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.

A Mid-Tone Grey

Chapter 26

With his body wrapped around mine, Corey falls asleep before I do. Outside, the bright morning sun filters through the heavy window drapery, illuminating the bedroom to a mid-tone grey. I watched him sleep, wondering what will happen next.

As if he feels my gaze touching him, Corey wakes with a start, realizes where he is, and then nuzzles my ear and neck with his lips. “Hello, Beautiful. What time is it?”

“Ten, and I haven’t made breakfast yet,” I breathed back. “Is there time?”

“Not now. I work again tonight. You too, right?”

“Yeah,” I sighed.

“I better get going. Do you mind if I take a quick shower first?”

“No that’s fine. Any chance that Sheila’s going to be there when you get home?”

“It’s not likely. She has coffee with her friends after yoga class, but you never know.”

“What will you tell her if she is?”

“I haven’t gotten there yet. I don’t really have anything figured out past this moment, Niki.” He rubs my shoulders, and I want him again.

We make love sweetly. Languorous, I lie in bed listening to the running water while Corey showers. He’s humming.

I watch him put his scrubs back on before getting out of bed and slipping on my old flannel robe. Together we walk to the front door. Corey puts his hands on both sides of my face, and kisses me long and deep.

“You better go.”

“See you tonight Niki.”

Closing the door quickly, I watch him walk up the street to his car from behind the living room curtain.

“Oh lordy, what am I doing?” I’m smiling.

In the kitchen, I throw out the eggs, placing the bowl and whisk in the sink to wash later. I refill my tote bag with its scattered contents collected from the floor and place it back on the table.

Before sliding back into bed, I make sure the alarm is set, and the phone ringer off. There’s a text message from Corey on my cell, “Sweet dreams, Lovely.”

I text him back with an emoticon of a smiley face blowing a kiss.

I sleep better than I have in months. I wake up looking forward to going to work.

He’s Not Here For Omelets (Eggs are broken)

Chapter 25

Corey’s car is in my rear view mirror the entire drive home. For a moment I ask myself, “What are you doing?” but the thought is overcome by that floaty, out-of-body feeling I get sometimes. From here on out, I’m both audience and actor in a disconnected state.

I park in the driveway, but Corey does not pull in next to me. Instead, he parks down the block. It occurs to me that we can no longer be seen alone together outside of the hospital. Sex most certainly does change friendship between men and women.

Instead of entering through the garage as usual, I let Corey and myself in through the front door, conscious that the neighbors may be watching. Then I remember, “I’m divorced.”

Corey breaks the silence. “Nice house.”

“Thank you. It’s rented,” I don’t know why I think it’s important to announce this. “Come on back to the kitchen. I’ll fix breakfast.” I have no idea how to do this.

I put a pan on the stovetop. Then I place a bowl on the counter, and crack a few eggs into it. “What are you doing?” I chide myself. “He’s not here for omelets!”  Despairing, I viciously beat the eggs with a whisk.

Corey rises from the stool and stands behind me. His arms encircle my waist. He places small, warm kisses on the back of my neck. I continue to beat the eggs fiercely, but he presses the length of his body against my back, taking the whisk from my hand, and pushing away the bowl. His hands go up my scrub top, and lightly run across my breasts before unhooking my bra. I turn into Corey, and our mouths connect.

With our bodies locked, we stumble towards the kitchen table. Corey knocks my tote bag off of it. Then I’m lying on my back, with Corey kissing me and our hands are everywhere.

“Where’s your bedroom, Niki?” he murmurs into my ear.

Half naked, I lead him by the hand to the bedroom, where again, I’m struck with doubt. I haven’t been with a man except Simon for years.

Corey slips what’s left of my clothing to the floor, then pauses to take me in. My doubt melts away for the appreciation on his face. He pulls me close. “You’re beautiful Niki,” he whispers in my ear.

I lay on the unmade bed while Corey undresses. He’s perfect: broad shoulders, and a six-pack. I didn’t know they make nurses like him.

Corey slides into bed next to me.

Corey is above me. He kisses the small scar of my c-section. My hands are on his shoulders. Out of nowhere, I think of a dumb thing I read about nurses being the best lovers because we are so knowledgeable of the human body.

“Oh yeah,” I moan agreement towards the ceiling.

 

Different Sides of The Family Room (Niki talks to Simon)

Chapter 19

I fumed in the car while Simon loaded Maddie into his. He knows me well enough to realize how furious I am, but neither of us wants to have an argument in front of our daughter, or in the driveway where the neighbors will hear. So I smiled with gritted teeth while waving to Maddie as they drove off to school. In the kitchen, I ignored the dirty dishes in the sink and the piled up garbage in the wastebasket. Throwing my tote bag on the table, I grabbed my cell phone from it, texted SOS! and waited for Raquel to call.

