How to Sabotage a Shift (Niki Meets a Service Dog)

Chapter 56

Never, ever think your shift is easy and you may go home early. It’s the quickest way to sabotage it.

The shift started well enough. I did vitals and passed meds for the two post-open heart patients first. They each have private rooms, and I chatted a bit with their respective parents. Transferring their children from the PICU to the general floor makes some parents uneasy, even though they understand it means their child is getting well. In the PICU, they become used to their child receiving one-on-one nursing care. They become accustomed to the vigilance of a nurse dedicated to the care of only their child. On the pediatric unit, the nurses are assigned three or four patients plus their child. The parents are now required to practice vigilance for their previously critically ill child’s care. Understandably, some are more comfortable than others. My patients’ parents recognize me from the PICU. A familiar face eases their minds. Our rapport encourages my belief it will be an easy shift.

My third patient shares his room with another.

During report the night shift nurse said, “Niki, your patient, Travis, is a delight, you’ll love him. Unfortunately, his roommate is a bit of a handful, so we assigned him to another nurse. He saw Travis’ seeing eye dog, Reege, and insisted his parents bring his dog to stay with him. They brought him in last night, claiming it’s a service dog too. Fortunately, Travis’ dog is a professional, and ignores the little dog’s aggressive behavior towards him.”

“Well, if Travis and Reege can ignore the other dog, I guess I can too.”

 

“Hi Travis, my name’s Niki. Is this beautiful dog is your partner, Reege?”

“Hi Niki, I need to go to the bathroom. Can you put the IV pole where I can reach it please?”

“Sure. Do you need help?”

“Nope.”

I watch Travis handle the IV pole, and grip Reege’s harness with his other hand. Reege, a golden retriever, pads along silently, leading Travis the to the bathroom. Travis seems steady enough, but his fall risk makes me nervous, so I wait for them in the room.

On the return trip I try again, “Is it okay if I take the IV pole for you?”

“Sure.”

After Travis is back in bed and Reege settled at his bedside, I take his vitals.

“Travis, are you hungry or is your stomach still bothering you? The breakfast trays should arrive soon.”

“I’m hungry. Do you guys have bacon?”

“Of course, but if there’s no bacon on your tray, I’ll call down to the kitchen and get you some.”

“Thanks!”

As if on cue, the meal cart arrives, and I find Travis’ tray. Lucky me! There’s bacon.

I place the tray on his table, adjusting the bed and utensils so they’re within reach. Travis tells me he’s right-handed.

“You’ve done this before, I see.”

“Yeah, a few times,” he grins. Would you tell me what’s on the plate, and its place on the face of a clock?”

“Sure. Anything else? Do you want me to butter the toast or cut anything for you?”

“Nope, I got it. Thanks.”

“Hey Nurse. Hey!” It’s the kid in the other bed. He’s got his dog, a nondescript terrier mix, in his lap.

“Hi. Do you need something?’

“Yeah, can you get some bacon for Rocket?”

“Sure. I’ll make a call to the kitchen.”

When I near his bed, Rocket growls at me.

“Do you want to pet him?”

“Does he bite? I thought strangers shouldn’t pet service dogs.”

“People just say that because they think their dog is more special than Rocket.” The kid glares at Travis, who flips him off. I try not to laugh.

“He only bites if he doesn’t like you. If you give him some bacon, I’m pretty sure he won’t bite.”

“Um, okay. I’ll order the bacon and let your nurse know.”

I leave their call lights within reach, bed rails up, and take breakfast trays to my other two patients. After they’re done, I help their mothers with bathing and dressing them.

One of the perks of day shift is the café is open. There’s time to go downstairs and bring a latte back to the unit. I get in line. There are two police officers ahead of me.

One of them is Officer Mike.

“Hey, Nurse Niki. What are you doing, getting a latte before heading home? I thought night shift prefers beer for breakfast.”

How the hell does he know that?

“Well Officer Mike, how nice to run into you again. No more nights for this nurse. I’ve transferred to day shift.”

“Congratulations. Welcome to the land of the living Niki. See you around.”

Mike and his partner take their coffees from the counter.

Did he just look my way again before walking away?

It’s Not Like You Work Five Days a Week (Twelve-hour night shifts are hard on marriages)

Chapter 14 

For the third night in a row, I returned to the PICU. Shortly after shift report, the father of the child I told how to ask for pain meds for his kid walks in carrying three large boxes of pizzas. He sets them in front of me, on top of the nurses’ desk.

