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A 25-year-old named Jan, a petite Hispanic nurse who had graduated from Academy’s nursing school, was one of the most grateful nurses at Academy. Like many of the baby nurses in the Academy clique, Jan would come to Molly with her questions rather than admit to the other baby nurses that there was something she didn’t know. Molly was happy to help nurses who wanted to learn from her. “I like teaching,” she explained. “I try to say stuff in a nice way so they don’t feel stupid. So many times in nursing school I was made to feel stupid, and I don’t want to do the same to other new nurses.”

In the early evening, Molly happened to see Jan standing in the supply closet looking confused.

“Do you need something?” Molly asked.

“What do I need to do a chest tube? They’re doing one STAT and I need to get back in there.”

Molly had drained chest tubes, which were used for patients with a collapsed lung, more times than she could count. The chest tube was inserted through the ribs to help the lung reinflate. “Okay, we need the chest tray for the doctor,” she said. Jan pulled the tray from a shelf. “We need the collection chamber for the blood or air coming out of the patient. We need some sutures. And then we need the sterile gowns and supplies for the doctor.”

After Jan collected the items, Molly followed her to the patient’s room, where a doctor was prepping the sterile field—cleaning the patient’s chest and opening supplies on a table covered in sterile drapes. The patient, a college student, was crying. A collapsed lung was painful and made it difficult to breathe. Like many young, thin males his age, the student had coughed and suddenly had shortness of breath. A chest X-ray had revealed the problem.

“Open up the collection chamber. You need to add water into the funnel,” Molly told Jan quietly so the patient wouldn’t realize that his nurse wasn’t experienced with the procedure. “The tubing needs to be attached to the suction. Good. Now we’ll wait for the doctor to insert the tube and then we attach the chest tube to the suction.”

After the successful procedure, Molly told Jan she had done well. Away from the patient, she told Jan a story. “Something to remember with chest tubes is if the doctor makes the hole too big in the chest, then air can escape into the rest of the body. Once I helped a doctor put a chest tube in a guy who was intubated. Well, every time the respiratory therapist squeezed the ambu bag, the patient’s balls would inflate!”

Jan started laughing. Molly continued, “The chest tube had just gone in, so they’re bagging him real fast and no one is noticing this but me. They started out normal testicle size but they were very large grapefruits by the time I figured out what was going on. The guy was naked and the air is tracking from around the chest tube hole through his lungs and into his groin. I had to say, ‘You know, his balls are blowing up every time you bag him.’ So they called in a cardiothoracic surgeon and had to suture the air leak shut.”

“I’m glad you didn’t tell me that beforehand,” Jan laughed. “Thanks for your help. I totally understand chest tubes now.”

Midshift, a 16-year-old girl was brought by ambulance to the ER from a school dance, where she had gotten drunk, thrown up, and passed out in the bathroom. When her father arrived, he screamed at her. Then the girl changed her story.

“Dad, I think when I was passed out, someone raped me,” the girl sniffled.

Her father immediately redirected his anger. He demanded that the nurses call the police and start an investigation. Everyone in the room except her parents knew the girl was lying.

Teen patients commonly said anything they could think of to avoid dealing with their parents’ reactions. Molly had treated dozens of teenaged girls who made up the same story, and not one of them had been sexually assaulted, creating what Molly referred to as “a ‘girl who cried wolf’ mentality.” Most patients didn’t realize that if police officers seriously considered somebody to be a sexual assault victim, they brought the patient to a hospital with a sexual assault nurse examiner (SANE) on staff, which Academy did not have at present. The patient wouldn’t come through triage or sit in the waiting room; the staff would usher her straight back to a private room for the SANE’s evaluation, a policy that Molly called “a very hush-hush process hidden in the ER.” Therefore, ER nurses knew that if EMS or the police brought a patient through triage, they did not believe the individual had been sexually assaulted.

When the father went into the hallway to call the police himself, Molly turned to the girl. “If you really were raped, we will do everything we can to help you,” she said. “If it’s not true, we have a big problem: Someone will get arrested, go to jail, and possibly serve time just so you can get out of trouble for drinking. Now tell me, what’s worse: being grounded for something you did or someone going to jail for something he didn’t do?”

The girl looked down. When her parents came back into the room, she muttered, “Maybe that didn’t happen. I don’t remember.”

On another occasion, the daughter of a local VIP got drunk at a school dance and passed out. A friend’s parents brought her to the ER. When the girl’s father arrived, he yelled so loudly that Molly closed the door to the patient’s room for a while. Soon after Molly opened the door again, the girl had an epiphany.

“Daddy, Daddy! Jesus is talking to me!” she shouted. “He’s showing me what I did wrong! Daddy! Kneel beside the bed with me and let’s pray! Dear God! Thank you for giving us your son to take away our sins! Thank you for showing me what I did today was wrong!”

The father fell for it. He knelt next to the bed with his daughter. “Praise God! Praise Jesus!”

“Daddy! We need to go to church when we leave here and let everyone know that alcohol isn’t the way. Jesus is the only way!”

Her father shook his head, feeling it. “Amen! Praise Jesus!”

“Daddy! I want to speak in front of the congregation and let them know that Jesus is good! Alcohol is not good! Daddy, this will never happen again!”

“Amen, baby. I love you.”

And the yelling was done. The Academy ER had a sticker sheet of glittery Oscar statues that were reserved for patients who put on Oscar-worthy acts. The nurses would stick one on a patient’s chart so that everyone who treated the patient knew what to expect. Some staffers didn’t like Oscar because it gave the practitioners preconceived notions. But Molly thought it was funny and a stress reliever.

Molly had to give credit to this resourceful teen. As a nod to her performance, Molly stuck Oscar onto the girl’s chart.

Citycenter Medical

One afternoon, medics brought in a woman who had attempted suicide by turning on a barbecue grill in her bedroom and inhaling the gas. It looked like she would survive. As Molly documented at the nurses station, a pregnant nurse walked by and sniffed. “Ta’quisha, you get grilled hot dogs for lunch?” she asked loudly. Ta’quisha, a tech, told the nurse about the attempted suicide; she was smelling the fumes off the patient.

“Now I’m hungry!” the nurse said.

At the end of the day, an ambulance brought in a 60-year-old man who had been found slumped over at his desk at work. The man twitched and his eyes rolled toward the back of his head. The staff at the nurses station was busy watching the attending doctor question the EMT to determine whether the patient had suffered from a stroke or a seizure.

“Is anyone watching him?” Molly asked, jumping up to help. “Does he have a line?”

After the patient was intubated and sedated, Molly brought him into radiology for a CT scan. The neurology team crowded into the viewing room, excited to see what had gone wrong in the man’s brain. As the scan materialized on the monitor, a voice behind Molly shouted, “I win!” She turned to see the neurology resident making the victory sign. “It’s not a stroke, it’s a seizure!” he said happily. “Who else had seizure?”