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I’d Like to Go Home Now

Chapter 72

Simon, and Grant are standing by my gurney. Raquel is seated precariously on its edge, holding my hand. The IV saline bag is nearly empty. The nurse comes back to check my IV, and takes my blood pressure.

“How are you feeling?” she asks.

“Calmer, with the lorazepam on board. When can I go home?”

“Medically, you’re probably good to go, but I’ve been instructed not to discharge you until the police say it’s okay. I don’t know if they’re going to file your report now, or later.”

Just then, a woman in business attire enters the tent. She’s carrying a clipboard with papers, and a pen.

“Niki, I can’t tell you how relieved everyone is that this is over, and all of you survived. We’ve been very concerned about your wellbeing.”

“Everyone didn’t survive. Frank didn’t survive. I saw him shot in the head.”

“No, of course; I’m sorry. I didn’t mean… I realize this has been horribly traumatic for everyone involved. I’m Jane Merger. I’m a resource manager from HR, and human resource liaison during your leave of absence that I assume you’ll want to take as you recover from this, um, event. Here’s my business card.”

“Thank you, Jane.”

She hands me a card. I take it with the same hand that’s holding Mike’s business card. I look at them blankly.

“Here, I’ll keep those for you, Nik. I’ll start taking notes and keeping track of your paperwork,” says Raquel.

“Thank you.”

“I’ll be in touch with you through email, and by phone, Niki. Don’t hesitate to contact me when you have questions. We don’t need to do anything about forms right now, except I do need you to sign this nondisclosure agreement between you and the hospital. We would like you to refrain from speaking with the media about this, um, event. That includes posting about it on your social media sites, like Facebook.” Jane reaches to hands me the clipboard, and a pen. Grant intercepts it.

“Hi Jane, I’m Grant, Niki’s brother-in-law, and legal counsel. I’m going to insist that Niki doesn’t sign any agreements at this time. I will be reviewing all legal agreements between the hospital and my client. Here’s my business card.”

Grant hands back the clipboard to Jane, along with his business card.

I’m beginning to realize that although the crisis is over, my life has changed.

“I’d like to go home now.”

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Call Lights Magazine: Looking for Real Nurses (Niki & her friends apply for modeling)

Chapter 30

Walking into the staff lounge, I find Kris, Liz, and Kathy laughing and talking excitedly.

“Here she is,” says Liz. “I bet Niki will come with us.”

I head towards the phone to clock in and ask, “Go where?”

Kris holds up a magazine. “Call Lights Magazine is looking for real nurse models for an article on different types of scrubs. It’s an open call on Tuesday. The three of us are going. Wanna carpool with us?”

“What’s Call Lights Magazine?”

“It’s a new lifestyle magazine for nurses,” explains Liz. They print stuff like healthy recipes for packed lunches, tips on keeping your make up fresh during a twelve-hour shift, and articles about relationships. It’s pretty cool.”

“I read it, but I’m not sure why nurses need a magazine like this. There’s not much clinical information in it.” This from Kathy.

“There are over three million nurses in the United States, Kathy,” interjects Kris. Magazines like Call Lights give advertisers access to an otherwise untapped market. It’s pretty smart.” Kris is worldly wise, no doubt.

“Oh yeah, I’ve read that magazine. They’re looking for real nurse models? That sounds like fun. Yeah, I’ll go,” I say.

“Awesome! We’ll meet in the hospital parking lot on Tuesday at seven. We’ll stop for coffee. Liz will drive.

“This will be a blast, even if I’m not chosen as a model,” I muse.

“You never know. You can’t win unless you play,” adds Kris.

***

On Tuesday, Kris, Liz, Kathy and I pile into Liz’s car, and head over to a coffee shop close by the hospital. As the four of us enter the shop, we stop just short of bumping into a police officer making his way out.

“Excuse me,” says the officer, and then, “Hey, Nurse Niki!”

It’s Officer Mike, the cop who accompanied the child abuse patient a while ago.

