Ha. He'll do great here. Nellie slaps him on the shoulder. 

There's a LOT to be done, getting the patient settled while keeping his vitals stable, and right now they've got all the hands they could possibly want, but that won't last long and Pascal doesn't have the nursing experience - or bossiness - to take advantage of it while it lasts. 

Nellie tells him to park himself at the computer desk outside and focus on getting a detailed report from the surgeon and anesthesiologist. "You'll want to know everything that happened over there. Might be relevant later. Take notes." 

And she herds the remaining scrub nurses and ICU sightseers into helping transfer the patient back to his bed. It's a big job, bigger than before; there are even more tubes and lines to keep track of, and they need to avoid jostling or putting any pressure on his open belly. It's tempting to do a hasty job of it, but day shift will appreciate if they get the pumps and lines organized in a sensible order. And it must have been a really frantic surgery; normally OR is meticulous about using rows of T-shaped IV stopcock connecters, rather than just Y-hooking multiple lines into each other like some kind of repeatedly-dividing set of tree branches. 

At least the OR's notoriety for returning their patients freezing-cold is helping out here. The guy's temp is 37.7. 

Once the kid has his report and an entire page of notes - wow, he's great at note-taking, neat handwriting and everything organized in categories, Nellie compliments him on it - she shows him how to do an assessment on the dude's convenient intestinal window. 

"Don't you kinda wish sometimes we could do this to everyone?" she jokes. "What a view! Look - that's his colon, you can see it's pretty swollen but it's all pink. No dark spots, that's good, means he's perfusing well and none of his tissues had a chance to die yet." 

"I don't, uh, actually...know what it should look like," Pascal admits, staring in awed disgust. 

Dr Agarwal is still parked at a bedside table with his laptop. "I've got some pictures saved somewhere, I can show you..." 

At some point in the midst of walking Pascal through his post-op assessments, Nellie glances at a clock and, this time, properly registers that it's 5:09 am. 

Mayumi is nearby and not clearly in the middle of putting out a fire. "Hey? Mind grabbing a glucose on my guy in 202 when you have a minute? He's got an art line, don't need to stick him." Earlier tonight she would have done it herself, but Ma'ar seems to have calmed down a lot about strangers, and Mayumi is especially inoffensive and harmless. 

Ma'ar can't get warm. 

He just wants to sleep. He's so tired. He's sure he could fall asleep in about ten seconds if he could only get comfortable. The friendly incredibly-young man who came in a while ago let him have the heating blanket again, and the drug helped even if its method of administration was weird, and for a few minutes he was able to doze.

But now he's awake again - or half-awake, at least, the awful kind where flickers of incoherent dreams are overlaid on his waking surroundings. He's shivering uncontrollably even when he burrows all the way under the blanket. 

Nellie might be able to help, and she did say to call him if he felt worse. Ma'ar is pretty sure this is worse? His whole body aches, deep in his bones, and he's feeling queasy again which just seems unfair. It's dark, though, and he's tossed and turned a lot under the blanket, and now he can't find the call-button or the clean bag that the other nurse brought.

Eventually the sun will come up and he'll be able to find it. Right? That's how time works? He shivers under the covers and tries to endure. 

Mayumi is back outside 192 in less than thirty seconds. 

"Nellie? I think you should go see him. Is the fever new?" 

"Hmm?" She's occupied trying to find pedal pulses on 192. "He was running a little warm before." 

"Why did you leave the Bair Hugger? He's at 39.5 now." 

"I didn't–" She stops. "Pascal? When you said you 'fixed' his blanket...?" 

"Sorry! I didn't know -" 

"You need to check a patient's temp if they're complaining of being cold, before you give them more blankets!" Nellie lets out her breath and steps on the desire to chew him out more. "Sorry, not your fault. But I gotta go. You're doing great here. Dr Agarwal? Can I have you or the attending wander down to 202 when you're done tying up loose ends here?" 

And she forges down the hall. 

Mayumi's gone on ahead of her, and is already in the room when Nellie finishes properly washing her hands - she just touched guts, after all, even if it was through plastic wrap - and joins her. She seems to be having a minor tug-of-war with Ma'ar over the Bair Hugger. 

