Chapter 1: Cigarette
She was so tired of this resident. He would not stop commenting on her ass in these scrubs, and she has about had it. She understands there's a semblance of a power struggle here, since he is a physician and she is a nurse, but she is a professional and she had damn well better be treated like a professional.
"Dr. Murphy," she begins, looking at him square in the face. She doesn't have time for this. She has fifteen meds due and an ET tube to suction on his patient. "I hate to think I would have to remind you about our facility's sexual harassment policy. It would be a shame since you just went through your orientation last week."
The young resident suddenly looks like a puppy whose been caught getting into the trash. Embarrassment - and maybe the slightest twinge of guilt crosses his face. But then his face is trying to be cute so she doesn't want to kick him - not working on her.
"I'm sorry nurse, uh..." he stammers out.
"Griffin. Clarke Griffin. And if you'll excuse me, I am going to go into this room to take care of your patient. I'm sure you have other patients to see, Doctor. Do you have any further orders on Mrs. Jenkins?"
He looks down at his clipboard, embarrassed, "Um, I do want to do a weaning assessment on her this morning," he mumbles, scribbling something down on a paper. When he hands it to her, Clarke is pleased to see it truly is just ventilator settings and not his number. He'd tried that on Harper (a married woman) yesterday. It seems she has gotten through to him this time.
"Thank you, Dr. Murphy. And I assume you will be entering these orders into the system, correct?"
"Yes." He states, not even meeting her eyes. "I'll be on my way now." He swivels himself around and heads down the hallway toward yet another awkward exchange at Harper's patients' rooms. Clarke half smiles, throws on some gloves, and heads into Mrs. Jenkins' room. Just another day in the life of an ICU nurse.
She's been at Pramheda Memorial for two years now, since she was a brand new baby nurse entering the hospital scene. She was bright-eyed, bushy-tailed, and very nervous. She took to the hospital scene quickly, though, learning as she went, and asking entirely too many questions - according to her preceptor.
However, even with the nerves and the flood of new information, she did feel at home among the beeps and the ventilators and the alarms. At this point, she was still fairly new, but could hold her own. And she could definitely stand up to a new resident who was still swinging his dick around.
7pm rolled around, and Clarke sat at her workstation impatiently awaiting the arrival of her relief. He's lucky he's a good nurse, because he is late every single time... She keeps her peripheral vision on her patient's monitor, praying that the blood pressure didn't drop any lower. She had dealt with that enough today. She and that poor woman both need a break.
Lincoln all but stumbles onto the unit, toting two large backpacks and a large gas station soda. His jacket is hanging halfway off of him, and his stethoscope swings around his neck, nearly falling off.
"I am so sorry, Clarke." He starts jogging past her to throw his stuff into the locker room. "There was-"
"Horrible traffic on I-70. I know, Lincoln, I've heard it all before." Clarke chuckles a bit under her breath and organizes her papers. She is so ready to go home, but she will stay until she knows her patients are all taken care of.
A moment later, Lincoln emerges from the locker room, clipboard and pen in hand. He flops down into the seat next to Clarke,stating, "Alright, friend. Who do we have tonight?"
Clarke begins her report on Mrs. Jenkins, an elderly woman with a history of three heart attacks and horrible COPD. She's been fighting a low blood pressure all day, was on medications to keep her blood pressure up already, and 70% Oxygen- quite a bit. She was not doing very well.
As Clarke is engrossed in her report, aggressive beeping starts sounding behind her. Lincoln shoots out of his seat and nearly shouts, "Clarke, she's in V-Tach!"
Clarke spins herself around to see that the woman whom she's been caring for all day is coding. She runs to the bedside to check for a pulse, but finds none. She hits the code blue button on the wall, and Lincoln calls out for a crash cart as she begins chest compressions. I hate this part, Clarke thinks as she pushes deeply into the woman's chest. Soon, she'll feel the frail woman's ribs crack beneath her hands.
More people rush into the room. The respiratory therapist runs in to ventilate the patient, and Lincoln switches with her to resume chest compressions as the charge nurse puts the monitor and defibrillator pads on the patient. In all the commotion, the physician enters the room.
It's him. Dr. Finn Collins. Shit, She thinks to herself.
"Hello everyone, I'm Dr. Collins. I'm on call tonight. Who can tell me about this patient?"
As Lincoln is currently doing CPR, this falls to Clarke. She sighs, grabs her notes, and looks at her ex-fiance to brief him about the patient who is currently knocking on death's door.
Clarke was about a month into her orientation period when she met Finn. She was attempting to place another IV on a patient (emphasis on attempt), when he walked into the room. He fumbled with his notes on his clipboard to try to locate this patient somewhere in the mess of papers. He had a handsome face, and his brown hair flopped without any rhyme or reason. He was brand new as well. A first-year resident.
"Hello, I'm Dr. Collins, " he reached out his hand to shake hers, but remembered that she was currently occupied. "I'm here to check on this patient."
Clarke was still very nervous around the physicians at this point, and her preceptor was on her break, so this was all on her. "Sure," she said, as the vein blew yet again. She sighed. This patient was not going to get an IV. She needed a central line.
"We are unable to get any more access on this patient. She only has one IV and has four IV medications due. I think she needs a central line," she told the new doctor, who nodded his head in agreement.
