Author Aria Orchard

I dreaded being transferred to the fourth floor, also known as ‘The Surge Floor’. Patients were sent here when they were near death. The name ‘Surge’ was given by a veteran nurse who noticed a pattern – before dying, these patients would experience a sudden burst of energy.

They would become introspective, wanting to reconcile with estranged loved ones and make plans for their future. Unaware that they would never leave the hospital, they spoke optimistically about the changes they would make in their lives if given another chance.

As a nurse, it was heartbreaking to witness this false hope, knowing what came next: death. I wanted to tell them, but instead I smiled and listened attentively. The duration of each surge varied – sometimes it lasted a few hours, other times only minutes. But in the end, every patient ended up in the morgue awaiting an autopsy on a cold metal gurney.

As I approached the nursing station, I heard a familiar voice call out to me. “First day?” Dr. Phillips asked, his blue eyes meeting mine with a hint of recognition. Despite my previous encounters with him during his shifts in the ER, he seemed to have forgotten who I was. It stung a little, but I knew that as a quiet and reserved nurse, I didn’t stand out like the others who threw themselves at the doctors.

“Yes, sort of. I just transferred from Oncology,” I replied with a small smile, pushing back a stray strand of brown hair behind my ear.

“Well, welcome to the Fourth Floor. You must be either dedicated or a little twisted to make that jump,” he joked, offering his hand to shake. “I’m Dr. Greg Phillips, one of the Residents.”

I shook his hand firmly and introduced myself. He smiled warmly before offering to help me settle in. Graciously declining, I instead asked for directions to the employee lounge.

“I’m actually heading there now. I’ll walk you down,” he offered as we passed by patient rooms. Some were quiet with only the soft beeping of monitors and machines, while others had muffled voices – nurses speaking to patients or visitors talking in hushed tones.

Finally, we arrived at the lounge, and he held open the door for me. There was another nurse sitting at the table, eating a yogurt. She glanced up briefly before returning her attention to her Yoplait.

“Hey Erin, this is Maddie. She just transferred from Oncology on two. Can you give her a hand getting settled?”

Erin gave a half-hearted ‘sure’ before standing up and tossing her empty cup into the trash can. Dr. Phillips then excused himself and left me alone with Erin to begin my new journey on the Surge Floor at the hospital.

I stood awkwardly near the door, shifting my weight from one foot to the other. Erin approached me and planted herself directly in front of me, her hazel eyes piercing into mine before sweeping over my appearance.

“Why’d you transfer from Two?” She asked bluntly. I could have told her the truth – that most of the nurses on Two were being laid off and transferring was my only option – but instead, I chose to give a vague answer.

“I really enjoy helping people. I think I can make a difference here.” I smiled, hoping it didn’t come across as forced.

Erin snorted in response.

“Come on, that’s bullshit. I know about the layoffs. I’m just curious why you’d choose to come up here instead of getting a job at Westgate or doing private duty.”

She had a point. I could have chosen those options, but I couldn’t afford to be unemployed while searching for another job. Living paycheck to paycheck was already tough enough.

“Well, I could ask you the same thing,” I retorted.

Erin shrugged nonchalantly and headed towards the coffee pot.

“I have bills to pay and I kind of like it here. Been here for ten years now. And let’s face it, you have to be slightly messed up to work here for so long and still stay sane.”

Before I could reply, the door swung open, and a man walked in looking exhausted and irritated. His brown hair was thinning at the top and he sported a five o’clock shadow with hints of grey.

The man in the lab coat and scrubs stormed past me, his name and badge hidden from sight. He headed straight for the coffee maker, muttering under his breath.

“For fucks sake, Erin. Are you gonna just stand there looking at the pot, or are you gonna make some? I’m going on 36 hours. I need fuel!”

Erin smirked and gestured to him. “This is Denny, our floor mascot and dickhead. He’s been here forever.”

“Fuck you Erin,” Denny replied as he filled the carafe with water from the faucet.

Erin then turned to me and opened a door. “C’mon, I’ll show you around the floor.”

I followed her quickly, taking in each room we passed- the nurse’s station, supply room, and the family waiting area.

“That’s where patients’ loved ones go to meet with doctors. Usually it’s for end of life conversations and organ donation requests.”

