02x05 - The Revolving Door Admit

[bunniefuu]

("Oh! Susanna" playing)

(banging) (whirring)

Didi: No, no, no. Pull this side, hon.

Pull it, Sherrie.

These doors! This place is such a sh*thole.

Watch your mouth.

Good morning.

Good morning.

Hey princess, I need you to get me those Pyxis audits a bit faster today.

We are all over it.

I thought I got it ready pretty fast yesterday.

Well, could be faster. Okay?

He needs to keep his mouth shut, 'cause if he calls me that one more time, Imma pop him.

No, no you are not.

Yeah? Watch me.

Not if you wanna become permanent.

You can't be up in here throwing tantrums.

Oh, come on!

You come on.

Good morning, Dawn.

Morning.

Hi, Sherrie.

Hey.

God! I'm swamped!

Dawn: I got another ticket in the car pool lane coming in.

Who the heck is she?

I don't know. Maybe it's the new pharmacist.

Oh. Hey, can you page Dr. James and let her know that her packages were delivered?

She's probably up on six with those mice.

(Laughs)

Right. So... good morning, Nurse.

But...

(stutters)

Dr. James.

Dawn: Dr. James.

Mm-hmm, good morning to you too, Dawn.

Didi: Good morning.

Bed two is over her pneumonia and she is back on a steady meds regimen.

Her maniac delusions are under control.

Thank god. So I'm sending her home.

Uh-huh, today?

Yes. Today, Dawn.

Here's her discharge orders.

Didi, claim it as a hospice scatter bed.

Right.

Uh, what I meant to say Dr. James...

Mm-hmm?

No one told me about this beforehand.

No, but that's why I'm telling you now.

Well, it's just that umm...

Varla is a high-risk discharge.

Jenna: Mm-hmm.

Dawn: So I have to coordinate some stuff with Pharmacy and Social Services...

All right then.

... And Mental Health.

Why don't we just get cracking on that? Didi...

I pulled up a list of hospice patients whose initial 60 days are about to lapse.

So we need to reevaluate.

We need to recertify that they are indeed terminal, and I'll need you to bring me their files.

I see your sister's still with us.

Half.

Half-sister still with us.

Are you permanent now?

Oh, she's just filling in until Marguerite gets back.

But, maybe, if you like me.

Who knows.

Jenna: Mm-hmm.

(laughing)

Good morning, Varla.

I've been told you are going home today.

Yes.

Hospitals just aren't my thing.

Well, I bet there's a lot you're looking forward to doing when you get out of here.

Well, I try to keep busy.

I have a lot of energy.

I have Finches tomorrow.

Oh, what are finches?

Oh, that's my book club.

Hand me my things!

Oh, no, no, no, no, no.

You can't just get up and go yet.

Some things we gotta take care of.

Let me ask you some questions.

(clears throat)

"I believe I can do the following: cooking, shopping, bathing, dressing, using restrooms by myself."

No, I can't do any of those things.

"Do you have any family or friends who can help you do these things?"

No. Uh-uh.

Okay. Uh, let me go visit with our social worker and see what kind of support I can arrange.

Alright. You're the boss.

Okay.

Ms. Birdy, this is Sherrie.

She's gonna take your blood.

Brenda, what size needle would you use?

A 25. Thinner damages the blood cells.

Yeah, not for Birdy. Her surface veins have scarred.

So you gotta go deep. You wanna use a 21.

Something that won't break off while it's in there.

You got nice peppers.

Aww, thank you.

Yours aren't so bad either.

(Laughs)

Now, this may hurt a little bit, but she told me to do it like this.

Didi... - This vein just rolls all around.

Right. That's why I said you gotta hold it in place.

You wanna put another cuff at the bottom to hold it in place.

Yeah, okay. I got it.

Okay... not that angle.

Stop! Or I'll shove this up your butt.

Your big fat butt. Ha!

(laughs)

Yeah I do, but I think that I'm missing a shipment.

I've got the 10 male off-the-shelf, tumor-engrafted cohorts.

Man via phone: Okay...

Alright, I've got the...

20 light-skinned, mixed-sex alpha gammas.

Uh-huh...

I have the 10 pinkies with the lactating mothers.

Man: Right.

