02x02 - Is Soap a Hazardous Substance?

[bunniefuu]

Hi. I don't have an appointment, but could I speak to Ms. Pepperell?

I only have 10 minutes before my shift.

I appreciate you want to keep your condition confidential until your 12-week scan.

It's always smart to wait.

Yeah, I'm actually still feeling so thrown by it all.

Yeah, but you wanna know what your rights are and your union benefits.

Yes. Are those your two boys?

Nephews. This isn't about me.

You are... (Papers shuffling)

Entitled to...

36 weeks maternity leave...

18 weeks ordinary, 18 weeks additional...

And also flexible work arrangements in your last trimester.

Wow. I didn't realize...

Yeah, they don't want you to know.

You're entitled to paid time off, for prenatal and postnatal care.

I can get you a private fridge for your expressed breast milk when the time comes. Hey, what's wrong with your hands?

Oh, they're just a little sore.

It's all the alcohol from the new hand-sanitizing gel.

You know, it chaps my skin.

It gets a little red and itchy.

May I see?

Getting On - 02x02

Soap a Hazardous Substance Now the profit margins on healthy hospice patients who survive for years with minimal care exceeds 20%. Now you don't get that in oil, you don't get that in pharmaceuticals.

And patients can pretty much stay indefinitely.

You and I just need to recertify that they remain terminally ill every 60 days.

Is that for hemophilia?

Oh. No, no, I'm a tri delt. S.M.U.

Now technically, we lease your beds from you.

We pay you per diem, pay you a percentage of the Hospice Benefits.

Also, in exchange for you referring all of your terminal patients into our program, we're gonna transfer all of our patients in the inpatient care to you.

And we fully staff with our own teams, except for the coordinating Nurse Liaison.

Oh, I've got one, Didi Ortley.

She's a good gal, she's got a lot on the ball, and she'll work for peanuts.

Wonderful.

Dawn, are you prepared for what it's gonna take to be a single mother?

Look, Didi... (Sighs)

I may not know who the exact father is, I know who'll make the best one.

Oh, look, it's our new team hospice rolling with the punches already.

Uh-huh. (Chuckles)

Oh, well, here's to aging baby boomers, right?

We're now taking care of our parents and our own children at the same time.

Oh. Well, no, sorry. I meant they're starting to die in droves.

You know? This is our window.

There's no money in children anymore, but a Hospice is the growth industry, and, well, we're providing a valuable service.

Indeed we are. Okay, bye-bye.

Good morning, Didi.

Didi, have you told Dawn that you're our new official, part-time Hospice Nurse Liaison?

And, Dawn, I think that you'll be happy to know that Mr. Cesario has stepped up to the plate to assist me with my research.

He was quite pleased to sink his teeth into vaginal atrophy.

Well, shall we?

In passing, kindly notice our two new dedicated use hospice comfort suites.

Look, Dawn, I wanted to tell you about the Hospice Nurse Liaison position.

I had to take it. I need the money.

It's fine.

Besides, I'm more interested in helping patients get better and keeping them alive. Not the opposite.

And nothing changes. I'm still your boss.

Jenna: A soothing, harvest wallpaper and the fold-out couch for relatives.

Here we have Mrs. Weller.

Excuse me, are you my doctor?

Yes, I am. I'll be with you in just one moment.

I need some more Vicodin right away.

It's not time yet.

Well, then some Klonopin or Valium or something.

Mrs. Dottie Levy, severe alcohol-related disease.

Okay, bring her up. There's no need for drama this early in the day.

How are you, Dottie Levy?

I'm Dr. Jenna James.

Not so good.

Mm-hmm.

Mrs. Levy has four staples in the back of her head from a grade 3 concussion that brought her to the ER.

I see two small subdural hematoma.

Coup-contrecoup.

The "blow's repercussions."

Yes, you speak French. Well done.

Touché, Dottie Levy.

Let's get you back to bed.

