The next problem turned out to have already solved itself by the time Ronnie arrived. He’d been called because a patient had taken a fall in one of the MRI rooms in the imaging center. But by the time Ronnie got there, a resident had shown up, examined the patient, determined he had not sustained any injury, and the patient had been taken back to his room. Ronnie made a mental note to check in on the individual when he made his general rounds after his dinner break.
With no other outstanding problems of the bewildering variety that Ronnie had to deal with hour-to-hour or even minute-to-minute, he was now free to make a preliminary check on how things were in the SICU in regard to Jack Stapleton. After a short elevator ride and then coming around a right-angle bend in the corridor, Ronnie’s anxiety ratcheted upward. His pulse, already high, inched up at the mere sight of the two uniformed policemen with all their law enforcement paraphernalia, including holstered pistols, sitting on hospital-supplied folding chairs on either side of the double swinging doors to the SICU. Despite knowing that the officers posed no threat to him, Ronnie felt a cold sweat break out on his forehead.
“Evening, Officers,” Ronnie said, being as nonchalant as he could manage as he passed.
“Evening, Doctor,” the two officers said in unison. Both were on the youthful and probably inexperienced side in Ronnie’s estimation, as evidenced by the newness of their equipment, and he sensed they were more nervous being in such an alien environment than he was at their presence.
Without hesitating or showing any identification, Ronnie pushed through the doors. He wasn’t challenged, which was a relief. “Some protection they provide,” Ronnie whispered snidely, since they didn’t even know he wasn’t a doctor.
Every night and sometimes on multiple occasions, Ronnie visited all the MMH intensive care units, as allocating intensive care beds was one of his main jobs, even though he’d complained on multiple occasions that the night bed manager should be the one doing it. The job fell to him because he was able to visit the units, whereas the bed manager wasn’t. If and when the census was high, it fell to Ronnie to decide which patients, if any, could be moved out to make room for a new, sicker patient. During the height of the pandemic the decision had often been difficult.
The SICU was comprised of sixteen cubicles, eight on each side, and currently was nearly full with only two cubicles vacant. Each patient had their own intensive care nurse, and each cubicle had its own panoply of medical technology with multiple flat-screen monitors displaying various vital signs. Clusters of intravenous bottles hung from poles, and the entire room was filled with a low-volume cacophony of various beeping with occasion brief alarms. In the middle was the central desk, serving as a kind of command post, complete with additional monitors that served as a backup for the monitors in each cubicle. At that moment a couple of staff doctors and a couple of residents were working at computer screens, oblivious to the various comings and goings of nurses obtaining supplies and medications. In command of it all, like a symphonic maestro, was a charge nurse named Patricia Hoagland, along with a clerk named Irene.
Ronnie paused just inside the swinging entrance doors and surveyed the scene. It comforted him that the atmosphere was relaxed, and despite his knowing that the situation could change in an instant, the current relative calmness helped take the edge off his high anxiety. Of the two doctors within the central desk, he was familiar with only one, Dr. Colleen Benn, who was one of the more senior intensive care doctors with whom he dealt frequently. The other woman Ronnie didn’t recognize, but it didn’t bother him in the slightest nor did the presence of the two residents.
Looking all the way down to the opposite end of the room, he could see the cubicle where he’d assigned Jack Stapleton. Every so often he could catch a glimpse of the nurse busily attending to him, meaning to Ronnie that Stapleton was still in the process of being stabilized after his arrival from the PACU. Ronnie was eager to walk down there to check out the man’s status, but he didn’t want to make it seem so obvious. Despite having already visited the unit an hour or so earlier to see which beds were available and check on the status of each patient, he made it a point to poke his head randomly into a few of the cubicles to catch the attention of the attending nurse. On each occasion, he simply asked if all was okay and either got a thumbs-up or a quick word of affirmation. He then approached the central desk and got Patricia’s attention. She was a particularly friendly, soft-voiced motherly figure, who liked everyone and whom everyone liked, yet despite this affable façade, she was highly organized and ran the unit competently. Ronnie had never had any trouble dealing with her, which he couldn’t say about some of the other intensive care unit charge nurses who took themselves way too seriously.
“How’s the shift going, Patti?” Ronnie asked, making casual conversation.
“So far, so good,” Patti said. “No complaints. Everybody stable. How about for you?”
“The usual number of nursing and nursing assistant no-shows,” Ronnie said. “But we had enough coverage in the pool. I suppose you noticed the armed police presence out in the hall.”
“I’m aware,” Patti said. “Dr. Benn told me. It will keep the riffraff out.” She laughed in her characteristic crystalline fashion.
“Talking about Dr. Benn,” Ronnie said, “who is the other doctor with her? I’ve never seen her before.”
Patti looked over at Laurie and Colleen. “She’s a medical examiner, or so I have been told.”
“Really?” Ronnie questioned. Now he was truly interested. “Why is a medical examiner here?”
“She’s a friend of Dr. Benn’s. She’s also the wife of the patient in cubicle eight.”
Ronnie’s anxiety ticked up a degree. This was something out of the ordinary, and under the circumstances he was not happy about it, considering what he had to do. “Hmmm,” Ronnie voiced, pretending to take the news in stride. “Interesting, but it seems highly irregular. Are you okay with it?”
“Oh, yeah,” Patti said. “Dr. Benn asked me, and since the woman is a doctor and dressed appropriately, I couldn’t see anything wrong with it, especially with Dr. Benn coming in and out. She said she was content to sit here within the central desk and wouldn’t interfere in any way. Are you okay with it?”
“I suppose so,” Ronnie said with a shrug after giving the situation a bit more thought. If the woman agreed to stay within the central desk area, it didn’t seem to him that it would make any difference. “It’s all right. I just would have preferred to have been given a heads-up. I am supposed to be in charge of this institution during my shift and to do that I need to know what’s going on.”
“Would you like to talk with Dr. Benn? I can ask her to come over. Or would you like to meet the woman?”
“No, no! It’s not necessary if you are okay with it,” Ronnie said. “This is your domain.”
“Fair enough,” Patti said. She then turned back to respond to the clerk who had shouted a question to her about a stat lab result.
After the short conversation with Patti, Ronnie did what he’d come to do, namely head down to cubicle eight to check out the newest arrival. Walking in, he looked up at the monitors. Blood pressure and pulse and oxygenation were all entirely normal. The nurse was Aliyah Jacobs, a woman whom Ronnie knew rather well as a particularly competent intensive care nurse and who never minded being moved around from unit to unit depending on need, which Ronnie appreciated and took advantage of frequently. One of the major aspects of his job was to make sure staffing was adequate for the night shift, which could be a challenge with people calling in sick, particularly in the ICUs.