"Yes, it seems so," he stated. "Um.. well I got checked off at the insertions last week. I can put one in now."
"Okay," Clarke replied. "I'll grab the supplies."
Let it be known that Clarke had only assisted on one of these procedures before, and that Finn had only preformed one on his own at this point, so what should have been a twenty minute procedure turned into an hour and a half.
She had noticed he was flustered while trying to advance the catheter, and that as they had opened the third central line kit, there was a sheen of sweat on his brow. She took a chance and said, "Dr. Collins, everyone has to start somewhere. You will get this. And the patient was very dehydrated when she came in tonight anyway, so this could've happened to anyone."
He looked up at her, and she swore she could see his cheek turn up in a slight smile under his mask. "Thank you," he stated simply.
"Any time," she smiled back, hoping that he could see it in her eyes since her face was covered as well.
Clarke gives report to Finn Collins without meeting his eyes. She can see his chin nodding in her periphery as she gives the patient's history. She does not want to meet his eyes. She is still angry with him, even after an entire year.
As she finishes her brief report, she dares to lift her gaze. His eyes are already looking at her, and he looks sad. He then looks away and to the charge nurse, whom he asks, "How many shocks have we given?"
"Two, doctor," She says back.
"Let's push one of epi," he states. Whatever sadness that was there, plastered on the man's face is gone now, replaced by a look of stern determination. Clarke walks to the other side of the patient's bed to relieve her friend of compressions. Even Lincoln looks worn out from this one.
Ten minutes later, after innumerable rounds of CPR and many doses of epinephrine, Dr. Collins calls it. "Time of death, 19:41."
A somber calm falls on the room, and those who need to be somewhere else disperse. The respiratory therapist begins breaking down the ventilator, and Lincoln covers the old woman's body with a sheet. It is quiet. There was no family present for this patient's death.
As Clarke exits the room, she feels a hand on her shoulder. She turns her head to see that it's Finn. She inhales and exhales deeply as he asks, "Can you please find the patient's husband's number for me? I need to call him."
Clarke nods and walks to the patient's chart to find the contact information. He follows her, several feet behind her as she walks. He is trying to keep his distance too.
She hands him the slip of paper, and meets his gaze again. "Thank you, Clarke. I know you must be exhausted. You've been here all day haven't you?" He asks her.
She nods. "Yeah. it's been a long one." This attempt at light conversation is honestly clawing at her heart. She can feel it breaking again, even through all of the pent up anger. She sees the light glisten off of the golden wedding band on his left hand. She concocts an excuse, "I'd better be going. I'm supposed to meet my mother later."
He nods. He seems to understand the awkwardness surrounding their situation as well. "Okay. I'll see you around, Clarke."
Before she darts into the locker room door behind her, she gives a nod, "See you around, Finn."
Clarke really doesn't smoke often. At least that's what she tells herself. But the other nurses say smoking keeps them sane after years on the job, and, right now, she just needs a cigarette. On the way to her car, after a particularly grueling shift, she will usually stop at a bench near the ambulance bay to the ER. It's a popular smoking spot, but, at this time of night, it's usually not occupied. Tonight, this is where she finds herself.
She sets her bag on the ground next to her as she sits down and breathes in the cool night air. She reaches into her jacket pocket and pulls out a pack of cigarettes and her lighter. She knows it's unhealthy, but she also understands that everyone has their vices, and this is hers.
She lights the cigarette and stares out at the city. St. Louis is dangerous and loud and bustling, but it is beautiful at night. She can see the Arch off in the distance, and she can hear the traffic heading home from the baseball game. She is at home here, oddly. Among the lights and noise and, frankly, the smells. She chuckles under her breath at the thought.
Off to her right, there is an ambulance team loading up the rig again before heading out. This particular rig has two EMTs and a paramedic. She can tell from the emblems on their shirtbacks. The two EMTs look to be around her age, 24, and the Paramedic seems to be a bit older.
She is glad she can think about something other than the shift she just left or the man who had uprooted her life in so many ways. She notices that the two EMTs seem to be shoving each other around, laughing.
"Guys, why don't you take the Rig back to the garage, and I'll see you both on Sunday. Here you go, Monty, " the paramedic tosses one of the men the keys to the ambulance. Clarke makes the connection that this is her friend Harper's Monty, who works as an EMT for the EMS service adjacent to the hospital.
"See you then, Bellamy," Monty replies to the paramedic. "Make sure to get out and have some fun this weekend, will ya? You've... had a rough day to say the least."
"I'll try, Monty," the paramedic offers up a smile and waves them off. "Now get the rig back for the next team."
"Will do," the other EMT says, and, with that, they're off.
The paramedic, Bellamy stands there for a minute by the ER bay doors. Clarke notices him sigh, take in a deep breath of the night air, and reach into his jacket for a pack of cigarettes. As he's about to light one up, he looks over to his left and sees her there sitting on the bench.
His mouth turns up in a crooked grin as he sees her looking at him. He holds up his cigarette almost as a toast toward her, "Popular night for these bad boys, huh?" he asks her. His black hair is slightly unkempt and he has a beard it looks like he's trying to grow out.
She points her cigarette back at him, "I guess you could say that." She lets out a half-hearted laugh. He lights his cigarette.
"Mind if I sit?" He asks her, gesturing to the unoccupied half of the bench.
"Be my guest."