ALWAYS A NURSE
Disclaimer: I am a nurse. But I work in Med-Surg, not in the emergency room, so I'm a bit fuzzy on ER details. With that being said some elements of emergency care have been fictionalized to fit the Star Wars universe.
Also a warning: this story contains descriptions, though not necessarily graphic ones, of injuries and medical procedures.
…
Petro was going to die. By accident.
He wasn't surprised by the dying part. Ever since the clones had turned on him and his master death was a constant possibility, but he thought he'd bought himself a few hours. He'd managed to evade clone troopers and the regular police for weeks now. It was only a matter of time before a droid recognized him from his wanted holo and alerted patrols, forcing him to bolt from his bed in the flophouse he'd rented from and make a mad dash to lose them. At this point he was used to running in bare feet with just the clothes on his back, his feet getting cut to pieces and the Padawan brain he hadn't been able to cut smacking against his back, while troopers chased him down alleyways and through fields until he finally lost them for a second.
No, what really surprised him was the by accident.
It had been a horrible idea to run down the freeway. But it was an ungodly hour of the morning with very little traffic, and the open road was the easiest place to use the Force to speed away after losing the troopers. So he did. He ran blindly and faster than he ever had. So fast, in fact, that he didn't notice the oncoming speeder until it was too late.
The last thing he saw was the headlights rocketing toward him, turning his whole world into a single bright light.
I'm going to die. By accident.
...
"Does this look like the break room to you?" Temi joked, pointing at Maddie's cart.
Guilty as charged, nurse Madeline Labiin raised her iced tea without looking up from her charting and said "JCAHO can bite me."
Temi clucked her tongue. "Maddie, Maddie, Maddie."
"Like you don't eat pudding when they have your favorite kind in the fridge." Maddie rolled her eyes. "Don't knock my drinks."
"Eh, that's fair." Temi dragged her cart next to Maddie's and sat down, making sure her lekku didn't get pinched on the back of the chair. They'd been nurse friends for as long as they could remember, having met their first day in nursing school, been inseparable through the entire program, and gotten jobs in the same emergency room after graduation. Every time they came into work and saw each other's name on the board, they smiled and the other nurses shuddered.
"So is this your first of three?" Maddie asked.
"Second," Temi corrected. "You?"
Maddie nodded. "Is it over yet?"
"Not quite," Kaylah the care tech piped up. "But it's not a bad shift. It's been quiet."
Everyone at the nurse's station froze.
"Who said it?" Dr. Kreps demanded from the doc box. "Who said the Q word?"
"The Q word?" Kaylah repeated. It wasn't really her fault; she was fresh out of aide training and hadn't learned the ins and outs of hospital culture yet.
"The word which is spelled Q-U-I-E-T," Temi explained. "Whenever someone says that in a hospital, stuff hits the fan."
"But it's three in the morning and nobody's come in all night."
"You think that matters to the gods of the Q word? Better pee now Kaylah. Actually," Temi got out of her chair. "I'd better pee now."
Maddie was about to grab her snacks and scarf something down before it was too late, when the desk radio squawked to life. "Squad 51 to Bethesda."
She shot Kaylah a look and grabbed the radio: "Go ahead 51."
"Bethesda we have a human male approximately fourteen years of age found unconscious along the side of the road, looks like he's been hit by a speeder. His GCS is 9, BP is 85/60, heart rate 140 in sinus tach, respirations 26, pulse ox 88% on non-rebreather mask. Both pupils reactive, left is dilated. We have an 18-gauge IV in the right AC."
"51 start normal saline wide open," Dr. Kreps ordered. "What's your ETA?"
"Five minutes Bethesda."
"Ten-four 51, we're waiting for you." Maddie shared a nod with Dr. Kreps and switched off the radio. "I'll take this one."
"Kaylah, page Neuro," Dr. Kreps chugged the last of his caf.
Kaylah did. "What was a fourteen-year-old doing out at three in the morning?"