Nellie flicks on about half of the lights - not the really bright ones that'll go straight in his eyes, but enough to see what she's doing. 

"Ma'ar." She crosses the room and yanks the blanket away from his face. "Stop it. Let me have that. Sorry - you can have one flannel - I know you feel cold, it's 'cause you're running a fever." 

Ma'ar gives her an incredibly betrayed look and then tries to scrunch his whole body under his gown. Which is damp from sweat. He's shivering impressively hard.

He's also lying on his art line now or something, it's alarming but the reading looks highly questionable, and he's lost his sat probe somewhere in the bed. 

"I'm sorry, I know you must be feeling pretty awful. How long ago did this start - why didn't you call me?" 

Ma'ar has no idea how time works right now. 

:Lost call bell–: He breaks off. :Feel sick: 

"Still?" They've loaded him up with SO many anti-nausea meds at this point. "Mayumi, grab the washbasin?" A lot grosser to deal with after, the emesis bags are a great innovation, but it'll be easier for Ma'ar to hold onto it when he's groggy and shivering, and Nellie needs her own hands free. 

"Here - no, you need to sit up more than that, sorry - Mayumi, help?" Ma'ar seems to be inclined to keep lying completely flat and just stick his entire head in the basin. Nellie disapproves of this plan. 

They get him pulled up in bed with the head lifted, which earns Nellie another very betrayed look from him. Nellie finds his sat probe and sticks it back on. 

Situation: he's still running a high fever but at least he's not actively under a warming blanket. He's making incredibly miserable noises over the basin. His other vital signs are okay for the moment - well, heart rate is pretty elevated but that's unsurprising. His blood pressure curve is swooping all over the place, but she has a vague memory that vomiting causes parasympathetic nervous system activation - the same mechanism that can trigger fainting, for susceptible people - and besides who even knows if it's accurate, the line isn't accurate zeroed or calibrated and he keeps moving his arm. She should get a cuff measurement just to sanity check. 

More worryingly, his sats are pretty variable too, repeatedly dropping briefly below 90%. 

She turns to Mayumi. "He might be due for Zofran, if so you can pull some, but I'm suspecting this isn't just post-anesthesia or opiate side effects. Either it's a gastro bug, or gut stasis and nothing's going anywhere." Or maybe both. "...Pass me that 60cc syringe?" 

Mayumi does, but looks puzzled. "What for?" 

"Well, you know how you're not supposed to hook a single-lumen small-bore feeding tube to wall suction? It's much less likely that I, a human being rather than a dumb machine, am going to try to eat his stomach lining without noticing. So I'll just do this by hand. ....Uh, can you get me one of the graduated measuring thingies? I have a feeling this little kidney basin is not going to cut it." 

She steals the bedside table and gets her workstation set up. 

"Clever," Mayumi says, and darts out to provide supplies. 

The other problem with attempting to use a small-bore feeding tube is that it's designed to be comfortable for the patient, so it's both thin and soft, easily collapsed by suction. And she's definitely getting stuff back, but some of it is goopy, bits of gastric-lining mucus mixed in with bile and minimally-digested grape juice. A few times she has to go to the sink, rinse her syringe, and fill it with some tap water to un-gunk the tube. 

She's still at it when Dr Agarwal walks in. "What are you doing?" 

"What does it look like?" Seriously, has no one in this hospital ever considered the concept? If he'd come in vomiting in the first place they'd have placed a proper two-lumen suction tube and kept his stomach drained via wall suction. They didn't, but if you can check tube-feed gastric residue, which everyone does every day, then obviously you can also do this, it's the exact same concept. Sure, it's more disgusting, but since when has that ever stopped nurses. 

She's pulled out three entire syringes full and it looks like it's helping; Ma'ar is still shivering over his basin, occasionally gagging, but not actually vomiting. 

Dr Agarwal looks kind of impressed. "Neat. When did he pop a fever on us?" 

"Last hour or two, I think? Not sure, thanks to our little dual shitshow thataways. ...Are you sure you can't fucking get me some IV Tylenol. Maybe on the black market?" 

"...If you want to talk to hospital administration, er, I think the OR wants it too. Uh."