A Bad Feeling About Frank

Chapter 63

Several days ago, the neurologist treating Nathan held a family conference, and updated them on his prognosis.

“Nathan’s spinal cord was severely damaged in the accident. While there maybe some improvement after several months of healing, he will be paralyzed for the rest of his life. However, I believe that Nathan will not be ventilator dependent as he is during this acute phase. Since it may take many weeks for Nathan to breathe on his own without mechanical support, I recommend we place a temporary trach until he fully recovers and gets stronger.”

As the nurse caring for Nathan this shift, I was present at the family conference. Liz was prepared for the news, but openly sobbed anyway.

Frank had a lot of questions for the neurologist.

“What makes you so sure Nathan’s spinal cord damage is permanent? What about alternative treatments?” and “If we transfer Nathan to another hospital that specializes in this sort of care, would they offer more advanced treatment that could heal him?”

The physician answered his questions with patience and empathy.

I watched Frank as the neurologist answered his questions. Chameleon-like, his facial expressions changed from sorrow, to anger, to tears, and then to stone. Sitting in a chair next to Liz, I noticed he was lightly kicking her in the ankle under the room’s coffee table. She appeared not to notice. I almost said something, but thought better of it. A few minutes after the conference ended, he left the hospital.

Liz stayed in the conference room, asking more questions about what rehab services for Nathan will be offered, and how long would he be there as an inpatient.

I went back to the PICU, and resumed Nathan’s care.

“How’s Liz holding up?” asked Sue.

“Like a nurse. She’s focusing on what’s next; asking about rehab services, and what equipment she’ll need when he comes home. I don’t think his dad, Frank, is doing so good though. He was kicking her under the table during the family conference.”

Sue frowned. “I’ll have a talk with the nursing the nursing supervisor about that,” she said. “We may have to place some boundaries on Frank’s visits. Night shift said he came in late last night, intoxicated. When he started acting out they had security escort him to the hospital parking lot, and he took Uber home.”

I have a very bad feeling about Frank.

When it Happens to One of Your Own: Niki’s Heartbreaking Admit

Chapter 60

It’s 1730, and I’m caught up on patient care. Not only this, but so are my coworkers. It’s been a quiet dayshift, but none of us say this out loud, because that’s the fastest way to jinx your shift. I helped Craig transfer his last patient to pediatrics, and he’s left early. The remaining three of us sit at our pods and finish charting. We have an hour left before night shift arrives.

Of course, it was too good to last. The phone rings and Sue picks up the phone. I can tell by what I overhear we’re getting an admission. A trauma. A motor vehicle accident.

It’s a fifteen year-old boy, intubated by paramedics at the scene. He was the unbelted passenger of the truck his buddy was driving. They crossed a freeway barrier, and hit an oncoming car head-on. Our patient flew at least thirty feet before hitting pavement. He coded on the scene. There was a fatality in the other vehicle. The driver of the fifteen year-old’s vehicle survived without significant injury.

We call respiratory, and a ventilator is set up in the room. I pull out kits for arterial and central line placement. Neurology calls to have us prepare for an ICP monitoring device insertion.

It’s all hands on deck as the paramedics roll the boy into the PICU. He is strapped onto a back board, and wearing a neck collar. I step up to the gurney as we prepare to transfer the young man onto the hospital bed. He’s unconscious, and there’s blood spattered on his face. His face: I take a closer look, and I recognize his face! Oh my god; it’s Liz’s son, Nathan.

A Trip to The Mall

Chapter 44

I get home from work and fall into bed without showering first. Troubled about Corey, and tired from a long nightshift, I toss and turn through fragments of terrible dreams I can’t remember.

After several hours I give up all hope of restful sleep, and lie awake in the darkened room. The extra cell phone charger I bought for Corey’s use sits on the nightstand across from me. I wrap it around itself before tossing it into the back of the drawer. Padding into the master bathroom, I remove the bar of soap, the brand Corey uses, from the shower tray, holding it to my nose, and breathing its fragrance into memory before tossing it in the wastebasket. Almost a year ago I purged Simon the same way.