"This is what happens when you say the Q word."
…
Maddie took the patient knowing full well he was going to be a trainwreck. He was in a coma, his vital signs were unstable, and there were a whole slew of neuro issues going on plus force knew what else after being hit by a speeder. On top of that he was a kid, which made everything worse.
She didn't know how much of a trainwreck he was going to be until he hit the door and the trauma team helped the paramedics transfer him to the bed.
"We don't know how long he's been out," the lead paramedic said. "A passing driver found him lying in the ditch and called for help. No name, no ID, no nothing."
Temi spoke up: "Blood pressure 83/61, heart rate 138, respers 24, pulse ox is still 88."
"I've got bilateral breath sounds," Maddie said. "Abdomen's rigid."
"Let's get a STAT CT abdomen and pelvis. Open up the saline." Dr. Kreps opened one of the boy's eyes and checked his pupils. "The left is blown. It looks like intracranial hemorrhage."
"The neurosurgeon's on his way." Temi put in the order for the CT. "Want a CT of the head too?"
"STAT please. Also draw a CBC, BMP, tox screen, ABG, and type and cross, and page the general surgeon."
"This kid's got abrasions everywhere," Maddie muttered, her bandage scissors cutting off the patient's clothes. "Not all of these are consistent with getting hit by a speeder."
"Like he's been beaten?"
"No, they're scrapes and minor cuts, mostly on the lower extremities and the feet. It's like he was running."
"Maddie." Kaylah froze at the head of the bed.
Dr. Kreps didn't hear her. "It would make sense if he ran out in front of the speeder."
"But these look like he was running for a while. I've got grass stains and gravel on his feet as well as the wounds - if I didn't know better I'd say he was running for his life."
"Maddie," Kaylah repeated. "He was."
All eyes went to Kaylah, standing by the patient's side and holding a long, thin object between her thumb and index finger. It looked at first glance like a black cord, like part of their medical equipment. Only - Maddie looked closer - it was made of hair.
Her stomach plummeted.
It was a braid. A Padawan's braid.
Her fourteen-year-old trainwreck patient bleeding into his brain and his abdomen after he lay alongside a road for gods knew how many hours, was a fugitive.
She and Dr. Kreps stared in shock until Temi finally said what they all were thinking.
"Kriffing Q word."
…
Time stops in trauma rooms. Medical workers will walk out of them and stare at the chrono, shocked they were in there for three hours working on their patient. The two minutes between pulse checks during cardiac arrests feel like seconds or years. But never in Maddie's career had time stopped because she had absolutely no idea what to do.
"Do you think the paramedics saw it?" Temi whispered.
Kaylah shook her head. "It was stuck in the C collar."
"If he's a Jedi then they're going to be looking for him."
"If we call the cops they won't let us take him to surgery," Maddie protested. "They'll kill him!"
"They'll kill all of us if we don't." Dr. Kreps closed his eyes.
"We're not killing a patient! He's just a kid."
"I'm not suggesting that. I'm making sure everyone knows the consequences if we do this."
He didn't have to say what this was, and Maddie didn't even know if it was possible. In this day and age, with HoloNet medical records and the Empire everywhere?
"We're either all in, or we're all out." Dr. Kreps looked around the room. "What's it going to be?"
Temi's answer was immediate, though her face had turned a paler shade of the normal blue: "I'm in."
Kaylah looked nervously at all of them, then at the patient before she said in a shaky voice. "Me too."
Dr. Kreps nodded to both of them. "Maddie?"
It was crazy. How could they hide a patient, especially one who was this sick, from the Empire? Surely there was no way. Surely they'd get caught before the kid even emerged from the operating room and then it was the business end of a blaster if they were lucky.
Maddie cursed her career choice. Why hadn't she become something safer, like a bounty hunter?
"I'm in."
"Then I am too." Dr. Kreps looked back up at the vitals readout. "We're going to have to intubate. Temi, scope."
