(NOTE: I think this story may be writing itself, but I do nothing to stop it...so, here's more)
Wilson and Dr. Mathis were quickly paged into the room.
House was on the floor. He had apparently rolled off the right side of the bed and had landed sort of to the right and sort of face down. When House shifted himself after the nurses had left, his leg went over the edge of his bed. The brace was fairly heavy, so it was only natural for it to drop first and House to roll after. Due to his position and flailing, his foot had been the first part to go over the edge of the bed.
The nurses didn't want to move him until they had further instruction from Mathis. His leg was still spread off to the side and his rear was up in the air because he couldn't even end up flat on his stomach because of the incline his leg was braced at. The hard brace was making his body poke up in the air at a weird angle.
He was still flailing his arms and left lower leg. His screams were starting to turn into sobs. The nurses held him as still as they could.
Mathis charged in and immediately took charge.
"Sedate him! STAT." Mathis didn't think twice. "Get him on oxygen!" Mathis had already started to assess him.
He had been injected and was stilling as Wilson came running in.
Mathis was now running her hands over the brace to check if it had held.
"Dr. Wilson, check his arms. Make sure he didn't try to break his fall."
Mathis and Wilson were both concentrating on their respective tasks as the nurse held the oxygen mask over his face.
"His arms and shoulders are fine." Wilson thought this was a blessing.
"The brace is intact, so his bones should be okay. Still, I need a portable X-Ray in here. He had to have been jarred pretty good and he's going to have substantial bruising. He'll probably be very sore."
When she got to his foot she paused, "He's got at least two broken toes - when he landed, there was nothing to protect them."
After the X-ray was through it was determined that there was no additional damage to his femur or hip.
The brace had apparently protected him.
A large portion of his right foot had been left out of the brace for comfort and it appeared his foot had taken the brunt of the fall because of the elevated position his leg was braced in and the direction he went over the edge of the bed.
Mathis figured they better check his foot out since he obviously had a couple of broken toes.
Wilson and Mathis stood in front of the light board looking at the x-rays of House's foot.
"House is going to be livid!" Wilson was already livid.
"At least it won't require surgery." Mathis was trying to reassure Wilson.
"He has 3 broken toes, a broken metatarsal, and another break further up his foot close to the ankle - right there. You're better at reading these than me - I'm an oncologist!" Wilson was so furious he could barely think straight and was viciously pointing at the x-ray.
"It's only a hairline fracture of the metatarsal, but there is another fracture up here almost at the ankle right inside where his brace ends."
"He has 6 new fractures!"
"Yes." Mathis was her calm matter-of-fact self on the outside, but she was inwardly fuming.
Wilson was outwardly fuming.
"Why would it have broken severely like this?"
"There definitely isn't a tumor here. He fell out of bed leg first and all his weight went slamming down right there on his foot. The rest of his leg was braced into a still position, so his foot took some torque as he apparently rolled from his right side to his abdomen.
"How do they let an immobilized patient go tumbling out of bed?"
"It was an accident. These things just happen. House panicked."
"What? You make it sound like it was his fault!" Wilson was outraged.
"That is not what I meant."
"Why weren't they holding him?"
"They didn't turn him, so three nurses left. Of the remaining two, one was holding him while the other got pillows. When he got agitated he started flailing and knocked her over with his leg. The other nurse couldn't get back fast enough to catch him."
Wilson was pacing and stewing. House should have been safe in the hospital!
Rationally, he knew these freak accidents happened, but this was House.
The truth was that Mathis was quite upset herself, but it did no good to show it.
His bedrail should not have been down. She had never had an incident like this involving one of her orthopedic patients.
She found out that a nurse had been gone and the nurse holding his leg had worked a double shift to cover for a friend.
She had been working almost 16 hours straight. Legally and by hospital regulations, no medical personnel should be working that long straight. Was she distracted or too tired to hold him? Did she get caught off guard? She had also never worked with House before. She wasn't hurt and thankfully House was okay other than his foot and the pain the fall would cause in the rest of his body, but this was catastrophic in Mathis's eyes.
"Dr. Wilson, I think that we should move him to the orthopedic ward instead of the oncology ward."
"He should be starting cancer treatments soon!"
"All of the nurses there are used to handling patients in various states of immobilization and patients that are skeletally fragile. Nurses in oncology deal with people who have cancer in their bones, but they rarely deal with patients who have this level of rigid immobilization. They don't work with patients that require so much specialized moving and lifting very often. I think it would be safer for him. I could have my top people right there all the time. I realize your oncology nurses have this training as well, but the experience of working with orthopedic patients every day does help. A couple of orthopedic nurses have been leaving the ward to lead the oncology nurses through moving him, but all of the nurses working with him need this level of experience. It is not possible to have that quantity of nurses leave the orthopedic ward at one time to turn him, but if he was in the orthopedic ward…"
"Okay." If it would be safer, Wilson was willing to move House.
"I want to get him casted so that we can get him moved and set up while he's still out of it." Mathis started out of the room.
"You're going to cast him? What about the brace already on him?"
"It wouldn't be adequate because it stops mid-foot. We'll cut it away from his lower leg at mid-calf and then cast him from there down. We could bandage him, but with the insert I use this would provide greater accuracy in lining up his bones."
"I don't know how he's going to react to this."
If he reacted half as bad as Wilson, it would be horrible.
"Dr. Wilson, please calm down. Why don't you take a breather and my staff and I will get him set up. You need to get it together so that you can sit with him and be there when he wakes up. He's not going to be happy about this, but if you're an angry wreck, you won't do much good as emotional support for him. He needs you right now."
With that, Mathis left Wilson in the room.
Foreman had been standing in the back of the room. He needed information as House's proxy, but didn't want to get into the heated emotions. He quietly followed Mathis out.
(NOTE: This is not an attempt to make nurses look bad. People in many workplaces try to cover for friends, work longer than they should, etc. Reviews are appreciated just like chocolate)