Page 37 of Fighting For You

When one of your patients crashes, your other beds don't empty out. The nurses around you absorb them until you're free. It happens fast, nobody thinks twice about it, and by the time the crisis is over, half the floor has touched charts that weren't theirs an hour ago.

Jen's patient in bay fifteen crashed around ten thirty on a Tuesday morning.

The rapid chime of the monitor alarm carried across the floor, then Jen's voice calling for help. Josie was moving before the alarm finished its second cycle.

"Jen, talk to me."

"She was stable twenty minutes ago. BP is dropping, she's altered, I can't get a response."

Sullivan was already at the bedside. "Bolus her. Push another set of labs and call the blood bank. Page ICU and tell them we need a bed."

Josie turned to the floor. "Nora, pick up Jen's fourteen. Low-acuity, abdominal pain, CT pending. Liz, cover sixteen."

"Got it."

The chart on the workstation told me what I needed. Forty-two-year-old woman, right lower quadrant pain, vitals stable, CT ordered but not yet done. Labs drawn on arrival, results pending. An anti-nausea medication had been administered for the patient's discomfort.

Bay fourteen's patient was awake and irritated. "When am I getting the scan?"

"Let me check on that for you."

Radiology was backed up. I called down and moved her up in the queue, then came back, updated the chart, and continued my rounds.

An hour later, Sullivan stopped at the nurses' station where I was charting.

"Bay fourteen." He didn't sit down. "Did you administer the Zofran?"

"No. The patient was already medicated when I picked her up."

"The chart shows eight milligrams IV. I ordered four."

I pulled up the medication administration record. He was right. Zofran, 8mg, IV push. Time-stamped before Josie reassigned the patient to me, during the window when bay fourteen was still Jen's.

"So we don't know what she actually received?" He looked at the screen, then at me. "Monitor her. Vitals every thirty minutes until we're confident there's no adverse reaction. And find out who entered it."

He walked away.

I went through the chart line by line. The original order was clear. Zofran 4mg IV push. The administration record showed 8mg. Jen's credentials were on the entry. It was her patient, her login, her timestamp.

But I was the nurse on this patient now. I'd picked up bay fourteen, read through the chart, and hadn't caught the discrepancy before Sullivan did. That was on me.

Jen was still working the crash in bay fifteen. When she finally came out, she was wrung out, running on adrenaline and muscle memory. I asked her about the Zofran entry.

"I might have," she said. "Honestly, Nora, I can't tell you. It was right before she crashed. I was in and out of three bays."

She didn't remember entering it. The credentials said she did, but she couldn't confirm whether the patient actually received four or eight. Neither could I. I corrected the entry, added a note, and flagged it for Josie. She looked at it, looked at me, and said she'd document it.

I found Gracelyn in the break room during her fifteen. She was eating a granola bar and scrolling her phone. I sat down across from her and told her what happened.

She set her phone down. "This has been happening with Liz and Jen."

"What do you mean?"

"Charting errors. Documentation that doesn't match orders." She lowered her voice. "Remember Josie's announcement about administration cracking down on error tracking? That's because of Liz and Jen. Their charts are the ones flagging. Josie told me, but don't say anything. She wasn't supposed to tell me either."

"How many times?"

"Enough that administration noticed. That's all I know."