You Remember What Night Shift’s Like (Niki & Kris Talk)

Chapter 48

 The following morning, I gave report to Kris, beginning with what I hoped she would interpret as an apology,

“Kris, I just want to say again that I’m really happy about your engagement. You must be super excited about going on tour with Spider.”

She smiled, and then added shrewdly, “Thanks Niki, but I get the feeling you have more to say on the subject.”

Busted, I decided to charge ahead,  “Aren’t you at all worried about giving up your nursing job? I mean you’re really a great PICU nurse. Do you think you’ll miss it?”

“What you mean is, ‘Aren’t you worried that marrying a rock star is a little crazy, and what if the marriage doesn’t work’?” replied Kris. “That’s the fun of being alive, isn’t it Niki? A willingness to be surprised. Letting go of things so you can go to the next adventure. I’ve tried many things in my life, and lived in most of the United States. Not everything has worked out, but I’m still standing, no worse for wear. I’m not the kind of person to put down roots for too long anyway.”

Maybe because I’ve been up all night, or maybe because I won’t see Kris much more, I let my guard down, “Do you ever worry that in the end you’ll be all alone?”

Kris’s upper lip begins to curl into laughter, but meeting my gaze, she changes her mind. “You mean, like when you die?”

“Maybe, I’m not sure what I mean exactly, but sometimes I wonder what the right choices for my life are; if I’m doing the things I’m supposed to do, or if I’m missing the point.”

My words don’t make a lot of sense, even to me. “I guess I worry a little that it will end, and I haven’t lived the life I want, or maybe I’m not living life right.”

“I’m not sure what you mean. Right by who’s standard, Niki? Like God? Like the life your parents wanted you to choose? Who’s standard of what’s right or wrong are you judging yourself by?”

I realize I’ve said more than I’d intended. “I’m just tired Kris. You remember what night shift’s like.”

Kris looks at me brightly, and then her eyes soften. “It’s hard being a nurse, taking care of everyone all the time, feeling as though you always have to have all the answers,” she says. “Don’t over think things, Niki. It doesn’t take much to wreck the best-laid plans: a car accident, a cancer diagnosis, or a debilitating disease. Try having more fun, and let go of some the responsibility for healing the world. Have you thought about transferring to day shift? Someone has to take my place. It might open up more of a social life for you.”

“Oh, I don’t know if I’d like day shift,” I hedge. “Too many phones, the doctors overrun the place on day shift.  I’d be expected to join committees.”

“Suit yourself, it was just a thought,” retorts Kris. “So tell me about this kid. Another case of measles? How many does that make this year?”

Rashes & Fevers (measles admission)

Chapter 47

Once I clock in, there isn’t time to contemplate Kris’s engagement, Simon’s remarriage, Amber’s pregnancy, or Corey’s move to Seattle with his family. As charge nurse, I took the call from an ER nurse requesting three beds for immediate admissions.

“Three beds? What’s happening down there? Was there a bus accident?”

“No, but maybe as bad. We’ve got three kids from two different families with fevers and red rashes. It’s measles. We’re coding a three year-old now”

Ten minutes later the ER nurse calls back with an update, “The three year-old’s stabilized, but maybe not for long. He’s intubated. We’re transferring him to you guys now. We’ll get back to you about the other two.”

While Gerald sets up a ventilator for the three year-old, Liz helps me take vital signs, and change the IV fluids to our pumps. “I really hate seeing a child suffer when this could be prevented by immunization,” she comments. “Why have so many parents lost trust in science and medicine? If you mention vaccinations to some, they react like you want to poison their child.”

“I think measles, pertussis, and polio decreased so much from recent memory that today’s parents don’t believe there’s a threat. I’ve heard some say, ‘Gosh, what’s the big deal about a fever and rash?’ or, ‘We have antibiotics now, so these diseases aren’t as serious as they were in the old days.’

“Yeah, everyone thinks childhood diseases are a thing from Little House on The Prairie,” added Liz.

“Yeah, well measles killed a daughter of Roald Dahl, author of Charlie and The Chocolate Factory in the sixties, before the vaccination was readily available,” I agree.

Once Gerald finishes setting up the ventilator, he joins the conversation, “I remember the first kid with measles I saw in the PICU. That time, the ER nurse reported they had a kid with a high fever, and unidentified red rash. No one knew what it was. So we wore respiratory masks, and isolation gowns, which was a good thing after infectious disease diagnosed measles. None of us had ever seen it.”

” I was sure grateful the hospital makes us have updated MMR immunizations. It’s supposed to protect the patients, but they protect us too,” said Liz.

A fever and rash don’t sound particularly lethal, but what is often not remembered is that measles is a virus, so antibiotics are not effective, although they are used to treat secondary pneumonia or infection.  High fevers can cause febrile seizures, and encephalopathy, which may result in deafness or permanent brain damage. That’s what happened to the child with the first case of measles I saw. Previously a healthy third-grader, she has permanent brain damage and lives in a home for medically fragile children.

“No one knows better than PICU nurses the dangers of childhood,” I added. “Kids die from so many causes: Motor vehicle accidents, drowning, falling out of upper storey windows, SIDS, choking, cancer, school shootings, heart defects and illness. The list is practically endless. If medical science can shorten it through vaccination, I’m for it. My kid is vaccinated.”

“So’s mine,” says Liz.

* * *

Report on the newly admitted three year-old with measles goes like this: The outbreak started when one of the kids was exposed at his pediatrician’s office.

“Wow,” says Liz, “The kid catches measles from another kid in a doctor’s office. Go figure.”

“Yep, and he exposed the neighbor’s kids: Four kids from one exposure. What if there were infants too young to be immunized in that waiting room?”

By the end of the shift, the remaining two children have cases mild enough to be admitted to isolation rooms on the regular pediatrics unit. They’ll be treated with IV fluids, and comfort measures. If their conditions improve, they’ll go home in a few days. If they worsen, they will be admitted to the PICU.