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.

Angst and Cake (Niki’s smiling face)

Chapter 43

 “So what happens to Melissa now, Grant?”

“The hospital can file a complaint against her with the Board of Nursing if they choose, but that’s unlikely. She isn’t named in the suit, so she’s off the hook for that. Like I said, Dr. Straid filed against the hospital to protect his financial interests. With Melissa’s testimony, it’s clear the hospital has responsibility for not preparing their pediatric nurses better, and we can successfully throw in understaffing the unit too. There will be more discussions, but ultimately, the hospital will settle with the family out of court.”

“And Dr. Straid will still be a bully, and a child is dead.”

“I defend clients Niki, I don’t have to necessarily like them. You said it yourself, even if Straid had come in, the child still might not have survived.”

I drove home from La Jolla with feelings of angst. I think about how lucky I am to work with a good group of doctors in the PICU. Dr. Polk is respectful, even if he does sometimes forget he’s in a pediatric unit and cusses. He knows if a nurse says, “Come in and see this kid,” he’d better.

At home I sort through the pile of mail that collected while I was away, and am shocked by my smiling face on the cover of the latest issue of Call Lights Magazine: summoning the power of nurses! I remembered Todd saying, “Niki, look into the camera and smile,” before snapping the photograph. I had no idea it would be on the cover. Should I be happy or embarrassed? Have my friends at work already seen it? Probably. I’m sure I’m in for teasing of some kind.

I was right. I enter the PICU at change of shift to find every nurse on both shifts has a tiny photocopied print of the cover with my face taped over their picture of their employee name badges. Dr. Polk is there, and he’s wearing my face on his name badge too. So’s Gerald, and standing beside him, Corey, giving me a shy smile. It cracks me up; it’s so funny.

Kris walks over holding a copy of the magazine. “Great picture of you Niki. It’s too bad they didn’t Photoshop that crease between your brows though. You know, not taking care of that with a little Botox is sort of like having a unibrow.”

Is she kidding? I can’t tell. “Thanks Kris, I’ll keep that in mind.” I make a mental note to look more closely in the mirror when I get home tomorrow morning.

There’s a sheet cake in the staff lounge with the Call Lights Magazine cover airbrushed on it in sugar and food coloring. I cut into my face with the knife, and everyone has a piece during report.

Before taking his cake down to the ER, Corey touches my elbow, saying, “Congratulations, Niki,” and then quietly, “Let’s meet during our breaks tonight. I need to talk to you.”

“Okay. Text me.”

* * *

Around 0100, Corey texts me to meet him in the stairwell between our floors. Instead of bringing the lunch I’d packed from home, I cut two slices of what’s left of the ravaged cake, and bring them on paper plates with plastic forks. When I reach Corey several flights down, I see he read my thoughts: he’s holding two cups of coffee. I’m touched to see he’s remembered I like mine with half and half.

“You guys have half and half in your fridge?”

“No we don’t. All I could find was that irradiated or whatever stuff in those tiny plastic tubs that don’t need refrigeration. Sorry.”

While arranging the coffee cups and paper plates on the stairs, we’re uncharacteristically shy with each other. Seated, our hips touch on the narrow stair. He smells clean, of soap and water. Corey turns towards me, and I think he’s going to kiss me, but he pauses before placing his hand on the side of my face, brushing away the hair that fell loose from my ponytail.

“You’re beautiful, Niki. No wonder your face made the cover of the magazine.”

I don’t know what to say, so I start in,

“How’s Sheila? What’s been happening?” I’m afraid to go down this road, but we only have half hour breaks.

“She’s a fighter. She’s got a positive attitude, and the oncologist says there’s every chance they caught it early and she’ll beat it. I never knew Sheila was so strong, so vital.”

Uh oh. I braced myself for what was coming next.

“You’re staying, aren’t you Corey?”

“Niki, I,”

“No don’t, I get it. She needs you. You see her in a different light. She’s the mother of your girls.”

“Niki, it’s not that simple. I really love you.”

I will not cry.

“Corey, stop, it’s okay. We were both going through a rough time. No harm, no foul.”

“Niki, don’t, it’s not like that.”