I don’t bother to dry my hair after showering. Instead I make a cup of tea in the kitchen. Maddie will be home soon. Like a mantra, I count the many blessings in my life, beginning with Maddie: I am lucky to be her mom, and have a career by which I can support the two of us. Things will look up. I recover the sense of unexpected relief I felt when Simon left, and again when Corey first told me about Sheila’s cancer: “I don’t have to do this anymore.”

Maybe I’m not supposed to have long-term relationships? But the thought of spending the rest of my life alone chills me. In nursing school I saw too many elderly dying alone in hospital beds- their only visitors a hospital assigned chaplain, or the occasional neighbor checking in. What if I become a hoarder, or a crazy cat lady?

I reel myself in. Where do I get these thoughts? Simon’s right, I always jump to worse case scenario.

Next, I change my Facebook settings, making Corey an “acquaintance,” which seems more grown up than unfriending him. “You’re single,” I remind myself. “You can do as you please,” but I cry for a bit before placing cold, wet washcloths on my eyes to lessen the redness, hoping Maddie won’t notice when she gets home from school.

Her arrival is announced by the slamming of a car door in the driveway, and Kaylee’s mom driving off. Kaylee’s mom works at home. I admire her for being president of the PTA, and organizing social activities at our daughters’ school. I help out making snacks, occasionally manning a table, and carting boxes of chocolate bars, cookie dough, or gift-wrap to the hospital, and selling them to coworkers for fundraisers. I feel perpetually guilty for not being more of a presence.

So I quickly agree when Maddie, after throwing her backpack on the dining room table beside my tote bag, asks breathlessly, “Mom, will you take me and Kaylee shopping at the Mall this weekend? Can we see a movie too?”

“Sure,” I answer.

Maddie hovers over me, delivering a hug and quick kiss. “Thanks Mom! How was work? Did your friends like your picture on the magazine?”

“Yeah. They brought a cake, and taped little copies of the cover on their name badges. It was funny.”

“Cool! I’m going to text Kaylee and tell her you said yes.”

Simon and I agreed it’s time for Maddie to have a cell phone.

“Okay. Do you have homework?”

“Yeah. I’ll do it before dinner,” Maddie is already down the hall to her bedroom, shutting the door behind her.

***

On Saturday morning I’m up early for a three mile run while Maddie eats breakfast and gets ready for the mall; a complex ritual requiring phone calls to Kaylee, several changes of clothing, and experimenting with the small amount of make up she’s allowed to wear when out with her friends.

After my shower, I slide on yoga pants, a fluorescent pink tank under a jacket, and flip flops, which are essentially off-duty scrubs.

We pick up Kaylee. It’s a warm, sunny day and I’m looking forward to hanging out a bit with them. Their faces are pink and healthy, their bodies strong. I whisper a small prayer of thanks.

The girls chatter non-stop in the back seat of the car reading texts they send and receive. I have some shopping to do too, so we enter the mall together.

“So let’s meet back here after the movie. Text if you’re running late.”

“Mom, can we go out to dinner after? And can Kaylee spend the night?”

“Sure. Ask Kaylee’s Mom if it’s okay though.”

“We already texted her. She said it’s fine.”

“Well, okay then. Stay out of trouble. Text me if anything comes up.”

“We will. How many times are you going to tell us to text, Mom?”

Giggling, they run off to their exclusive universe.

***

At a department store counter I try on a new lipstick, scrutinizing my face in the small mirror the clerk hands me. The color is good, and brightens my mood, so I buy it.

In the uniform store, I find a set of scrubs I modeled for Call Lights Magazine. I buy them, and a new pair of clogs too. Having something new to wear will help me through the next post-Corey shift.

After aimless window-shopping, I take the escalator upstairs to the food court where a teenager wearing the same pair of disposable gloves to handle everything makes my smoothie. I settle at a table overlooking the ice rink two levels below. Children and adults glide over the ice to an instrumental version of “I Will Always Love You.”

