Christmas Day in Einstein Emergency
First in a three-part series about Christmas in the Emergency Department.
Nurse Joshua Krosskove is logging patient information into a computer, wearing a Christmas tree hat, chatting with a colleague—when the voice of a dispatcher comes over the loudspeaker: a patient is on the way to the emergency room at Einstein Medical Center Philadelphia. It is late afternoon on Christmas Day, and this is one of the few trauma emergencies that has come in.
Krosskove jumps off of the stool, and opens the doors to the trauma suite. He grabs a lead apron to protect himself from potential X-rays that might be required for the patient. But the description of the case that’s on its way doesn’t sound too serious: it’s a fall. “I just put this on because I think it looked nice with my hat,” he said, joking, of the zebra-striped apron and the Christmas tree hat. He is sucking on a small candy cane.
The patient arrives, head bloodied, and is wheeled into the trauma room—and everything changes. The relaxed mood turns vigilant and Krosskove is intense, serious and fiercely focused, working at a computer on a podium, recording the information the docs are calling out. The room has gone from empty to crowded, in response to the Trauma 1 alert: the highest level of alert that summons docs and technicians and nurses and residents and everyone else who’s needed to help the patient.
It soon becomes apparent that the patient on the table, who’s barely conscious, can’t move their arms or legs. “Squeeze my hand,” someone says. The patient doesn’t respond. “Can you feel this?” says another, pressing the patient’s leg. Again, no response. The team takes the patient’s temperature, examines the wounds, asks questions: What happened? Was there a fall down the stairs? They worriedly confer with each other.
The sudden and powerful transformation explains the intense connection ED folks say they feel to each other: in these critical moments, they’re individual parts of a working whole that comes to bear when someone’s life may be at risk.
The patient is examined and stabilized and soon wheeled out of the trauma room to a CT scanner as subsequent medical intervention is set in motion: tests to determine the cause of the paralysis, consultation with the family, the implementation of treatment. The intensity of the moment gradually wanes as the ED team drifts away, back to other patients and other tasks.
There will be more traumas to come on this Christmas Day in the ED. And festive hats and holiday cheer notwithstanding, the emergency team will—when alerted—assemble instantly and perform the same impeccable dance at the next patient’s bedside, in order to save the day. That’s what it’s about for nurses like Josh Krosskove. “We’re the front line for the healthcare system,” he said, and he likes it that way.