Look, I just fall on my head is all.

I tripped on the sidewalk or something.

When they brought Ms. Levy into ICU, GI found ascites and removed six liters of fluid from her abdomen.

You could use some pointers in not expressing your judgment.

Well, what you see is concern for your future and it does not look good. How do you feel about your drinking problem?

How do I feel? Oh, it is the demon drink, it is.

No, it's not a laughing matter, Dottie Levy.

You have 10% liver function.

You have 20% kidney.

You had six liters of ascites fluid taken by needle from your abdomen.

It's a miracle you're still alive.

Corticosteroids, 40 mg a day.

Yes, could reduce 30-day mortality.

I can't take corticosteroids.

Why not?

Because if I take them, I can't drink.

If you stop drinking immediately...

Not one more drop... you may live.

Another drink, you will die.

Your body is on the verge of shutting down in every conceivable way.

Please use your time with us here to make a wise decision.

You know if you have a problem, you can come to me first, right?

Yeah, I know.

Are your hands really that sensitive?

That dry?

Yeah, they're chapped from the hand sanitizers.

Is that what you're asking me?

Why'd you call a health and welfare meeting?

I didn't.

Memo says you did.

(Scoffs) Paula...

Patsy, I met with her, but I didn't set this into motion. She did.

Oh, my... I would cleanse my hands to the bone for you.

You know I would. Oh, my goodness. I'm such a jerk.

I'm so sorry, Dawn.

I... I was shocked.

I... I-I... I couldn't believe that you would've hurt me that way, you know?

No.

And I don't want your little hands upset with me.

No. Never ever.

You know what? I'll just refuse to say anything, and it'll just blow over. Trust me.

Now, can I talk?

Can I have some my time? Because there's something I really wanna tell you.

Okay.

Okay.

Let's start here. I saw the best of all possible apartments for us over the weekend.

(Laughs) Okay. It had everything, including a water feature.

I love water features.

I know. It had a patio for entertaining.

Oh, my God. Dawn, can't you just see it?

Us barbecuing for friends?

Yeah.

So I put a deposit down.

Excuse me?

I put down a two-month deposit, and we can move in on the first of the month.

What... what... what do you mean by "the first"?

Pats, there's a really good reason why I want us to move in on the first.

Oh, no, I'm sure there is, but I can think of, like...

500 reasons why not to.

For starters, we were supposed to be "just looking."

But it's on Ocean Avenue.

Dawn, we were talking about a dream house someday type of situation, not next month.

You know what?

Patsy, I think this is that someday.

Wait. Not for me, it's not.

You know what?

Let's get off of the apartment.

We're getting hung up on a detail.

I mean, there's a bigger picture, Patsy, and it's something that's beautiful, it's lovely and it's life-affirming.

I'm sorry, Dawn. I need some space, I need some my time.

But this is still my my time.

(Stammers) Well, then I need some alone time, for... for me, because...

I just feel like I'm suffocating.

Yeah, I feel like I'm strangling.

I'm sorry, Dawn. This is just way too much input for me.

(Bangs desk)

Dr. James, it's my understanding you've taken my mother-in-law off of her Namenda.

I would like to understand why.

And you are?

I'm Arlene Willy-Weller.

Ellen Weller is my mother-in-law.

Mrs. Willy-Weller?

It's an unfortunate hyphenate.

Yes. Well, it was my estimation that Mrs. Weller's Namenda had overstayed its welcome.

Namenda is an epilepsy drug that supposedly offers off-label benefits for dementia.

Since she now has dementia, it either didn't work or it's not working now.

Um, I did want to ask one thing: I noticed some small dots on her last chest X-ray.

She's had those for two or three years.

Have they been diagnosed?

The technician said they were just dots.

Oh. She had an X-ray for TB when we brought her here from Nebraska for boarding care.

They're... Nebraska dots, some sort of airborne something...

From a feed lot.

What?

