Bayside Café Chap 7

Settling in

St. Vic's Hospital

Intensive Care

"Good morning, I am Ellen Dixon. Mrs. Adams told me to report here. To a Miss Watson."

"That's me. Oh yes, you are the newbie. Welcome, I will orient you. Just have a seat, I will be right with you."

CODE BLUE ICU BED 3 – CODE BLUE ICU BED 3

Ellen jumped up, dashed to the crash cart and wheeled it to the foot of bed 3. She stood with her hands crossed in front of her. Waiting for a doctor to shout out what he needed.

A doctor and respiratory therapist (RT) join her and two other nurses. She can see that the patient is in asystole, and not breathing. She opens a drawer and sees a #11 endotracheal tube – she sets it on top of the cart.
Almost simultaneously she picks up an epi syringe w cardiac needle. She holds it in her hand.

"ET tube," the RT shouts.

"#11 ok, ma'am?"

"Yes!"

Ellen slaps the tube in her hand.

"Cardiac epi!" The doctor shouts.

Ellen places it in his outstretched hand.

"Thank you," w/o looking up.

"You're welcome," Ellen softly replies. She doesn't think he even noticed her. She is wrong.

Ellen picks up a 2nd epi, holding it at the ready.

"Anything else I can get you, sir?"

"Yes, prep-

Before he finishes, she has gel on the defibrillator paddles and has it charging to 200 – the usual starting setting.

"- the defibrillator."

She hands him the paddles. "Charging to 200, sir."

"CLEAR!"

All personnel at the bedside raise their hands as they step back.

"SHOCKIMG NOW!" The doctor discharges the paddles. The patient's body jumps a bit. Ellen can see that the shock was ineffective. In one motion she takes the paddles from the doctor, applies more gel and pushes the button to charged to 250.

"250, sir?"

"Yes."

"Here, sir."

He takes the paddles w/o looking.

"Tell me-

"Charged, sir."

"CLEAR!"

Personnel comply.

"SHOCKING!"

The patient lifts more this time. Ellen can see sinus rhythm, but only for 12 seconds.

"I need a runner to get 2 more cardiac epi syringes. STAT!" Ellen shouts.

The doc smiles a bit.

She has the paddles ready in seconds. "300, sir?"

"Yes . . . ah-

"Ellen, sir. Paddles charged to 300, sir." She hands them back to him.

"CLEAR!"

"SHOCKING!"

This time sinus rhythm appears and holds. The observe the cardiac monitor for 5" before they start to put equipment away.

Jill, the student nurse who ran for the cardiac epi returns. Ellen takes the syringes and places them properly in the cart. "Thank you, Jill."

"You are welcome, ma'am." Jill blushes slightly. Not everyone thanks students.

Unbeknownst to her, doctor Brust (Chief of cardiology) was watching her. She carefully arranged things in the cart; making note on her note pad of what items needed to be restocked.

"Will you restock the ET, ma'am?" She asks the RT.

"Yes, I will."

"Thank you."

"Welcome."*

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As Dr. Brust leaves the unit, he says to the head nurse, "That Ellen. I want her assigned to the crash cart whenever she is working."

"But sir, she's new, and-

"You heard me! Whenever she is on duty."

"Yes, sir."

"And you might consider having her train the students. I've never had anyone handle a code better than she just did. Never."

He walks off.

Leaving a stunned head nurse. Her friend in California hadn't laid the praise on that thick. What's going on?

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BAYSIDE CAFÉ

Michael does a thorough examination and inventory to start his work at Bayside. He finds plenty needing repair, upgrade or replacement. 'Will ownership bite the bullet and do what is needed to make this a truly 1st class operation? Or will they scrimp and just get by? We will find out soon enough.'

He makes a detailed list. His prioritized list of recommendations consumes an entire page. H:e makes a copy to show Ellen at home.

Then he gets to work cleaning.

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Middle Island Elementary school

Michael and Ellen have been called to a parent-teacher conference by Abby's kindergarten teacher. They enter the classroom after all the students are gone. They take a seat as Abby is occupied in the book corner.

"I am Mrs. Reynolds, welcome." Greetings are exchanged setting all at ease.

"It's so nice to meet both of you. I've seen Michael pick Abby up, but we've never had a chance to talk."

it seems that we are always so rushed. I wish we could slow things down." Michael chuckles.

Ellen seems tense, like she is expecting bad news.

"Abby is a joy to teach, but we have a problem."

"Yes,

"I knew it," Ellen moans; dropping her head to her hands.

Michael grasps his wife's hand. "What-

"No, no, it's a good problem. Your daughter tests in the 3rd grade for math. And the 4th grade for reading. Now it's natural to start her in school with kindergarten. But frankly, she will be bored to death."

"Do you have a recommendation? Ma'am?" Michael pursues the issue.

"Well, I have a conference scheduled with the K-4th grade staff. We have several students with asymmetrical abilities and needs. I am hopeful that we can come up with solutions for most, if not all of these students. Let me ask you this – has there been anything in Abby's home environment that would pusher ahead?"

"Yup," Michael points at Ellen.

"Her mother?" The teacher looks surprised.

Ellen stares open-mouthed at her husband.

"Abby's grandparents, yes."

"I don't understand."

"Ok, he is probably correct. In California we lived in the lower level of my parents split level home. They took care of her a lot. I don't remember Abby playing with other kids her age much. Grandma or grandpa were always reading biographies, historical stories and the like to her. And helping her learn to read them herself. I would listen to her read in the evening and be amazed. So, now what?"

"I would suggest we get together in 2 weeks. Then I can tell you what we've come up with."

"I like that," Michael says. Ellen nods in agreement.

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TXT Miss Watson to Ellen: 30" early Monday, my office.

She shows to Michael. "She is to orient me. Then I jumped right into the middle of that CODE BLUE."

"How'd that go?"

"Flawlessly."

"That's good, right?"

"Unless someone thinks you are trying to show them up. Then it's dicey."

"Ah . . . watch your 6, babe."

"Yup."

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MONDAY 06:30, MISS ANNA WATSON'S OFFICE

"Come in, Ellen. Have a seat." After they are settled, Anna hands Ellen a bright pink smock. "After the CODE BLUE the other day, Dr. Brust – the chief of cardiology – asked (Ordered, she won't say that) me to give you one of these. This designates the nurse in charge of the crash cart during a CODE. Needless to say, he was impressed with your work. He asked (Again, ordered) that you be the designated PIC at all CODES while you are on duty.
You should not wear it at all times, but keep it handy. If two pinkies show up, 1st one there does the job."

"Ah . . . how many-

"6 that I'm aware of. Play nice in-

"CODE BLUE 3312, CODE BLUE 3312!"

Ellen looks to Anna, who points to the door. She drops her coat on the chair she was sitting in, pulls the smock over her head, and takes off at a run.

She gets to the 3300's unit, finds the crash cart and speedily pushes it to 3312. She positions the cart at the foot of the bed and locks the brakes. She takes a ready position and waits. No one comes.

She looks carefully at the bed, there is a line of stuffed pillows. No patient. She throws her head back and laughs, "DAMN!"

Then she sees a cameraman – and Dr Brust comes around the corner; talking into a microphone. He pauses, smiles and says "And that, ladies and gentleman is how it is done. Courtesy of Mrs. Ellen Dixon!"

He drops the mic, walks to Ellen and shakes her hand.

"Do I get a copy of the video, Dr Brust?"

"I will be sure you do, my dear." They laugh together.

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TBC

Writing that CODE BLUE was a kick. It felt like I was "BACK N THE SADDLR AGAIN."