identified and addressed, the problem can be prevented from happening again in the future.