Violently, I’m thrown from reverie by the sight of Corey in line at a food stand across the court. Beside him is Sheila, radiant in a pink sundress; a scarf artfully wrapped around her head. Next to her are their two daughters, also dressed in matching pink sundresses.

I can’t breathe.

I abandon the smoothie on the table, rapidly, and I hope inconspicuously, making my way to the women’s restroom. Ducking into the first empty stall, its door slamming behind me, I squat in front of the toilet, trying to avoid touching the seat. I vomit until there’s nothing left but dry heaves. I’m sweaty and chilled.

The retching stops and I can stand without crumpling to the white tiled floor. I exit the stall and splash cold water from the sink in my face until its color returns in the mirror. I comb my hair, and apply the new lipstick, but my bravado is gone.

After what seems like long enough, I venture out of the women’s restroom into the long hallway leading back to the food court.

I am taken aback by bumping into Corey outside the restroom door.

For Whom the Phone Rings (Niki does ‘wine by phone’)

Chapter 10

After working a night shift, my soundest sleep occurs between 10 am and noon.

At 11 am the ringing of our landline phone wakes me. Drowsily, I pick up thinking it could be the school calling about Maddie. What if she’s sick, or hurt? But I forgot, the school only has Simon’s and my cell phone and work numbers. The landline is for Maddie.

It’s my sister, Raquel.

“Hullo?” I slur.

“Dammit, I woke you up, didn’t I? I’m sorry. I never know when you’re working.”

“It’s okay. I forgot to turn down the ringer.”

“Niki, why don’t you get rid of your landline and just use cell phones like normal people?”

“Because Simon and I think Maddie is too young for a cell phone. The landline is for Maddie.”

“You’re gonna have to let her grow up one of these days, Nik.”

“And this is why you woke me up?”

“No, I’m just checking in. Are you off tonight? Wanna do wine by phone?”

“Yeah, I am. Wine by phone is perfect. After dinner?’

“Yep. We’ll talk then. Goodnight, or whatever.”

“Goodnight.”

***

Raquel and her family live south of us, in La Jolla. It takes two hours to get there, depending on traffic, and the day of the week. It’s too far for us to get together regularly, so Raquel and I started wine by phone. Once a week or so, we each open a bottle of wine, and talk by phone for an hour or more. We sit in our kitchens drinking wine while catching up one each other’s lives. Our husbands and children are forbidden to interrupt wine by phone unless they are bleeding severely about the face or neck.

Besides being my sister, Raquel is my best friend.

“So Doll, things must be a lot better now that Simon’s working again, right?”

“Yeah, I think so. He’s happier for sure. He’s cut down on watching sports now that he has lesson plans and paperwork to do in the evenings. He helps Maddie with her homework more too. He’s preparing her for classes at Woodman next year. She loves the attention.

“What about you, Nik? Are things heating up a bit for the two of you?”

“I guess. I mean there’s more to talk about now that Simon’s working and has stories about his day. He’s spending time on his appearance again, and getting more exercise since he’s coaching too. If this lasts, maybe we’ll try to have another baby, although there’d be a big age gap between Maddie and a new brother or sister. Then again, we really should put money away for a down payment on a house. But there’s saving for Maddie’s college education too. I don’t know. I can’t seem to make up my mind. I think the weekend trip in Coronado will help. Thanks for taking Maddie for us”

“Niki, why don’t you stop worrying about the future so much and just make love to the man?

Silence.

“Right. Okay, so, how’s work? Are you still having breakfast with that ER nurse, what’s his name again?”

“Corey. Yeah, we go for breakfast once a week or so. Sometimes another nurse or two come along.

“Is Corey cute? Have you hooked up with him yet?”

“What? No! I mean, yeah he’s cute. No, we’re not hooking up. He has kids. He’s married.”

“So are you Niki.”

“What are you saying Raquel? What are you getting at?”

“Nothing Niki. Nothing at all. Don’t get all defensive.

