===== Chapter 3. Getting Admitted to the Hospital ====

Mary, Jenny, and Lisa had arrived at the hospital and were working their way to peds admission clinic when Jenny needed to use the restroom. Lisa was waiting out in the hallway with the x-rays and Jenny's when an old instructor of Lisa's spots her.

Janet, a middle aged woman in hospital nursing uniform with RN pins says,"Lisa McKenzi, is that you? What are you doing back here? Did you decide to take a position here?"

"Janet, it's good to see you! It's Lisa Miller now. Jason and I finally tied the knot last year. And I am just here as a friend of the family. Helping to bring in a girl in for pneumonia."

"Is that .... oh what was her name ... Jenifer Finch? I heard that we were getting a teen for an urgent admit today."

"Yes that's her. Hey, I don't suppose that you could do anything to divert her to an adult floor. She is a pretty mature 18 year old and I would like to keep off the open ward if we can. Her condition doesn't rate a private room, but she would probable do better if she didn't have to put up with the younger patients." Lisa asked. When she was a student nurse here, most of separation had been by condition with only a rough separation of the ages. She didn't want Jenny to end up one of the large wards with a dozen patients aged anywhere from 10 to 20.

"Sorry, but the hospital is still pretty strict about putting anyone under 21 on the peds floor. However, we have been doing more age base separation lately, unofficially."

"We have some 4 and 6 bed rooms at the end of B wing near the isolation rooms that we try to put the older patients in. We try to keep a couple of rooms to put the 18 to 20 year olds in and a couple for the other teens. It's our unofficial old adolescents wing."

"It gives them a little more privacy and keeps them with their peers. I think that it as done a lot to reduce their stress too and it's helps keep them less ..... fussy. Well mostly. There are always some patients." Janet says with a smile. "Jenny has been tagged for one of those rooms. And I'll keep an extra eye on Jenny for you, but I have to run now."

"Thanks Janet. I think that it will make Jenny's stay a lot less stressful."

As Janet retreats down the hall, Lisa feels Jenny hug her from behind. "Thanks for looking out for me. I was worried about that."

"You're welcome Jenny, but you still need to expect less privacy than you are used to."

"I know, but I was thinking about my friend Linda, from back in New Jersey. She just had her tonsils out and was in a big room with a dozen beds with kids crying and all kinds of things. It sounded awful. A few other people my age, sounds a lot better."

Lisa give her a hug back and a nod to Mary and they head off towards a door marked "Peds Admissions". The area is a largish waiting room with a number of orange and chrome chairs and benches, some office nooks off to one side, double doors at the other end, and a counter in the middle. They go to the counter in the middle where a woman is doing paper work. There are only a couple of others patients waiting with family at this time.

"Hello, I'm Mary Finch. I have my daughter Jennifer Finch here to be admitted."

"Good afternoon Mrs. Finch, Jennifer and...."

"Lisa Miller, RN. I'm just here as a friend of the family helping get Jenny here. And to deliver x-rays and the doctors reports." Lisa said, holding up the bundle.

"I'm Phyllis. Well, hold on to them. You can give them to doctor. Normally we only let the family go back, but since you're handing off the patient, I think we can make an exception." She says with a small smile.

"Here we are. Jennifer Finch. Admit for double pneumonia. You do look peaked dear, but don't worry, we'll take good care of you. Let me see your right arm dear. I have to put this wrist band on you, so everyone knows who you are." She says and then puts the plastic wrist band on Jenny, snapping the metal clasp and trimming the excess with a pair of shears.

"Why don't you go sit down and rest while I do paper work with your Mom." Lisa takes her over to chair and then gets her some water from the cooler to sip from a paper cone. Mary spends about 10 minutes providing insurance information, signing consent forms, etc. before returning to wait with Jenny and Lisa.

After a short wait, a nurse came from the double doors, and after consulting with Phyllis, walked over to the group calling "Jennifer Finch."