(Loudly) We're talking about your dots!

Well, I think I'd like to run a scan just to be sure.

Well... are you thinking cancer?

Oh, I'm absolutely thinking nothing, except that old age rarely travels alone.

(Stammers) Ellen...

Ellen, I'm gonna call Phil.

We're gonna get Phil involved in this real soon.

That's her son, my husband.

What's the best number to reach you at?

Main line. Definitely.

(Drawers banging)

What are you doing in there?

I'm looking for some Percocet.

You are not.

Yes, I...

Shame on you.

You should know better.

You were a Literature Professor.

I was. I was canned.

Let me see your hands.

Hands!

In this bed.

What difference does it make?

I'm probably dying.

That's what that idiotic doctor said.

Okay, well, clean the wax out of your ears, 'cause that's not what I heard.

I heard that if you stop drinking, get it under control, you'll probably live.

Dottie: Well, that would be the glass-is-half-full version.

My mother was a drinker.

She couldn't stop Cold Turkey, but she did stop on the weekends, and that helped her get it under control.

I do have it under control.

I drink until my eyes turn yellow, and then I stop Cold Turkey until they clear up, and then I drink again.

Maybe it wasn't that funny, I guess.

We have... clergy. We have social workers.

We have all sorts of support staff, if you need it.

(Sighs) Maybe you're right.

Maybe I would like to talk to someone.

Maybe I can make peace with myself and the world.

I had a preacher once.

Maybe they remember me.

Well, I could call and ask them to come and bless me.

(People chattering)

(Panting)

(Bangs) (Clatters)

Patsy? What happened? Can you speak?

My chest.

Your chest?

My chest.

Oh, my God, are you having a heart att*ck?

Cur... cur...

Oh, my God.

The curtai...

What?

The f*cking curtain.

What are you saying?

The f*cking curtain, Dawn. The curtain.

Okay. Okay.

What are you doing?

f*ck. I'm getting you to cardiology.

No! Dawn, no!

What do you mean, "no"?

Listen to me, it can't be here.

I'm putting you in cardiology.

It can't be here!

Yes, Dr. NG please.

It can't be here!

Why?

No. It can't be here.

I'm... I'm sorry.

Why can't it be here? (Exasperated sigh)

You guys have a pool at home?

A pool? Yeah, yeah. We rarely use it.

If I had a pool, I would use it all the time.

Hey, Dee. This is Mrs. Hughes.

All right. Mrs. Hughes, we've been expecting you.

I can't... I can't breathe.

Here we go.

Shh. Oh, my God.

Can you get up on this? Can you get up?

Oh! Oh, my...

Oh, God, my leg.

You're up.

Okay. Oh. Ah.

Get up there. Okay, you're good there.

I'm gonna die. I'm so scared.

Okay.

What's my blood pressure?

It's still going.

What is my pulse?

You know how this machine works.

Read my pulse!

Patsy! I am working on it.

Okay, don't scream at me.

142 over 110.

What? Oh, my God!

Shh! (Sobs)

I'm... I'm dying. It's done for me.

Sit up.

We got it here. Wait, you're stuck on the finger thing.

Okay, what... get the f*ck off me.

Stop, stop, stop, stop. Patsy!

I'm scared... (Mumbling)

Stop talking.

Just stop talking.

Where are you going?

What is going on back here?

Patsy might have had a heart att*ck.

(Mumbles) Oh, f*ck.

Oh great. Dawn, get his ass to the ER!

Okay, right here.

Patsy: I told you...

Didi: Let me take off your shoes then.

Patsy: Oh, no, no, no, no.

Let me take your pulse.

Okay. Okay.

Yes, hi, I need an ambulance to Long Beach Memorial, please, in 10 minutes.

I'm at the corner of Carson...

Dawn. Here. Our ER. (Mumbling continues)

Can't. He can't. He had a BMI of 33 at his last physical and HR said they would fire him or put him on probation pending weight loss.

