A good nurse has 'Mercy'

"Mercy"

NBC, 8 p.m. Sept. 23

Episode: "Can We Get That Drink Now"

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The premise

Veronica Callahan (Taylor Schilling) has returned from Iraq suffering from post-traumatic stress disorder, for which she is taking the antidepressant Paxil.

Even with treatment, she is frequently irritable and has flashbacks to the war. She has taken a nursing position at Mercy Hospital, where she takes charge of cases the way she did in Iraq.

At the scene of a car accident in which the driver sustains a tension pneumothorax (a deflation and collapse of a lung), Veronica assumes control of his care after a dermatologist nearby declines to do so. She makes a hole in his "fifth intercostal space" (in between the ribs) with a needle and then inserts a straw through the hole, feeding it into a soda bottle and, as air is sucked out of his chest cavity, his lung reexpands.

At the hospital, Dr. Dan Harris (James LeGros) criticizes her actions at the site, saying that a doctor, rather than a nurse, should be managing a trauma case.

Shortly thereafter, gunshot victims are brought to the emergency room; one of them, a 15-year-old boy, has a cardiac arrest but is resuscitated. He has a bullet lodged in his hip and develops a rash on his chest. Veronica is convinced he may have a fat embolism (in which fat enters the bloodstream from a wound, usually because of a severe trauma) and suggests he be given the blood thinner heparin. An ER resident disagrees, though Veronica insists that heparin was used on the "front lines" for this type of situation and that studies show that such treatment can help patients recover. The boy ends up dislodging the embolism to the lungs as Veronica predicted, has trouble breathing and sustains severe brain damage from lack of oxygen.

Finally, one of Veronica's patients, a 60-year-old woman dying of metastatic liver cancer, is subjecting herself to further surgery and chemotherapy only to placate her adult children. Veronica tells the surgeon privately that his treatment is "snake oil." When the patient asks her opinion, Veronica asks her to reconsider the therapy, saying the surgery is not likely to add to the quality or quantity of her life.

The medical questions

Is Paxil a good treatment for PTSD? Is it reasonable to treat a tension pneumothorax by jamming a needle, then a straw, into the chest? Did Veronica overstep her bounds at the accident scene? Might her forceful behavior be the result of PTSD?