Posted on by jparadisirn

This is Your Fault: Frank Lashes Out

Chapter 64

Liz is assisting me with Nathan’s trach care. The stoma is healing well, but still a tender pink, with frothy secretions. Carefully, I swab around the collar, while Liz measures and cuts new ties to replace the old ones.

“It sounds like Nathan’s going to begin weaning from the ventilator soon,” I say, trying to sound cheerful. “He’s starting to do more breathing on his own since Dr. Polk had us lighten his sedation.”

“He opens his eyes every now and then too, that makes me so happy,” says Liz. “I swear he squeezed my hand when I was talking to him last night. Maybe he’ll regain some movement in his hands.”

“That would be great, Liz. I’ve known patients who were able to use a computer, and navigate their mobility chair independently, using a single hand. He’s strong, and young.”

“Should we wash Nathan’s hair this morning, Niki?”

Before I can answer, I sense in my peripheral vision a shadow standing in the doorway. It’s Frank. He grasps the side of the doorway with one hand, swaying a little. I can smell the alcohol he’s been drinking from across the room.

He’s staring at Nathan in the bed, but doesn’t step further into the room. Something about him blocking the doorway sets me on edge.

“Hello, Frank.”

He doesn’t take his eyes off of Nathan.

Liz looks uneasy too, but ventures to speak to him, “We’re just finishing Nathan’s bath and trach care. He had a good night.”

Frank turns to Liz, fury in his voice. “You raised our boy to be a fucking pussy. How’s he going to learn to be a man and toughen up when you keep letting him be sensitive and all that shit? I told you time after time, and now look where he is. You made this happen, Liz. This is your fault!”

“Frank, that’s enough,” I say to him. I need you to calm down.”

“You’re a cruel asshole,” mumbles Liz, barely audible.

Frank takes a step forward into the room. “What did you just say?”

“Nothing, Frank. I didn’t say anything.”

Frank looks at Liz, and his shoulders relax. In a voice frighteningly calm, he says, “Oh, it was nothing.”

Then, with the speed, and precision of a striking rattlesnake, Frank grabs Liz by the throat, pulling her away from Nathan’s bed, and slams her head against the wall. He releases his grip, and she slides to the floor, unconscious.

I scream, “Call security! I need help!” from the room to the nurses’ desk.

And then Frank pulls out a handgun, and points it at my head.

Posted on by jparadisirn

Bruises Not Scratches (Niki Discovers Something Unsettling)

Chapter 58

“Raquel, it was absolute mayhem. The little dog took off down the hall after the bunny, and then the charge nurse called Security to help round them up. Of course, Security didn’t have any idea of what to do. Eventually, two officers cornered the animals, grabbed Rocket, and the pet therapist gathered up the bunny, but not before the blind kid, Travis, somehow felt his way to the fire alarm, and pulled it. The sprinkler system went off, and the fire department arrived. No, I didn’t leave early. After we settled everyone down, finished the shift, and gave report, it was 9 pm before I finally I got home, and reheated for dinner the lunch I didn’t get to eat. I’m ready for a second glass of wine, are you?”

This story was just to good not to call my sister Raquel and tell her about it over wine by phone.

* * *

I had a couple of days off before my next shift. Like I said before, day shift is challenging in its own ways.

“Niki, the phone’s for you.”

I take the call from the pod outside my patient’s room. It’s Finch, one of the day shift pharmacists.

“About that Ancef dose your resident ordered,” he begins.

I block, “He’s not my resident. He belongs to the attending,”

“Well, whoever he belongs to, he’s placed an order in the EMR for Ancef.”

“Yeah.”

There’s not enough Ancef in all the hospitals in the city to cover the dose. You need to call him and point out that the kiddo only weighs 10 kgs.”

“Finch, the RT is here and we’re about the re-tape his ET tube. Can you call and get the order changed, please? You can educate him about placing orders while you do it.”

“That’s not really a function of pharmacy, Niki.”

“It’s not a nursing function either, Finch. Why does everything get turfed to nursing? Health care is a team sport, no?”

I interpret the the silence on the other end of the phone to mean he’s strategizing an offense.

“Alright, Niki, I’ll do it this time.”

“Thanks Finch, you’re a real gem.”

“Phfffp,” he mutters before hanging up.

