Chaos at Crescent City Medical Center (6 page)

Kathy frowned as she left the room.  Gastric cancer was bad enough as it was, but Mrs. Raccine's cancer had spread to her liver. She also had metastasis to her lungs which made her more tired and short of breath.  It seemed so unfair for such a wonderful woman and community leader to be so
cruelly
ill.  Kathy wondered if Mrs. Raccine's dreams were related to her diagnosis.  She'd mentioned
her dreams
had snakes and evil things in them but
Mrs. Raccine
couldn't seem to remember much else.  Mrs. Raccine was Creole and Creoles traditionally believed all dreams have meaning.  Kathy wouldn’t be surprised if Grace had b
r
ought a gris gris with her to the hospital to help her heal.  Kathy left the hospital with a heavy heart for Grace Raccine.

At one-fifteen in the morning, the gentlemen in Room 626 had a heart attack, and the nurses were busy with him until after two-thirty.  A nursing assistant documented at two o'clock that Mrs. Raccine was sleeping soundly with her side rails up.  That was just an hour before all hell broke loose.

Alex approached CCMC at seven-thirty on Tuesday morning and was dismayed to see TV trucks, camera crews, and reporters.  A sinking feeling came over her, and she immediately felt her
stomach knot.  Nausea prevailed
as she wondered what was wrong.  What could have happened?  It must be bad. Of course, she admonished herself, it could be something positive.  Many great things happen at CCMC, but somehow she wasn't able to convince herself that something good had happened.  Her gut told her the opposite.  It was bad.  Reporters never came out this early in New Orleans
for anything, except to photograph the trash after Mardi Gras,
unless it was something bad. Anything good could have waited until noon.  She walked towards the administration offices with an overwhelming sense of dread. 

The administrat
ion
suite was
in chaos.  Two of the secretaries were trying to keep the press out of the suite, and the other two were on the phone.  Alex wondered why everyone was in so early.  One of the secretaries motioned her towards the conferen
ce room. As she entered, sh
e
noted
Don Montgomery, Dr. John Ashley, the chief of medicine, Bette Farve, chief of nursing, and Elizabeth Tippett, the director of hospital-media relations
sitting around the conference table
. Don was speaking as she entered the room.

His voice was loud, blaming and arrogant.  "Where the hell's Alex Destephano
?
 
This
is when we need her.  Where in the hell is she?"  Don's face was red, his eyes blazing.

Elizabeth, a pretty young brunette, spoke calmly.  "Don, we called her around six and didn't get an answer.  It's only seven-thirty.  I'm sure she'll be here soon.  Relax a little.  We need to focus on a press release.  What are you going to say?"

The CEO glared at her.  “I’m not saying a damn thing.  That is
your
job.  What is it about you people that you don’t understand that I cannot do everything around here?
"

Alex stood frozen at the door.  Her voice was quiet.  "I'm here.  I was probably in the shower at six.  What's going on?"

Her colleagues looked at her strangely, speechless, but obviously glad to see her. Elizabeth was the
f
irst to speak.

"We're not really sure what happened.  At five this morning, the charge nurse on Six North was making final rounds on her patients.  When she entered Mrs. Raccine's room, the room was in shambles, destroyed.  Blood was all over the place.
"

"
What! 
What about Mrs. Raccine
?
," Alex interrupted, fearing the worst.

Elizabeth continued, "Mrs.
Raccine's alive, but in 
shock.  She has no injury.  Physically, she's stable, at least for now.
"

"What?” Alex looked dumbly at Elizabeth. “What about the blood?   Where was she injured?" 

"The blood's not Mrs. Raccine's."

"What?"  Alex barked at Elizabeth.  "I don't understand, then whose blood is it
?
... how did the blood get into the room?"  Alex's voice was demanding.

Elizabeth held her arms up in a back-off gesture.  "Alex, chill out and please let me finish.  I'll tell you what we know, which isn't much.  We think the blood belongs to a rooster found in the room with her.  We also found a dead snake, cut in three pieces under her bed.  We don't know the meaning."  Elizabeth paused for a breath.