I’m not going to be able to hold back the tears much longer. Shit, I have sick kids to take care of for the rest of the shift. I will not let this wreck me. I pick up my paper plate and cup, standing to leave.

“Thanks for the coffee Corey. I wish you the best.”

Corey’s also standing, and calls after me as I hurry up the stairs back to the PICU. “Niki, wait!” Behind me, the fire door closes more loudly than I’d intended, and I can’t hear the rest of what he’s saying.

Leaning against the door, I bite the inside of my mouth until the metallic taste of blood overcomes the sugary residue of cake. The pain forestalls my tears. I dump the cake and coffee into a wastebasket in the PICU’s empty family waiting room before entering the unit and return to my shift.

An Awkward Silence (the trouble with bullies)

Chapter 42

Melissa took a sip from the glass of water in front of her before speaking.

“It was supposed to be my night off, but I came in extra at 11 for an eight hour shift. There was a sick call, and when they got a third admission that night, the charge nurse asked me to come in. I took report on the new admit from the charge nurse, who’d settled him into his room with his parents, but nothing else, because she was busy helping another nurse with a transfusion.”

“Did you have other patients assigned to you that shift?” Grant interrupted.

“Yes, I had three other patients, besides, you know.  One’s IV was out, and I needed to restart it. I did vital signs on the new admit, and hung his antibiotic first, though.”

“So, you assessed Bobby and started his antibiotic within an hour of his arrival on the pediatric unit?”

“Yes.”

“And then you went to another patient’s room to start an IV?”

“Yes.”

“When did you return to Bobby’s room?”

“I went in when the pump alarmed that the antibiotic infusion was finished. That’s when the parents pointed out Bobby’s rash.”

“Were you concerned by the rash?”

“Yes. I took another set of vital signs, which were unchanged. Then I called Dr. Straid at home.”

“To report the rash?”

“Yes. I was worried that it was serious. It was all over his body, even his cheeks. He seemed more lethargic than when I’d seen him earlier.”

“What time was this?”

“It was after midnight. Dr. Straid told me that Bobby’s lethargy was due to his needing sleep, and that I should stop over-nursing him.”

“But Dr. Straid was concerned about the rash, and ordered treatment for Bobby, didn’t he?”

“Yes, he ordered IV diphenhydramine and an IV steroid to cover the rash. The next dose of antibiotic wasn’t due until morning, and Dr. Straid said to hold the dose until he came in to assess the patient.”

“Did this sound like a reasonable plan to you?”

“No. Bobby seemed more sick than tired to me. His parent’s said he wasn’t acting like himself. I asked Dr. Straid to come in and see him then.”

“Because the boy had a rash, and was sleepy?”

“Lethargic, I used the word lethargic.”

“Were you aware of the severe neutropenia?”

Melissa looked at the hospital lawyer, then her hands folded in her lap before looking at Grant and answering softly, “No.”

“So Dr. Straid was unaware of the lab results. You asked him to come to the hospital in the middle of the night without looking at or reporting the lab results. Do you think that if Dr. Straid had been aware of the severe neutropenia he would have come to the hospital to see Bobby immediately?”

“Maybe. I don’t know.” Fierceness flashed in Melissa’s eyes at this inquiry.

“What do you mean, you don’t know?”

“I mean Dr. Straid has a reputation for not coming in to see his patient’s when asked by a nurse. I mean that most of the nursing staff is afraid of calling Dr. Straid in the middle of the night because he usually bites their heads off.”

“There’s no notation in this patient’s chart that Dr. Straid refused to come in, or that he was rude to you on the phone.”

“I’ve stopped writing about Dr. Straid’s behavior a long time ago. Writing him up doesn’t do any good. Nothing happens.”

“So you assumed Dr. Straid wouldn’t come in to see this patient because he is sometimes rude to nurses? You knew that reporting the lab results was useless?”

Melissa sat in awkward silence.

“Did Dr. Straid refuse to come in to see the patient after you told him the lab results?”

“Objection!” The hospital lawyer said quietly.

“Melissa, did you report the lab results to Dr. Straid?”

“No. I did not report the lab results.”

“Why not?”

