HawthoRNe (2009) s02e01 Episode Script

No Excuses

What's up, Dr.
Ryan? Hey, you paged? What's this? Red ink or blood? Both.
They're closing us down.
What? This is the fifth audit, costs are out of control.
Patients can't afford it.
We can't, either.
Insurance companies cap payments.
The state won't help us to bridge the gap.
Morrissey, we did everything they asked.
They can't do this.
They just did.
Three months, that's all we've got.
We'll shut our ER down in a month and begin layoffs immediately.
You and the other surgeons will gain OR rights at James River.
We start transferring cases over there to help us empty out.
James River is a pit.
Right now it's the only hospital in this area left standing.
State wants me over there.
Maybe we can avoid making the same mistakes we made here.
I need you to go with me.
I need people I can trust.
Wait.
We did everything right here.
It's pointless.
If we went belly-up this fast, James River won't last a year.
And if it goes under, there won't be a hospital in the area that'll care for anyone without a gold card.
Well, congratulations.
You are officially our last patient.
You know, we usually give our lucky finalist a going-away present.
But this is the best we could do.
You take care, little mama, okay? All right.
Okay.
Ready to go.
Thank you for everything.
You're welcome.
Take care, all right? That's good.
Thank you, everybody.
Melissa.
Keep in touch, okay? Yes.
Well, that's our last chopper out of Saigon.
You know, this could end up being a good thing.
Oh, come on.
You've got your new cush gig.
Yeah, what, working at a home healthcare service? Please, ask me how long before I die of boredom.
James River is tough.
We could use the help.
They've got a staff.
Why put people out of work? I was lucky to get my folks down there.
What about you and Sloan-Kettering? I haven't decided yet.
It's a good opportunity.
Yeah.
No more administration bullshit.
That's for sure.
Full caseload.
All that blood and guts, cool new toys.
I'm happy for you.
How do I get to the hospital? The hospital's closed, sir.
James River is the closest one.
Where the hell is that? Sir, you're bleeding.
I didn't hear about the hospital closing.
Well, it's been big news.
Do you live here? Just down the block.
Whoa.
Let's get him in the car.
How's he doing? Radial pressure's thready.
Which way? Oh, there it is.
There it is, there it is.
Stay with me, Vernon.
All right.
How is he? He's okay.
He's okay.
Right there.
Got it? Okay, here we go.
Vernon, stay with me.
Come on, buddy.
I got you.
We're gonna move you out.
We'll need a gurney, Tom.
Sorry, I don't have one on me, okay? Here we go.
I got him.
I got him.
You got him? Yep.
Come on, Vernon.
Listen to my voice.
Okay, Tom, you gotta go over there.
Okay.
Stay with me, Vernon.
Vernon.
Help me out.
We've been waiting here three hours.
I'm sorry, sir.
We're going as fast as we can, okay? Sir, excuse me! You gotta wait until the triage nurse sees We got a GSW! You can't just come back here.
It's okay.
I have OR rights.
Sorry, excuse us.
Put him on this gurney right here.
Bobbie! Thank God you're on today.
What are you doing here? Gunshot victim.
Where's your trauma bay? Right there.
All right.
Go.
I'll get some units of O-neg.
Incoming! Coming through.
Excuse us.
Sorry.
Watch it.
Coming through.
Here we go.
Gunshot, said he was cleaning his gun.
Ooh, nasty.
With that much bleeding, I assume the bullet fragmented? I can't tell yet.
Do me a favor.
Put some pressure on this? Yep.
Thanks.
I assume you work here? Yeah.
Steve Shaw.
Tom Wakefield.
Nice to meet you.
All right, we need to get this guy up to the OR.
Yeah.
Okay.
Here we go.
Hang in there, Vernon.
Coming through! Chang, I can't get any information.
Excuse me.
You are? I'm Christina Hawthorne, CNO at Richmond Trinity.
Well, thanks for bringing in the GSW, but I'm gonna need you to wait outside.
Sure.
This man's dead.
Yes.
Well, how long's he been dead? Since he died.
The morgue is full.
We're gonna move him down in a little while.
Yeah, but he's dead.
I don't want you to alarm the other patients.
