“What have we got?” Laurel rushed forward, clutching the tablet she hadn’t gotten used to using yet. Casting a hurried glance at the triage area, she pushed her glasses up the bridge of her nose and pinched it between her thumb and index finger. Too many patients, not enough staff. South Minneha Hospital was supposed to be different, yet just a week after opening, they were running into the same old problems. Plus some new ones.
In front of her, a female paramedic gestured to a gurney. Laurel couldn’t remember her name. A young male was strapped to it, barely conscious, eyes rolling as he grappled for the oxygen mask on his face. Blood trickled from a gash on his forehead, which clearly wasn’t his biggest problem.
“Twenty-three-year-old male, Tommy Jones, front passenger seat, collision with a truck, signs of internal bleeding.”
As the paramedic reeled off the boy’s stats, Laurel’s mind was already three steps ahead. “He’s going to need a chest tube,” she said loudly. “Bay Three!” She gestured to the biggest of the empty bays as her team gathered around her. Two nurses and a resident. Allison Park. Not the worst resident she’d ever worked with, but not the best either.
As Laurel pulled on a gown and gloves, Park took the tablet and started to swipe at it. She was attempting to enter the patient’s information. A step suggested by the bureaucrats who ran the new, extra high-tech hospital that Laurel had found herself working in.
“It’s not connected—”
“Leave it,” Laurel snapped. “You think we have time for that? Gown up, Park.”
Taking a second to gather her breath, Laurel made herself look at the boy in front of her—really look at him. For just a second, she allowed the weight of the responsibility she held to crush her. Then she shook it off, opened her palm and said, “Scalpel.”
A longer-than-usual beat passed. Laurel looked up.
“I can’t find—” One of the nurses, Janet, was scrabbling in an instrument drawer. “It’s not where it’s supposed to be.”
“Help her,” Laurel gestured for Park to look too, but as the resident moved away, a series of alarms began to sound. “He’s in v-fib! Crash cart!”
Laurel started compressions, heaving her entire body weight into the movement, thankful—not for the first time—that she still worked out six days a week.
“Where is that crash cart!” She looked up, over the top of her glasses. Park was staring wildly around the room as if the cart might appear from somewhere.
“It’s not here. I thought we were supposed to have one in every room?” Park’s expression froze as the color drained from her face; she was beginning to panic.
“What is wrong with you people!” Laurel glared at Park. “Take over,” she growled, then ran from the room. There was a cart in Bay Two, she’d used it yesterday.
As fast as she could, she lurched out of Bay Three, into the bay next door, and grabbed the cart. When she returned, the alarms were still ringing. At this rate, they’d lose the kid before they even got him to an OR.
“Charge two-hundred,” she yelled, slapping pads onto the boy’s chest. “Stand clear!”
After the third charge, the alarms stopped. Instinctively, Laurel held out her hand and, this time, Janet pressed a scalpel into it.
* * *
With Tommy finally on his way to surgery, Laurel put her hands on her hips and marched back into Bay Three.
“That was an absolute shit show!” she yelled. “What was that? We could have lost that kid, all because no one knows their ass from their elbow! I shouldn’t have to run out of the room to grab a crash cart. It should have been there. One of you should have noticed it was missing.” As Janet, the two other nurses—Sandra and Maggie—and Park blinked at her, Laurel continued. “I was a field medic in Iraq for three years, and never had to put up with performance as dreadful as this.” She paused. Janet was shaking her head. Park looked like she was about to cry, Sandra and Maggie were blushing. She was being too harsh. This wasn’t her usual management style. She was good with people. She didn’t shout or scream. Something about this place, though, was getting to her. Just a week in, and she was beginning to realize that South Minneha wasn’t as shiny and perfect as she’d been promised it would be.
Opening her mouth to speak, Laurel noticed Janet narrow her eyes a little. The gesture made her stop, press her lips together, and leave before she said anything else.
Twenty minutes later, she was waiting in line for the coffee cart when Janet lightly touched her elbow. “Tough day?” she asked, raising an eyebrow to indicate she was not sympathetic.
Laurel sighed. “Coffee?” She’d reached the front of the line.
Janet nodded and allowed Laurel to buy her a double-shot latte, and then the two of them headed over to a bench nearby. Positioned under a large tree, looking out at the impressive fountain at the front of the hospital, it was a beautiful place to sit. Yet, somehow, it made Laurel uncomfortable.
