ms Anna is a registered nurse at a small rural hospital's Emergency Department. She has been working as a nurse for about 1 year, so she still feels like she has a lot to learn. One night in October, Nurse Anna begins her shift and speaks to the nurse on the previous shift for the handover of patients. Nurse Anna is told that one patient, Brenda, is having chest pains and nausea, and that her condition is serious and concerning. Some test results are pending, but Brenda has a history of heart murmurs and several risk factors. Dr. Derby, the on call cardiologist, has been paged, and should arrive soon. A second patient, Charles, is waiting for some final test results but Nurse Anna is told he is totally fine and should be discharged soon. Nurse Anna goes to see Charles soon after her shift begins, and he tells her that he still doesn't feel "right," but he seems to be acting normally and has no outward indications of pain. When Nurse Anna goes to check on Brenda about 20 minutes after her shift begins, she finds Brenda to be short of breath and clutching her chest. Nurse Anna pages Dr. Derby again. Nurse Anna gets very busy for the next hour, but when she finally goes back to check on Brenda, the patient is barely conscious and has a very erratic heartrate. Nurse Anna learns that Dr. Derby has not been by, so she pages and calls Dr. Derby yet again. While the ED doctor stops in and tends to Brenda while he waits for Dr. Derby to arrive, Nurse Anna goes back to bring the discharge paperwork to Charles, who she finds to be suddenly lethargic and slurring his speech. She asks him if he's okay, and he says he's just tired and wants to go home. She is unsure about what to do, since he seems sick suddenly, but remembers that the nurse on duty before her has several more years of experience and that she and the doctor have done a thorough work up and they say that he is fine. Suddenly, Nurse Anna hears a Code Blue being called, and rushes over to find Brenda is in Cardiac Arrest. Unfortunately, Brenda dies. About 30 minutes later, Dr. Derby comes rushing into the ED, mumbling about how it's his wife's birthday, and even though he was on call, he didn't want to really be called unless it was for a real emergency. He is told that it is too late, the patient has passed away. Right before he leaves, Charles is rushed back into the ED with the clear signs of a heart attack. "Well, thank goodness I was here!" Dr. Derby yells as he rushes in to help save Charles' life.