No, no, no, no, no, no.

Let's get this off you.

Let's get you in a gown.

No, no, no, no.

Yes, I know we're by.

Yes, we're very close.

No, no, no. No, no!

Stop it!

Okay. Okay.

Stop acting like a big old baby!

Okay.

So, Andrew, when a patient has been taking part in regular sexual intercourse into their 70s and 80s, which this lady clearly has, the likelihood of atrophic degeneration is considerably reduced.

Contrary to popular belief, it is the postmenopausal vag*na which benefits the most from intercourse.

Mrs. Spivy.

Spinny.

How are you feeling?

Spinny.

Queasy.

I think she meant her name is "Spinny."

Good. I'm very pleased.

You're looking a lot better.

Um, can we take a little look at your abscess?

Would you mind?

I don't mind.

Okay, great. Let's have a see.

Oh, yes, that's healing up quite nicely.

We're gonna do a bimanual examination and take another quick documenting photograph.

(Squishes) (Sighs)

Sorry, ma'am, I've got fat fingers.

I don... I don't mind.

(Flash popping)

Dr. James? I'm sorry.

Could you come, please? Patsy's sick.

Oh. Well, I bet that's my responsibility.

Right. I just make everybody ill, don't I?

Please, I think he's having a heart att*ck.

(Sighs)

Dr. James.

Nurse De La Serda, how do you feel?

I'm... I'm okay.

What are his vitals?

137 over 85.

How do you really feel, Nurse?

Clammy and woozy.

Why is he not in ICU, ER?

He had a... he had a body mass index of 33 at his last physical. And as you know...

(Scoffs)

HR is f*ring people because of weight issues.

Oh, so you're proposing that we hide him here and we just pretend that this isn't even happening.

I'm so embarrassed.

This needs to be handled by a cardiologist.

The whole thing's ridiculous.

But what if it's... what if it's real?

(Sighs) All right.

Okay. Start a 12-lead EKG.

Nurse De La Serda, I...

I don't... I don't even know if I'm addressing you as a colleague or as a patient.

Okay.

I'm going to draw blood and run labs and rule out an actual heart event.

What I strongly suspect, though, is what we're dealing with is another middle-aged man who needs to diet, exercise more, eat less, who is monopolizing nursing staff and medical resources with phantom chest pains when there are far more pressing uses for this bed.

"Kittens? What kittens?" Says I.

"I left them in the rain barrel."

(Women laughing)

You're k*lling me, Dottie.

What?

Did you... what is going on in here?

Did you bring that bottle in here?

I am improving her mental health by not demanding that she stop drinking because, clearly, she likes it. (Laughs)

I like it.

There's a dance in the old dame yet.

Give...

Toujours gai.

(Mutters) What the hell?

And shame on you. You should know better.

Don't be cross with my Reverend Margaret.

Give... give me that.

You think I don't know how to deal with a drunk lady?

(Clangs) I am her friend.

Everyone else in her life has been told to detach.

"Detach." (Laughter)

Sit down. Sit down before you fall down.

Oh! You said one more drink.

Didi: Shh!

Look, I'm not dead. I'm here!

What's happening here?

They're smashed.

What are you three harpies talking about?

Talking f*cking sh*t.

You are gonna stop this at once.

Who the hell is this?

I'm out of here!

No, you're going nowhere.

Come on, Maggot. Let's go.

Get that one off the ward.

How did she get in here?

She asked me if she could see her preacher.

Toujours gai. Toujours gai.

Lie down.

You just wanna kiss me really bad, don't you?

Listen.

But you're not pretty enough to kiss me.

I am in charge of this operation.

And it might look ragtag to you, and it might look like anything goes, but it's not.

(Chuckles) (Sighs)

"Dear Hospice Liaison, as Hospice Nurse Liaison, you facilitate assessments, admissions, discharges, transfers, communication..."

Got it.