“Because I hadn’t seen them.”

I sat in conflicted silence. She should have looked at the lab results before getting on the phone with Straid. She should have trusted her nursing instincts that the boy was gravely ill. Anxiety over calling Dr. Straid in the middle of the night, combined with a busy shift, and inadequate staffing got the best of her, an all too familiar story in nursing. The result was catastrophic.

 

 

The Wrong Side of a Sentinel Event Review (Niki empathizes)

Chapter 40

I woke up in Raquel’s and Grant’s guest room when a bright shaft of morning light slipped between the honeycombed shades and into my eyes. This never happens at home where I’ve installed black out shades in my bedroom, because I work night shift. My hand, tingly-numb from sleeping on it, reaches for and locates my phone on the nightstand. I check it for texts.

There’s one from the PICU manager asking if I’m interested in picking up an overtime shift. She doesn’t realize I’m out of town.

Next, Maddie’s sent a selfie of her and Wade eating hot dogs in Amber’s backyard after our phone conversation yesterday.

I’m disappointed there isn’t one from Corey. It hurts a bit, but I remind myself this is a tough time for him. Then I dismiss the matter from further thought.

After a serving a quick Raquel drops her kids off at school, we go to a cross fit workout at her gym. She’s is an animal, performing amazing feats with weights, pull-ups, and standing squats. I admire her “guns,” the well-defined muscles of her upper arms, noticeable in her tank top.

“Niki, you should work on your core. You’d gain a lot of strength with a little work,” observes Raquel.

“Maybe, but I rarely go to gyms. Don’t judge me. I like the outdoors, running or riding a bicycle. Maybe because hospitals are such closed environments. You are a lot stronger than me though.”

Afterwards, we stop for smoothies before going home. Then I shower, and borrow a pair of slacks and a blazer from Raquel, hoping I don’t look out of place at the deposition this afternoon.

Grant greets me in the conference room at his office building, fifteen minutes before the deposition is scheduled. We choose our places at the conference table, facing the door before the other nurse and her legal representative arrive.

“Thanks for coming Niki. I realize you hadn’t expected to sit in, but I think it will be useful to us. I don’t want you to say anything, just listen. Have you sat at deposition before? No, of course you haven’t, because I would have been there for you. Sometimes it’s good to have a lawyer in the family, right?”

“Absolutely Grant, I just hope I never need you. The long-term goal of my career is to never sit on the wrong side of a sentinel review committee.”

“Well, unfortunately, it happens to very good nurses sometimes. I’ve seen my share,” admits Grant.

“I guess I’m kind of feeling bad for this nurse I’ll meet today, Grant. I mean, good or bad aside, I don’t know anyone in health care who starts a shift thinking, ‘today I’m going to hurt a patient.’ People go into nursing to help others, not to cause accidental harm.”

“I understand, Niki. What you have to realize, is that this case isn’t really about placing blame on the nurse. What we want to establish is that an employee of the hospital, in this case a nurse, made a mistake contributing to a wrongful death, making it the hospital’s responsibility. Nobody is interested in suing the nurse. We’re defending Dr. Straid from being sued. He stands to lose a considerable amount of his financial assets. He has a couple kids in college, a house, and a business to protect.

Maybe the nurse won’t get sued, but she’s going to have to find a way to sleep at night for the rest of her life if she’s blamed for contributing to the death of a child, I think to myself. I keep forgetting which team I’m on.

“But Dr. Straid’s not guilty, is he Grant?”

“Of course not, the nurse didn’t inform him of how sick the boy was. The hospital is the deep pocket here Niki, not the nurse. A patient should be safe in a hospital, right?”

“Yeah, you’re right, Grant. Patients should be safe in any hospital.”

“That a girl. Now, here comes the nurse, and the hospital lawyer. Remember, don’t talk just listen.”

Seeking Justice (Niki reviews a nurse’s notes)

Chapter 37

In the conference room, Grant gives a brief explanation of the case I’m to review:

“According to the ER record, the parents reported their three-year old wasn’t interested in eating for a couple of days and when he stopped drinking fluids too they became concerned, bringing him to the hospital’s ER. A temperature of 102.5 was recorded, but otherwise his vital signs were normal, with a slightly elevated pulse. Concern for dehydration led the ER staff to draw blood tests, and start an IV. They decided to admit the boy to the pediatric unit for IV fluids, antibiotics, and observation overnight.

