This is a preview to the chapter Chapter Twelve from the book PERSONAL BAGGAGE by Margaret McMillion.
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Finally, he spoke to her. “How did it happen?”
Penny’s eyes burned but she did not cry. “I had just given him the Vitamin K. I flushed the line with normal saline, walked over here to the desk, and sat down to finish charting...and he arrested!”
“It was an embolus then.” Dr. Scales moved his hand as if to say “so what,” and wrote “Embolus” as the event leading to death in his progress notes. He gave her a conspiratorial wink above a smile that didn’t reach his glacial eyes. “Thank you, Mrs. Pewitt. His family is coming and they want to see him before you send him to the funeral home.”
Alone at the desk, Penny picked up the chart. “Had she flushed too fast? Dr. Scales must think that when she flushed the line she had dislodged a clot, and Mr. Aceworth’s circulating blood had picked it up and carried it into a smaller vessel where it lodged and blocked blood flow to his heart.
What had he meant by that wink? Did he believe she had killed the man? She turned to Dr. Scales’s order for Vitamin K. It looked like he wrote IV but it could be IM. She thought she remembered giving Vitamin K to other patients by the IV route, but at this point she couldn’t be sure. She looked up the drug in The Physician’s Desk Reference. Under Administration, she read Precautions:
“SubQ/IM administration less likely to produce side effects. Rarely, severe reaction occurs immediately following IV administration and may progress to shock and cardiac arrest.”
A nursing tech had come to help clean up from the code and night shift would be here soon. There was no time to think. Someone had laid telemetry unit number four on the desk and turned off the monitor. Penny removed the battery and put it away. Feeling fragmented, scattered as a shipwrecked boat thrown onto a rocky shore, she walked to the bedside of her remaining patient who had slept through everything, and whose skin color and monitor pattern looked beautiful.
After giving Report on the CCU patient and two telemetry patients, Penny dismantled Mr. Aceworth’s chart. She taped the defibrillator print-outs in correct sequence onto a sheet, and completed the code form describing the occurrence and the measures taken. Night shift would close out the nurses’ notes after the funeral home picked up the body. She placed the medication sheet behind its divider and wrote over where she had earlier written IV as the route of administration for Vitamin K, so that it was now hard to tell whether it said IV or IM.
The night-shift nurse drank coffee and ate a stale breakfast roll, looking forward to an easy twelve hours spent reading her book. She didn’t even notice that Penny was covering her butt for the second time in one day.
Turning her back on River Park Hospital, Penny drove home Saturday evening beneath a fading sunset that resembled a strep throat. Lights shone from her neighbors’ houses on Oakwood Street but her own house was dark, and when she turned into her driveway a wave of acute disappointment swept over her. Johnny’s Mercury was gone, and she had been counting on telling him her troubles.
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