We continued down the hallway, with Erin pointing out each patient’s room and their condition without ever peeking inside.

“Room 403 is John Burke-68. End stage renal failure. Been here for three months. Spent the 70s partying and destroying his liver and kidneys with drugs and alcohol. Can’t be put on the donor list because of it. He only has one visitor- his daughter Jamie. And judging by his labs, she’s sneaking him booze.” Erin shook her head sadly before moving on to the next room.

“Room 410 is Shelley Davis, 42. She’s been in a coma for over a year. The only thing keeping her alive are machines, but her family refused to pull the plug,” Erin rattled off while we walked down the hospital floor. I followed closely behind, taking in the sterile smells and sounds of beeping machines.

Erin seemed distant and jaded as she pointed out each patient’s room and condition. I hesitated to question her attitude, knowing that I was new on the floor.

“And, right here is Doc Phillips Office,” she said with a hint of disdain, gesturing to the closed door. I nodded silently, not wanting to get involved in office gossip.

“Phillips’ is known for sleeping with most of the nurses here, so if you’re looking for a fling, keep your emotions in check. He’s not going to marry any of you,” Erin whispered with a sly look in my direction.

Feeling slightly uncomfortable under her scrutiny, I blurted out defensively, “I don’t date co-workers.”

Her response was a sarcastic eye roll and muttered remark.

Suddenly, we were interrupted by a blonde woman walking towards us.

“That’s Sheila, the Head Nurse here. Not the brightest bulb in the box, but eager to please any doctor who shows interest. She used to be one of Phillips’ conquests, but she played her cards right and fucked the Chief. Now she’s Head Nurse- pun intended,” Erin spoke under her breath as she sized up the woman approaching us.

“Hey, have you finished your rounds yet?” Sheila asked, looking at Erin.

“Not yet, I’m giving a tour to the new girl. This is Maddie,” Erin introduced me with a wave of her hand.

Sheila gave me a friendly smile as she came closer, her blue eyes shining with warmth. “It’s great to meet you,” she greeted before extending her hand for a shake.

“Nice to meet you too,” I replied, feeling relieved that at least one person seemed genuinely friendly in this cutthroat work environment.

“Can you take Maddie with you while you make your rounds?” Sheila asked, her voice tense and hurried.

“Sure,” Erin replied flatly.

I followed behind her as she hustled through the hospital corridors, her white coat flapping behind her. “I can’t stand that bitch!” she exclaimed under her breath.

We arrived at the nurse’s station and Erin snatched a patient’s chart off the counter. But before we could do anything, an urgent announcement came over the intercom: “Code Blue in 439.”

Erin cursed and grabbed a crash cart, urging me to follow her. We rushed down the hallway, our footsteps echoing against the linoleum floor.

When we got to room 439, Dr. Phillips was already there, barking orders while struggling to intubate the patient lying on the bed. His face was turning blue from lack of oxygen.

“Shit,” Erin muttered. “It’s David Tucker.” She quickly scanned his chart and saw that he was Denny’s patient.

Denny arrived moments later, looking pale and panicked. He stood silently next to Dr. Phillips as they worked on the patient together.

“He’s having an allergic reaction,” Denny finally spoke up, flipping through the pages of David’s chart. “What was he given last?”

Dr. Phillips continued to work on David, trying to stabilize him as he convulsed on the bed. “Heparin,” Denny stammered, his eyes fixed on the lifeless body in front of him.

Dr. Phillips ordered Denny to get epinephrine while he continued to work. Despite their efforts, David’s condition worsened and he flat lined.

“Charge to 250- Clear!” Dr. Phillips yelled, grabbing the paddles to shock the patient’s heart back into rhythm.

The room was tense and chaotic as everyone held their breath, waiting for any sign of life from David’s body. But after several attempts, it became clear that they were unable to save him. Denny’s patient had died under their care.

Dr. Phillips’ face turned a shade of crimson as he checked his watch and announced the time of death. The room was heavy with grief as the doctor quietly left. I stood there, staring at the patient’s lifeless body on the bed, trying to place where I had seen him before.

Suddenly, Erin’s voice broke through my thoughts. “Well, welcome to the fourth floor, Maddie,” she said as she gestured for me to follow her out of the room.

As we walked down the hallway, it hit me – this patient was one of the doctors from Oncology.