Alex could hardly believe what she was hearing.  She was stunned and could feel the hair stand up on her a
rms. The hospital leaders
started talking at once, shouting over each other in an effort to be heard, except for Alex, who was speechless.  She watched as an administrative aide closed the conference room door from the peering eyes of news reporters.

"Quiet, quiet," Alex said firmly.  "One at a time, please." 

Finally the noise died down. 

"Help me understand.  What does this mean?  What else have you done?"  She looked around the room.  "Have the police been notified?  Does Governor Raccine know?  How'd the press find out?"

Dr. Ashley, a fifty-some year old, silver-headed gentle-faced general practitioner
who
seemed a little calmer than the other administrators, attempted to answer Alex's barrage of questions.

  "Alex, please keep in mind we don't know much. Yes, the police have been called.  Captain Francois of the NOPD is currently questioning the staff on Six North." 

Alex looked at
her nemesis,
Bette Farve
,
and asked her sharply, "Have you spoken to the nurses about what happened?  Have you interviewed and prepared them for the police questioning?  Did you impound the chart from the unit?" 

Bette Farve, an angry, thin-faced stick of a woman, bristled at Alex's questions and responded sarcastically, "I talked with the night nurse briefly, but she was so traumatized that
she didn't make much sense.  It was a waste of my time."  Bette hesitated for a moment and continued
arrogantly
, "If we'd been able to reach you, Ms. Destephano, perhaps we could've been more prepared for this."  Bette's voice was cold and had a caustic edge to it.

Alex ignored the implication.  She and the chief nursing office
r
rarely agreed on anything, and Alex frankly didn’t like her.  "We're preparing now.  You need to get up there and provide psychological support for the nurses who cared for and observed Mrs. Raccine's situation for lack of a better word.   You need to call psych and arrange for a post-traumatic stress counselor for the nurses. Please leave here now and report to Six North so we can know firsthand what is going on up there."

Alex knew she was invading the territory of the chief nursing executive, but didn't care.  She detested Bette Farve and found her an inept nursing leader who neither cared about her staff,
her
patients, nor anything other than the prestige of her position and time off.  Usually Alex had a little more patience with Bette, but it was unfathomable that Bette would be in a meeting with the administration when her staff was coping with a medical and political disaster and the police.

"I wasn't aware I worked for you, Ms. Destephano.  As you know I report to Mr. Montgomery." 

Alex
glared at Bette,
looked at Don and spoke directly to him, "To safeguard our legal position, Ms. Farve needs to be on Six North reviewing the situation and providing support for her staff.  This is necessary for obvious reasons, especially for support of CCMC's potential liability.  We can manage here without her.  As soon as she assesses these things, she can report back to us.  In fact, I'll b
e up there shortly to talk with
the staff myself."

Don looked at Alex blankly and seemed unable to respond.  He looked back at the floor. 

Alex persisted, "Don, Ms. Farve needs to report to Six North.  Now.  I insist
!
"

After a brief silence, Don nodded his head, and Dr. Ashley addressed Betty directly, "Please go to Six North as Alex suggests.  Any information you
gather
wi
ll
help us handle this situation the best way we can."

Dr. Ashley continued to speak with Alex and the group after Bette left. "Captain Jack Francois will report to us shortly and give us his preliminary findings.  And, to answer your final question, Alex, the Governor does know, and he's terribly
upset,
distraught
even
.  We moved Mrs. Raccine to the other VIP suite and he's with her now.  At this point, his concerns are
only on his wife."

The room was quiet as each staff member reflected the situation and contemplated the hospital's situation.  After a few moments, Don Montgomery's secretary, Latetia, entered.  "Mr. Montgomery, the reporters are pressing for a statement.  Are you ready?"

Don didn't respond, but continued to stare at the floor.  Everyone was looking at him for direction, but he seemed incapable of speaking, much less of making a decision. 
He seemed to have checked out.

Alex glanced at Dr. Ashley and said, "Tell the press we'll issue a statement at ten this morning.  In the meantime, we'll continue to gather information and assess the situation."  The other members of the executive tea
m nodded their
in agreement.