"Hello Jennifer, Mrs. Finch, nurse Miller. I'm Kim Smith, RN. I'm here to help get Jennifer ready to go up to the floor. I'm going to bring her back to an examination area where we can get her into a hospital gown and do a few exams before sending her up to the peds floor."

"Do you go by Jenifer or Jen or Jenny?"

"Jenny, but any are fine. Can Mom and Lisa come back with me?"

"Sure dear. They can come back. They won't be able to come up to the floor, because visiting hours will be over by time you go up."

The nurse lead them through the double doors into a room like a long hall divided by curtains in to six bays. The first one that they passed was open and empty of people. Jenny could see a gurney acting as an exam table in the middle, small cart with some mysterious boxes to one side and a pair of uncomfortable looking chairs near the head of the bed, and plenty of room on either side. The back of the bay was open and she could see part of a long counter with various supplies in the back.

The curtain in front of the next bay was almost closed, but was open enough that Jenny could see a boy about her age laying face down on the gurney, a familiar red tipped thermometer peaking between his cheeks and the back of his ball between his legs. Jenny blushed and quickly averted her eyes, feeling embarrassed for him. It reminded her of her old doctor, Dr. Stevens.

The nurse stopped at the second to last bay and ushered them in. Jenny was glad that the front curtain was pulled all way shut. She just wished that there was a curtain in back.

"Jenny, let's get started with your weight. Can you take off your shoes, socks, top, and pants?" The nurse says as she steps into the area behind the bays.

Jenny doesn't like she doesn't see a scale in place, but she hops on to the gurney and takes off her sneakers and socks, handing them to her Mom. Next she unbuttons her jeans a pulls them off, reveling athletic legs and firm petite bottom partially covered by small green panties. Finally, regretting that she didn't wear a bra, she takes a deep breath and pulls off her sweatshirt, exposing her small, but perky breasts.

Nurse Kim comes back into the bay and puts her supplies on the side table. She hands Mrs. Finch a plastic bag marked "Patient Belonging", "For her clothes" and then turns to mostly naked teen on the gurney. "I just need you to step back here and get on the scale. Don't worry. The coast is clear."

Kim takes Jenny to where she has moved the wheeled scale and directs her to stand on the scale. Jenny looks up and down the area behind the bays and steps on the scales with an inward sigh. This and the glimpse of the other teen getting his temperature taken reminded her of her days at Dr. Stevens. She might not care for all of the policies at Valley Care, but she had come to realize how much more effort they had put in to protecting her privacy. Standing here hoping that no one sees her practically naked, reminds her of her last physical at Dr. Stevens where a boy from her school saw her in bra and panties getting weighted in the hallway.

Kim is oblivious to this as she records the pale girl's weight and tells her to "Turn around now so I can get your height. Arms down, chin up, and stand straight." Jenny feels like she is on display with her chest out, but she just wants to get back into the relative privacy of the bay.

"Got you height; go ahead and hop back up on the table." Kim says and watches the teen quickly go back into the bay and hop up onto the gurney.

Pulling out her stethoscope she places the bell between Jenny's breast to listen to her heart and count her pluse. Moving the stethoscope to her back, she has Jenny breath in and out. Not as bad as she feared from the teen's color, but not good either.

Moving on she wraps the blood pressure cuff around Jenny's arm and pumps it up. 90 over 65 with a pulse of 115. Not what she would like, but not immediately dangerous.

Next came the part that sometimes made the older kids upset: the temperature taking. Some were still getting their temperatures taken rectally at home or at their doctors, while others a been moved to mouth temperatures for a while. Although teens Jenny's age didn't like it, they were usually compliant as long as she was matter a fact about it. It was usually young teens who put up the most fuss. Usually.

From the side table, Kim picks up a rectal thermometer that she has prepared. It's stubby bulb sunk into an open packet of surgilube. With a kind but firm voice she said, "I need to take your temperature now. Because you are under 21, you are going to the peds floor, so I have to take it rectally, in your bottom. It may have been while since you had your temperature taken that way, but everyone on the peds floor has it done that way. It is hospital policy, so I need you to roll over."

