The Shift: One Nurse, Twelve Hours, Four Patients' Lives by Theresa Brown Page A

so soon we will have a plan and it will be a good one. I think of the frustrated heme/onc attending, Dr. Martin. He was upset about having a patient with a blood disorder. Sheila’s situation will only make him feel less capable of taking care of her.
    “Nicholas Martin is the oncology attending.”
    “Oh, I know him,” Peter says. There’s something in his voice, not neutral, but I can’t fix on it. “I’ll call him.” He hangs up.
    I look down at the admission paper on my medcart. I need Candace Moore to take her time getting here because I’m short on patience, even though Sheila can’t be operated on for hours because the Argatroban would make a complicated abdominal surgery even more dangerous than it already is. Because Argatroban slows clotting times, any cut would bleed much longer than usual and fixing a perf requires a large incision. Sheila’s also overweight enough that she has thicker-than-normal layers of tissue to cut through for the surgery. The risks of excessive bleeding are obvious.
    “You have no idea how much blood the human body holds,” Matt, the ICU doctor from this morning’s emergency, told me once, recalling what it was like to watch that precious fluid run out of a patient’s body and cover the hospital floor when he had no ability to stop it.
    But Sheila’s stuck. The bacteria in her abdomen will multiply and spread while we wait for the Argatroban to clear her system. As time passes we swap one potential for death with another, but it’s what we do here. The cutting edge of health care sometimes nestles just next to the razor’s edge of survival. I check my watch. It’s 11:00 a.m.: we’ll have several hours of watch and wait.
    I log into the computer, checking for any new orders on Dorothy, Mr. Hampton, or Sheila. All orders get recorded electronically and the computer is where newly placed orders pop up for nurses. While I think of it, I enter the verbal order the intern gave me to stop the Argatroban on Sheila and I write a note to myself to disconnect the drug once she’s back on the floor. That should be soon.
    But why wait? I call radiology and ask a nurse there to disconnect the Argatroban and ask her to tell Sheila there’s been a change in the plan, which is true, even if my banal phrasing doesn’t reflect how dire her situation is.
    Ping-ping-ping
. “Your admission is here!” the secretary says in her chirpy voice. Ugh. This timing is so bad. Not that I’m rushed right at this moment, but I’m worried about Sheila and preoccupied with my own useless feelings of guilt. Well, both of those will have to wait.
    I quickly glance into the empty room between Mr. Hampton and Dorothy. Candace will start in on us right away if it’s not, in her view, perfect. I repress my impatience as I see her push through the double doors toward me. She’s pulling two designer suitcases behind her; she’ll be here for at least a month. Her straight black hair is beautifully blown out. Is that a wig? I can never tell.
    She smiles a big smile and I smile back, but I know the warmth she’s offering probably won’t last. Taking care of her usually feels like an emotional chess game.
    “Candace. So it’s really time for transplant.”
    She hugs me, giving my back a soft pat. She smells of citrus and expensive shampoo. “Well, first my dye study,” she says and I squint at her because I don’t understand.
    “Dye study?”
    “My Hickman’s not working right,” she says. She’s had it for several months now and they do malfunction. If we suspect a defect in the line, the patient goes to interventional radiology where they run dye through it while taking X-rays. It’s a fairly precise way to show where the Hickman ends in the body and if each of the three lumens works correctly. “I told them I’m not having my transplant with this line until I have a dye study and that it’s going to be today, right now.”
    I know I should just agree with her, but my curiosity gets the