I'll be back with your meds.
All right.
Let's go! Tom, I heard you were in here.
I didn't recognize you without your chainsaw.
Paul.
I'm glad you're here.
I just ordered a sandwich downstairs.
Will you pick it up for me? Yeah, I'll get right on that.
Shooting victim? Yeah, a fragment nicked his carotid.
Had one of those last week.
Guy wasn't so lucky.
Well, I see you've been practicing.
Well, not as much as I'd like.
Being Chief at Trinity, most of the cutting I did was red tape, but I guess you know all about that.
Being Chief here is not so bad.
Got my own parking spot.
Oh, I know.
I'm in it.
Not anymore.
I had it towed.
You bastard.
You just gonna stand there and look pretty? Come on, jump in.
Thought you'd never ask.
Good work, Tom.
Thank you.
Excuse me.
Could you move this back just a little bit to keep it clear? Just one minute.
Double-stick tape, best tool in the carpenter shop.
Okey-doke.
Genevieve Larazzo.
Yeah.
Hi.
What seems to be the problem? You know, we've been here nearly four hours.
She's in a lot of pain.
Abdominal? Are you pregnant? No.
Let's take your temperature.
Pulse and temperature are normal, so let's go back and take a look.
All right, come on, Gen.
Here we go.
Excuse me, miss.
You know, I'm just with someone.
Someone will be with you This is important.
Hey, hey, buddy.
Why don't you wait your turn? Look.
Sir, is this your penis? My dog told me to cut it off.
What do you think I should do? I'd get a new dog.
Someone will be right with you.
Oh, come on.
All right, baby.
Come on and sit down.
Hey, Dr.
Shaw? I could use a hand in here.
Of course.
Hello, sir.
What do we have? See for yourself.
Oh.
Is it yours? It's lost a little color.
His dog told him to do this.
Yes, always been a cat fellow myself.
Okay.
Examine the wound, see if reattachment is even possible, and I will call in a psych consult? Yeah.
Please.
Poor guy.
Yeah.
Hey, Marcus? Yeah.
Could you admit the patient in number Eight? Eight.
And also, could you And call in a psych consult.
I already did.
I got ice.
Ice? Eight.
Thank you.
That's awesome.
That's remarkably efficient, but I just have to ask, how did you know? Dog called it in.
Gail? My man's had a psychotic break.
Hallucinations, self-inflicted genital amputation.
So my wait time just got longer.
There's a woman in the waiting room complaining of abdominal pains.
I saw.
Fever? No.
Pulse? Sixty-two.
She's been waiting for hours.
We'll get to her.
Can we at least run a preg test? Get her in line for a CT scan? At the very least, get her some pain medication? Folks here like to lay it on thick, so they can cut to the head of the line.
She's faking? You'd be surprised at some of the stuff I've seen.
Mrs.
Carrollson, how long have you had that tumor? About 19 years.
And why did you say you never had it looked at? It didn't hurt.
Another faker? Welcome aboard.
I didn't say anything.
Why else would you be here? All right, what do you plan on doing with your existing director of nursing, who happens to be storing corpses in your ER? I'll deal with that.
You know, I can't afford your old salary.
I'll deal with that.
Then what are you standing around for? Here is your office.
In here? No, no.
Here.
This is a waiting room.
Yeah, it's the only space we have available right now.
I can't displace any of the James River staff.
This is a waiting room.
I'll make it work.
Look, this hospital is below the national average on everything, from heart-attack care to giving out the right antibiotics.
Across the board, our quality of care sucks.
What about the Joint Commission national performance summary? John, we had over 90% at Richmond Trinity.
You mean to tell me that this place is not providing minimum quality of care? The Joint Commission said they'll inspect us in six months.
If we don't get 75%, they'll cut our funding.
I'm on it.
I'm on it.
Thank you.
I'll get your furniture from Richmond Trinity.
It'll feel like home in no time.
Hey.
Someone left him behind.
Thanks, Kelly.
It hurts! Please.
Please, stop.
It hurts! Hey.
You need any help? I can't get a vein, and I can't use the other arm.
Okay.
Why don't I get a hot pack to bring out the veins, and then I'll try? I need to change his dressing, too, before the OR.