We’re happy to have Maddie for the weekend when you and Simon go to Coronado. So when are you going to get her a cell phone?”

No Good Deed Goes Unpunished (Niki gets a speeding ticket)

Chapter 9

After charting on the fourteen-year-old boy with the AVM, I left the PICU to the well wishes of my coworkers: “Get some sleep, Niki. Good job.”

As usual, I leave through the Emergency Department exit, glancing around before remembering that it’s after eight-thirty; Corey went home over an hour ago, and I stood him up for breakfast. He probably heard what happened in PICU from radiology. It’s not that large of a hospital.

The sun is almost blinding this time of morning. After wrapping my stethoscope around the rearview mirror, I search the glove compartment until I find my sunglasses, and put them on. Pulling out of the hospital’s parking lot, I head for home on surface streets. During prime time morning traffic they are congested, requiring my concentration.

While driving home, I relive the shift in my head, wondering if the boy will survive (he doesn’t), and if I’d missed any signs during the night, which may have gotten him help sooner. Lost in thought, I suddenly realize I’m driving in front of an elementary school as I careen a crosswalk at 35 miles an hour. On the curb stands a crossing guard wearing a neon green vest with several school-age children huddled around her.

“Oh shit,” I hiss at myself.

In the rearview mirror I see the flashing lights of a motorcycle officer pulling away from the curb after me. I signal, and pull over. From the mirror, I watch him note my license number, and call something in over his radio. He’s already writing the ticket as he approaches. By the time he gets to the passenger door, I have the window down, and am apologizing profusely. He asks for my driver’s license.

“Officer, I’m so sorry. I didn’t see the crosswalk. I forgot what time it is.”

“Ma’am, you were going thirty-five in a school zone. You just missed taking out a group of children and a crossing guard.”

“I realize that sir. I’m really sorry. I just got off work and I’m really tired. I know that’s no excuse. I’m really, really sorry.”

He contemplates what I just said, and takes a look into my car. I see him take note of my green scrubs, and notice the stethoscope hanging on the rearview mirror.

“Do you work at the hospital a few blocks from here?”

“Yes sir.”

“Are you a nurse?”

“Yes sir.”

“Dammit!” he says. Do you work night shift? Are you getting off late?”

“Yes. We had a bad last few hours.”

“Dammit!” he repeats. “I don’t ticket doctors or nurses. It’s bad Karma. For all I know, I may be a trauma patient in your hospital one day, but I already started writing the ticket. I can’t make it go away once I start writing a ticket.” He looked genuinely worried.

“Ticketing me won’t affect your Karma, Officer. Really. I deserve the ticket. I almost hit a group of kids. I was lucky this time. It doesn’t matter how tired I am, I need to be more careful.”

“Are you sure?”

“I’m sure. Give me the ticket.”

“Alright, well. I’m checking the box that says it’s okay for you to go to traffic school though. That way, it won’t affect your insurance premiums.”

“Thank you, Officer.”

He handed me the ticket.

I rolled up the window, and slowly drove away. When I was out of his sight, I pulled into a large commercial parking lot, locked the doors, and cried.

I didn’t go to traffic school. I wrote a check and paid the ticket.

Something Goes Wrong (Nice families always have the sickest kids)

Chapter 8

Besides my fourteen year-old head trauma there is only one other patient in the PICU.  Because that one is stable and expected to transfer to the regular pediatric unit in the morning, staffing for our night shift dropped down to two nurses, Kathy, and myself.

The fourteen year old’s parents had been at the bedside since his return from the OR. Throughout the evening his siblings, grandparents, and extended family visited two at a time until visiting hours were over at nine o’clock.  His parents, who really are very nice, took advantage of our empty waiting room across the hall, deciding to spend the night sleeping on the sofas. Kathy and I outfitted them with sheets, blankets, and a couple pillows. I promised to wake them if anything happened.

Around two am, Corey came up from the ER on his break. “Hey Niki, let’s have breakfast after our shifts in the morning, okay?”