And I got the male transparent recombinant inbred females.

Oh, except, they're males. Great!

Man: Hmm...

I have no use for transparent inbred males.

Um... overnight, yeah.

Man: You got it.

All right, thank you.

Oh, and I still get my 5% off list price, right?

Man: Sure, I'll do that.

Yay! Thank you, Frank.

You're welcome. Okay, take care.

All right, bye-bye.

Yeah? Here are the files to recertify for terminal illness.

The forms you need to sign are on the top.

Mm-hmm.

We are swamped, Dr. James.

We have 14 overnight hospice admits.

Oh... great!

Scatter beds galore!

What's going on out there?

Nurse De La Serda won an award.

Nurse De La Serda won an award... What kind of an award? He doesn't deserve an award.

The Millicent Schwartzman Award.

I've never heard of a Millicent Schwartzman award.

Umm... could you have Transport take my deliveries up to the... sixth?

Thank you.

"For inspired leadership and charting new directions for Mt. Palms Hospital."

Oh, and we're all going to be on the Mt. Palms Closed Caption TV channel...

He is one big gas bag.

Yeah, it took me six months to learn that.

sh*t, he needs to get his butt kicked.

Say the word and I'll hold him down.

(both laughing)

Hey, what's so funny?

(both continue laughing)

Wha... what is so funny?

(whispering indistinctly)

Oh...

Pardon me.

Oh!

Jenna... Wow!

I know.

(laughs)

Oh, Jenna! I... I didn't... umm...

Well, my gosh! You look amazing.

Do I? I don't know.

I just felt like it was time for a new look and...

It's nothing, but... thanks for noticing, Paul.

(indistinct chatter)

Rick. Yeah...

Jenna!

Ann! Hi!

I didn't know you were in the Goals and Forward Focus Committee.

I was recruited last week.

You've done something...

It's my hair.

I like it!

Thank you!

I like people who aren't afraid to try something new.

Thanks.

Jenna: Before we move on to new business, I'd like to run something up the flagpole.

The chair eagerly recognizes Dr. James.

I'm applying to the NIH and the National Cancer Society for two grants to purchase two mouse MRI trays at $75,000 each.

I just wanted the committee to know...

Multiple mouse MRIs offer vast efficiencies.

You can fit 6 bodies on a single tray...

125 mice per hour, with contrast!

And then, if it's just heads... up to 14 at once.

Uh... how do you get just heads?

You snip them off with scissors.

Scissoring is a common lab procedure for pinkies and pups in all reputable, prestigious institutions.

Jenna, it becomes an Animal Rights thing.

People start throwing blood at us every time we walk in.

The mice are just a small piece of the puzzle.

We're also doing solid, non-mouse research in rectal augmentation.

Also.

Paul: But...

How big are we going on all this?

That's the question that we're asking.

Jenna, you've got your studies, your hospice, your mice...

Who knows what's next.

I wanna hit the pause button on the mice thing, pending a review on where all this is headed.

All right?

All right, next.

Yes, uh...

Patient: Pounder, Varla.

I just faxed over a list.

Prescriptions for her stress-coping strategies workshop, her mood management seminar, her life skills training class, and then there's also a smoking cessation clinic.

Yes, however the patient is bipolar one, so stress really triggers her mania.

Yes, I'll hold.

Didi, you've gotta help me with Varla's discharge.

She's starting to get antsy.

Dawn, I am swamped. I can't!

I mean, we have 14 overnight emergency hospice admits.

Everybody from the hospital is enrolling their patients now.

Didi, please. Her meds alone. I just...

Keep her calm and get some of this information for me.

I need to go home. I need to go home.

I can't stay here!

I need to go home!

Okay. Varla, stop pacing.

I need to go home.

Sit, Varla.

"Sit, Varla."

Sit, Varla.

I need to go home. Varla, Varla... Sit.

We need to get your phone number so we can call you and make sure you're taking your medications.

No! That's my business.

We have the number of the main desk at her home.

We just need her room number.

My room is 16, I'm on the second floor, the bathroom is down the hall, and I wanna go home.

Didi: Thank you, Varla.

Mm-hmm... Mm-hmm.

Dr. James?

Mm-hmm?

Ruth Lee is back.

