I could see her relax slightly as she slung her stethoscope around her neck. “We need labs–”
“I’m already here,” Natasha said as she stepped toward the bed.
Haley nodded, then looked at Marie, rambling off instructions for a portable chest X-ray, oxygen, EKG, blood gas, and fluids.
She looked at the monitor once more before turning back to me, a question in her eyes. “You did good,” I said.
We walked back to the physician’s charting area, and Haley got right to work, documenting and entering the official orders. While waiting for the labs and X-ray results on that patient, we saw a couple in between—an abdominal pain, and another that came in with chest congestion.
Back in the charting area, she’d just put in an order for a CT for the abdominal pain patient when the collapsed runner’s lab results came in. She scanned over them, her brow furrowing. “His potassium is seven, magnesium is three, and creatinine is four…”
I looked at her. “And what does that tell you?”
“Severe kidney dysfunction.”
I gave a nod. “And what else?”
“With his lytes that high, it’s going to affect his heart function. That’s why he coded.”
“Good,” I said. “So, what are your next steps from here?”
Her lips parted to respond, but she didn’t get a chance beforethe monitor at the nurses’ station alarmed. “Guys, he’s in VT again!” Marie called out as she flew up from her chair.
We were both up, hurrying toward the patient’s room. Sarah was already starting compressions as we walked in, and both our eyes snapped to the monitor—his vitals were tanking.
I stayed back as Haley moved, amping up the defibrillator to two hundred. “Clear!” Everyone stepped back before she gave the shock, watching the monitor. “Push one of epi, continue compressions.”
Marie grabbed the epinephrine from the code cart while Sarah continued compressions. After a few minutes, Haley called for a pause in compressions to check the patient’s rhythm.
“He’s still in VT. Clear!” They stepped back as she gave another shock and called for another push of epinephrine.
Sarah continued CPR after that, and my eyes flickered from the patient to the monitor and then to Haley. “You can do another epi, or what else is there that you can try?” I asked, trying to keep her engaged in the teaching moment because I could see the panic starting to fill her eyes.
Haley repeated her same steps as before a few more times—check for rhythm, shock, epi, continue CPR. And despite trying to keep herself level-headed, I could see the frustration and worry mounting when the patient wasn’t coming out of it.
It’d been roughly thirty minutes now…and I knew we had already lost him.
“Stop compressions,” Haley breathed, looking at the monitor. He was still in VT. “Marie, grab the amio.”
Marie looked at her. She knew we lost him, too. “Hales…”
“Three hundred of amio, Marie!”
Marie slid her gaze to mine, and I took a step forward. “It’sbeen thirty minutes, Haley.” I wasn’t trying to undermine her, just hinting at how long it’d been in case she hadn’t realized.
Haley stepped forward and grabbed the amiodarone, pushing it herself. “He’sthirty years old! We can’t just give up on him!Move!” She pushed Sarah out of the way, stepped onto the step stool, and began performing compressions herself.
Marie and Sarah both looked at me again, understanding shining in their eyes. No matter what role you played, loss was never easy, especially with a patient so young.
“Haley,” I said gently as she continued compressions. I watched her head whip toward the monitor, and I saw the defeat start to creep into her expression at the lack of change, but she persisted with compressions anyway. I took another step forward. “Haley.” She looked at me, and I could see the glisten in her eyes. It fuckingguttedme. “You need to call it…” She started to shake her head, but I cut her off with a nod. “He’s gone,” I whispered.
She let out a ragged breath as she looked back at the patient…then slowly, she stopped compressions. She stood there frozen, but no one moved, giving her a moment. “Time of–” Her voice cracked as she pulled off her gloves and threw them in the trash. “Time of death…seventeen twenty-three.” She stepped off the stool and walked out of the room.
I helped Marie with a few things, then I left the room on a mission to find Haley.
After five minutes of searching, I found her outside in the small alleyway between the ER and one of the clinical office buildings. She was sitting with her knees to her chest, leaning against the brick with her face buried in her hands as she cried.
I approached her slowly, then crouched down in front of her. “Hey…” I heard her breath hitch through a quiet sob, and I reached up, gently peeling her hands from her face. “Look at me.”