“I think I’m having a hard time adjusting,” she said as Janet sat down beside her. “All this.” She gestured with her coffee-holding hand to the neatly manicured lawn, which had clearly been designed to convey the idea that South Minneha was not a run-of-the-mill hospital. This place was something special. Something new. “I said no to another tour so I could work here.” Laurel shuffled uncomfortably in her seat and sighed a little. “I’ll admit it, I was swayed by the Board’s proposal. Brand new equipment. State of the art facilities. The kind of resources I’d only ever read about in medical journals.”
“But—” Janet added, pausing for effect.
“But it’s so different from what I’m used to. I used to enjoy my work, but here it feels like I’m fighting fires I shouldn’t have to be fighting. Does that make any sense?”
After sipping her coffee, Janet nodded. “If you don’t like it, why don’t you leave? You don’t have to stay here.”
Laurel hesitated for a moment. She hadn’t told anyone about the real deciding factor in her move to South Minneha.
Watching her, Janet sighed, then straightened her shoulders and sucked in her cheeks. She was a friend, but not the kind of friend to tolerate poor behavior or excuses.
“Look,” she said, folding her arms in front of her plump stomach. “You made a choice. You chose to come work here because the money’s good and because they promised you a bunch of shiny toys.”
Laurel nodded, pushing her glasses up the bridge of her nose.
“From where I’m sitting, that’s exactly what you got.”
“What’s the use of shiny toys if we can’t get the basics, right?” Laurel almost laughed.
“Okay, so some things need work. We’re all new here, Laurel. But I’m telling you now—you’re not going to make any friends if you carry on like this.” She paused, softening her tone slightly. “Let’s be honest, there’s no way you’re quitting. You’re not that kind of person. So you should probably start thinking about taking a different approach. The nurses are doing their best. Even Park is doing her best.” Janet stood up, clearly not in the mood to sit and make further conversation. “You’re in charge of the ER. You want things done differently? Then screw the Board and do them differently. Just don’t take it out on us.”
Laurel was about to apologize—a sincere apology—when a noise near the entrance interrupted. Following Janet’s gaze, she rose to her feet.
“Great,” Janet said through gritted teeth. “Looks like more inmates have arrived.”
“More?” They started to walk back toward the entrance, watching as a prison transport pulled up and three large guards piled out onto the sidewalk.
Banging a fist on the side of the van, one of them yelled. “Shut up! We’re here. No nonsense or we’ll take you straight back.”
The van doors opened just as Laurel and Janet drew level with them. Inside were two gurneys, each with a prisoner handcuffed to it.
“We were told there’d be a maximum of six per week but that’s got to be…” Laurel trailed off as she tried to recall how many had arrived yesterday and the day before. Janet was chuckling. “What?” Laurel turned to her. “What’s funny?”
“Haven’t you figured it out yet?” Janet stopped and looked up at the imposing white building in front of them. “The only thing the people in charge of this place care about is money. They didn’t build this hospital because they wanted to use the wonders of modern technology to help people. They built it to bring in big bucks from big donors, big pharmaceutical companies, and big-pocketed patients. More prisoners in the inmates’ wing equals more money.”
“If you’re so skeptical, why are you here?” Laurel asked, folding her arms in front of her chest, tilting her head as she waited for Janet’s answer.
“Same as you. Money. Fancy equipment.” Janet glanced back toward the coffee cart. “And I like the coffee.” Without offering a smile, she tossed her empty takeout cup into a nearby trash can and stalked back inside, sashaying a little as she walked.
As Laurel finished her own coffee, she watched the prison guards wheel the inmates inside. Straight through the main entrance, despite Robert Sullivan’s promises about them being kept completely separate from her ER.
Taking out her phone, she flicked to Robert’s name and typed out a quick message: Need to talk ASAP.
He’d avoid her, of course he would, but she wasn’t going to let him get away with this. Janet was right; Laurel was in charge, so she darn well needed to act like it. Normally, she’d never even dream of kowtowing to someone like Robert—nice but, ultimately, interested more in the hospital’s bottom line than anything else. The problem was, after everything Robert had done to get her mother into the trial—the only one in the country getting results for her type of cancer—she felt indebted to him.
Somehow, she needed to draw a line between the two things. Robert did her a favor, but she did him a favor too by agreeing to head up his fancy new ER. She was good, and he knew it, or he wouldn’t have gone to the lengths he had to secure her. It was about time she reminded him of that.
* * *
In the break room, Laurel took off her coat and hung it on the back of a nearby chair. Janet, who’d sat down with a group of other nurses, looked up and raised her eyebrows. From the couch in the corner of the room, Park swallowed hard as if she was expecting another telling off.