"While they're doing that get the clippers off the EKG machine," Maddie ordered Kaylah. "Shave that thing off and throw it in the biohazard bin."
Kaylah took off like a shot.
No sooner had Dr. Kreps gotten the tube in and stepped aside for Kaylah to shave off the braid than radiology transport arrived and whisked the boy away, leaving Maddie to field the million comms that inevitably came with a trauma case.
…
"He has a brain bleed, a ruptured spleen, and he needed four units of plasma. There's no way he's going to the floor after surgery."
Dr. Kreps nodded in agreement. "So the ICU. That complicates things. I could make up a reason for a transfer."
"If we put him on the whirlybird then we'll raise questions. No one has reason to suspect anything unless he talks," Maddie continued. "As long as he's intubated there's no problem but once we take the tube out, we don't know how much judgement he has after his bleed."
"Nothing we can't fix with a ride in the 'van,'" Temi said. When Kaylah stared at her blankly she elaborated. "The Ativan."
"Except we won't be the ones taking care of him up there. Even if you or I floated to the unit for a day, we wouldn't be able to cover his entire admission. And then there's the surgeons to think about."
"I told them he was a John Doe," Dr. Kreps said. "They aren't asking questions. I think they get the sense they don't want to know."
"Can we convince them to order him a truckload of sedatives?"
"I'll just order them myself and hope no one questions or discontinues it."
"If I can manage to give report to the accepting nurse I'll tell her not to." Which led to the question of the day. "Now we have to figure out who to give him to in the ICU."
Several nurses she discounted immediately. They either didn't have the skills to care for someone as sick as this kid or would rat him out. In fact Maddie quickly saw the entire ICU roster disappear before her eyes, with very few exceptions.
"Alora," Temi said. "Remember her from school?"
Maddie did. "She's good and she'll keep her mouth shut."
"Okay, let's do it." Dr. Kreps nods. "I'll talk to the intensivist and the nursing supervisor. With a little luck I can get her on the case."
"Don't worry about the super. Vicki's on tonight; she'll go with it."
Sure enough Vicki was easy to convince. All Maddie had to do was mention that she thought Alora would be a good fit for this patient if staffing permitted and Vicki went with it. If this was a normal case that would be the end of it, but tonight was nothing but a normal night. So it was at the end of her shift that Maddie sat down and called the ICU.
"ICU, Alora speaking."
"Hey Alora, it's Maddie. I'm calling up report for that pediatric John Doe patient you're getting."
Alora sounded rather confused. "He's a post-op. Why isn't surgery calling?"
"They'll call. I just wanted to give you a heads up on the meds Dr. Kreps ordered for the kid."
"You mean the very generous orders for IV sedatives? I was meaning to ask about those. Is he fighting the vent?"
"He's been comatose since he got here so I'm not sure if he will, but those sedatives are more for after we extubate."
"...You don't think he's going to be violent, do you? He's been in a coma."
"If the kid starts talking out of his head, sedate him. Do not pass go, do not collect 200 credits. Just give the Ativan."
"Maddie, what's going on?"
Time for the moment of truth: "There are some things the kid can't say for his own safety."
Alora was silent for a long time and Maddie crossed her fingers.
"Ativan it is then," Alora swore under her breath. "I can't kriffing believe I'm doing this."
Maddie could. "If things get messy I'll take the heat."
"You're never giving me a bad admit again, Labiin."
Maddie knew she wasn't going to be able to hold up that bargain, and so did Alora. "Thanks for taking him."
"Don't thank me yet. PACU's calling. Here goes nothing."
…
Alora checked her patient's ventilator settings for the fiftieth time and wondered, also for the fiftieth time, what she'd gotten herself into. Or more accurately what Maddie and Temi (because if Maddie was involved, you could bet your Crocs Temi was too) had gotten her into.
A close look at the patient provided an answer. There were the scrapes Maddie had mentioned, injuries that suggested running for his life, calluses on his hands that weren't like a worker's but more like a gymnast's, and he had an odd shaven patch behind his right ear.