Oh, I can help with that.
Knock yourself out.
Why don't you get the hot pack and I'm out of here.
I hate her.
Aw, she's doing her best.
I was new once.
All right, let me see that arm.
What happened? Burnt.
How? I was cooking for my sisters and spilled a pot of water for the noodles on it.
Hmm.
So, tell me about your sisters.
They're all right.
Just all right? Yeah.
Hey.
What? That kid was just scared.
Thanks.
Yeah, some kids just have crappy veins.
It takes time.
I mean, you should have seen me when I first started.
I've been here two years.
Yes, we're gonna x-ray him first.
The surgeons will do what they can.
Good luck.
What are you guys doing here? Responding to a 911 call.
Get me a doctor.
Sir, you can't call 911 if you're already in the hospital.
Well, take us somewhere else then.
I can't do that.
She's in pain.
They won't see her.
She's been triaged.
We've had higher-priority cases come through.
I understand how frustrating this is.
I can take her.
See? There you go.
Sorry about this, fellas.
Excuse me.
We have a toddler that ingested cleaning fluid.
She's having retractions.
Isn't there anyone else? No.
Well, I think this woman I didn't ask you what you thought.
I know you were RN Charge Nurse at Trinity, but let me explain how this works here.
A doctor or senior nurse gives an order, you follow it.
Take care of the toddler first.
Yes.
Can someone tell me why Mr.
Greener is still snuggled in bed? I ordered an X- ray hours ago.
Mr.
Greener? Yeah.
Dr.
Marshal, Greener is scheduled for an echo later this afternoon, and he hasn't really been sleeping.
So, you know, I thought I'd just let him rest.
He can get the X-ray on his way back from echo.
How considerate of you, Nurse Stein.
I'm all about patient comfort, but I'm also about patient care, and I would love that X-ray as soon as possible.
That's not too inconvenient for you, is it? Is it? No.
I wouldn't want to ruin your tea party.
No, sir.
Ma'am.
Excuse me.
Doctor.
Doctor, one more thing.
You look so hot today.
Watch it, Stein.
Mmm-hmm.
Hey, Marcus? Yeah.
These are for Tiber.
Your abdominal just got sick all over the waiting room.
No one's seen her yet? No.
This place is insane.
You're still here? Yeah.
I just signed on as Director of Nursing.
Oh, thank God! Now, listen.
First things first.
How long has that abdominal been in there? She's been waiting for over five hours.
What? Hmm.
What is wrong with you people? Is she a hostage? I'm so sorry Sorry? I want to see the president of the hospital.
Whoever's in charge.
I'll frickin' sue this place! This is the boyfriend of our abdominal patient.
Oh! You know? We're gonna see her right now.
It's about time.
Wait, wait, wait.
What's going on here? This man's girlfriend has been waiting forever.
She needs to be seen.
And she will be.
Now.
Excuse me? Listen, obviously Morrissey hasn't talked to you and this is not really my place, but I just signed on as Director of Nursing.
He can't do that.
I'm Director.
See, these two, they don't even know who works here.
Get me a doctor.
Look, sir, I told you I'm done with you.
Okay, let's just evaluate No! Get me a doctor! You have to calm down! Don't tell me to calm down, or I'll knock the crap Whoa, hey! Call security! Hey, hey, relax! Just get off of me, all right? Whoa, whoa, whoa! Somebody call the police! All right.
Look, I'm fine.
I'm gonna get security.
My girlfriend, please.
Okay.
I have to help this patient.
This is still my ER.
Not anymore.
Bobbie, please? Sir? You are crazy.
Why wouldn't you jump at Sloan-Kettering? Why do most guys do anything? A girl.
Yep.
She's here in Richmond.
How long you been going together? Well, we're not technically, you know Her husband died.
He was my patient.
It's complicated.
Uh-huh.
When did he die? A year and a half.
Kids? Yeah.
One.
She's awesome.
She's great.
Well, is your girl ready to move on? She's ready-ish.
I'm getting a lot of mixed signals.
Is this like Rachel in med school? God, no.
No, this is Complicated? Yeah.
The OR is ready for you.
How long will this take? Another graft? Maybe an hour.