Jenny gives a little laugh. "A while. Like a few hours. - cough cough cough - I'm used to it." Jenny says as she lies down on her tummy. The teen lays there, naked except for her green panties that have already slipped down, revealing the top quarter of her buttocks.

Kim is happy that she doesn't have to argue with Jenny. She reaches for her panties and pushes them down to her knees, reveling a pair of petite but firm buttocks whose pale white color is broken by a bruise from the earlier antibiotic shot.

Kim nudges Jenny's legs a bit apart and then gently parts the base of her buttocks to reveal a pink anus. Aiming for Jenny's belly button, she pushes the thermometer in with a slight twisting motion, stopping when about a third of it is buried in the teen's rectum. She releases the girls buttocks and glances at her watch. Holding the end of the thermometer between thumb and forefinger she settles to wait.

As Jenny is laying on the gurney waiting for the thermometer to register, the curtains open exposing her bare butt to the hall and a woman in scrubs and a resident length white coat enters followed by a man in the shorter coat of a medical student. They only partial close the curtain behind them, but Lisa quietly tugs it shut the rest of the way.

"Hello, I'm Dr. Samantha Lee and this is my med student William Sanders. I hear that Jennifer hasn't been feeling well. Valley Care sent her up here for double pneumonia. The note says that you have some x-rays and some records for me." She says trying to identify the people in the bay. She assumes one is the mother, but she is not sure who the nurse is in a non-hospital uniform.

Lisa speaks up "I'm Lisa Miller, one of the nurses from Valley Care, and this is Mary Finch, Jenny's mother. Here are Jenny's chest x-rays from this morning and reports from Dr. Burnes from Saturday and Dr. Janet Smith. I can answer any questions about her treatment." She said, handing Dr. Lee the x-rays and doctors notes.

As Dr. Lee is scanning through the notes, Kim separates Jenny's buttocks and withdraws the thermometer. "Go ahead and pull your panties the rest of the way off and sit up, dear. The doctor will want you undressed for her exam."

Jenny is a little dubious about being naked in front of these new strangers, including a MAN who isn't even a full doctor, but she complies. She feels vary vulnerable sitting there naked and is glad to have Mom and Lisa along. She pulls the top sheet on the table up over her lap to provide a little cover.

"Her temperature is up to 104.1." Kim announces after reading the thermometer and goes to put it in the used tray.

"Thank you nurse. Could you show Bill where the Tylenol is? I'll have him administer 1000mg PR after I've finished the exam." Dr. Lee said off offhandedly, thinking that she hadn't had her new med student administer a rectal suppository yet.

"These are well written notes, Lisa. Please pass my thanks on to the doctors."

"Well, Jenny. I can definitely see from your x-ray that you have a good case of pneumonia going. Your left lung is completely inflamed and there is good start on the right. Can you tell me how you've felt the last few days?"

Jenny tales the same story that she told Dr. Jan and then added, "... and then Dr. Jan gave me a sterr a steroid shot in my arm and a big penicillin shot in my butt and then she had me rest in a quiet room with an oxygen mask on and gave me Tylenol pills and some water and after a while I started feeling a little better. It was less work to breath. But the air has been getting soupy again and I am starting to feel hot and cold again." She ran down coughing a bit and absently rubbing her sore butt.

"Well let's get a look at you, can you swing your legs over the side for me?" She says, pulling an otoscope from the side tray and stepping in front of the girl. She starts with checking Jenny's ears, nose and throat, telling her med student, "Never ignore the basics. Just because you know a patient has one problem, it doesn't mean that they don't have another. Always do a good basic exam."

Dr. Lee then got her stethoscope out and put the bell against Jenny's right breast and put her left hand on her back. Moving the bell around her chset and occasionally asking Jenny to breath in deeply. She then goes behind Jenny and switches, putting the stethoscope on Jenny's back her hand on Jenny's chest. She repeats the same pattern, sometimes asking Jenny to "Breath in deep and breath out", sometimes thumping her back.