Aww... with the daughter?

Three...

There we go.

Hello, Ruth.

Andrea.

Dawn: Mrs. Conrad.

Jenna: Olive? (Laughs)

Oh, look at you!

Hi, Dr. James.

You remember us.

Yes!

Well, it was such an ordeal.

Here, back to the hospital, here, back, here, back...

(sighs) Well, here we are again.

I think this time it's for the long haul.

Cachexia, wasting away, opportunistic UTI...

I see.

It's just...

Mom!

Mom!

Do you remember Dr. James?

Jenna: I remember you, Ruth Lee.

It was my very first week and you read everybody The Riot Act, scared me to death... you had me completely buffaloed.

(groans)

Her aphasia's progressed quite a bit.

She really couldn't speak much this year at all.

Jenna: Well, she was so well-spoken that I imagine she... was probably too embarrassed to continue trying.

And I think she's mad at me.

Oh...

I promised her I would visit her one weekend and I couldn't, and she went into her room and stopped talking to me.

And for the most part she stopped eating as well...

Where are we on a feeding tube?

Is that something you would like to discuss?

Yeah.

Alright, well, I'm gonna make some notes.

I'll be right back.

So she followed around behind me, tottled around with this little plastic tiara on, and she just wouldn't take it off.

Started calling her my little princess.

Try my haricot verts?

Sherrie... Haricot verts? Hmm... (laughs)

So sorry I'm late.

I was being interviewed for the "What's New, Mt. Palms" show with Steven Shays.

Oh, Dr. James, did you know I won the Millicent Schwartzman Award?

Yes, I heard, Nurse. Congratulations.

When they interviewed me, I told them, "You know, when I started... all of my ideas seemed fringe. But now my fringe is baked in the cake."

"I mean, you're the fringe if you don't know what 'Lean In' or 'Make Someone Happy' is."

Patsy: Would anybody care for some of my rooftop baby greens?

Dawn?

Oh, no thanks.

I'm off heavy oil-based dressings.

(chuckles)

Patsy: Dr. James?

I don't really care for baby anything.

When they asked my philosophy on nursing, I told 'em, "You have to think outside the box."

Well, like my fecal study.

Talk about outside the box.

Because inside of the box is toxic.

Jenna: Nobody imagined that there were more than seven types of patient stool.

Orthodoxy prevailed. Who knew?

Colleen, ever thought about becoming a nurse?

Well, I like the sound of ambulances, and I don't know why, but the sound of an ambulance in the night... it's calming.

I need a large water. Anybody else?

So the spirit of service runs through your family... mostly, I gather. Your older sister, maybe not so much.

Her... her children still living with you, Didi?

Yeah. Yes, I have a house full.

Yes, people don't understand that parenting has so many responsibilities, just sacrifices beyond your wildest dreams.

What do you mean, exactly?

It's just that there are so many people in the world who shouldn't be parents.

They're having babies willy-nilly, with no thought of how much it costs, the unexpected sick days.

Didi and Sherrie, once again, your older sister... am I right?

Yeah, a complete mess... the rehab, the court orders, I mean, and she brought it on herself.

Jenna: Yeah.

How about we leave my sister out of it.

Jenna: Mmm, right. Well, all I was saying was that having children is not like having cats.

Some people just aren't cut out for it, which is why, Dawn, sometimes these things have a way of working out for the best.

Why did you say what you said about Janisse being such an unfit mother, and in public?

I didn't say that. Dr. James did.

I don't air my dirty laundry here.

Uh-uh-uh! Don't eat those peanuts.

Those are Patsy's peanuts.

So what? Black people do all the cleaning up around here.

Didi, if I want to have a f*cking peanut, just let me have a f*cking peanut.

How many times I gotta tell you to watch your mouth?

And stop cozying up to Dawn, making fun of Patsy.

Stay out of that mess. Dawn has issues, and you don't want to take advantage of that.

She can get me a job here. She has clout.

How about you become full-time here by working hard, by being the nurse I know you can be?

(whirring)

Ah.

Dawn, Admissions is not happy with your discharges.

A patient waits for bed two, and yet Varla Pounder is still in it.

Administration is on my back to reduce our 30-day patient readmit rate so we don't get fined again.

