“Could be a blood clot in the lung,” said the doctor. “Does anyone have any ideas?”

“What do you think about t-PA?” Lara asked. Tissue plasminogen activator could save a patient by dissolving a clot or it could cause a patient to bleed out and die. Typically, the procedure required the patient’s or family’s written permission. In this case, the patient was technically dead anyway.

“Yeah, let’s do it,” Dr. Hawkins agreed.

The other nurses backed away from the bedside, suddenly busying themselves with other things. Lara looked around. She hadn’t given t-PA in more than a year. “Wow, really, guys?” Lara said. “Okay, I’ll do it.”

As the others continued CPR, Lara explained to her student what she was doing. “Usually you give a bolus [a single dose] of t-PA first intravenously, and if the patient is still alive, you do the second half over thirty minutes. But we don’t have that kind of time, so we’re doing a straight push over three minutes,” she said. She encouraged her student to take a turn performing CPR, which she had never done before. “It can be creepy to do CPR because you often break ribs even when you’re doing it right, so I want you to know what that feels like,” Lara told the student. Lara stood by the intravenous drip, slowly depressing the plunger of the syringe of t-PA while instructing the student how to set up the remaining medication. Afterward, the student thanked her effusively.

The patient, as expected, didn’t make it, but Lara found that she had completely regained her medical confidence. “I felt like it came back and flowed,” Lara explained to a friend, relieved that she was back on her game. “I didn’t feel like I was struggling to think through anything. That was nice, because my fear at work was missing something on a patient. As a team, we didn’t miss anything. T-PA might have helped, so I was glad I thought of it. Even though the patient died—really, she came in already dead—I walked out of there knowing I did every single thing I could possibly do to try to save her.”

•   •   •

A week later, Lara was having a tough morning. If getting through a divorce was a process that took two steps forward and one step back, then today was definitely a step back. She dropped the kids off at school and cried on the way to work. This sucks, she thought. I’m an old single mom and now I’ll have to date again.

Now that she was single, she supposed she could do what many nurses she knew had done: They kept an eye on the firefighters and policemen who brought patients in to the ER. At her former hospital, at least half a dozen nurses had married men they had met that way.

Lara had always been drawn to men in these positions, both because their uniforms were a turn-on and because they understood what it was like to be a nurse. “They’re protectors and caregivers,” Lara said. “Maybe it’s the whole men-in-uniform thing. Firemen stay in shape, and they have that sensitivity about saving lives. You feel safe when there’s a fireman or policeman around. They know what it’s like to look into the eyes of a parent whose kid just died. They understand.”

Still, Lara was scared to return to the dating world. How would she find the time to get to know someone when her life revolved exclusively around her kids, job, meetings, and workouts? Puffy-eyed and sulking, Lara moped into work at 11:15 a.m. “Are you coming from the breakfast?” Holly, that day’s charge nurse, asked her.

“What breakfast?” Lara asked. “I’m just coming in to work a couple hours.”

“You were supposed to be at the breakfast for the finalists,” Holly said. Lara didn’t know what she was talking about. “You’re a finalist for Nurse of the Month!” Holly said.

Lara laughed uneasily, thinking this was like an “Oh, you’re mom of the year” joke.

“The ER director sent you something in the mail.” Holly was serious.

“I moved,” Lara said.

For the rest of the day, Lara bounced between excitement that her work had been recognized and guilt that other ER nurses’ work had not. Her nomination was the talk of the department. Someone had taped a copy of the letter listing the finalists to a medicine cabinet for everyone to read. The ER nurses hadn’t even known the honor existed, because in the history of the award, no ER nurse had been a finalist.

Lara sensed some resentment from her coworkers toward the ER management. “If our managers can nominate us, why haven’t any of us been nominated all this time?” they said. “I work my ass off!”

The other nurses mostly teased Lara. They kidded that she missed the finalists’ breakfast on purpose because they knew that socializing with “management types” made her uncomfortable. Lara joked back that administrators must have “just been feeling sorry for me because I’m such a pathetic loser in a pathetic place right now.”

Another nurse snorted. “If that was the case, I would have been nominated a long time ago.”

Lara poked her head into the ER director’s office to say thank you.

“Girl, you work hard. It doesn’t go unnoticed,” the director said.

The boost came at just the right time. Until the nomination, Lara hadn’t realized how badly she had needed some sort of validation that at least something was going right in her life.

Two weeks later, when Lara arrived at work, Holly said, “You’re the hallway nurse from eleven to twelve, but then you’re going to the luncheon.” Nurses nearby snickered.

“A luncheon? I’m not going, guys,” Lara said.

“You have no choice. You won the award!” Holly said. She purposely had not told Lara she won until the last minute, so Lara couldn’t duck out.

Lara was stunned. Word spread quickly, as usual in the ER. Within an hour, everyone was referring to Lara as Nurse of the Month. “Hey, Nurse of the Month, can you help me in Room Nine?” “Can you roll this patient off the backboard, Nurse of the Month?” Only one nurse sneered at her, nastily sniping things like, “I’m going to take my patient up, if that’s all right with you, Nurse of the Month.”

Lara laughed it off. As great as it felt to win, she was a little mortified that she had been chosen above equally deserving coworkers.

At noon, Holly and the education coordinator found Lara in the hall. “I’m going to watch your patients for you,” the education coordinator said, clapping Lara on the back.

In the elevator, Lara squirmed. She was no good at chatting up bigwigs. She envisioned sitting across from them, stumbling to make conversation.

When Lara poked her head into a fancy doctors’ conference room she had never seen before, the head of the hospital stood up and came over to her, his arm extended. “Hello!” he said, shaking her hand. A handful of department heads and three nurse finalists from other departments were seated at a table laden with catered food. Wow, I would’ve looked really jerky if I hadn’t shown up, Lara thought.

As the hour progressed, she relaxed. The hospital chief was laid back and friendly. Mostly the group talked about the hospital. The chief discussed upcoming events and how much he appreciated the employees. But he kept coming back to the ER, which he seemed particularly excited about. “The ER holds this hospital together,” he said.

Lara listened with pride. “That made me feel grateful I was a part of it,” she told a friend. “I could have lost my license for my ridiculous behavior in the past, so this was a nice reminder. It got me energized to keep doing what I’m doing.”

The chief presented her with a trophy engraved with her name. Because it was too large to fit in her locker, Lara left it at the nurses station. But her coworkers moved the trophy to wherever Lara was working. If she was in a patient room, when she left, the trophy would be waiting for her at the door. If she went to the meds room, the trophy would magically appear in the hallway outside of it.