“Sure Corey. That sounds great.”

Corey and I met at New Employee Orientation when we were hired. He’s married with two small kids. He’s become one of my best buddies at work. We regularly go out for breakfast after our shifts.

***

The shift nearly passed without mishap.

Around six am, I was taking vital signs on the fourteen year-old. Nothing changed all night. I charted the oxygen saturation and TCO2 monitor readings to check against the results of the arterial blood gas I’d just drawn with his morning labs. Suddenly the monitor alarmed loudly.  Glancing at the screen, I see the ICP numbers are rising, and then out of the corner of my eye I see bright red blood pulsating inside the clear plastic ICP device in the kid’s head and backing up into the tubing it connects to. What the Hell?

Then I shout,

“I NEED HELP!”

Kathy runs in, sees the blood, and says, “Oh my God, what’s happening?”

“I don’t know! I’m not even sure what to do. Should his head go up or down?”

I pondered this while quickly verifying his peripheral pulses and blood pressure manually. I take him off of the vent and begin hand-bagging him, hoping to control the rising ICP. Then I hit the code button. Meanwhile, the boy starts seizing.

Immediately, Gerald, the respiratory therapist runs in. The blood pressure and pulse are high, not low, so we don’t begin chest compressions, but Gerald takes over the hand bagging.  Dr. Polk runs in from the call room as the dayshift nurses begin to arrive.

Dr. Polk orders ativan and a loading dose of phosphyenatoin, which I run to retrieve from the automated drug dispenser.

Immediately, Kris is at the bedside:

“Keep his head up! Call CAT scan. Tell them we’re coming down NOW, this is an emergency. Draw a type and match too,” she commands.

Dr. Polk is entering orders for the scan, and phones the neurosurgeon.

“Should we clamp the ICP tubing?” Kathy asks.

“NO!” both Kris and Dr. Polk yell out.

Dr. Polk asks, “Niki, what happened?”

“Nothing. He was stable all night, then this.”

Meanwhile, the rest of day shift arrives, and a team of nurses flurry into action, transferring the boy’s monitor leads to a portable unit, drawing more labs, and gathering equipment. A green O2 tank is slid into a rack on the bed for the ambu bag. Gerald continues hand-bagging him for the trip downstairs. Another respiratory therapist appears to roll the ventilator down with us.

“Has anyone told the parents yet?”

I awaken them in the waiting room, and bring them back to the PICU. When we get there the team has already wheeled the boy in his bed out the door, with Kris at the helm. Trailing behind, I explain what’s happening. The three of us take a second elevator to CAT scan. Once the parents are seated in the anteroom, I help Kris and the radiology techs transfer the boy onto the narrow table that slides into the tube-like machine.

Behind me, Dr. Polk and the neurosurgeon view the black and white images with grave expressions. The neurosurgeon makes a phone call and instructs OR to prepare a suite.

The CAT scan reveals the cause of the bleeding is an ateriovenous malformation, an AVM, deep in the boy’s brain. Most likely, it’s lurked there undetected since birth. Though no one knows for sure, it’s assumed that when the boy hit his head against the wall, the AVM began leaking, causing the original small bleed, but wasn’t picked up on the original CT. Apparently the bleeding continued, the pressure building until the AVM blew like an old rubber inner tube.

The boy is rushed to OR. I return to the PICU, where I struggle to grasp the medical terms I need to document the incident in the nurse’s note. My adrenaline level is so high, I have difficulty concentrating and keeping the events in order.

Kris comes back up for report. “You did okay, Nik. It wasn’t anything you could control.”

“Thanks Kris. I appreciate that, and your help too. I really do.”

The Center of This Body’s Universe (Niki needs caffeine and meets a nice family in the PICU)

Chapter 7

I can’t tell if my headache is caused by too much sleep or not enough.

Without coffee my night shift tuned body doesn’t know whether to wake up, or go to bed, since neither daylight nor darkness have circadian relevance anymore. Caffeine, not the sun,  is the center of this body’s Universe.