Now, Varla's been here three times in the last six months.

Whoa! Whoa.

So yeah, I would say that that's a high-risk discharge.

Okay, patient flow is about balancing hospital input and output to create a harmonious throughput, and right now, your throughput... (whirring) is compromising my flow.

Okay, well, if you have a problem with your flow, you should talk to Dr. James.

(grunts)

I am doing a thorough, comprehensive discharge to reduce revolving-door readmissions.

Come here. How much longer with this attitude? Huh?

I don't know.

Because I don't appreciate you having a laugh at my expense with that half-sister of Didi's, okay?

Well, don't sweat it, 'cause I am currently exploring new horizons, new challenges in new places.

What, you mean over at the hospital?

Could be there, could be Haiti. I don't know yet.

Haiti?

I have worked in OR, Geriatrics, a surgical step-down unit, I've been a psychiatric float nurse, so yeah, I think I could be of great service to the people of any needy country.

Well, we're needy here.

Just discharge Varla now and free up that bed.

Princess, help Nurse Forchette with patient Pounder.

No. No.

Nurse De la Serda, maybe you shouldn't call Sherrie "Princess" anymore.

It was just a pet name when we were younger.

She doesn't really like it now.

Yeah, I can't even do this right now, okay?

Dawn: Yes, I need someone to sit with a patient.

Thank you.

Dawn, you're not helping Sherrie.

She's sucking up to you and making me pick up the slack.

Sucking up?

Yeah, that's what she does to shirk her responsibilities.

She sucks people in.

How about she likes me?

Maybe somebody actually likes me, Didi.

You know, maybe she thinks I'm worthy of being a mentor and sees value in me.

That's not what I'm saying.

Maybe there's someone, Didi, who doesn't go around telling other people to be careful, 'cause Dawn has issues.

I...

Sherrie.

Dawn: Didi.

Okay, we will get you over to the lounge where you can relax and be that much closer to going home.

I'm f*cking ready already.

I need to arrange for a special bed.

Occupational therapist won't order one until you are discharged, and the social worker says it has to be in your room before she'll allow any type of a discharge.

You're imbeciles, that's what you are.

They must've been handing out degrees to retards.

Dawn: I know this is stressful and that your stressors are being triggered.

Oh, you blame me. You always do.

I need you to make sure you sit with her until security comes, please.

Can you strip the sheets and make the bed, please?

For sure.

Hello.

Are you leaving these?

Varla: No, they're not mine.

Do not take the patient's food. Don't do that.

Let her have the f*cking thing.

She obviously likes to eat a lot.

Don't you talk to me like that.

No, no, no.

Varla suffers from bipolar and verbal disinhibitions, so don't start it.

Can you please try to keep things calm and stress-free, okay? We do not want her sexual disinhibition to kick in.

Okay.

Get your fat hands off of me.

Oh, shut your nasty mouth.

Varla: You can't tell me how to talk.

I'm gonna f*cking report you, you stupid, brown cow.

Your message was a lifeline.

Oh, that meeting this morning was nasty and mean-spirited.

Right?

I wanna run something by you.

Okay.

Oh, Jenna, I don't know.

I haven't published since 2004, my preliminary article on ovarian yolk sac tumors with nude mice at Nagano University.

And I've got nude mice.

You could continue your research.

I've got X and Y strains.

I've got gammas. I've got transparents.

Weren't you at one point working on donated female-to-male transsexual ovaries?

I wanted to grow viable human eggs with human ovary tissue grafted into immuno-incompetent mice.

You can grow those ovaries.

I've got immuno-incompetent mice.

Whoa. Oh god, don't do this to me.

(Laughs)

And I've got all the funding that you would need.

I've got 47 scatter beds over at the hospital, but I need your support, because I've come too far in my studies to let Paul slam my door.

I agree.

(Sighs)

I don't know. It's like my days at NIH before Richard.

It's that pure research. It's the chipping away...

Yeah.

... at the unknown, and gaining insights that no one else has ever had before, and then sharing it with humanity.

So I guess I... it's... it's my way of saying "I'm here. I'm back."

"Look at me!" (laughs)

Yeah, look at you.

Mmm!

Oh, you are so pretty.

(chuckles)

Hey, Dawn.