No.
I mean, when can I go home? Well, it depends how the graft takes, but at least a few more days.
Don't worry.
You are gonna be back at home in no time, playing with your sisters, seeing your mom.
She works all the time.
What do you do for fun? You play sports? Not anymore.
I'm a lefty.
Oh, well, I have seen a lot of patients learn how to use their right, so they're almost ambidextrous.
I can't even eat without spilling my food everywhere.
William, you're gonna be fine, okay? I promise.
Let's get this over with.
I need a terminal.
Well, let me try that again.
I need a terminal.
Oh, I'm sure your word find can wait, huh? Yeah.
I don't care if her patient is turning purple.
I'm not lifting a damn finger to help him.
Yeah, I don't think that would really solve anything.
I mean, come on, aren't all doctors rude? Rude, my ass.
That woman is a stone-cold bitch! Can't wait to get rid of her.
Kelly.
Oh, thank you.
Mmm-hmm.
Is that William's oxacillin? No, it's for the boy in 724.
Why, did you give him oxacillin? Is there a problem? You have to call the OR right away.
He's allergic to penicillin.
Well, they may have already started.
Well, then, run.
I'll call.
They have to know that there's been an error.
Which floor? First.
Forget it.
Here.
I'll go.
Pressure's still It hurts? Yes.
Peritonitis.
Acute pain.
Let's order an abdominal series.
Bobbie, tell them to get it down here super stat, or I'm gonna drag it here myself.
Thank you.
What is it? Well, the bag around your intestine is inflamed.
Can I have something for the pain? I'm sorry, not until we know what's causing it.
How about if I get your boyfriend back here? Okay.
Bobbie? Can you do me a favor and get her boyfriend? I'm gonna go find Morrissey.
Thank you.
Need a carpenter? Yes! Yeah.
I could use some shelves on this wall.
One or two for some books of mine and stuff.
Length of the wall.
Brought you something.
Got it.
Thanks.
I would have never found it.
It's all good.
See you around.
Yeah.
Where are we? My new office.
Are you serious? Well, what about the other job? You said it was good, more money, less hours, no more banging your head against the wall.
Well, even you said it probably wouldn't last.
I mean, look at this place, Camille.
What could I do? You know, you could scan all this stuff onto, like, two DVDs.
You know what? That is a great idea.
Why don't you intern for me and do it? It would look great for college.
I need the car.
Do not try to change the subject.
Did you do your list of colleges and download your applications? Oh, we have time.
No, we don't.
You can't blow this off, Camille.
Can I have the keys? Here.
Sorry.
That's cool.
Where is it? It's at Trinity.
Long story.
Here, just take some money.
Take a cab.
I left it in a spot.
And, hey.
No Arizona State and no Miami.
U.
Penn is a party school.
Love you.
Camille? Not too late, okay? Oh, no, I'm staying at, uh, Suzanne's tonight.
No.
Camille! See that? NPO.
Do you know what that means? It's Latin for nil per os.
Nothing by mouth.
It could also stand for non per os, but it means the same thing, nothing by mouth.
That means Mr.
Hanson should not be eating a BLT, which stands for bacon, lettuce, tomato.
Pull your act together.
Doctor.
How did I ever let you convince me that this would be a good move? You're very suggestible post-coital.
I really think you should try to lighten up on them, okay? They're idiots.
Are you fraternizing with the enemy? Trust me.
It will do you a lot of good.
Trust me.
I don't know how to be nice.
You're nice to me.
Sort of.
That's 'cause I like you, Steinie.
Sort of.
I'll try.
Yeah.
Hey, Mark.
What happened with patient Harris? I'm sorry? You are? I got a call about a peds nurse screwing up the OR schedule.
That's who I am.
He was given oxacillin, and he's allergic.
How did you miss that? He's not my patient.
Let me see the chart.
Malia! Coming.
Good thing we caught it on time.
Good thing.
Malia, did you write this up? Not yet.
I want it in 15 minutes.
And, you, uh, Nurse Kelly.
Epson.
Nurse Epson, this isn't Richmond Trinity.
Here we follow protocols.
We don't just run into the OR and stop a surgery.
I'm writing you both up.