Like a Jedi.
Gods help Maddie Labiin the next time she showed her face in the ICU.
With no other outlet for her anger Alora grabbed her computer cart and started to rage-document.
The ICU was high-stakes, high-acuity, but it was orderly. There was a place for everything, and everything in its place. Alora thrived on it. She lived for the protocols, the titration, the lifesaving procedures done like a well-rehearsed ballet. And then the ER had to throw a kriffing Jedi into the mix and wreck her mojo. As if her patient acuity ratio wasn't high enough.
Who was in on this? Maddie for sure, Temi most likely, definitely Dr. Kreps with his mack-daddy sedative orders. The surgery nurse hadn't given any inclination she was, nor had the surgeons ordered anything weird, so they probably had no idea. Looked like Alora was part of an exclusive club. The - Alora bit the inside of her cheek to keep from screaming when she saw the chart - "not documenting suspicious stuff" club.
She grabbed the sides of her cart so tightly, she was surprised the handles didn't break.
She was going to go crazy by the time this kid got discharged. And if she had anything to say about it, then it wasn't going to be a celestial discharge. She'd put in too much effort for that.
"Alright buddy. Let's give you a better haircut."
…
Petro was … alive?
He didn't believe it at first. He was so sure he was going to die he thought he'd joined the Force.
"Kid?" A woman's voice asked. "You waking up?"
Was that his master? Her voice sounded different. And his master was dead, and wouldn't put a tube in his mouth.
"There's a tube in your throat to help you breathe. Don't try to talk or cough; let it breathe for you."
Petro forced his eyes open and looked around. He was...in the medcenter?! Kriff he couldn't be in the medcenter!
"Don't fight the ventilator!" the woman ordered. Petro hadn't realized he was. "Relax. Relax and let the machines work."
He did, not willingly. It was weird having a machine breathe for him.
"My name is Alora," the woman said. "I'm your nurse. You were taken to the medcenter after being hit by a speeder. Do you remember?"
She produced a board with the alphabet and a series of common phrases. "Point to the answer."
Petro pointed to yes.
"Great," Alora smiled. "So you're going to be hanging out with me for a bit while you recover from your injuries." She lowered her voice. "The good news is that me and your nurses from the ER have a plan to keep you safe. Namely, we gave you a haircut -."
His braid. Petro tried to look but he couldn't see his padawan braid. Had...had the nurse cut it off?
"And we've arranged for you to go to a rehab facility on Alderaan, courtesy of Senator Organa himself. He tells me he's really looking forward to having you as a guest." She held out the board. "All I need is your name for the admission paperwork. And kid?"
She bent to whisper in his ear: "You only get one chance."
For a moment Petro thought it could be a trap. But all he sensed from the nurse was care and compassion. She might have been a little scared, but she'd come to terms with it and she was going to do her best to keep him in one piece.
You only get one chance. Maybe Alora was his.
He thought a minute, then pointed to four letters.
"'Aarlo?'" she asked. "You want to go with Aarlo?"
Yes
Petro had never seen a being smile brighter than Alora did when she touched her name badge. And despite the ventilator, he tried to smile too.
"I'll fill out the papers then Aarlo." She winked. "Let's see if we can get that tube out of your throat."
Glossary of nursing terms:
Cart: A computer on wheels
Celestial Discharge: Death of a patient in the hospital. Also known as "discharge to Jesus."
Code Blue: Cardiac or respiratory arrest. Commonly called a "Code."
The Joint Commission (JCAHO): The accrediting body for hospitals in the US, which makes all the safety rules and seems to be on a crusade against nurses having drinks at the nurses' station. It and its equivalents in other countries cause enough stress for nurses that the Star Wars universe just had to have JCAHO.
Ride in the 'van: To give a patient Ativan (a sedative), usually because they're having an anxiety attack or have become violent.
STAT: Immediately, as soon as possible.
Whirlybird: Helicopter