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.

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 911 (Niki comes to the aid of a family in distress at the grocery store)

Chapter 4

The rest of that shift was uneventful. Once dayshift arrived, I gave report on the new admission, and my other patient too. I wash my hands, use the restroom, and wash my hands again.

Never get into a car with a full bladder.

I leave the hospital by the ER exit on my way to the parking lot.

From the driver’s seat, I wrap my stethoscope back in its place of honor around the rearview mirror, lowering the driver’s side window so the cool morning air can keep me awake on the drive home.

It’s seven forty-three am. Simon is getting Maddie ready for school about now, I think to myself. The morning sky is overcast, good weather for daytime sleeping. I can get in a few solid hours of sleep before Maddie comes home from school.

While sliding the key into the ignition, my cell phone rings. It’s Simon.

“Hello?”

“Hey Nik, it’s me. How was your night?”

“Uneventful. What’s up?”

“”I made Maddie pancakes for breakfast and used up the last of the eggs and milk.  Would you pick up some on the way home from work? Oh, and some elbow macaroni too. I’m going to make macaroni and cheese for dinner.”

“Why can’t you do it after you take Maddie to school?”

“Because, love, I have a job interview at Woodman at 10, remember? I need to come home and dress the part.”

“Sorry, I forgot. What about after that?” I whined.

“No good. I have to get home and put together dinner before picking Maddie up from school. The play-offs start today.”

“Can’t you record the play-offs and watch them later?”

Silence.

“Okay, I’ll stop at the store on my way home. Milk, eggs, and elbow macaroni, right?”

“Oh, and get some cheddar cheese. I just looked in the fridge. We’re out of cheddar cheese too.”

“Anything else?”

“Broccoli? Yeah, broccoli. Maddie needs to eat more vegetables. See you when you wake up, Hon. Love you!”

“Yeah. Okay. Me too. And Simon, good luck with the job interview. I know you’re the best candidate.”

I start the ignition, and drive home the long way, so I can stop at the store, feeling guilty I forgot about Simon’s job interview this morning. I should try to be a better wife.

Entering the grocery store, I perk up thinking that the good thing about early morning shopping is that there’s not a whole lot of people. The lines are short, and I can get in and out quickly. I grab a cart, mostly just to have something to lean against while going up and down the aisles after standing most of the night.

A distracted woman is pushing a cart with a boy sitting in it who looks about two years old. Alongside trails his brother, who looks about four. The kid in the cart is playing with a can of spray paint.

I know what happens next before it happens.

The two year-old takes the lid off of the can and in doing so sprays black paint all over his face. Screaming, he drops the can to the floor where it spins around on its side like one of those pinwheel fireworks, spraying black paint instead of sparks everywhere, because its nozzle is broken.

Now the woman and both her children are screaming and crying. The store manager appears, and disables the can. Someone yells, “Call 911!”

I go over to offer help. I’m wearing scrubs, and identify myself as a nurse. The two year-old is crying, but otherwise he’s not in visible distress. Most of the paint is on his chin and neck. Little was ingested, but I don’t know if inhaled fumes are dangerous or not.

I tell the store manager, “Call the poison control center number printed on the side of the can. They can advise us what to do.” The grocery store has a pharmacy, and if Poison Control advises vomiting, I figure Ipecac is probably available. My own phone is in my car.

The store manager stares at me blankly.

Turning my attention to the two children and their mother, I try to calm them. This turns out to be impossible. They continue to scream and cry.

Then a man runs up informing us that he has called 911.

By now a small group of people have gathered and are staring.

Relieved, I hear the sirens of the fire truck bringing the paramedics as it pulls into the parking lot.

I roll my cart to the checkout line. There’s nothing more I can do.

I overhear one of the paramedics ask as he arrives on the scene, “Has anyone contacted Poison Control?”

Sigh.