“Officer Mike, hi! Finishing a coffee break?”

“Yeah, and now it’s back to work. Good to see you again, Nurse Niki.”

“And you, Officer Mike. Bye.”

“Didn’t we meet him in the PICU, Niki? asks Liz.

“Yeah, he brought in that kid with the lacerated liver, remember? He gave me his business card.”

“So did you go out with him? Kris asks.

“No, I’m not ready to start dating. It’s too soon after my divorce.”

Liz gives me a funny look, but doesn’t say anything.

With lattes in tow, we get back into the car and arrive at the address where screening the potential nurse models will take place. In reality, it’s a tiny, vacant storefront, with sheets in the window concealing a heavyset woman wearing hipster glasses, and designer jewelry. She’s seated at a folding table next to a fortyish looking man, also wearing hipster glasses. We don’t know this right away, however, because when we arrive we take our place in line on the sidewalk behind approximately 100 other nurses also wanting to be models.

The line moves slowly. Latecomers collect behind us. My feet are starting to hurt. Why is it I can run continually for a twelve-hour shift without my legs bothering me, but standing still in line is killer?

After a couple of hours, Kris, Liz, Kathy, and I are at the head of the line, where we’re handed clipboards bearing several forms to fill out.

“Wow, you have quite a turnout,” I remark to the woman in hipster glasses.

“Yes, we certainly do,” she agrees. “We used to do our nurse model calls by email, you know, asking for a jpeg photo, and information about the applicant, but we were getting applications from would-be actors, and models pretending to be nurses for the exposure. So now you have to present your nursing license or employee badge in person, and sign this declaration stating you are in fact a nurse before we accept your application. After that, we’ll take a photo of you, and attach it to your application. You’ll be contacted in a few weeks after we’ve made our decision.”

“How many nurses will you choose? asks Kris.

“Six for this particular shoot,” says the woman, “but we’ll keep everyone’s information; you may be contacted for future issues.”

After completing the forms we hand them to the guy wearing hipster glasses. He leads us further back into the storefront, where a camera is set up and a floor light next to it. He directs us to sit, one at a time, on a stool in front of the camera, and takes a full-face picture. Then he has each of us stand, and takes a full body shot too.

“Okay, ladies, that’s it for today,” he announces. Thank you very much for participating in a Call Lights Magazine event. You’ll be hearing from us soon.”

Several weeks later, we did in fact, and I was chosen as a Call Lights Magazine real nurse model!

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Buy Yourself Another One (Foraging for food on night shift)

Chapter 27

While getting ready for work I struggle over wearing my hair loose around my shoulders, foregoing the usual scrunchy-bound topknot I wear when I haven’t bothered to wash it.

“Pull it together, jeez,” I reprimand myself. “He’s still married. Don’t set yourself up like this.”

Pulling into the staff parking lot, I look for Corey’s car, but I don’t find it. He may have parked elsewhere, because there are never enough close-in staff parking spaces. I unwrap my stethoscope from around the rear-view mirror, grab my tote from the passenger seat, and breathe deeply to calm my giddiness before entering the hospital.

“Jeez-us, you’re a grown woman. Calm down,” I repeat, but the butterflies in my stomach still flutter.

Corey catches me at the elevator just before I head up to the PICU. He’s holding a little pink bakery box.

“Hey, I brought you a cupcake for your break tonight. I’ll stop by if it’s not too crazy. You’re hair looks nice down.”

I take the box, hoping he sees how happy this makes me before I recover my normal expression and say, “Thank you.”

Corey waits in front of the elevator until the doors close and I am out of sight.

As it turns out, Corey’s gift of a cupcake is prescient.

***

One of the problems of nightshift nurses is foraging for food.

Budget cuts have limited hospital cafeteria hours, leaving nightshift without options besides bringing their food or snacking from vending machines. Occasionally, nurses will send a “runner” to an all night fast food place to pick up dinner for several coworkers, but that only happens if the department can spare the nurse. This was not one of those nights.