* * *

At change of shift, I give report to my old night shift buddy, Liz, first telling her about the patient, and then Finch’s one-liner that the resident ordered more Ancef than what’s available in the city that was pretty hilarious, when I notice the bruises on her neck, three of them. They’re long and suspiciously resemble fingers. I can’t help myself, “Liz, what’s up with the marks on your neck. They look like bruises. What happened?”

Her gaze drops downward, and she turns her head the other direction attempting to hide the bruises, but not before I see her cheeks flush bright red.

“It’s nothing, Niki. I scratched myself.”

She’s lying.

“Liz, those aren’t scratches, they’re bruises. It’s me, Niki. We’re friends, remember? What happened?”

“I’m having problems with Nathan. He’s skipping school and failing his classes. He got suspended for smoking pot on campus. I called his dad, hoping he could talk some sense into him.”

“Frank, you’re ex did this to you?”

“I thought he could help, but when he came over to talk to Nathan he starting hitting him. I got between them. When I started yelling at Frank to leave, things got out of control.”

“He choked you? Oh my god, are you okay? Have you seen a doctor? Did you call the cops?”

“This is exactly why I didn’t want to tell you Niki. I knew you would overreact.”

“Overreact? Jeez, Frank was strangling you! He should be in jail.”

“Mind your own business, Niki. I appreciate your concern, but mind your own business,” was all Liz said as she stood up and entered her patient’s room.

Posted on by jparadisirn

Their Pounding Hearts (parenthood is hard)

 

Chapter 52

“Maddie certainly is your daughter, Niki. The family resemblance is startling,” laughs Gerald when I tell him and Liz about Maddie’s pranks.

“Gerald, are you calling me a smart ass?”

“Uh, yeah.”

“Amber should lighten up a little,” says Liz. “I’d give anything if Nathan pulled simple hijinks like that instead of staying out all night, and skipping school. Amber has no idea how difficult a teenager can become.”

“How is Nathan?” I ask.

“He was suspended for smoking on campus again. When his locker was inspected, they found some pot. He’s missed so much school this year I’m afraid he will have to repeat his junior year unless I can get him into summer school. He used to be such a good student, a good boy. I can’t find a way to reach him.”

“Is his dad any help?” asks Gerald.

“Frank? No Frank’s part of Nathan’s problems. He’s an alcoholic. Our marriage was pretty bad. It took me a long time to learn that I couldn’t save him from his drinking. Or that it wasn’t my fault he hit me. Nathan got between us once, and Frank hit him really hard. That was when I finally realized we needed to leave. I thought I was helping Nathan by keeping our family intact, but I stayed too long.”

“That’s a hard decision to make sometimes, Liz. I’m sure Nathan will have more understanding when he gets older,” I volunteer.

“I can only hope. His behavior is so reckless, I fear for him. Every time we admit a trauma from the ED, my heart pounds with dread, wondering if it’s Nathan.”

I give Liz a hug, and Gerald pats her shoulder.

“Have you considered taking Kris’s day shift position, Liz? Would that help things at home?”

“It wouldn’t help. I’ve lost control. Nathan walks in and out as he pleases. I can’t afford to lose the night shift differential either. Money’s tight on a single income.”

Something about Liz’s words gives me goose flesh.

* * *

We get two admits from the ED. The first is an eight-year-old new onset Type 1 diabetic. He’s admitted with a blood sugar of 550, and semi-comatose. Dr. Polk intubates him, and we start IV fluids and an insulin drip, drawing blood sugars hourly.

His parents are devastated by the news that their child needs daily blood sugar monitoring, and insulin shots. Then Dr. James, the pediatric endocrinologist arrives. It doesn’t matter what time of day or night a new diabetic is admitted to our PICU; Dr. James shows up and spends as much time as needed to explain to the parents that their child’s diabetes is manageable. He cheers them up with stories of athletes and celebrities who are diabetics. He’s so kind and gentle. I love standing in the room watching the parents’ anxiety come under control while he teaches. He is passionate about his practice, and my favorite physician.

The second admit is a six month old with a respiratory infection. After failing to respond to Gerald’s inhalation treatments and chest percussion, he buys an intubation tube and ventilator. His mother sleeps in the cot by his crib, finally able to rest after hours of worry about her baby.

It’s three in the morning before I sit down to eat the sandwich I brought from home  while catching up on my charting at the nurses’ desk.