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Yet he seems willing to sacrifice the patient's wellbeing for Bailey, as if he would defer to a more senior physician--a glaring flaw in his advocacy, since, of course, even senior physicians can make deadly errors. Can you please just talk to him, smooth things over, so that when I go to take my patient back to radiology and get his drain put back in, he doesn't make a scene? In fact, nurses are autonomous professionals who report to nurse managers.Oddly, the scene actually overstates nurses' authority; surgeons typically prescribe the removal of these drains and nurses would not generally just remove them without first consulting the physician, though nurses do provide advice on when that should occur. Managing those irrational nurses can be such a drag! Physicians can complain to a nurse's manager, but nurse managers are the ones with the power to "write up" nurses in the sense that they can impose discipline on them. If we remove the drain on day 3 instead of day 5 we can reduce the formation of fistulas by 30%.
Mark says that because Lexie is a resident, "I'm sure all the nurses hate you." We guess that Mark is suggesting that the nurses resent being ordered around by the brilliant young pretty stars of the hospital, or that the nurses are just jealous. When Mark finds out the nurse is Eli, he wants two drinks. Mark approaches Eli, outside of Lexie's hearing but in her sight. Now listen, I don't know what's going on here, but I know better than to mess with you on your turf. These patient records for the last three months show a post-op complication rate way lower than the norm. Lexie: OK, can you two stop being impressed by him? She starts saying "day 3" over and over; apparently she has seen that Eli always takes the drains out on day 3. (She's giddy.) I'm going to leave these files for you to look at. However, there is no apparent irony that Bailey is taking all the credit for what Eli actually did.Kepner is very upset because she will not be winning the contest. I need to be able to see the fluid to tell if there's an infection. Eli: You have your list, but I have 12 years of experience that tells me that putting that drain back in right now could actually put him at more risk for infection. Eli doesn't explain the infection risk--viewers may think that he doesn't really understand it. Bailey" while she calls him "Eli." Of course this naming disparity remains common in real life, but we would hope for better from a strong nurse.Eli: Well, I can tell by looking at it that it's not infected. Best practices on post-op gallbladder surgery care may still be evolving, but if Eli is so sure that removing the drain earlier is better, he should be as willing to fight Bailey as the residents. The naming disparity suggests at a minimum that nurses are lower-class workers and, together with the "write him up" line, arguably implies that nurses report to physicians.Another competing resident, April Kepner, stops by and expresses skepticism that walking makes any difference. Lexie is trying a standard post-op protocol, but with a "checklist I've developed for accountability." Lexie turns to Eli. On the whole, the scene does present Eli as a forceful patient advocate who has some health knowledge and who does not just automatically do whatever the physician says. But we have to admit, Sloane's deference, however flippantly presented, does suggest that Eli has expertise on his "turf." Later, Lexie gets Bailey to stop by and clear up this whole Eli business. Couldn't that itself increase the risk of complications and a compromised immune system thereby inhibiting healing?sometimes does, that one key nursing role is to be the messengers who get physicians for other physicians. Eli responds that that will be tough because he took the drain out. Eli: Well, with the drain in, he can't turn over, which means he has to sleep on his back, which means he isn't sleeping, so-- Lexie: OK, just call radiology, we have to put it back in. But Eli does not really explain what he knows in a way that viewers will understand or remember, suggesting that nurses operate more on longevity-based intuition rather than advanced training or skills, something NBC's ER also did at times. And finally, here we have this strong veteran nurse, who is supposedly in his "house" and on his "turf," calling the physician "Dr.