Yes, ma'am.
Way to get my back.
Excuse me? Well, you really threw me under the bus.
It was your error.
Don't play that sweet, innocent baby girl thing with me.
You could have covered for me.
I helped your patient.
And if that pisses off the higher-ups or you, whatever.
And, Malia? I do have your back.
So if you need help, just ask me.
Gustavo? We're gonna need you to step out for a bit while we take some X-rays.
Oh.
Uh, gladly.
It's the abdominal, right? Yeah.
Okay, let's go, then.
All right.
That's the position.
This man.
Sir, we need you to step outside with us.
For what? Attacking and threatening hospital personnel.
I didn't attack any You threw one of my clerks up against the wall, and you threatened me with physical violence.
He was agitated.
My girlfriend, she'd been waiting for hours.
Come with us, sir.
This is crap.
Put your hands behind your back.
Sorry, Gen.
This is not gonna fly.
This is still my ER.
I don't care what anybody says.
This is your office? Yeah.
Tell me it's true.
Are you here? You didn't think I would leave you here by yourself, did you? Okay, good.
Then you can save us from the nine circles of hell.
These folks certainly are lost souls.
Well, can you blame 'em? I mean, I can't help but think that they closed the wrong hospital down.
Christina! Oh, I'm so happy! How do I get in there? How crazy is your floor? Oh, the patients are great.
I love it here! So, Gail's on the warpath.
Mmm-hmm.
She just had Genevieve's boyfriend arrested for assault.
She can't do that.
Gail? The mean one? Yeah.
Are you her boss? Yeah, I'm supposed to be, but obviously, she's not getting that.
Yeah, she came to peds really upset with me for finding a medication error and pushing an OR call, and she's writing me up.
She's what? This is crazy.
What about you? Any run-ins? No, I got my hands full with Marshall.
I bet.
What, you just waltz in here and take over? Am I fired? Listen, Morrissey is gonna talk to you, okay? All I know is that you getting that guy arrested didn't help anything.
He threatened me.
Now, come on.
I know you could handle him.
Is this a joke? No.
It's not.
And he actually has a point.
Five hours? You see how backlogged we are.
Try "backwater.
" This place doesn't have any systems.
It's like being out of 1972.
I don't have to listen to you.
I've been working here for 17 years.
Doc, pressure's dropped to 89 over 50.
Genevieve? Genevieve, can you hear me? She's unresponsive.
Page Respiratory.
Marcus? Yeah.
Respiratory.
You got it.
Draw a gas? She's not oxygenating.
Get me 20 of etomidate and 120 of succinylcholine.
She must have a perforated bowel.
The X-ray came out clear.
Well, it must have just burst.
You need the combination.
Why is the cart locked? Just stay out of this.
Who locks a crash cart? We've had one taken.
Get the other cart! Quick as you can.
Come on, come on, come on.
Pressure's dropped, I'm gonna intubate.
Give me a 7 and a half ET tube.
She's desaturating.
She needs more fluids.
Prime the rapid infuser.
This was taken by the boyfriend's cell phone.
It's all over the Internet.
It'll be on the news by tomorrow morning.
I need full reports right away.
We need to be able to explain how this could happen.
It was a systemic breakdown.
Yes, the whole hospital is broken.
That's why we're here.
I know, but it's gonna take awhile to get this ER up to the 21st century.
I don't even know where to begin.
That's not your problem.
Yes, it is.
What is this? I'm splitting the nursing department.
Gail will handle critical care, ER and ICUs.
You'll take everything else.
That is not what we agreed to! Joint Commission is pulling up their inspection date to three months from now.
You two need to work this out, or we will lose our funding.
Look what happened today.
What's next? So, you mean to tell me you can kill somebody else and end up on the Board of Directors? I'm the fall guy? Yes.
My nurses Your nurses? Your hospital closed.
My nurses were right.
You're more concerned about not being shown up than these patients.
That woman died today unnecessarily.
You know how many of you folks I've seen parade through here? Dozens.
You come here with big plans, big goals, but no idea how this hospital really works.
No idea what we deal with.
