On the Road
Deloris and Ivar had settled into a comfortable routine already. They were listening to some music as they drove down the road following Petra’s trailer in front of them. With that as their view forward, they did some sightseeing out to the sides as they drove along. About every half hour the automatic blood pressure cuff on Sofia’s arm would trigger and Deloris would write the vital signs down on the cart in her clipboard. She was watching the signs, trending them and trying to keep pace with the drugs. She had a small IV pump hooked up with various bags of meds she was working through; Pain meds, antibiotics, vasopressors, all at the rate she best could flow them.
Deloris was watching the numbers on the chart. She didn’t like the direction they were headed. She made new calculations and planned the next medication intervention. It was ICU work all over again. One nurse for one patient, only this time she wasn’t turning over to another nurse at the end of the shift. She was with this one for the duration. She didn’t know if it was better or worse that way. What she did know was the newfound freedom to make the call on meds and treatments had a downside. If she made the wrong choice, she had to own it instead of blaming the doc.
Deloris was sitting in the seat, just lounging, when something caught her eye, or was it ear? She reached behind her and turned down the music so she could focus. Ivar looked over at her for an explanation but she was too busy now.
Deloris’ fingers danced over the monitor, punching buttons and flipping switches. She looked over at Ivar.
“Full stop. Shut it off. I need a clean reading.”
Before Ivar could say anything, Deloris was half out of the seat leaning forward over Sofia as the truck slowed to a stop. Ivar shut off the engine and turned in the seat to watch. He wanted to ask, needed to know, but he knew she would tell him when she could. He had to trust her.
The front passenger door opened. It was Amber.
“What is it Deloris?”
“ST elevation across all leads and some other squirrelly stuff on the EKG. It’s time. Do you want the tube while I push the drugs or want me to handle the tube while you push the drugs?” Deloris had the drug bag and the intubation pouch in her hands as she asked.
“Someone want to tell me what’s going on?” Ivar asked.
Amber looked up at him. God she hated to see the worry and the panic in his face, especially since she knew she was having the same feelings.
‘Sofia is really sick. She has an infection attacking her whole body despite the antibiotics we have going into her. The infection is strong enough we can see where it’s effecting her heart now. We are going to have to do some more stuff right away and we have to use one of the contingency plans Silas and I have worked out.”
“Like what?”
“Get the rest together and we can lay out our plan. Besides, it might be better if you don’t watch what we do.”
Amber really didn’t want Ivar watching her cram a breathing tube down his wife’s throat, but they had to for the ventilator to do it’s job. Now it was a race. Can they do enough to turn Sofia back before she fell off the cliff.
“Please, go get the rest together and we will all meet at the front of this truck and lay it out, Ivar. Just let us get this taken care of.”
Amber could see how hard it was for Ivar to get out of the truck. Once he was gone, she turned back to Deloris.
“Alright, you run the drugs, I’ll drop the tube.”
“Drug choices?” Deloris opened the drug bag.
“I was told in med school, you date before you suck, so Etomidate to sedate then the Succinylcholine for paralytic. After we are in and set, we can adjust the other meds to keep her out.”
“Sure thing, doc. We got a plan after that? You know this is all just buying time?”
“Yeah, I got a plan, and a much worse back up plan if the first one doesn’t work. You’re going to need another nametag. You’ve been doing Post-Op and ICU. If plan A works, you’re back to OR nurse.”
“Shit! That’s plan A? I don’t want to know plan b, do I?” Deloris commented as she was drawing up the drugs.
Amber looked up from where she had Sofia’s head tipped back, a laryngoscope and endotracheal tube in her hands. “I don’t want to know plan b and I’m the one who came up with it.”