Oh, hey.

Your patient's right over there.

Sherrie is sitting with her.

We don't really have a basis to put her on a hold, but she definitely needs patient watch supervision so I can finish her comprehensive discharge.

Okay.

(Door whirring)

(breathes shakily) Got a promotion.

Oh.

I'm gonna be in charge of parking patrol.

That's great.

Thanks.

You wanna go out with me?

Oh.

Dennis, I don't know. I just... came off a really rough patch.

People that I thought I could trust and count on disappointed me.

Well, I'm sorry to hear that.

I suffered a blighted ovum.

I'm... really sorry.

Seems like you've been through a bunch, you're probably traumatized.

Yeah, I bet I am.

Thank you. That was very nice.

You're welcome.

You wanna join any of our sports betting pools?

(Scurrying)

Oh my god.

Jenna: Ruth, can you talk?

'Cause I need you to tell me what's going on.

You depressed?

You angry? Why aren't you eating?

You understand what I'm saying, Ruth?

(mumbles)

(mimics)

What's that mean?

Does that mean "My feet are cold"?

Does that mean "I wanna watch TV"?

Does that mean "I don't wanna live anymore"?

Can you show me three fingers?

Ruth, can you show me three fingers?

All right, I'm... I'm gonna let you rest.

All right? We're gonna take good care of you, and we're gonna continue our conversation.

(whispers) Your mice are on the loose.

No.

Yes, I saw one just now up in that light over there.

Where? What was the silhouette like?

Was it sharp and distinct, or maybe vague and blobby?

You know, basically there, but not precisely.

Okay, well, then what you're describing could have been a small rat.

Mm-mm.

It could've been a large moth.

No. I know what I saw.

It was a mouse. It was one right on that panel, and there were two over there.

Oh, so now there were two.

Now we're just making things up.

Dawn, this is an untenable conversation, and it's over.

Didi: Varla, can we get you anything?

Do you need a snack? Can we get you a plate of watermelon?

Do you need to be toileted?

I want nuts.

Didi: We've just got to schedule your follow-ups.

I don't want any follow-ups, 'cause I'm never coming back here.

That right there is what we want, too.

I want your big hairy nuts.

Hey, you look like you got big balls.

I'm gonna grab your nuts...

No! What?

... and I'm gonna give 'em a good licking!

Ow! No!

What in H is going on here?

Didi, why is she agitated?

I don't know!

Get some Haldol, please.

She can take it...

Dawn! Dawn! Don't worry about 'em.

I got 'em.

Varla, let go.

Ow!

Haldol. Get me some Haldol.

If I lick 'em, you'll like it.

Varla, let go of his nuts.

(shouting)

You just want in here yourself!

Dawn: Varla, let go of his nuts!

(phone rings)

Extended Care, this is Dawn.

Oh gee, that's great.

Okay. She's discharged.

That's... She'll be thrilled.

(Mumbles)

Dawn: Yeah, she's been waiting and waiting and the stress is just not good for her.

Okay, thank you.

Oh sh*t.

Dawn!

Oh my god.

Birdy got a rat in her lap, and she's feeding it toast.

Birdy, no!

Look at that thing! Look at it go!

Sorry. Yes, there he is. Sorry, Betty.

I am not at all surprised.

All those damn mice up on six.

You see it?

It's on the pipe.

Ooh! I knew it.

I knew I saw a f*cking mouse.

Didi: There it is! It's going in that big hole.

Gimme a diaper. Gimme a diaper, Didi.

Didi: No, you can't put a diaper in there.

It'll just chew it and make a nest for its babies.

You're always such a know-it-all.

Dawn: Thank you, Sherrie.

Mm-hmm.

Well... yes.

I was just about to come and tell you.

I am missing one mouse, that's true, but only one, and since the lifespan of a mouse is three months, it will die, desiccate, and problem solved.

Patsy: Except, rule of thumb: If you see one, there's probably 10.

Well, what I'm saying is, there was one and only one of my mice missing.

Patsy: How do you know? You let them out, they run all over the place.

Jenna: No, I don't let them out.

Patsy: You ordered a chair without wheelie balls so that you wouldn't run them over.

Jenna: Oh, so here we go again with the wheelie balls.