Just when Jenny thinks that it can't get any more embarrassing, Dr. Lee says "William, put on your stethoscope, I want you to hear this." She takes the med student's free hand and places it on Jenny's chest. (Touching both of her breasts!) She then guides his other hand to move the bell of his stethoscope to various places on her back, tell her to breath in and out and telling William what he should be hearing and feeling. By the end of this, Jenny wants to craw under the mattress on the gurney, but fortunately Dr. Lee has William step back for now.

Next she has Jenny lie back on the table and pulls the top sheet off of her, leaving the poor girl laying naked. putting her stethoscope back on, she proceeds to listen to Jenny's abdomen and then do a quick palpation. Jenny turns a bit redder as Dr. Lee's palpation reaches her pubic area.

Then Dr. Lee, does a quick check of Jenny's lymph node, starting with the neck, then moving to her armpits and breasts. As Dr. Lee spreads Jenny's legs to feel her groin, she hears Dr. Lee say, "just going to take a quick peek while I am down here" and feels Dr. Lee part her lips briefly. "All done down there, you can sit back up now.

Dr. Lee finished the exam with a quick reflex test and then turned to wash her hands. "Nurse Kim, could you get Jenny a gown? We're done with the exam."

Kim brings out a hospital gown and opens it for her. "The opening goes in the back." She says as she helps Jenny into it. Jenny is quick to put the gown on, happy to be able to cover her breasts and privates, even if it didn't offer perfect coverage for her butt. Even after Lisa helped her tie up the back of the oversized gown, she felt exposed.

Dr. Lee finishes making some notes in Jenny's chart and then address the group. "Mrs. Finch, I think that Jenny will need to stay about a week, maybe ten days. We'll get some blood and sputum cultures started so I'm not going to change her antibiotics until we get those back, although i will put her on some stronger steroids. I also want her on some supplemental oxygen, at least for a day or two and to get some IV fluids. Does that seem OK to you?"

At a nod from Lisa, Mary says, "Yes, if that is what you think is best."

"Excellent. I'll just have William give her the Tylenol and then I'll go and put in the orders. It'll a be a little while before transport gets here, you can wait with Jenny until then. William, go ahead."

William had asked one of the outgoing students what to expect from Dr. Lee on this clerkship and had been told, "She can be a little blunt, but she's a good teacher. I got to do a lot more than I expected. Remember three rules. Be polite and respectful to every one, doctors, nurse, parents, patients, everyone. Ask if you don't know. No task is beneath you or not worth learning. Don't try whining that something is a nurse task. She will shut that crap down fast. Follow those rules and you will learn more in any other two clerkships."

This was the first time that he had given a rectal suppository and he was a little nervous. He now knew why Dr. Lee had him follow a nurse giving meds. ("You won't always have a nurse handy.") He put on gloves and spoke to Jenny. "Jennifer. I have a suppository to give you for your fever. Do you know what a suppository is?"

Jenny groaned inwardly. The exam had been mortifying enough. Now she was going to have a MAN stick his finger up her butt. Still, she was so tired that she just wanted to get it over with. "Yeah, it's a pill that goes up your butt." she said as she turned over on her side and pulled up her knees.

William moved the gown out of his way, exposing the teen's pale butt and the bottom of her back. Setting the pill cup with the suppository on the gurney in easy reach, he squirted some surgilube on it and on his gloved index finger. Seeing the bruise, he gently lifted her buttock and smeared a little lube on her anus as he had seen the nurse do. Then took the suppository and placed it against her pink rosebud. Taking in a breath for courage, he pushed the suppository in with his finger following to the first knuckle.

"All the way in William. You want to push the suppository in a deeply as you can and hold it there for 20 or 30 seconds. Don't worry, I haven't had a student lose a finger yet." Dr. Lee said.

Despite her mortification, Jenny couldn't stifle a little giggle even as she felt William's finger penetrate further into her rectum. After a brief awkward pause, she feels him withdraw his finger and pass a tissue across her to wipe of extra lubricant. Then he recovers her with her gown and she feels a little less exposed.