In the PICU all Hell broke loose.

The kid in bed two continually seized despite being in a medically induced coma, and no one knew why. This kept Kathy busy with frequent lab draws, adjusting drips, and administering anti-seizure medications, all the while trying to comfort distraught parents, and documenting the frequent changes.

Liz’s hands were full with a post-open heart surgery patient whose blood pressure repeatedly tanked in room five. She also had a second post-open heart patient weaning off of sedation in preparation for extubation from the ventilator in the morning; the short of this being that she had to keep that child from pulling out his breathing tube and IV’s while allowing him to breathe on his own.

And me? I was managing a new onset diabetic admitted on dayshift with a blood sugar of 400. This meant frequent blood draws for lab values, and several changes of IV fluid solutions, lowering the potassium as the insulin drip took effect, and the blood sugar normalized.

This did not prevent me from being up for the next admit, however: a stable neurology patient accompanied from the OR at midnight by his neurosurgeon, Dr. Kearney. The boy had an infected shunt, a surgically implanted device that drains excess cerebral spinal fluid from the ventricles in his brain, caused by a congenital condition. The infected shunt was removed, and a temporary external one now drained CSF through a tube into a buretrol. IV antibiotics were prescribed around the clock. Once the infection healed, the neurosurgeon would replace the implanted shunt with a new one in the OR.

Dr. Kearney sat at the nurses’ desk, calling lab for culture results, and entering orders. I overheard him saying into the phone, “What do you mean I can’t order ‘antibiotics per pharmacy protocol’?” There was a pause. “Well why isn’t there an ‘antibiotics per pharmacy’ protocol?”

Shortly before Dr. Kearney’s arrival, Liz had sat in the same seat at the nurses’ desk in which he now sat. In front of him was a small open bag of potato chips belonging to Liz, which she’d momentarily left unattended to answer an alarm in her patient’s room. She hadn’t had time to pack a dinner, and this bag of potato chips from the vending machine represented the only food she would probably eat tonight.

When she returned to the desk, the bag of chips was empty, and Dr. Kearney brushed the last crumbs from his mouth.

“What happened to my bag of chips?” demanded Liz.

“Oh, were those yours? I thought they were out here for everybody,” Dr. Kearney was unapologetic.

“That was my dinner,” growled Liz. “Now what am I going to eat?”

Dr. Kearny said, “Here,” and tossed a couple of dollar bills into the empty bag on the desk. “Buy yourself another one.” Then he left.

Liz returned to the PICU ranting. “The damn vending machine ate both of Dr. Kearny’s dollar bills without giving me a bag of chips, even after I kicked it!”

Kathy and I shared our food from home with Liz, and I divided Corey’s cupcake three ways.

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Simon’s Turn (Simon talks back)

Chapter 21

“Yes you are, Niki.  You’re wrecking our home.”

Simon, seated across from me in the family room hadn’t moved a muscle, but the power of his words hit me like a punch to the stomach: breathless, and unable to speak. My bravado was gone. Defeated, I crumpled into the chair, fighting back tears.

“I don’t have the strength to do this,” it occurred to me.

Before I recovered, Simon’s shoulders dropped. His energy changed. He looked down at his hands in his lap before looking into my eyes, and said,

“I’m not angry at you for wanting a divorce Niki.  I’m angry that you gave up on us before I did.”

Puzzled, I stared at him.

“Our marriage hasn’t worked for me for a long time. I don’t know when the magic stopped, but you’re different now Nik.

You used to be fun. We used to go to games together. You were as big a fan as me. Now you don’t want to be in the crowd in the bleachers anymore. You’re not interested in watching on TV either.

You take everything so literally. You used to have a sense of humor and laugh. Now I have to explain, ‘I’m just kidding,’ so you know it’s a joke.

When we go to movies or concerts, the first thing you do is locate all the emergency exits. Everything is always worst-case scenario with you. You’re too intense. When was the last time we laughed?”