“Excuse me, everyone,” Laurel said, trying not to shout. When no one except for Park and Janet looked up, she cleared her throat and raised her voice a little louder. “Excuse me?”
Finally, they noticed her and stopped talking.
“I have an apology to make.” She flexed her fingers at her sides, resisting the urge to fold her arms.
Janet’s mouth twitched as she bit back a smile.
“Many of you have worked together before, but I’m new here, and I’m not happy with the way I’ve been conducting myself. This is not the way I like my ER to run, but that’s on me. Not you.”
As the frowning faces in front of her softened a little, Laurel tried not to fiddle with her hair. Before her shift started that morning, she’d tied it back into a bun, neat and smooth at the base of her neck. After just a few hours on duty, strands were snaking free and tickling the side of her face. She gave in and tucked one behind her ear, then offered the nurses a smile.
“I promise you,” she said, “I’ll be taking my concerns to the Chief, and I’ll be talking with the Board about some other matters too. First, though, I want to know what’s not working for you. So, please, tell me… which procedures need to change?”
“You mean apart from those infernal tablets?” Janet asked, prompting a ripple of laughter from the other nurses.
“Yes, apart from the infernal tablets,” Laurel replied, biting back a smile. “I believe they’re here to stay, but we could certainly address the way they’re used.”
“Shouldn’t all this have been worked out before the place opened?” Mark, a nurse about Laurel’s age, said gruffly.
“In an ideal world, yes.” Laurel stopped herself from saying that in an ideal world Robert and the rest of the Board would have thought to ask the person they were actually employing as head of the ER to advise on procedure, rather than some overpaid consultant who barely looked old enough to have graduated. “But we are where we are, and this hospital has the potential to be great. If we work hard to make it great. So, hit me with your ideas. What can we do to whip South Minneha into shape?”
Laurel was jotting down comments in her small black notebook when the breakroom door opened. Expecting to find one of the residents, warning her of an incoming trauma, she turned to stand up and reached for her coat in one fluid motion.
But it wasn’t a resident. It was Robert Sullivan. One of the hospital’s most influential Board members.
“Robert?” Laurel glanced at her phone. “I didn’t expect you to come all the way down here.”
Lingering in the doorway, puffing out his chest—the way he always did to compensate for his lack of height—Robert frowned.
“Is this about my email?” Laurel asked, lowering her voice and motioning to the others that their meeting was temporarily suspended.
“What email?” Robert shook his head. His hair was thinning at the front. “I came because your mother asked me to.” Robert stepped out of the door back into the hallway. Laurel followed, sucking in her cheeks.
Whenever Robert talked about Laurel’s mother, he did so with a slightly disdainful look on his face—as if Laurel was abandoning her daughterly duties by working, despite the fact he was the one who’d employed her.
“Is she all right?” Laurel still hadn’t quite gotten used to the idea that Robert and her mother had once been romantically involved. Yes, it was a long time ago—before her mother and father were married and before Laurel was even born—but it was still something she couldn’t bring herself to picture. Her mother was so beautiful. Free-spirited. Wildly intelligent. She lit up every room she walked into, even now that she was sick. And Robert? Well, she couldn’t imagine Robert Sullivan being anything other than the rigid, white-haired, humorless guy she’d met when he tracked her down in Texas and offered her a job.
“She’s having a bad day, Laurel. She’s asked to see you.”
Glancing back into the breakroom, Laurel drew a long slow breath into her chest and folded her arms. She couldn’t leave in the middle of a shift, no matter how much she wanted to and especially when she was trying to make amends to her team, not isolate them even further. “I’m sorry, Robert, I can’t right now. We’re still short-staffed and we’re having problems with some of the new systems. Could you tell her I’ll come up after my shift?”
Robert pressed his lips together and nodded. “Problems?” His eyes twitched as he narrowed them.
“Yes. I was hoping to speak to you, actually—”
“Of course,” Robert replied quickly. “Perhaps when you’re less slammed?” As his lips stretched into a smile, Laurel caught herself tapping her foot against the slightly sparkly gray tiles that adorned the floors in the hospital corridors.
“I’ll call your secretary to make an appointment,” she said, a hint of her Texan accent bleeding into her speech the way it always did when she was trying to hide the fact she was annoyed. Luckily, Robert didn’t know her well enough to know that.
“Do,” he replied. “And don’t forget your mother, Laurel. I’ll tell her you’ll visit after your shift.”