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Jun 23, 2021 7:58 PM
there's a Sith loose in the hospital
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Well, at least her patient is stable. She's stuck alone in a pod watching three other patients and trying to do an admission with ZERO help, but it could still be worse. 

(Marian immediately crosses her fingers and tries to unthink that thought, because the universe might hear her.) 

Okay. What next. It would be really nice to have, say, the admitting doctor telling her what to do, but unfortunately the admitting doctor is busy - it's Dr Millinger, apparently, she can hear his raised voice snapping at someone down the hall, he must be stressed. 

Eventually she gets together the courage to put in some 'verbal orders' under his name, for the standard ICU admission bloodwork plus all the drug test panels she can find in the comptuer. Also a catheter, a nasogastric tube, blah blah blah. He'll probably forgive her. 

She gets the lab tubes and prints barcode stickers for them off the barcode printer and gathers her supplies, then starts hunting for veins. 

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It's not hard to find a good one, fit as she is.

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Poke, tubes of blood, off to the lab. Easy peasy. She might as well get a couple of less sketchy-paramedic-style IVs while she's at it. And then put even more tubes in other places. And god, at some point she needs to get Dr Millinger to clear her to get the patient - she's already forgotten the woman's code name - off the stupid backboard... 

This is clearly not going to happen anytime soon, because right when she's sterile-gloved and in the middle of placing a Foley catheter, the overhead intercom beeps and starts announcing a code blue in the dialysis-patient's room one pod over. 

Marian is kind of busy and also the only nurse in the pod right now. She hates missing codes, but she stays put and keeps working, watching her patient's vital signs. 

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Her blood pressure creeps up another couple of points to settle at something basically normal; everything else is steady.

It's subtle, but there's slightly more resistance than usual to putting the tubes in - it doesn't feel like they're caught on anything, exactly, just that sliding them in past the woman's flesh takes a bit more effort than it should, even with plenty of lubrication. They slip out again just fine, though, if Marian tries that at all - if anything pulling them out seems easier than usual.

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This results in Marian pausing and pulling back and double-checking several times that the tube in question is in fact going into the right place, before she shrugs and figures the patient is just Like That.

Is there any urine coming out into the catheter bag? That's an easy confirmation. For the nasogastric tube, she'll plop in a verbal order for an X-ray to get confirmation of its placement before doing anything else. 

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The catheter bag is filling at a normal rate; the urine is fairly dark.

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She doesn't otherwise look dehydrated, but Marian notes this down to ask Dr Millinger about once he's available for questions. Which might not be before lunch, at this rate. She has no idea what's going on next door. Probably the patient isn't dead, since there are still muffled voices from that direction. 

She parks herself at the computer-on-wheels and repeatedly refreshes the tab for bloodwork results. 

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For the most part the only weird thing about her bloodwork is how good it is - all the markers of long-term health look great, her organs all seem to be working well, and she's not low on any vitamins or minerals, even the ones people tend to have trouble getting enough of; the only thing even slightly concerning in that realm is a slightly raised level of proteins. The drug screenings all come back negative. Her blood type is odd, though, one of the rare ones that pops up from time to time, and her immune system is... well, they're pretty sure she doesn't have an active infection, but from the notes, that's nearly all they're sure of.

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This is kind of informative, but also confusing again, and in a way that doesn't really clarify any of her earlier confusion. 

Elaine is still busy so she leaves her apparently-surprisingly-healthy patient for a while and does a round of checking whether meds are due for the other three, and doing her very best to pull out and rearrange pillows to turn the two comatose patients in 114 and 115 onto their other sides. Leg Lifts Lady is doing leg lifts as always, and trying without any success to free her hands so she can pull out her trach. 

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About an hour after the patient's admission, Elaine finally makes it back over to the pod. "Oh my god." She collapses at the desk. 

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"Did they make it?" Marian asks, absently, she's busy mixing pressors for the gunshot-wound patient in 115. 

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"Uh, for now. Doesn't look good." 

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Sigh.

"Is Dr Millinger still busy." 

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"He's getting us coffee and doughnuts." 

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"Oh good!" Marian could really use more coffee. "I guess I can wait. Uh, I turned your people and gave them meds." 

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"Awww, thanks. I'm beat." Elaine flops her head down on the table. 

 

 

About ten minutes later, Dr Millinger arrives with a large tray of coffees. "This is the new admit?" 

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"Yeah. Uh, she's completely unresponsive, GCS three, we have no idea why - bloodwork is almost totally normal, drug screen negative - vitals stable, head CT wasn't grossly abnormal but I haven't read the report yet..." 

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Dr Millinger goes to pull this up. 

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Her neck is in good shape, but the report notes pervasive nonspecific grey matter changes.

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"- Huh, that's weird. Let's get an EEG, I'll put the order in now." 

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Marian nods and writes this down and fidgets. 

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When she happens to glance at the readouts, her patient's heart rate is up to 83 - it was 59 a minute ago.

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"Huh."

Marian mutters to herself under her breath and heads into the room to cycle the blood pressure reading again. 

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That's up, too, and by the time the reading comes through her pulse is up another dozen beats a minute.

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This isn't yet that worrying in itself but the change is confusing and Marian does not like being confused. 

"She hasn't done this before," she says to Dr Millinger. "I don't know what - maybe she's in pain? If she's waking up... I'll do a neuro check." 

She repeats the usual process - shining a light in her patient's eyes, talking loudly at her to gauge any reaction, pinching her nailbeds and rubbing her knuckles on her sternum. 

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