I fill the coffee maker and hit “start.”

Maddie is still asleep. Pausing in the doorway of her room I watch the even rise and fall of her chest. She is perfect, her skin creamy and unblemished. I’m constantly wonderstruck by her healthy color, unlike that of the sick children in the PICU.

Silently, I count the blessings: Despite her premature birth, we’ve made it safely past Sudden Infant Death Syndrome, and without childhood febrile seizures. Her bout with Chicken Pox was mild. Maddie’s learned to swim, and is forbidden from riding her bike without a helmet. I calculate my next bout of parental anxiety will begin when she’s old enough to drive.

Although I fix breakfast for Maddie and Simon, I only have coffee. I pack Maddie’s lunch while Simon showers before they leave for school together.

Simon got the teaching position at Woodman middle school, which Maddie will attend this fall. He’ll even supplement his pay by coaching after school, which he’s excited about.

This takes a lot of stress off of me, and things are better in our marriage. In fact, Simon and I have planned a weekend getaway to Coronado for our anniversary in a few weeks. We booked a luxury suite with an ocean view. Maddie’s staying with my sister and her family while we’re away. Simon and I haven’t taken a trip in years. I’m hoping this will refresh our marriage. Things are stale lately; actually it’s been longer than lately.

After Simon and Maddie left, I dressed in riding gear and rode my bike along the beach on the Strand, almost to Santa Monica. It’s not too crowded on a weekday. This morning the sun is out, and sunspots sparkled and danced on the ocean. I love how bicycle riding provides an opportunity to both see and interact with my surroundings.

The rest of the day I spent cleaning the house, followed by a short nap. There’s enough time for a quick dinner with my family before I leave for work.

In the PICU, Kris gives me report on an intubated fourteen year-old boy with an ICP bolt surgically implanted in his skull. It’s recording the pressure in his brain, which is represented as a number on the monitor screen overhead. During report, the number is normal. I assume that’s because he’s sedated.

“No ma’m, no sedation,” Kris informs me. “That’s the problem. He was at basketball practice and took a header into a wall. The coach and his teammates witnessed it. According to them, he didn’t hit the wall all that hard, but he lost consciousness. He’s roused a little, but he’s in and out, mostly out. The CAT scan showed a small bleed, which neuro removed in surgery, but he still isn’t coming to. He has a MRI tomorrow morning. In the meantime, they bolted him, just in case. This is a weird one.”

“It is weird. Is his family in the waiting room? I asked.

“Yeah,” said Kris. “They’re the nicest family.”

Of course they are. The nicest families always have the sickest kids. When a PICU nurse starts report by saying, “This is the nicest family,” you know something is going to go wrong.

It Should be Magical (Niki contemplates her marriage)

Chapter 6

At dinnertime Simon pops the macaroni and cheese into the oven to bake. I helped Maddie finish her homework, and then she helped me set the table. Simon reentered the kitchen briefly to sauté the broccoli lightly in olive oil. Transferring it to a platter, he sprinkles the broccoli with a couple of tablespoons of slivered, dry- roasted almonds, and lemon zest. Satisfied with his effort he returned to watch the rest of the game on TV.

Every now and then I jumped when Simon shouted out over a play he felt strongly about, and Maddie would giggle. “Dad,” she says, shaking her head knowingly.

I poured myself a second glass of Chardonnay before the three of us sat down for dinner.

“How’d the interview at Woodman go, Simon?”

“Oh you know. It’s always the same:

‘We’re looking for someone with more experience,’ or, ‘We’re looking for someone with less experience, this position has a limited pay scale.’ It’s all just bull-, oops, sorry Maddie. Don’t use bad language; it’s a sign of poor upbringing.  Anyway, there were a dozen other teachers interviewing for the job. At least I have something respectable to write on my unemployment paperwork this month.

“Well, you put it out there. That’s all you can do, isn’t it?”