He arrived on the pediatric unit at 10:30 pm. According to the nurse’s admission note, he was lethargic. He received a dose of IV antibiotic within an hour of his arrival. After that, the order of events is vague. His mother noticed a rash on the boy’s chest and arms during the antibiotic infusion. The nurse called the attending pediatrician, who was at home, and reported the rash. The boy received a dose of IV diphenhydramine, and steroid to treat the rash assumed to be an allergic reaction to the antibiotic. The boy fell asleep.

The next entry in the nurse’s note records that an hour later she was called to the room by the boy’s parents. The rash had spread over his entire body. They were unable to rouse him.

The nurse documented a blood pressure of 67/45, a pulse of 50, and respirations of 10. She called a code, and the boy was intubated in the room. Resuscitation attempts followed. The attending pediatrician was summoned from home. He arrived half an hour later. Unfortunately, the resuscitation attempts were unsuccessful, and the child died.

Later, the results of the blood tests drawn in the ER revealed a severe bacterial infection, which was the cause of the rash, not an allergy to the antibiotic. The parents are suing the hospital and the attending pediatrician for wrongful death. Our client, the attending pediatrician, maintains that he is not at fault because the nurse failed to report the results of the blood tests, and how sick the child actually was. Therefore, the responsibility for the boy’s death rests on the nurse, and as her employer, the hospital.

What I need you to do, Niki, is review the chart, and find indications that the pediatric nurse neglected or did not follow standard practice in her care of this child; anything pointing to our client’s innocence.”

“Wow. Okay Grant. I’ll read through the record, and see what I can find.”

“Thanks Niki. If you need anything, let Claudine know. I’ll see in you in a couple hours. Raquel and I are looking forward to having you stay with us the next couple of days.”

“Me too. Thanks for inviting me, Grant.”

After Grant leaves the room, I settle into the leather chair at the large, polished table of the conference room, a hard copy of the medical record lying on it. Leafing through its pages, I feel queasy at the realization that whatever I find wrong will be used to blame another nurse. I dismiss the thought, however.

“I am a patient advocate,” I remind myself. “By reviewing the medical record, I’m helping a family receive justice.”

What Nurses Look Like (Niki Ponders Professional Identity)

Chapter 33

Back at work, the photo shoot is quickly forgotten in the revolving chaos of pediatric intensive care nursing. Despite the cute styles and print fabrics of the scrubs we wore on the set, tonight I’m wearing plain green scrubs pilfered from the OR.  You have to know someone with the keypad code to the dressing room to get them. Everyone in PICU wears OR scrubs, even the doctors. I suppose this confuses patients, who can’t identify the different roles of the myriad of staff entering their rooms. Despite Registered Nurse stamped in large letters on my name badge, I’m often asked by parents, “Are you the doctor?”

What makes a nurse look like a nurse?

Tonight I walk into a change of shift admission. In pediatrics this sometimes happens because everyone agrees that a child shouldn’t die in the ER if there’s time to transfer them first. Tonight, this is the case.

My patient is a two year-old near drowning. Near drowning is sort of like saying a patient has an infection. It describes a broad range of outcomes from “The kid swallowed a bunch of water, and we suspect aspiration pneumonia,” to “He’s brain-dead, and the parents requested organ donation. We’re waiting for the team to arrive.”

The parents of my patient have requested organ donation services.

Gerald sets the child up on the ventilator, Kris transfers the monitor leads, and Dr. Polk assesses the child, while Corey gives report.

“He was with a babysitter, while his mother went to work. The baby sitter is a close friend, like a grandmother. The two year-old had a cold, and he can’t be sick at daycare. The babysitter says she was only on the phone for a few minutes while the child watched TV. When she turned around, he was gone. After searching for him inside and out for about fifteen minutes, she called the police and the child’s mother. Waiting for them to arrive, she knocked on the doors of her neighbors, asking if they’d seen him. It did not occur to her to look under the heavy cover of her hot tub. She knew the cover was too heavy for a toddler to lift. It was the first place the policemen looked when they arrived. Somehow, the boy lifted the cover, and fell into the hot tub. His face had wedged below the water. CPR was started, and a heartbeat recovered. He was intubated at the scene, and arrived at code speed by ambulance to our ER.”