I couldn’t think of an answer to this. Simon used my pause to continue.

“When you talk about work, and the drugs you give to those kids, all I can think about is, “Jesus, she knows how to kill someone!”

“I like to think I know how to save lives, Simon.”

“The point is Niki, I don’t know you anymore. You’re not the fun girl I met in college. It’s like saving the world is your only concern. I married a wife, not a super hero.”

Simon bit his lip then clenched his jaw. His eyes were red-rimmed, and moist. Then he pulled his finger out of the dike, and it burst open, changing the landscape of our lives forever.

“Niki, I want a divorce too. This doesn’t have to be a bad thing. You’re a good person, and I’m glad we share Maddie, but I don’t love you anymore.”

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The Most Important Thing (Niki makes a decision)

Chapter 16

Corey put his arms around me, holding me close. My face nestles in the warm triangle where shoulder meets neck, and I can feel his carotid pulse beating against my cheek. He smells like soap and water, clean and nice. I place tiny kisses against his smooth neck, tears welling in my eyes.

“I want this Corey, I really do, but I’m not going to.”

“Niki…”

“I can’t. I’m not happy, but that doesn’t give me the right to hurt others. Maybe Liz is right. Maybe being happy isn’t the most important thing.”

“Niki…”

He tightened his hold of me, burying his face in my shoulder. I felt the sob rack his body, and when he released me, there were tearstains on my scrub top. Looking at me, he did not wipe the tears from his face.

“I get the idea there’s no discussion here.”

“I’m sorry Corey. This hurts me too. I’ve gotta go.”

I fumbled with the car door handle before opening it, and slipped inside. Corey stood immobile, watching me with tears silently streaming his face. I choked back my own, started the car, and drove away. In the rearview mirror, Corey stood among the empty cars of the parking lot. The morning sun cast a sharp shadow from him, as if he were a statue.

***

In the garage, I slide 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.

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 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.

I take a quick shower, towel off dry and practically fall into the unmade bed in our darkened bedroom. I cry into my pillow before falling asleep.

I dream I’m still at work. The monitor and pulse ox alarms are going off in a patient’s room. Inside, a crowd of people is gathered round a crib with a baby in it. The baby is blue. Horrified, I see the ventilator is disconnected. Triumphantly, the child’s mother holds up the breathing tube she has pulled from her own infant’s throat. She turns to me with zombie-like eyes, and says,

The roar of a passing motorcycle outside wakes me up abruptly before I can make out what she says. I sit up in bed, clutching the blanket to my chest while my heart beats wildly.

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Two Separate Worlds (Corey tells Niki how he feels)

Chapter 15

Corey’s hand is warm, and dry, its nails clipped and clean. I left my hand on the diner table under his longer than I should.

“Hey Niki,” he said.

I withdrew my hand.

“Um, we should go. Thanks for the bacon, Corey.”

I put a ten on the table as Corey flagged the server for the check. He pushed it back towards me. “I got this,” he said. “Wait, and I’ll walk you to your car.”

Walking alongside Corey, I felt butterflies of trepidation in my stomach, and that disconnected from my body feeling I sometimes get. We made small talk, but I don’t remember what we said.

“Well, goodnight,” I murmured, putting my hand on the car’s door handle.

Corey once again put his hand over mine, but this time his other arm encircled my back. I leaned into him sideways, resting my head on his shoulder. He smelled like soap, clean and nice. We stood that way for a minute or so before, turning me towards him, he framed my face with his hands, and placed his mouth on mine. I leaned in, kissing him back.

Corey’s touch was strong and gentle, confident. We kissed again.

Separating, I looked up at Corey’s face. His gaze was soft. I imagine it mirrored mine.

“Now what?” This time he was murmuring.

“I don’t know, I can’t bring you home,” I said.

“Sheila might show up unexpectedly at my place,” but before he finished his sentence I was already protesting, “Oh no, I can’t do that either.”