“My wife and I want to thank you PICU nurses for the extraordinary care our daughter received while she was a patient in this unit, and we are  treating you to a pizza dinner.”  He looked at me.

“So how is your daughter doing tonight?” I ventured.

“Great!” Her surgeon talked to us by phone. He wanted to make sure her pain medications kept her comfortable. We really appreciate his concern for her well being. She had a very good day, and we’re going home tomorrow.”

“That’s great news,” I told him. “Thanks for the update, and the pizzas.”

“It’s our pleasure,” he replied. “Enjoy!”

After he left, Liz looks at me quizzically, but only says, “Well Niki, you certainly excel at the ‘concierge service’ the hospital keeps pushing on us. Obviously that family thinks you’re the bomb. Way to score pizza! Thanks!”

***

At breakfast the next morning I swear Corey to secrecy, and tell him about Dr. Eubanks, the dad, and the pizzas. It was two of us, because Liz had to take her mother to a doctor’s appointment.

“That’s awesome, Niki. Way to advocate for your patient. I’m tired of being told to ‘manage up’ without a way to honestly speak up when I see something wrong. What administrator’s going to support a nurse’s concern about an under medicated patient over a surgeon’s insistence that his patients don’t need it? Nurses are hospital employees, and in most cases, doctors are not.”

“I think nurses could push on an issue like this in nurse council, but it takes forever to change hospital policy. My patients can’t wait that long for help. It’s a problem.”

“Amen,” agrees Corey.

The server brings Corey’s breakfast. I only ordered coffee because of the pizza I ate last night, but Corey’s ordered bacon, eggs, hash browns, and his usual beer. The bacon smells so good, and Corey notices me eyeing his.

“Go ahead Niki, have a piece.”

“Oh no. I ate all that pizza last night. I don’t need any more calories. Plus it’s your breakfast.”

“No, really have some,” he insists, placing a couple strips of bacon on my plate with his fork.

Corey watches me eat the bacon. It tastes heavenly. I love bacon.

A smile breaks across his dimpled face, making him adorable. I smile back.

“So, Niki, maybe it’s none of my business, but last time we had breakfast with the gang, it sounded like maybe there’s trouble at home.”

“Oh I don’t know… No, that’s not true. Maybe I expect too much from Simon. I mean he’s a good man, and an affectionate father. He was out of work for a while, but now he’s teaching again. You’d think that would get us back on track, but when he tells me about his day, like normal people do, I try to be sympathetic, but I’m thinking, “When I have a bad day at work, somebody’s child died.” He doesn’t understand why I can’t let my work go when I get home, like he does. How about you Corey? You didn’t say much about your marriage.

“My wife, Sheila, is beautiful. When I met her, she was a high-powered realtor selling spectacular homes for the wealthy. She was so girly, you know: blonde hair, pumps, always wore dresses. I fell hard.

I think I’m a big disappointment to her. I know she doesn’t consider three 12-hour nights shifts a week in a trauma center full time employment. She actually says that out loud,

‘You know, Corey, it’s not like you work five days a week like my friends’ husbands. They don’t sleep all day either.’”

“When the bottom fell out of the real estate market, Sheila went on hiatus. She’s home with the kids while I work, “single mothering it,’ as she calls it. On my days off I get the girls ready for school, drop them off, pick them up, shuttle them to and from dance classes, and then start dinner. Sheila leaves the house early in the morning for a full day of Pilates, a pedicure, her book club or shopping, and then happy hour with her girlfriends, but not before making a ‘honey do’ list of repairs around the house for me. Occasionally she texts me something she forgot. It’s pretty clear she doesn’t respect nursing as a career for a man.”

“Corey, I’m sorry. Your wife should spend a night watching you work in the ER. A lot of people are alive because you’re a great nurse.”

“Sheila would never willingly enter a hospital. She doesn’t want to know about the ‘blood and guts’ of my job. When I try to explain it to her, she tells me it’s not an appropriate conversation for our daughters to overhear.

“So, I pick up as much overtime as I can handle. I don’t know if it’s for the extra money, or to avoid being home anymore, but I get a lot of satisfaction from nursing. I’m part of a team there. It’s like I matter to something larger than myself.”

Corey and I have a silent moment of eye contact. He reaches across the table and touches my hand.

“Thanks Niki.”

