“Saw we had a full house at shift change,” I say, logging intothe workstation and pulling up the patient assignment board. “Figured you could use the hands before the evening rush.”
Nate watches me start redistributing the assignment spread before he’s even begun the handoff.
“Told the nursing director last week you might be ready for charge,” he says, matter-of-fact, already pulling up the first chart. “She agreed. We’re working out the timeline. I’m thinking about retiring next spring and sleeping in for once in twenty-five years. My wife would appreciate it.”
I actually stop what I’m doing and look at him. “You can’t retire. That’s not allowed.”
Nate was on my interview panel six years ago. He’s the reason I know how to run a trauma bay without losing my head, or tell a family their person isn’t coming home without losing myself in the process.
He snorts and gives me the look he gives residents who ask obvious questions. “You’ll figure it out.” He pulls up the next chart. “You know this floor better than half the people who’ve been here twice as long.”
He says it blunt and offhand, like he always does. “We’ll see how the process goes. There’ll be other applicants, but you’re the top pick. You’ve put in the years and the work. It shows.”
He leaves it at that, but I’m not sure what to say. I just nod and turn back to the board.
“Anyway, we’ve got a mixed bag today. Bay 4 is chest pain, probably indigestion or reflux, but we’re running the full cardiac workup because he’s got risk factors. Bay 7 is a nine-year-old with a fever. Mom’s worried it’s meningitis, but hopefully it’s just another common virus. Bay 9’s a hand laceration from a beer bottle incident.”
“A beer bottle incident…I’d tell you it happened with me in college, but it could’ve been last week too.”
“Knowing you, probably closer to last week.” Nate hands me a stack of charts. “You’re taking Bays 2, 5, and 8 to start. Josh is floating as tech, so grab him if you need an extra set of hands.”
“Josh, Mr. Always-On-It? I can’t wait to work with that enthusiasm in action.”
“That’s the one. Consider it character building.”
I take the charts and head toward Bay 2, where an elderly woman is waiting for lab results on what’s probably a urinary tract infection. The curtain is pulled back just enough to see her sitting on the gurney, hands folded in her lap with the patience of someone who must have been through this before.
“Mrs. Hiddleston?” I knock on the frame even though the curtain is already open, because barging into someone’s space without warning is a great way to get punched by a confused patient. “I’m Lance, and I’ll be your nurse for the afternoon. How are you feeling?”
“Same as I told the last nurse,” she says, but she’s smiling when she says it. “It’s burning when I pee and I feel tired all the time. My daughter insisted I come in.”
“Smart daughter.” I wash my hands at the sink mounted on the wall, the hot water and industrial soap turning my skin pink. “Let me check your vitals and see if those lab results are back yet.”
The next hour moves fast. Meds, IV lines, anxious families who need to hear that their person is being seen even when science is working on its own schedule. Patience isn’t a common trait when someone you love is sick. I make sure everyone knows we’re on theirs.
At 4:15, Dr. Aubrey Fernandez emerges from Trauma 1 looking like she’s just gone three rounds with a particularly difficult diagnosis and won. Sharp eyes behind wire-rimmed glasses, a no-nonsense demeanor that came from being one of the few women to fight her way up through emergency medicine in the nineties.
“Bradford.” She stops at the nurses’ station. “Please tell me you’ve got magic hands today because Bay 4’s cardiac workup is clean and he’s still convinced he’s dying.”
“That sounds like sure heartburn with a side of anxiety,” I say, pulling up his chart. “But I’ll work my charm.”
“Your charm.” She raises an eyebrow. “Is that what we’re calling your ability to talk patients down from the ledge?”
“I prefer to think of it as therapeutic honesty delivered with excellent bedside manner.”
Nate snorts without looking up from his computer. “Yesterday he told a guy quite bluntly that his ‘heart attack’ was actually because he ate an entire pizza in one sitting and then decided yard work was a good idea.”
“He was seventy-two and it’s August,” I point out. “I know people can be a bit stubborn, but someone had to explain from a place of concern that pepperoni and heat exhaustion don’t mix well. He thanked me for it.”
“That’s after he stopped being mad at you,” Nate adds. “Then he’s been asking for you ever since.”
“Details.” I wave my hand dismissively.
“Somehow these patients love you anyway.” Dr. Fernandez shakes her head, but she’s almost smiling. “Bay 4. Go work your therapeutic honesty on him before he demands to see a cardiologist.”
“You got it, boss.” I pick up the chart and stand.
The ED has filled up by the time I’m charting the meds I’ve given. Tall brunette Charlie appears, materializing at my side as nurses do when they’re ready to unload whatever personal or professional drama they’ve been holding on to. She’s competent, quick, and has a habit of circling back to the same conversation whenever things slow down.