Alex spoke sharply. "Don, pull yourself together.  We've got a major crisis here and need to deal with the media and the public."

There was still no response from the CEO who seemed unable to answer or understand.

Alex sighed and looked at the group, "Call an emergency meeting
 
of the Hospital Board of Trustees.  They can help us decide the best
way to handle this.  Are you with me
on this, Don?"  Alex stared at the CEO
.
  He didn't answer, but did nod his head.

Elizabeth Tippett
stood to leave
the
room to notify the board as Alex asked the group
, "How did the press find out?"

Dr. Ashley
shrugged his shoulders and
replied, "Don't really know.  We suspect a staff member on Six North called them.  Otherwise, we have no idea." 

“Actually, Dr. Ashley, that’s not right.  Someone made an anonymous call to the CCMC operator and told us to go check on Mrs. Raccine, that something had happened to her and she nee
ded help,” Elizabeth reported,  "
at least that’s what the nurse told me earlier.
"

Alex could hardly believe her eyes.  “What, someone called us?  We didn’t discover it on our own?  This is incredible.  That must mean that…..
"

“
Exactly," Elizabeth interrupted, "
Yes, that whoever is responsible called to let us know,” Elizabeth finished the sentence for her. 

    "Who found
Mrs. Raccine?"

    "The night charge nurse reported that
she was called b
y the hospital operator and told to check on Mrs. Raccine.  The nurse did so and found Mrs. Raccine
unresponsive and covered in blood at five-fifteen
this morning
.  She immediately called hosp
ital security, who
called Bette, the administrator on call.
  After she called me, I contacted Dr. Bonnet.  We all arrived about thirty minutes later.  Then I called the police."

Alex's stomach knotted when she realized that Mrs. Raccine was Robert's patient.  "Has Bonnet seen Mrs. Raccine since this happened?"

"
Yes, he says she’s stable, and has
no physical injury, but is unresponsive, almost comatose.
She h
asn't moved or spoken since she was discovered.  Her vital signs are stable, except for some heart problems."  Dr. Ashley
had a worried look on his face as he
paused for a moment and
continued
, “
The
biggest
concern here is her mental state, although we'
re monitoring her heart
which could become a greater concern
." 

Alex stood up.  "I'm going up to Six North and talk with the sta
ff.  If anyone needs me, call my cell.  Let
me know about
the board meeting."  Alex leaned over and whispered to Elizabeth.
"See if you can get Don to pull himself together." 

"Okay, Alex.  How do
you want to handle the press?  We owe them something in less than two hours."  Elizabeth looked desperate.  "They didn't teach us how to handle these kinds of crises in
journalism school," she
smiled weakly.

"Elizabeth,
nobody's prepared for anything
like this.  The best thing to do, at this po
int, is to admit there was an attack on the Governor’s wife and that she is stable
.  Tell them something while telling them nothing.  You can do it.
You know, the Texas two-step kind of thing...
Draft it up and we'll talk about it later."

***

The Six North nursing unit was crackling with
chaos and
activity.
Instead of the normal early morning baths, treatments and vital signs, there wasn’t a nurse in sight.
There were three
uniformed NOPD police
officers in the hall, and three others in the nursing station.  Alex was greeted by Janelle Wells, nursing director of Six North.  Her disheveled appearance and rapid speech indicated her stress.

"T
hings are bad.  Six nursing assistants
and hospital attenda
nts have left the hospital, saying
they were afraid to work
here today.  We've only two RNs
.
Angela's working days, and Susan is still here from
a 12 hour
night
s
hift
.  S
he volunteered to
stay over, but she's zonked emotionally
and
probably too tired and stressed to be useful
."  Janelle
pa
used for a breath and continued as s
he waved
her arms toward the policemen.  "These guys
in the police uniforms
have got to go, or at least change their clothes.  Patients are frantic, and their families are asking
all sorts of questions. 
There are all kinds of rumors floating out there and s
ome
families are threatening to take patients
to another hospital.  I can't give care to these people with only two nurses.  This is crazy."  Janelle threw up her arms in dismay.