Page 14 of No Greater Love
"Stop right there." I cut him off, unable to hide my incredulity. "You took the nursing home's word for it?Without checkingyourself?"
He shifted uncomfortably. "They're—I mean?—"
"Let me explain something that will serve you well if you ever make it to med school," I said, leaning in slightly and putting an edge of drill instructor sharpness into my tone. "Rule number one in emergency medicine: Never,evertrust what a nursing home tells you about a patient's condition. Not because they're bad people, but because they're understaffed, undertrained, and overwhelmed. Half the time, the person who called you hasn't even seen the patient themselves."
His face fell as I continued, "That 'feeling a little weak today' could mean anything from fatigue to full septic shock. That 'hasn't eaten much' could mean they haven't taken food or fluids in three days. And 'seemed fine this morning' often translates to 'nobody's checked on them since yesterday afternoon.'"
I gestured toward the trauma bay where the patient was now surrounded by staff working frantically. "That woman has probably been deteriorating for days. Her core temperature is 89.9. That doesn't happen in an hour. She's been bleeding internally long enough to drop her pressure to critical levels. And now instead of coming in as the critical patient she is with resources ready, she rolled in as a 'weak elderly woman' and we're playing catch-up."
The young man swallowed hard. "I didn't realize?—"
"This is what separates the people who should be in medicine from those who shouldn't," I said, my voice quieter but no less intense. "It's not about the fancy degrees or memorizing the Krebs cycle. It's about developing the healthy skepticism and critical thinking that keeps patients alive.Always. Check. Vitals. Yourself. Always question what you're told. Assume the worst until proven otherwise."
I took a deep breath. "Look, I'm not trying to crush your spirit. But that woman deserved better, and so will every patient you encounter. This job isn't a line on your med school application. It's people's lives."
The terrified young man—who I'd probably be calling "doctor" in less than a decade,sigh—nodded frantically before scurrying off. I closed my eyes, took a deep breath, and exhaled slowly.
"Looks pretty rough," Maria remarked as I walked back to the charge desk.
"Yeah," I admitted, shaking my head. "She doesn't look good. Good chance she gets admitted to the 7th floor."
Maria winced and nodded. There was no 7th floor; our hospital stopped at six. The 7th floor wasabovethe hospital.
Well. I thought it was a better euphemism than "the basement room” or “being discharged to JC.”
"What techs do we have free right now?" I asked aloud, mostly to myself. "Maria, would you ask Arushi and Kevin to help Deonna get that patient stabilized?" That would leave my triage nurse without assistance, but I didn't see much other choice.
"You got it," Maria confirmed.
Acting as charge nurse during Sophia's absence was like juggling chainsaws while reciting the periodic table. This is why I preferred triage and loathed being in charge. Triage was mechanical: assess, decide, move. This was like conducting an orchestra playing in a burning semi traveling 75mph down the road.
Sophia was infinitely better at this than I was. But she was off gallivanting around New Zealand with that Kiwi paramedic boyfriend of hers, and I'd agreed to pick up a couple of her shifts. Sigh. To be fair, I did owe her—not just for helping out with Paige, but for so many things I'd lost count of over the past few years.
My phone vibrated in my pocket. Normally, I'd ignore it until a break, but the school's number flashed on the screen. My heartbeat accelerated immediately.
"This is Nate Crawford."
"Mr. Crawford, this is Ms. Wilson from Riverdale Elementary." The assistant principal's voice held that careful neutrality school administrators perfect, the one that says 'don't panic yet, but something's wrong.'
"Is Paige hurt!?" I asked, a pang of adrenaline shooting through my heart.
"Not hurt, no. But there's a... situation. Paige has locked herself in the bathroom and refuses to come out. She's been in there for almost forty minutes. We've tried talking to her, but she just says she wants to go home."
A dozen scenarios flashed through my mind, none good. Bullying. Illness she was hiding. Anxiety attack.
"Has something happened? Was there an incident with another student?"
"Not that we're aware of. She seemed fine during morning classes. Her teacher said she asked to use the restroom during math, and that's when this started. We wouldn't normally call for a bathroom issue, but she sounds quite upset, and she specifically asked for you."
I glanced around the ER, dubiously, trying to do mental arithmetic that kept coming back with an impossible answer.
"Mr. Crawford? Are you able to come to the school?"
The hard reality settled over me. I couldn't leave. There wasn’t a single other “charge trained” nurse on the schedule, and we were barely holding things together as it was.
"I'm in the middle of an emergency situation at the hospital." The words felt like ash in my mouth. "I can't leave right now."
Ms. Wilson's sigh carried through the phone. "I understand, but Paige is quite distressed. Our school nurse would normally handle this, but she's only here Mondays and Wednesdays due to budget cuts."