Beer for Breakfast (The night shift goes out for breakfast)

Chapter 11

Fortunately, the next two shifts are uneventful, which actually feels weird after a traumatic shift like the last one. There’s not enough time in between to process what happens to our patients, and the role nurses play.

Every so often, someone in hospital administration suggests holding “debriefing” meetings for the nurses after a particularly distressing patient death, but the meetings never develop meaningfully. In my opinion, this is because the meetings happen on day shift, which is too busy for those nurses to leave the unit to attend, and too late in the day for night shift to stay up. Besides, in units requiring ICU technology skills, many a nurse’s days off are consumed at the hospital in the form of mandatory in-services, skill competency workshops, CPR renewal, PALS re-certification, staff meetings, etc. We get paid for the time spent attending, but at a certain point, it’s a case of diminishing returns to spend more time at the hospital. So I don’t attend the few debriefings that occur. Besides, I don’t want to talk about my feelings and sing Kumbya in front of my coworkers.

What I do enjoy with coworkers is going out for breakfast after a shift, especially if I don’t work the following night. This morning, a few of us are meeting at a popular diner a few blocks from the hospital to do just that.

Besides Corey from ER, Gerald the respiratory therapist, and Liz join us in the booth. The guys order large, while Liz and I share an omelet, and order coffee. Corey and Gerald drink beer. When Liz comments on this, Corey speaks up,

“Because Liz, that’s what dudes do after work. We go out for beer.”

“If I have a beer after a twelve hour night shift, I’ll have to sleep in my car before driving home,” I laugh.

“That’s because you’re a light weight female nurse Niki,” Corey teases. “ER nurses are manly men, despite the media’s and society’s feminization of our kind.”

We laugh.

Changing the subject, I interject:

“Hey Gerald, guess what happened last night in the PICU.”

“Buh.”

“No really, Gerald. You know that mom from bed two? Well, she came over to the nurses’ desk, and told me,

‘I don’t know who to report this to, but someone working in this hospital is hitting a child on the chest and back in room seven.’

So I get up and look in room seven, and Gerald, it’s YOU, giving chest percussion to a toddler!! I almost burst out laughing trying to explain to her that you’re a respiratory therapist, and what you were doing helps the patient breathe. I told her the kiddo’s doctor prescribed it.”

“Gee thanks, Niki. I owe you one. Probably saved me from being arrested as a child abuser or something. You nurses complain about not getting recognized for your work, but when was the last time you saw a respiratory therapist character on a TV show?”

“Whatever possessed you to become a respiratory therapist anyway, Gerald? You hold nebulizers in patients’ faces, and then suction snot out of their tubes. I nearly gag just listening to someone with a wet, hacking cough. How can you stand your job?”

There’s laughter around the table.

“Well, Niki, it’s because I want to work ‘in the exciting world of doctors,’ and have my life choices questioned by bitchy nurses like you. Keep your opinions to yourself girlfriend, and kindly ask the server to bring me some coffee while I go use the head, okay?”

There’s more laughter, followed by a brief silence while the server brings our food, and Gerald’s coffee.

Corey asks, “Does your husband take your daughter to school in the mornings after your shift Niki?”

“Yeah, and brings her home. Simon’s a school teacher.”

“And what about you, Liz, do you have kids?”

“Yes, a son. His name is Nathan. He’s fifteen, and takes the bus. Next year, he’ll learn how to drive, and I won’t have to depend on other people to shuttle him to baseball, and basketball practices while I work.”

“How long have you been divorced, Liz?”

“Seven years.”

“Are you dating anyone?”

“On nightshift?”

“It’s probably hard being a single mom, but on the other hand, maybe it’s not so bad having control over your own life,” I realize I’m musing out loud.

“There’s a lot to be said for marriage, Niki, like having someone there to divide up the work. Sometimes I think people are too caught up pursuing happiness, and it gets in the way of commitment. Maybe being happy isn’t the most important thing in life,” says Liz.

“I don’t know, that’s sort of heavy,” says Corey. “Just because you’re married doesn’t mean you have a partnership. I think it depends on expectations. Sometimes one spouse has more expectations than the other. It doesn’t always work. I don’t know if sticking it out for the sake of commitment is the right answer.”

“I’ve always felt that a happy marriage or partnership is a wonderful thing,” says Gerald. “But it’s better to single than married and unhappy. Nothing is lonelier than an unhappy marriage.”

“You can say that again,” I mumble while shoving a bite of omelet into my mouth.