Simon was laid off seven months ago from his teaching job, because of budget cuts. Seemingly, education ranks right along healthcare as a national priority.

We met in college. Simon was an anthropology major with a minor in education. I studied early child education, and minored in children’s literature. I switched to nursing when I realized I needed a master’s degree in order to earn enough money teaching preschool to make it worth what I owed on my Bachelor’s degree.

We married after graduation with the understanding I’d work as a registered nurse while Simon completed his Master’s in education. Once he hired into a university, I’d drop down to on-call, raise our children, and start a second career from home writing and illustrating children’s books.

It would have been magical.

Unable to get more than substitute teaching assignments in the beginning, Simon dropped out of the Master’s program when I got pregnant with Maddie, and she was born prematurely. Although my health care benefits from the hospital covered most of it, a 20% deductible for emergent obstetrics, and four weeks of neonatal intensive care is a pretty big chunk of change on a mostly single income.

Eventually, Simon found a job teaching social studies in a nearby middle school. His job lasted two years before the budget cuts. The parents of his students signed a petition begging the administrators to keep Simon, but like they say, “It isn’t personal.”

After dinner, Maddie, and I watched a movie on the laptop. Then I read her a chapter of Henry and Beezus before tucking her into bed and kissing her goodnight.

Simon was so engrossed in the game he was watching, he hadn’t turned on the lights in the family room. In the eerie glow of the television, the features of his face appeared alien.

“Is Maddie in bed?” he asked.

“Yeah.”

He got up to go kiss her goodnight, and then resumed his perch on the sofa.

Despite sleeping most of the day, I retreated to our bedroom at eleven. I’m lucky; I’ve adjusted to twelve-hour night shifts. Many nurses never do. I read a chapter of E.M. Forester’ A Room With a View before falling asleep.

***

Simon spooning me from behind wakes me from a sound sleep. Wordlessly, he fumbles at pulling my oversized T-shirt above my hips in the dark. When pretending I’m still asleep doesn’t work I become irritated.

“What are you doing?” Even I’m surprised by the fierceness of my tone.

“I’m loving you, baby. You’re so damn sexy. I can’t keep my hands off of you.”

“Simon, what time is it?”

“What does it matter?  It’s not like you have to get up early. You don’t leave for work until tomorrow evening.”

“I’m tired Simon. I need to get some sleep.”

“Just a quickie? C’mon, you know you love me.”

Silently, I wonder if I still do love Simon, but I let him have a quickie. It’s the fastest way to get back to sleep, which is what I do as soon as he finished.

Little Earthquakes (Niki has a stress dream and learns about earthquake kits)

Chapter 5

I pulled into the driveway of our rented house. Simon’s left, so I park in the garage, closing the door. I removed the groceries from the backseat and set them on the washing machine before sliding off my scrubs, dumping them into the laundry hamper. I’m always worried about bringing home germs from the hospital, and spreading them to Maddie. I put on the robe I keep on a hook before entering the kitchen with the groceries.

Simon’s left the dirty dishes from last night’s dinner in the sink, and the wastebasket is brimming on the edge of overflow. Its contents defy gravity. Although exasperated, I admire Simon’s flair for sculptural design.

He’s left a sticky note in his methodical printing on the counter:

“I’ll take care of the dishes and trash when I get back.”

I put the groceries away, and then wash the dishes, but leave the trash. I’ll sleep better the less Simon clanks around in the kitchen. I’ll clean the rest of the house tonight when I wake up. Last night was my third twelve-hour shift in a row. I’m off tonight.

I take a quick shower, towel off dry and practically fall into the unmade bed in our darkened bedroom. In minutes, I am unconscious.

I dream I’m still at work. The monitor and pulse ox alarms are going off in a patient’s room. I go in and look at the baby lying in the warmer. He’s naked and uncovered. His skin is blue. I am terrified that I forgot he was my patient, and ignored him all shift. I can’t revive the baby, and the alarms keep ringing…

My heart is pounding from the dream when I wake up at two-thirty. It takes a minute to realize I’m not at work. In the still darkened room I feel around the foot of the bed, groping for the soft grey sweats and tee shirt I left there yesterday. I put them on, sliding my feet into rubber flip-flops before traipsing into the kitchen. The trash is still there from this morning. The sink is again full with the dirty utensils Simon used to make macaroni and cheese.