***

“Oh no, he did not!” was the first thing out of Raquel’s mouth after telling her about the near collision with the trailer, truck, and jet skis.

“Oh yes he did,” I chimed.

“And Simon cancelled the Coronado trip? We made all kinds of plans anticipating having Maddie for the weekend. Our kids will be so disappointed that she’s not coming.  Niki, what are you going to do?”

“He must have put us nearly $40,000 in debt. I still can’t believe he’d spend that kind of money without talking to me first.  He can’t keep them. I think we have twenty-four hours to change our minds about the purchase contract.”

Silence.

What, Raquel?”

“Niki, I’m sorry, but there’s no grace period on new automobile contracts once you drive off the lot. I don’t know about the jet skis, but I’m pretty sure the truck is yours.”

I could feel panic coming on.

“Don’t panic Niki. I’ll talk to Grant. He’s a sharp lawyer. Maybe he knows a way out of this.”

***

At dinner, the only words Simon and I speak are in response to Maddie’s chattering. The tension frizzles through the air, dispersing the aroma of meatloaf and potatoes. After clearing the table, I put a brownie and a small scoop of ice cream in a bowl, handing it to Maddie to take to her room along with a DVD movie. I explained to her that Daddy and I have some grown up business to talk about.

***

Simon and I face each other from different sides of the family room. He starts.

“So, I get it. The jet skis were a bad idea. I’ll drive the rig back tomorrow and return it.”

“It’s a bigger problem than that, Simon. There’s no return policy for trucks or the jet skis. They belong to us. And so does the debt.”

“Niki, the dealer said …”

“Simon, I talked with Grant this afternoon. Once they left the lot, they became ours. That’s the law.”

Simon contemplated this news silently. “Well, I’ll drive them back tomorrow, and see what the dealer says.”

“Grant suggests asking the dealer to consider keeping them on the lot, and reselling them for us. We’d take a loss, but not the entire amount,” I instructed.

“You’re sure you don’t want to see if we like them first, Niki?”

“No, Simon. I don’t,” my voice was icy. I couldn’t bring myself to say the rest of the words.

Just then, Maddie came into the room. “Are you guys fighting?”

“No, honey, Mom and Dad are having a discussion. Go back to your room.”

“Can we keep the jet skis?”

“No honey, they’re going back.” You need to go back to your room and get ready for bed.”

“I hate it when you fight,” she grumbled, and rolled her eyes at me before trudging to her room.

Why am I the bad guy?

Return Policy (Niki comes home to a surprise)

Chapter 18

After recognizing that the baby’s ET tube was blocked, and having the nurse gonads to pull the tube, I drove home from the hospital feeling victorious. Dr. Polk’s words, “Good job,” played over and over in my head, but they weren’t loud enough to calm my stomach when I thought about Corey, and the silent treatment he gave me earlier in the same shift. I hoped he would eventually understand, and forgive me.

Pulling into the driveway, I slammed on the brakes to avoid hitting the back end of a trailer hitched to a large truck in the place where I usually park. On the trailer perched a pair of brand-new jet skis.

With the car engine still running I wondered, “What the hell? Where did that come from?”

The front door opened, and Simon strode to my car wearing a gigantic grin. “What do ya think, Nik?” Surprised?”

“I think shocked is a better word.  Simon, what are they?”

“They’re jet skis.”

“I know they’re jet skis, I meant, what are they doing in our driveway?”

“I wanted to surprise you. Happy anniversary, Niki!”

I needed a moment to take it in.

“This is an anniversary present? For me? Simon, I don’t understand.”

“I know you don’t, Niki, that’s part of the surprise. The dealer offered a package deal, and I got a rad price on all of it. It includes everything we need to go down to the marina, launch, and spend a day on the ocean, shredding waves. It’ll be a blast! And with the truck, we can haul them everywhere; try different places. We’ll spend your weekends off having fun together.”

“Simon, we’ve never rode jet skis.  We’ve never even talked about them. This must cost tens of thousands of dollars. We just paid off our debts. We should start saving a down payment on a house, and for Maddie’s college fund. I thought we agreed going to Coronado for a weekend was our anniversary gift. We can’t afford this.”

“I know, I know, that’s why I cancelled the reservations for Coronado. The money we save will off set some of the cost.”

“What do you mean, you cancelled the reservations for Coronado? I’ve been looking forward to it for months. Why didn’t you talk to me first? You can’t just spend this kind of money without consulting me!  What are you thinking?”