And then you know what always happens? You move on to bigger outfits, following doctors to better jobs, while me and my people are left behind, doing the best we can! That's why things don't change! That's why I wouldn't do one thing differently! You know what? Before you go on telling me how I can't handle the truth, let's get one thing straight.
I don't care what backroom deal you made! What happened in that ER today will never happen again! And you set me up! I'm in an impossible situation.
Oh, really, Morrissey? Did she threaten you with a lawsuit? She's been here almost 20 years.
She knows where the bodies are buried! That's because she buried them! You know what? This woman must have a sex tape of Morrissey or something.
No, I'm serious.
Because she's not going anywhere.
How are we gonna work with her? No, I think the question is, how are we gonna work around her? Good luck.
Wait a minute.
Bobbie, you're gonna be my eyes and ears.
No way.
She'll make my life a living hell.
Bobbie, that woman died.
Don't put me in that position.
You tell me what choice I have.
Candy.
Can you hear me? Ray! It's good to see you.
How's the new hospital? Oh, it's weird.
It's so weird.
It's It's different.
You know? How, uh Where are you now? All I can say is it's a FOB.
Forward Operating Base.
That sounds dangerous.
Yeah, we've seen some action.
You know, this is really where I should be.
Good for you.
Yeah.
You're being careful, huh? Yeah.
I'm not the one you should be worried about.
What these people go through is amazing.
Have you given any thought to, uh, what you're gonna do when your six months are up? You know, there's been so much going on here, I just really haven't decided yet.
Really? Well, I'm sure they really need you, huh? Yeah.
I'm just glad to be a part of it.
It's a real honor.
But I miss you.
I'm Mmm.
How nice, waiting for me in my office.
Made us a reservation at The Hard Shell.
Oh.
You're so sweet.
Mmm-hmm.
You know what? I was thinking about your advice.
You know, to not be the dragon lady? You're good for me, Steinie.
Yes, I am.
See you tomorrow.
William? Are you okay? I want this over with.
Hey.
Get up.
Come on.
Get out of bed.
You're coming with me.
Watch out.
What are we doing here? You want to work on your right arm, don't you? Grab a paddle.
You ready? You ain't playin'.
I ain't playin'.
Okay, then.
Let's see what you got.
All right.
One love.
There you go.
Psst.
How's our shooting victim? He's stable.
Did you wait this whole time just for me? You wish.
I work here.
Well, what about your new job? They'll get over it.
So, we're staying? "We"? What about Sloan-Kettering? I passed.
I couldn't leave Richmond.
Besides, if you're gonna go up the River, you're gonna need some help.
Oh, is that a fact? Mmm-hmm.
You know, actually, I had a pretty good day today.
I assisted on reattaching a penis.
Hmm.
I'm surprised this place didn't lose it.
I'm surprised you didn't run for the hills the minute we got here.
Couldn't.
Although Morrissey's up to his old tricks.
So I guess we were both dealing with dicks today.
So, straighten it out.
The place, I mean, not the, you know Come on, it couldn't have been that bad.
Nah.
It was.
Oh, so tell me about it over dinner.
Good, I need a ride home.
Good.
You did get the car cleaned? Uh, was I supposed to? The guy was bleeding all over the place.
In the backseat! Of course I got the car cleaned.
Good.
So, what did the car wash say when they saw all that stuff? They must have thought you were an ax murderer.
Well, I couldn't let some poor Joe clean up that whole mess.
Oh, so you did it? Yeah.
Of course I did it.
Although, you know, technically, that's a nurse's Don't you dare.
That's funny.
Yeah.
Wow.
What do you think? Place looks great.
You like? Yes.
It's way different, huh? Very nice.
Very nice.
Want me to hang this up? You know what? That'd be nice.
As long as it's above 4 feet.
Forget it.
Where's Camille tonight? She's actually at her girlfriend's house.
She's gonna stay the night there.
It's just us? Yeah.
I'm sorry.
I feel so stupid.
I'm sorry.
I'm sorry.
No, I No, Christina, I'm sorry.
I shouldn't have Tom, it's not you.
I just That's okay.
I Listen.
So stupid.
You know what? I really want you to stay.
I just It's okay.
It's okay.
When you're ready.
When you're ready.
I'm not going anywhere.
Okay.
Good night.