In my mind, I visualized the rest of the story:

In the ER, his heart stopped several more times. The doctors and nurses performed heroics, while a social worker wrapped her arms around the child’s sobbing mother, “Please don’t die, please don’t die.”

They stabilized his vital signs long enough to transfer him to PICU, where our nurses will guide his parents through the remainder of their child’s journey on Earth.

After report, I prepared myself to spend the next twelve hours in a room of suffering in close proximity to a shattered family. You only have one opportunity to get it right. You cannot take away their pain, but you owe it to them to not add to it. Any anxiety I have about the child’s care will be shared privately with my colleagues, not spoken out loud in front of the parents.

In nursing school, our instructors taught us to not show emotion in front of the family, no matter how heart wrenching the story. They told us that our job is to deliver care, and offer support. While I agree that families should never be put in the position of supporting a distraught nurse, in my experience, showing some emotion, even tears, is interpreted by the family as an acknowledgment of their loss. Nurses are the embodiment of humanity in what is dubbed the “technological fortress” of a hospital. The ordeals patients suffer matter to their nurses. We are nurses, because life and death matter to us. We serve by way of our skills.

That is what nurses look like.

I’m glad I wore plain green scrubs tonight. Tonight the PICU is not the place for cheerful prints.

You Do Important Work (Niki Makes a Purchase)

Chapter 32

The photo shoot progressed in ‘hurry up and wait’ format.

We patiently stood in front of the camera while lights were adjusted, and the angles of our faces repositioned, dressed in brightly colored scrubs, with improved, professionally applied make up. Even the male nurse’s eyebrows were shaped with pencil, and he had concealer applied to blemishes.

We held “nurse props” like stethoscopes and clipboards in the photos. While a light above my head was adjusted, it dawned on me that we could easily be a group of dental hygienists or veterinary technicians instead of nurses. Although nursing science has burgeoned, the visual cues of traditional white caps and uniforms remain iconic. Instead of standing out visually in clinical settings, as in the past, modern nurses blend into the melee of scrub attired workers. Is there a similar icon for physicians? All I can think of is the old-timey black medical bag of the past century. I’ve never actually seen a doctor carry one, and they don’t recur in popular imagery like the nurse’s cap.

I’m snapped back into the present by Todd. “Niki, look into the camera and smile for me, okay?”

At 1230, we’re given a lunch break. The table in the back of the room holds stacks of white boxes.  They contain sandwiches, salads, and a cookie from a catering company. I choose one. Todd taps my shoulder.

“Hey Niki, mind if I eat lunch with you so we can catch up?”

Todd and I carried our boxed lunches outside, and sat on the cement edge of a large fountain in front of the convention center.

“I’m impressed you’re a professional photographer Todd. I remember you as a nice guy taking photographs for the high school yearbook, and newspaper. How did you end up doing it for a living?”

“You mean you remember me being a camera geek using photography as a way to meet pretty girls on campus, but I appreciate your rendition. Actually, after high school I travelled around Europe, and stumbled into a job with a modeling agency. They were looking for American models for a company selling jeans. It was fun, but I like being behind the camera more than in front of it. So I got a job as the assistant for one of the photographers. After I returned to the States I started out like most freelance photographers, shooting weddings, taking graduation pictures, that stuff. Then one of the models I met in Europe, Maggie, asked me to do her wedding. Her father’s a big time publisher, and I met a lot of editors at the wedding. I started getting calls, and here I am. I got lucky. What about you?”

“My story’s not as exciting as yours. I went to college, became a nurse, got married. I have a fabulous daughter. I’m divorced.”

“What kind of nurse are you?”

“A good one, I think. I work in pediatric intensive care.”

“Oh wow, with all of those little preemies?”