They raised the back of the gurney so that Jenny could sit up and be supported and then Dr. Lee hooked her up to a set of nasal cannula that went to a port on the wall behind them. "They'll unhook you for transport, but it might be a while and this should make you feel better." And with that Dr. Lee, the student, and the nurse left them to wait.

"Well that was mortifying." Jenny said weakly. "After having a man's finger up my butt, I'll never tease Sam about getting the old turn and cough from Dr. Sarah again."

"Best you don't young lady." Mary said giving Jenny a smirk and a very gentle swat to side of her butt. "Still you handled it well. How are you feeling? Really?"

"Run down. Like I said, the air is getting soupy again. But this thing helps." She says pointing to the canula feeding her extra oxygen. "Lisa, she said stuff about blood work and IVs and stuff? Am I going get a lot of shots? And are they going to keep doing stuff down there?" She said pointing at her butt.

"Sorry kiddo. You're probably going to feel like a pin cushion for a while. And there's a reason they have you wear those gowns instead of your own PJs. And I have to warn you, they are a lot less careful about nudity in the hospital than we are at Valley Care. You can probably count on your roommates seeing you get your temperature taken and getting shots and such and you seeing them. But at least you'll be in a smaller room, with fewer roommates."

"I guess." Jenny said, not looking forward to what was comming.

Nurse Kim came back to collect a sputum sample and to apologize for the transport delay. "It will be about another 20 minutes."

A little while later, they hear bits of conversation from a couple of bays over where a teen whining and arguing for a couple of minutes that she is too old to get her temperature taken down there and that it wasn't fair. "I'm 19 and in college. This is ridiculous!"

Jenny felt a little embarrassed for the girl. She remember the shock she felt getting switched back to rectal temps when she first went to Valley Care. After years of (mostly) mouth temperatures, it had felt like quite a demotion at first.

"Gee Mom. I hope that I wasn't that bad when we first moved to Green Valley. I feel embarrassed for her. She is just making it worse for herself." Jenny whispered to her Mom.

"Don't worry honey. You were a little grumpy, but you were never that bad. And you settled down quickly enough." Mary replied quietly.

"Well, you always taught us to be polite and it was really Sam that settled me down. He got really annoyed with me and Sally complaining and just talked us down. Ugg. I don't know how the little bas.... - cough cough - mmmmm how Sam does it. Course the story he remembered from Lisa helped, but that boy can be so infuriatingly sensible. Grr."

"Yes, I know what you mean dear. I think that he gets that from your Gran. She could do the same thing. No screaming. No yelling. Just talking until you can't help but agree with her. And mind you language. I am quite sure who your brother's father is." Mary said while hiding a grin.

A few minutes later, Kim opens the curtain. She is followed by an orderly with a wheel chair. "Sorry about the disturbance. Not all teens adjust to the hospital as well as Jenny." Kim says as she starts to disconnect Jenny's oxygen tube from the wall port.

"Jenny, this is Billy from transportation. He is going to take you up to your room on the peds floor. You're in one of the smaller rooms towards the back that we set aside for the older patients. It's away from all the noise and fuss and keeps you with just a few kids your own age, so don't worry when Billy takes you past the open wards."

As Kim is helping Jenny down from the bed to get in the wheelchair, she blushes as she feels the cold air on her butt and realizes that she is mooning Billy. "Hold on before you sit down Jenny. The corridors can be drafty so I snagged a robe for you and some grippy socks." Billy said as he held out a robe that had been in the chair.

As she slipped into the robe, she gave Billy a little smile and a "Thanks". He may have saw her butt, but at least he was helping her get some more cover. Sitting in the chair, her mother and Lisa helped her put on the yellow socks with the rubber bottoms and gave her goodbye kisses on her head.

With her patients belongings bag and her (curse you Lisa) school book bag in her lap, Billy wheeled her towards the doors at the end of the hall and towards whatever awaited her.

Before going through the doors, she heard the fading voices of her mother and Lisa. "So what is this story you told Sam? They've both mentioned it."

"Oh, that must be the Debbie story ....."