I maneuver the teakettle around the dirty dishes, filling it with water before setting it on a burner, and adjusting the blue flame to high. I drop a teabag, fragrant with cardamom, into my favorite mug and wait for the kettle to boil.

In the family room, I hit the random play button on the CD player before settling into the old rocker recliner. Rocking gently, sipping tea, my brain slowly rises from its fuzziness, much like the Southern California coast has emerged from the morning fog, which I notice burned off while I was asleep.

Twenty minutes later, Simon’s car pulls into the driveway. Two car doors slam shut, and I hear Maddie laughing as she runs into the house.

“Mom! We practiced earthquake safety at school today. We crouched under the desks and covered our heads with our hands. I have a note from Mrs. Marrs. Everybody has to bring an earthquake kit to school.”

“What’s an earthquake kit?”

I set down the mug as Maddie holds out a piece of folded paper. Sure enough, it’s from her teacher, explaining that every student needs an earthquake kit at school, in case of emergency. Each kit must be packaged in 2-quart Ziploc bags, double-bagged. The bags can’t be larger than 2 quarts because of space limitations in the classroom. The required contents of the kit are listed in bullets:

  • A lightweight hoodie sweatshirt
  • A packaged (not homemade) granola bar or snack
  • A juice box
  • A list of allergies, if any
  • Your child’s name, and the address of both parents, including home, work, and cell phone numbers on an index card
  • The name and cell phone number of a local, alternative emergency contact

I cringe; thinking, “Would I be able to get to Maddie if an earthquake happens while I’m at work?” then quickly dismiss the thought. I set the paper next to my mug on the table, reaching for Maddie to give her a hug.

Maddie cuddles into my chest. I touch her cheek with mine before kissing the top of her head. She says, “I can always tell when you worked Mom, because you wear the same old crusty clothes, drink tea, and rock.”

A Good Shift (Niki introduces two coworkers)

Chapter 2

One good thing about working twelve-hour night shifts in a Southern California hospital is driving against traffic for the commute. Californians don’t measure commutes in miles, but by how long it takes them to get there. Everyone knows to stay off the freeways, and take surface streets.

I pull into the hospital staff parking lot ten minutes before starting time, unwrap my stethoscope from around the rear-view mirror, and grab my sack lunch from the passenger seat. Then I sprint to the PICU for change of shift report.

Unconsciously, my nose wrinkles when I see on the assignment board I’m taking report from Kris. She’s nearing fifty, and thinks this gives her the right to treat me like I’m still a student, but I see through her. Her aging makes my youth threatening. Blonde hair, overly tanned skin; she’s so thin I’m sure she has an eating disorder. Last year she had a boob job, and when she returned from medical leave she pulled every one of us into an empty patient room for show and tell.  She’s currently dating the bass player of a struggling rock band that practices in her garage. Kris doesn’t have relationships with men, or girlfriends for that matter, only superficial encounters of varying lengths; it’s a frequent source of gossip among the nurses in our unit. However, she’s been a nurse almost thirty years. She’s worked ER, OR, and adult ICU. Even I have to admit she’s nursing muscle.

I brighten when I see I’m working with Liz tonight, and she’s charge nurse. Every bit as skilled a nurse as Kris, she’s a completely different type of person. She doesn’t hold my inexperience against me. Instead, she sees me as an opportunity to develop a coworker she can depend on. She understands I’m looking for the chance to sharpen my skills. Liz doesn’t wear any make up, and laughs too loud, but she is the rock star nurse in this pediatric intensive care unit. The doctors ask her opinion of their patients’ progress before they write their orders.

It’s going to be a good shift. I start every shift thinking it will be good. That’s how new I am to nursing.