“No, that’s neonatal intensive care. Sometimes my patients are premature, but mostly they’re newborn up to age eighteen. They have serious infections, surgeries, or are trauma victims. Most are on ventilators for at least part of their hospitalization.

“Wow, I couldn’t work with sick kids. It would break my heart. You do important work.”

“It breaks mine once in awhile, for sure. I always wanted to take up photography though. It must be great to make money doing something you love.”

“It’s like anything, really. I’m hired to produce specific work. It depends on the look the publication wants. The creativity is discovering my unique way of seeing it. I do fine arts photography on my own time. I have work in a couple of galleries.

“I would love to do something creative. The only photographs I take are with my phone.”

“If you’re serious about photography, I just upgraded to a new camera. I have a used kit I was dropping off at the photography shop to sell on consignment. If you’re interested, I’ll give you a good deal. The kit’s complete, lens, bag; the owner’s manual is there too. I can get you started using it today. You can text me with questions as you go along.”

Lunch was over. Todd and I returned to the shoot, which lasted the rest of the afternoon. Standing under the lights, I felt expansive, imagining all of the photographs I will take.

After the shoot, Todd explained the camera, and its accessories. He gave me a really great price, I think. To be honest, I don’t know a lot about cameras.

But I bought it anyway.

There’s Always Photoshop (Niki has a revelation about modeling)

Chapter 31

I arrive too early for the Call Lights Magazine photo shoot, because I was nervous about finding the location, but it was easier than I’d thought. So I’m waiting alone in the lobby of a small convention center room until the other real nurse models arrive.

The email from Call Lights Magazine with instructions about the shoot was rather vague, except in its insistence that all releases be signed and returned beforehand.

I have no idea what “real nurse” models wear, so I defaulted to the slacks, blouse and blazer I usually reserve for job interviews. I left my hair down, and wore some make-up.

One by one the other “real nurse models” arrive, dressed much the same way as me. The group of us looks to be in our late 20’s to mid-thirties. One of us is a man. I didn’t think to invite Corey to apply with the rest of us. Does that make me gender biased, I wonder?

Soon the doors open, and we’re ushered into the conference room, transformed into a photo shoot. There are three makeshift dressing rooms made of drapery hanging from curtain rods fastened to the walls. Two garment racks on wheels each hold dozens of scrubs sets of varying sizes, colors, and styles. Beyond these are make up, and hair styling stations. Floor lights and silver colored reflectors ring a fake hospital room backdrop. The carpeted floor is crisscrossed with thick cables secured by duct tape. At the back of the room is a buffet table laden with bottles of water, juice, coffee, hot water and an assortment of teas. I’m too nervous to drink anything at the moment, so I stand around with the other nurses making small talk.

“Niki?” I turn my head in the direction I hear my name called.

The voice belongs to a vaguely familiar man about my age wearing jeans, a white tee shirt and a light grey sports jacket with the sleeves artfully rolled up three-quarter length. He’s holding a camera with a huge professional lens in one hand.

“Niki Rossetti, is that you?”

Now I recognize Todd from high school. At least I think it’s Todd. He’s taller, or maybe just skinnier than I remember. He has a manicured, stubbly beard. His hair blonder than I remember.

“Todd?” 

“Hey, yeah, Niki! It’s me Todd. It’s been a really long time. What are you doing here?”

“I’m one of the ‘real nurse models’ for this Call Lights Magazine photo shoot. Are you a nurse?”

Todd laughs. “Hardly. I’m the photographer. So you became a nurse. This is wild!”

Before we could talk more, the heavyset lady with hipster glasses appears in the middle of the room, calling out, “Ladies, oh, I guess I’d better say, ‘and gentleman,’ we do have a male nurse model in our presence. Please gather by the make up and wardrobe stations where you’ll be matched with scrubs for the photos.

I stand with the other nurses waiting while the wardrobe woman sizes each of us up, selecting suitable sets of scrubs. Half of us are sent to the makeshift changing rooms to put on the scrubs. The rest of are directed to the hair and make up stations.

I’m instructed to sit on a stool under a lamp, by a woman wearing a white lab coat over her tattooed décolletage and black tube top.

“Hi. I’m Niki.”