“I think jet skiing together will be a lot of fun. It’s something we can do together. It will be good for us Niki.”

I opened my mouth to say something, but just then Maddie ran out of the house, yelling, “Surprise! Happy anniversary, Mom! Dad says if I wear a life vest, I can ride on his with him. This is so cool!”

I sat speechless, wondering where I would find street parking for my car, and what is the return policy on jet skis.

And husbands.

Is Everything Okay? (Niki’s nursing assessment saves a baby)

  

Chapter 17

I woke up in the afternoon having slept poorly after the bad dream. Schlepping my way into the kitchen, I made a cup of tea.

Simon dropped Maddie off from school, and then went back to coach practice. I helped Maddie with her homework while starting dinner.

During dinner Maddie chatted animatedly about what her friends at school are up to. Simon tells us about a new project he’s introduced to his students. He notices my distraction and asks, “Is everything okay, Nik?”

“Oh, yeah, I’m fine. I just didn’t sleep well today.”

Simon gives me a curious look, but makes no comment.

I kiss them good-bye before leaving for work.

***

Corey brings a ventilated baby with pneumonia to the PICU at change of shift. He turns his head away, but not before giving me a look so sharp I catch my breath.

Pointedly, Corey gives the report to Kathy. As he leaves the unit, he looks at me again. Silently, I mouth the words, “Can we talk?” but he puts his head down, rapidly disappearing down the corridor outside the PICU.

Kris is finishing her day shift charting at the nurses’ desk. I suddenly realize she’s seen all of this.

“Everything okay, Niki?”

“Yeah, why?”

“I’ve never seen Corey transfer a patient so fast when you’re here, that’s all.”

“Mind your own business, Kris.”

She raises an eyebrow at me, and returns to her charting.

***

Later in the shift, the pulse ox alarm in Kathy’s patient’s room sounds, and she gets up to check on it. Poking her head out the room’s door, she says, “Niki I need to suction him. Would you help?”

At the crib, I manage the ambu bag; manually giving the baby breaths of oxygen while Kathy suctions its breathing tube to remove secretions. Nothing comes up, so she places a few drops of normal saline down the tube before making another pass. A bit of yellow-green mucous comes up. She replaces the ventilator tubing, and silences the pulse ox alarm again when it continues to read 90%.

“That’s funny. His oxygen saturation should improve after suctioning,” she observes out loud.

“Maybe he’s due for a respiratory treatment,” I offer. “I’ll page Gerald.”

Gerald administers an aerosolized medication into the ventilator tubing, and then gently taps on the baby’s chest and back with a soft rubber percussor. Kathy suctions again, while Gerald bags. Still, no significant secretions. The baby’s oxygen saturation drops to 85%.

I listen to his chest with my stethoscope. There’s breath sounds on both sides. However, the little guy begins pulling hard with every breath. We watch as the tiny muscles between his ribs pull in with the work of breathing.

“He’s getting worse.”

Gerald takes him off of the ventilator, and starts hand bagging again. I suction without secretions, while Kathy pages Dr. Polk.

“He’s down in the ER, assisting with a pediatric trauma. He said to keep bagging.  He’ll be up as soon as he can.”

“I’m not sure we can wait that long,” I said. Not only were the sats less than 80%, but now the baby’s heart rate was dropping.

“What’s wrong?” Kathy called out.

Insight flashed before me, “His breathing tube is blocked.”

“Are you sure? asked Kathy. “How do you know?”

“It has to be. His chest sounds are good. He’s moving air, but he’s not getting oxygen from either the vent or the bag. We’ve got to pull the tube out now!”

“Dr. Polk said to continue bagging until he arrives,” warns Kathy.

“The baby is going to code if we don’t pull the tube now,” I insisted.

“Yeah, and who’s going to take responsibility for that, Niki?” Gerald cautioned.

“I will,” I said. “I’m pulling the ET tube.”

I removed the tape from the baby’s face, allowing the tube to slide out easily. At its end was a glob of thick, white secretions half the diameter of a ping-pong ball. It resembled a wad of chewed up bubble gum. I laid the mucous-blocked tube on a paper towel, and placed it on the bedside table. The baby started to cry.

“Well lookee there,” said Gerald. Immediately the oxygenation returned to 100%, and his heart rate returned to normal.

The three of us remained at the baby’s crib, watching him breathe; Gerald helping him out with occasional bagged breaths until Dr. Polk arrived.

Flying into the room, Dr. Polk saw Gerald bagging his extubated patient.

“Who pulled out the goddamn ET tube?” he roared.

“I did, Dr. Polk.” I held up the gelatinous ET tube for him to see.

“Good job,” he said. “Everything looks okay.”

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.