“Let’s get a room. I know that sounds bad, but this is not some cheap thing for me, Niki. I care about you. I have for a long time. You’re very special.”

“I care about you too Corey. I don’t want to, but I do.”

“Let’s get a room,” he pulled me close, his face against my neck.

I gazed past Corey’s shoulder as if I were disembodied, a member of an audience watching a movie or play. I saw the sharp shadows cast by the bright California morning sun from the empty cars in the parking lot. There was no place to hide from its glare. Everything was in clear focus to my painful eyes. Had it been the cover of night, in the parking lot of a bar instead, I would have remained lulled.

“Corey, I can’t do this, I’m sorry.”

“Niki, wait. I know it’s not right. I’m not a player. I haven’t done this before either. But you and me, we’re the same. We care deeply, and we give everything. Simon and Sheila don’t understand us like we do each other. This way, maybe we can stay married, and raise our kids with both their parents. You and I already live in two separate worlds: one in the hospital, and another not of the hospital. This will be ‘hospital.’ We deserve some happiness, Niki.”

I thought hard about his words. Their logic was seductive: Wouldn’t I be a better nurse, a better mother, and in a twisted way, a better wife by surrendering to the fact that I live my life straddling different worlds, playing different roles in each? I live a separate life from the one I lived in my parents’ home; yet keep the role of their daughter. As a mother, I play another role too, with different rules. It’s the same thing really, adapting to the different contexts of life.

I leaned back against my car, and let the morning sun warm my face.

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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.”

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Collusion (Niki coaches a parent on talking to doctors)

Chapter 13

The next night I returned to the PICU, and found that the eleven year-old transferred to the regular pediatric unit on schedule. As predicted, Dr. Eubanks not only discontinued the Fentanyl infusion before the transfer, but the puny IV morphine pushes too. It was out of my hands now. Or so I thought.

Later in the evening, I see the eleven year old’s Dad standing at the nurses’ desk, asking for me. I go to talk with him.

“What did you do last night to get my daughter pain medicine?” He demands.

“Um, I asked the PICU doctor for it,” I said. I didn’t think I should say that this was because I knew the surgeon wouldn’t order it.

“How’s she doing tonight?”

“She had a pretty good day. In the afternoon she rode a wheelchair to the play therapy room, played some games, and then walked back to her room. Right now though, she’s screaming in pain, and her mom and I can’t get her to stop. I asked the nurse to give her pain medicine, and she told me Tylenol is the only thing ordered. We gave it to her, but it doesn’t stop the pain. How do I get her more pain medicine?”

“Oh, boy,” I think to myself. My role of patient advocate is clear; I’m trying to think of how to word my answer without getting fired.

The child’s father, advocating for his daughter, doesn’t allow me this luxury.

“Are you a mother?” he asks.

“Yes I am. I have a daughter about the same age as yours,” I admit.

“So, if this were your daughter, what would you, as a nurse, do to get your daughter more pain medication?”

Silently, I think to myself, “Well, I was looking for work when I found this job…”

Out loud, I tell him the truth:

“Dr. Eubanks is a very good surgeon, but he doesn’t like his patients over sedated, so he doesn’t order a lot of pain medications for them. Your nurse isn’t calling him for more, because he will probably yell at her if she does. She’s afraid of him.”

“It’s only 9 pm. What I would do is tell the nurse I want to speak to Dr. Eubanks, now. She’ll make the call at the desk for you. When you get Dr. Eubanks on the phone, tell him your daughter is screaming in pain, and this is unacceptable; you expect her to be comfortable in the hospital. Tell him you want him to order appropriate pain medication for your daughter.”

“Got it!”  He said triumphantly. “Thank you.  Anything else?”

“Yeah, if you would not tell anyone that I coached you on this, I’d appreciate it. I’ll probably get written up if the pediatric nurses or Dr. Eubanks find out,” I solicited.

“Not a problem. I appreciate you honesty and help,” he promised, leaving the PICU, presumably looking for his daughter’s nurse.