“Hmmm,” she says, while placing a hand on my chin turning my face this way and that under the light.

“I need to add more make up. You’re supposed to look like a real nurse for these photos.”

“I am a real nurse,” I retort.

“Hmm,” she repeats, as if she didn’t hear me. “You should consider getting Botox for that furrow between your brows. These days, it’ almost as bad as having a unibrow. You’re pretty. Botox would make you look less tired.”

“Thanks. I’ll think about it.”

“Well, don’t make it any deeper by worrying about it. If the editor feels it’s distracting, there’s always Photoshop.”

I have the sense that this “real nurse model” stuff is separated from real nursing by a chasm much deeper and wider than the furrow between my brows.

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!

Sins of Omission (Niki keeps a secret & learns another)

Chapter 28

In the parking lot, Corey is standing by my car.

“You and Corey are seeing a lot of each other this week,” observes Liz, whose car is parked near mine.

I smile without comment.

Immediately, Father Michael’s catechism lecture when I was eight years old pops into my head: “Children, there are two kinds of lies.”  The priest, dressed in black with a stiff white collar clinging tightly to his pink neck, rocked back and forth on his heels with his hands resting on a round belly the way a pregnant woman might. “Children, there are two kinds of lies, aye, those of commission, and those of omission. Either are the work of the devil, and bring tears to your Father in heaven.”

Oh Lord. I shake this memory from my mind.

“Hi Corey. See you later Niki. Thanks for sharing your food tonight.” Liz gets into her car, and drives off.

“How was your shift?”

“Crazy busy. And then Dr. Kearney ate Liz’s potato chips. Kathy and I shared our food with her. Thanks for the cupcake, it was a nice treat. We split it three ways. How was ER?”

“You’re welcome. The usual, ‘I’ve had this terrible pain for two weeks, and randomly decided to come to the ER tonight to find out what it is’ patient, the perennial, ‘I stuck something where I shouldn’t have, and now I can’t get it out’ patient, your garden variety chest pains, and a kid needing a breathing treatment for asthma. It wasn’t too bad.”

We stood next to my car for a few moments in silence.

Giving Corey a hopeful look, I venture, “I still owe you breakfast.”

“Yes, you do.”

“Follow me home?”

“Naw, I’ll meet you there. I know my way.”

***

After making love, I scramble eggs while Corey fixes toast. I found a forgotten bottle of sparkling wine in the fridge, and combine generous pours with orange juice in a couple champagne flutes.

“Corey, I’m taking Maddie to visit my sister Raquel for the weekend. We’re leaving in the morning. We’ll be back Sunday afternoon.”

“That sounds like fun. Are you going to tell her about us?”

My heart catches in my throat at the thought of this. “You mean Maddie?”

“No, I mean your sister.”

I relax. “If I do, what should I tell her?”

“That there’s an ER nurse who’s crazy about you, and that’s who’s texting you all weekend.”

“Are you crazy about me?”

“Oh yeah, babe.”

I lean over and kiss him, nearly knocking one of the mimosas off the table.

***

That the afternoon I pick up Maddie from school. In the car I ask her,

“Are you excited about going to see Aunt Raquel and Uncle Grant? Your cousins are looking forward to our visit. Get your things packed tonight so we can leave first thing in the morning, okay? Do you need laundry done?”

“Yeah, I need my skinny jeans washed. I guess I’m excited. Dad and Amber are taking Wade to the Natural History Museum this weekend. I’ve been there a million times, so it’s okay if I miss it.”

Amber? Who’s Amber? This is the first time I hear her mentioned.

“Who’s Amber and Wade?” I hope I sound nonchalant, not nosy.

“Oh. Miss Greeley. She’s our principal. She used to be Mrs. Greeley, but she’s divorced like you and Dad are. Her name is Amber.”

“And she’s friends with your dad?”

“Yeah. They’re dating.”

“Your Dad’s dating your principal? His boss? Uh, that’s nice. Is Wade her son? How old is Wade?”

“Yeah. He’s four. He’s really cute. I always wanted a little brother.”

This is starting to feel weird. I say, “Well, that’s very special, Maddie.”

We drive the rest of the way home in silence.