While Rocks was healing from her heartbreak and shock after Luke walked the dock, she put her energy into the clinic. The hold Nici desperately tried to put on Rocks was in vain, and Walter continued to hammer her with demands and hostility. Their efforts to intimidate and irritate her fell on deaf ears and blind eyes. She was in her own zone, and was working on many projects. Rocks got her shopping list together and had the Ohmeda rep on the way with a new state-of-the-art anesthesia machine and a whisper-like ‘almost invisible suction machine that magically attached to the anesthesia machine that notified the physician that it was functional and sanitary (or not) after the machine was turned on. Rocks was also working on Storz for a fiberoptic, which in her mind was a deal-breaker if she was to stay on permanently. She had sent forward a proposal that read heavy on the safely stats and she was certain that the boys would approve her request. She had once again gone over Nici’s head, and expected Dragon Lady to react exponentially to the price tag.
Rocks’continued to run along the Sea Highway, but her distance had increased and it had taken several pounds off. She didn’t mind, she felt better at her fighting weight, and the nearby boaters noticed. She was the most eligible bachelorette at the marina. Max had put most of them straight and advised them to stay away, as he informed them she had been seen with Buck, and he was not one to be on their shit-list. Max was her buddy and didn’t want her to make any needless decisions. He knew what she was going through, and that none of the pennyless sailors hanging out at the Peli would capture her interest anyway. He ‘had her back’.
Her life was anesthesia and her staff, and she was into making the clinic first class. It was on the way, and she had organized the OR, stock room, and the drug supplies to make things easier to inventory and restock. She had reinvented the pediatric supplies as well, as the supplies on hand seemed minimally sufficient. Her office had been long ago arranged to her satisfaction and decorated with items she had found on island.
Most of her cases were elective and scheduled, however there were patients that came up unexpectedly.
One afternoon there was a patient from a cruise ship that needed a fracture repaired. Nici called one afternoon asking her to come to clinic ASAP. “What is the case, and is the patient NPO?” Rocks inquired.
“The patient was on the ship, and fell off a bar stool. He has a fracture that Walter needs to fix, and you need to come in now.”
“Nici, again, if the patient fell off a barstool, I would think they were eating and drinking, or at least drinking, and since it is after noon, they most likely had breakfast AND lunch, and a lot of both, if they are on the ship. Please get more information, since I don’t need to come in to find out that they need to fast another six hours before we do anything. Basic OR 101.”
Nici became irritable, and rang off. The issue was limb threatening injury versus potential aspiration pneumonia if the patient had not been NPO. Nici did not have the information.
Nici was going to call in the team and the surgeon, which would have been a waste of resources, and a disservice to the patient and the doctors. Rocks would have interviewed the patient and cancelled the case after discussing the situation with the surgeon. This was a common scenario which could be avoided by intelligent management at the triage nurse. Often if the surgeon made the appropriate orders at the initial evaluation, all of these problems could be avoided from the start.
Rocks had to be on her game to ensure that policies for add ons and emergencies were followed at Fire Island Clinic. Nici was being pushy as was her style, but Rocks had no time for it. Fire Island emergencies were going to be handled in a standard manner.