"...and participate in the difficult 'conversations' where patient and family are informed that curative treatments are no longer possible."

Ugh.

When do I do that?

Which "that"?

Any of that.

They're all different steps and procedures, and I need to know when exactly do...

All right. Okay. All right.

All right. Start with eligibility.

You need to pre-certify every patient with Commercial Insurance Company and Medicare.

Do I do that before or after you do your certification?

What on earth are you saying?

Didi: Do I get the insurance company to say that they're gonna pay for hospice care before or after...

I'm looking for Dr. James.

You certify that the patient is actually dying?

There you are. I'm sorry.

May I?

Yes, Mrs. Weller-Wally.

Willy-Weller. Arlene, please.

Okay. I've tried calling you through that main line three times.

It just rang and rang and rang and rang, and then it disconnected.

Oh, really? So odd. I had no idea.

Well, how is she?

No change, her heart is stable, but I did get the results back from her new lung scans and there's a bit of bad news.

There... there are tumors.

Oh, God.

Only the left lung, though, so there is that bit of a silver lining.

So, umm... what's the prognosis?

What... what happens next?

Oh, my. I'm... I'm crying.

You want to talk to a Social Worker?

No! No.

(Scoffs) I'm a therapist, actually.

Used to be. A Jungian.

Oh.

Now I write children's books, the "All My Friends Are Fun" series.

That sounds nice.

So I sent the images to thoracic oncology to discuss all the possible plan B's.

I assume that you want to talk to your husband.

To... to Phil, yes.

However...

He's dead.

He d*ed four months ago. She doesn't know.

(Sighs) And I am left caring for the mother-in-law who hates me...

And somewhat vice versa.

Time heals all wounds.

She said I wasn't worth the powder it would take to blow me up.

Mine called me an angry f*cking c**t at Thanksgiving.

Pulled me into the pantry to say it in private.

(Chuckles) Yes.

Yeah. Okay.

Okay. Yeah.

Dawn: Patsy.

I need to move you. Will do.

Okay. Bye.

You should not be taking calls.

You should be resting.

That was Bangladesh with our numbers.

Okay. Easy.

Our hand-washing is down.

(Sighs) Dawn, what's the matter with people?

I beg you. They don't like it. It's very harsh.

The hand cleanser is 90, 95% alcohol.

Well, remoisturize with Keri or Jergens for the love of God.

Where are we going?

To the lounge.

You still need to lay down.

No, I...

Oh, God, I'm weak as a f*cking kitten.

Patsy. Patsy, would you hold onto me?

Would you hold my hand?

Just hold my f*cking hand.

(Beeping)

Can I help you?

Hi. Yeah.

Are you the Hospice Nurse Liaison?

I am. Didi Ortley.

Hi.

I'm Colleen. Mrs. Hughes just passed away in comfort suite 107.

She just got here.

(Flatline)

So then you take her unused medications and you put them in a little baggy and crush them.

Got it. I'm called an 11th hour volunteer.

I come last minute, for the dying part.

My last name's Hoover, by the way.

People ask me all the time if doing hospice is depressing.

And it is for some people, but I mean, yeah, it can be, but it's for real. (Crushing)

I'm in beauty school off and on.

Here, let me show you. I'm not really allowed to handle this stuff, but I've seen them do it a million times.

So when there's leftover morphine, you're supposed to pour it into a diaper.

This company here is a little douchey, but I don't really like people my own age. They bore me.

Have you met Antoine? Antoine.

Hmm?

This is Colleen.

Hey.

She's gonna be with us for a while.

Oh. Excellent.

Hey.

Hi, Antoine.

My last name's Hoover, by the way.

(Phone rings)

Patsy, would you get up?

I know you're awake.

Patsy, the labs came back on your blood.

Your heart is fine.

Your lipids are fine.

Dr. James thinks you just had a panic att*ck, and lots of people have panic att*cks all the time.

You're just... you're just working too hard.