I ordered a new chair for my back for ergonomic reasons.

And you tried to make me think I was going crazy because of my trauma.

Patsy: They carry hantavirus, norovirus, Salmonella, Weil's syndrome... no known cure.

Not mine.

They breed endlessly, uncontrollably.

(Banging, whirring)

We have to report this.

Varla: Oh god.

Didi, show Princess how to fill out...

Varla: Stop, you f*cking doors!

... the Wild Animal Incident Report and the...

(bangs)

Varla: Hey, dipshits!

Oh sh*t. f*cking retards!

Varla!

Jenna: She's as naked as a jaybird!

Varla. Varla, this is just a little setback based on situational stressors, but you're on solid psychological footing.

My foot!

Okay, all right, she's going to have to have an X-ray.

People, just get out of there!

Oh!

Just pull the door and get it over with!

(Snaps)

Oh!

(Whimpering) (laughing)

Okay, Dawn, get her to X-ray.

She's been formally discharged.

I'm gonna have to readmit her.

All right, then call 911, have the ambulance pick her up and drive her around back over to ER.

f*ck. A readmit.

Varla: Bleeding!

(beeping)

Here are those precerts and recerts.

Do make sure that those go out ASAP to CMA, because that's critical that the patient approvals don't lapse.

Oh yeah, I've got the envelope already.

All right then. Good night, you two lovely ladies.

Didi: Why don't you come over for dinner?

With the extra money I'm making, we're putting in a pool. Darnell dug it.

And it's been forever since you've seen Janisse's kids.

Didi, no offense, but those kids are whacked.

They're messes, and they make me feel like a mess, and it feels bad for me to be around them.

Why would you say something so mean and nasty to me, time and time again?

I was like a mother to you... cooking for you, cleaning for you.

Don't get upset, but you weren't exactly the greatest mother either.

I tried.

Well, what about me?

What about you what?

When your mama went all haywire, and daddy brought you and Janisse to live with us?

He spoiled your asses, and I was the one who got screwed.

Do you think I wanted to do your cooking and your cleaning at 15?

No. But if I didn't do it, it wasn't gonna get done.

The truth of the matter is, your mama was a terrible mama.

She had me and Janisse walking around that house on pins and needles, and we never felt welcome.

So maybe, just maybe, you could show some gratitude for once in your life.

(beeping)

(button clicks) (beeping stops)

(curtain rings scrape)

Princess? I saw what you did.

You're fired.

And what kind of restraints do you have?

Cuffs, of course, soft ties for wrists and ankles, bed belt to hold you down, lots of straps.

Oh.

Didi: Dawn?

Hmm?

Did you see those hospice files I had?

I looked everywhere for 'em, and I can't find 'em.

Yeah. I just went ahead... I mailed 'em.

I mean, I saw 'em here, you had the envelope, and they were ready to go, so I just went ahead and I did it for you.

The tracking receipts are there.

(Door whirs)

Thank you. I appreciate that.

Have you seen Sherrie?

She wasn't feeling well.

We talked.

Extended care is really tough work, and she decided she didn't want to finish out the week.

What's wrong?

I'm sad.

I... I just wish she wouldn't have quit.

I was finally able to get something off my chest, and I think she really heard me.

Well, good. I'm glad.

I'm really glad.

Hey, who knew she was a chronic undresser, huh? Varla?

Well, Dawn, when I said that you had issues...

I meant the good kind.

(door opens)

(music playing)

Oh, no, no, no. Just a... just a second.

(sighs) Hi.

Hi, Nurse. You have a good lunch?

No. I'm sorry.

Dr. James may be a very good doctor, but... and I know I'm taking liberties here... she said I wasn't a fit enough human being to be allowed to procreate.

Well, I'm sure she didn't mean it or say it quite like that.

No, she meant it, and she said it like this, she was like, (mockingly) "You know, Dawn, having a baby is not like having a cat, Dawn.

I mean, you... you'd be a terrible mother, Dawn."

"An unfit mother, Dawn."

"I mean, you're being delusional!"

(mocking laugh)

Dawn.

You all right?

I saw you gesticulating and flailing.

I was describing a movie.

(whirs) There we are.

♪♪

(woman singing in Mandarin)