Critical Care Read Online Free PDF Page A

slowly according to
protocol. She'd start with the current situation and feel her way
toward the critical incident with the day care children.

    Sarah sighed. "She's on a ventilator, but the heart rhythm finally
looks decent. It kept going back into pulseless V-tach, so we gave a
bunch of meds: epi, amiodarone, magnesium ... bicarb. Shocked
her a lot. She went to CCU on an amiodarone drip." She glanced
down at her slim fingers and shrugged. "Out of our hands now."
    Claire turned toward the code room, eerily empty now that
the resuscitation team had moved the patient to the CCU. An
elderly housekeeper wearing a knee brace over purple denim scrubs
pushed a broom to clear the residue of lifesaving procedures: discarded tourniquets, syringe caps, iodine swabs, gelled defibrillator
pads, and monitoring electrodes. The patient's clothing, snipped
from her body by the paramedics, lay in a heap in the corner of the
room. It looked like a soft pink tweed pantsuit, carefully chosen for
a day ending in a way this teacher would never have dreamed.
    Claire looked away, fighting the image of Kevin's uniform suspenders and his pewter cross on its knotted leather cord lying on
a sooty pile in that Sacramento trauma room.
    "I know you want to help us," Sarah said. Her voice was husky,
soft. "But I don't have time for-"
    The PA crackled overhead and Sarah jumped, startling as if
stung and sloshing her Coke onto her scrub dress. The system
droned a simple page, and her shoulders relaxed. "Sorry," she murmured, her face coloring as she turned back to Claire.
    Sarah set the can down and reached for the paper towel holder
on the wall, snatching a handful and mopping at the front of her
scrub dress. "Really. I'm already late for my overtime shift upstairs.
Besides, I'm fine. Did someone say I wasn't or something? Not Dr.
Caldwell?"
    "No," Claire said quickly, reminding herself that peer counseling was free of fact-finding or implied blame. Not that there had been anything amiss. It was simply a release valve for staff, a
pulse check for the caregivers. Acknowledge, validate, reassure. "I'm
just here to see if there's anything I can do to help any of you."
She paused and smiled gently. "The explosion at the day care, the
injured children, and the one who died. . . " She watched Sarah's
eyes for a reaction. "It's normal to feel strong emotions related to
that, even days afterward, so I'd like to offer-"

    "I'm fine," Sarah interrupted, reaching for her drink. "I've been
in the ER for a couple of years now. Nothing gets to me much
anymore." She took another halfhearted swipe at a soggy angel
before folding the towel and pressing it to her forehead. "Can I
just go now?"
    Claire touched her notes, making certain she'd covered all the
bases. "Would you mind telling me what your part was in the day
care incident today?" she asked, knowing that having a person
retell the event allowed the related emotions to surface in the process. Exactly why she never talked about Kevin-to anyone. "Were
you assigned to the child who died?"
    "Yes," Sarah said, her eyes meeting Claire's directly for the first
time. "But I was also part of saving the kids who lived. That's what
I'm remembering. Only that. Look, I'm a nurse." She shrugged and
tossed her empty can in the wastebasket. "I do what needs to be
done. Then I come back the next day and I do it all again. Except
for those lucky days when I get to do it for two shifts in a row. And
that's today. Honestly, I'm fine and I've got to go." She smiled ruefully. "Literally. I'm heading to the bathroom next door."
    Claire smiled back, despite a sinking feeling that she'd done
nothing to help this woman. Offered her exactly ... zip. But Sarah
seemed to be made of stronger stuff than most. Some people were.
What was it that Logan Caldwell said earlier? "Tough comes with the territory"? Yes, and maybe Sarah was simply asking the same
thing he had: "Do you see me crumbling here?" It was