Dawn, I'm living out of sync with myself.

Don't say that. You are living into yourself.

You just... you need something to ground you.

(Sighs)

I just... I think it's the apartment, Dawn.

I... I think it's too soon.

No. No, I know you think that's what it is, but what do you think is really underneath all that?

Your mother and I were just talking about you a minute ago.

How'd the deal go?

Oh. He closed the deal, Ellen.

Let me talk to him.

No, he has to go.

Okay. All right, honey.

Talk to you tomorrow?

(People chattering)

Corporation Counsel has called this emergency meeting to address a serious health and well-being issue in our workplace.

Nurse Forchette has raised an issue concerning our new antibacterial hand sanitizers. (Clears throat)

She has dry, cracked, possibly infected hands, is potentially unable to perform her work effectively.

Obviously, this involves safety, legal, OSHA rules and regulations.

I want to encourage everyone to speak freely.

This meeting is being taped and Miss Lester will take notes.

Man: Nurse Frochette, have you made this claim or in any way put this hospital on notice prior to today?

Umm, no. But it's been a very stressful day and I haven't really had time to prepare.

Did anybody coerce you or otherwise imply that your job might be at risk were you to voice your concerns?

No. I would not say that.

People, hands are a documented infection risk.

Thousands of people are...

Are dying of infections.

You know what? A big problem with that was Howie Mandel, and the whole antibiotic soap of it all.

He wouldn't even touch his shoelaces because he thought they had germs.

The man never even ate at a buffet.

He didn't want to touch nothing.

And another problem is once you wash, you have to open the door by the unsavory handle.

I push it open with my backside.

Paula: The less I touch in public, the better.

Nurse De La Serda, what's going on? What's this?

Yeah, I just... I feel like my entire program is being ambushed. You know?

I mean, the whole thing. That's how I feel.

We are identifying problems and exploring solutions.

We need to provide education on barriers to appropriate hand hygiene and keep records.

Who was trained? How long were they trained?

Also, is soap a hazardous substance in the workplace?

Does the alcohol penetrate the dermis?

No.

Is there a possibility that Nurse Frochette may be risking fetal alcohol syndrome now that she is vulnerable?

These are all the questions we need answered.

Is it mine?

Of course.

This is not how I wanted to tell you.

I wanted to be in water and with candles and music.

You know, I respect you too much to tell you what to do.

You are so respectful of me.

I mean, you have a difficult time inserting yourself into me, you're so selfless.

I mean, it's your body.

I totally get that you would never wanna take away my choice and that you love my body. You love it.

I do, and I respect women.

You know what? That's why I love you so much.

I mean, someone as evolved as you, that's exactly who should be a parent on this earth.

It's like us, we're the future.

Okay, but maybe we can talk about this later, though.

I don't even need to talk about it.

We're there, and we're gonna be great co-parents.

Co-parents. That's...

(Sighs) an awful lot to discuss.

I know it is. Of course it is, and you know what?

We don't have to talk about it right now.

Just hugs now. Just hugs. (Giggles)

(Rustling) (Heart monitor beeping)

(Slurping)

(Gulping)

Mmm.

(Sighs)

(Slurps)

♪ Toujours gai, toujours gai ♪
♪ that's what I heard Mehitabel say ♪
♪ toujours gai, toujours gai! ♪
♪ Still a dance in the old girl today ♪
♪ after all's said and done ♪
♪ life is just having fun ♪
♪ toujours gai, toujours gai ♪
♪ toujours gai ♪
♪ she had a litter of kittens one spring ♪
♪ one night it rained and they drowned ♪
♪ she just declared she remembered them not ♪
♪ her song you still hear resound ♪
♪ toujours gai, toujours gai ♪
♪ that's what I heard Mehitabel say ♪
♪ toujours gai, toujours gai ♪
♪ still a dance in the old girl today ♪
♪ after all's said and done ♪
♪ life is just having fun... ♪