Bruises Not Scratches (Niki Discovers Something Unsettling)

Chapter 58

“Raquel, it was absolute mayhem. The little dog took off down the hall after the bunny, and then the charge nurse called Security to help round them up. Of course, Security didn’t have any idea of what to do. Eventually, two officers cornered the animals, grabbed Rocket, and the pet therapist gathered up the bunny, but not before the blind kid, Travis, somehow felt his way to the fire alarm, and pulled it. The sprinkler system went off, and the fire department arrived. No, I didn’t leave early. After we settled everyone down, finished the shift, and gave report, it was 9 pm before I finally I got home, and reheated for dinner the lunch I didn’t get to eat. I’m ready for a second glass of wine, are you?”

This story was just to good not to call my sister Raquel and tell her about it over wine by phone.

* * *

I had a couple of days off before my next shift. Like I said before, day shift is challenging in its own ways.

“Niki, the phone’s for you.”

I take the call from the pod outside my patient’s room. It’s Finch, one of the day shift pharmacists.

“About that Ancef dose your resident ordered,” he begins.

I block, “He’s not my resident. He belongs to the attending,”

“Well, whoever he belongs to, he’s placed an order in the EMR for Ancef.”

“Yeah.”

There’s not enough Ancef in all the hospitals in the city to cover the dose. You need to call him and point out that the kiddo only weighs 10 kgs.”

“Finch, the RT is here and we’re about the re-tape his ET tube. Can you call and get the order changed, please? You can educate him about placing orders while you do it.”

“That’s not really a function of pharmacy, Niki.”

“It’s not a nursing function either, Finch. Why does everything get turfed to nursing? Health care is a team sport, no?”

I interpret the the silence on the other end of the phone to mean he’s strategizing an offense.

“Alright, Niki, I’ll do it this time.”

“Thanks Finch, you’re a real gem.”

“Phfffp,” he mutters before hanging up.

* * *

At change of shift, I give report to my old night shift buddy, Liz, first telling her about the patient, and then Finch’s one-liner that the resident ordered more Ancef than what’s available in the city that was pretty hilarious, when I notice the bruises on her neck, three of them. They’re long and suspiciously resemble fingers. I can’t help myself, “Liz, what’s up with the marks on your neck. They look like bruises. What happened?”

Her gaze drops downward, and she turns her head the other direction attempting to hide the bruises, but not before I see her cheeks flush bright red.

“It’s nothing, Niki. I scratched myself.”

She’s lying.

“Liz, those aren’t scratches, they’re bruises. It’s me, Niki. We’re friends, remember? What happened?”

“I’m having problems with Nathan. He’s skipping school and failing his classes. He got suspended for smoking pot on campus. I called his dad, hoping he could talk some sense into him.”

“Frank, you’re ex did this to you?”

“I thought he could help, but when he came over to talk to Nathan he starting hitting him. I got between them. When I started yelling at Frank to leave, things got out of control.”

“He choked you? Oh my god, are you okay? Have you seen a doctor? Did you call the cops?”

“This is exactly why I didn’t want to tell you Niki. I knew you would overreact.”

“Overreact? Jeez, Frank was strangling you! He should be in jail.”

“Mind your own business, Niki. I appreciate your concern, but mind your own business,” was all Liz said as she stood up and entered her patient’s room.

It Makes Me Shudder (When the line between victim & perpetrator blurs)

 Chapter 23

 The police officer stands silently in the doorway of my patient’s room, watching as I listen to her chest with my stethoscope. Her breath sounds are clear and equal on both sides. Next, I check the tube threaded through her nose into her stomach. It’s draining dark green fluid into a suction canister fastened to the wall. I measure the amount of fluid in the canister and record that number in the electronic chart. I feel her pulses. They’re strong, and easy to find, coinciding with the numeric value for her heart rate on the monitor overhead.

When I’ve finished the assessment, the officer speaks. “I don’t know how you nurses do it. I couldn’t work with hurt kids. It would break my heart everyday.”

“I don’t know, I guess I think of it more as helping,” I offer. “I couldn’t be first on the scene like you police officers. I mean, putting yourself in lethal danger in order to protect the nameless public takes more heroism than I could muster.”

“I guess we just sort of pick the kind of work we’re able to do, then. By the way, my name is Mike.”

“Hi Mike, I’m Niki. I’d shake your hand, but I need to wash it first, after I take off the glove.  I don’t want to be rude, but I’m pretty cautious about spreading germs.”

“Understood. Thanks for the information.” Mike has a cute smile, and gentle eyes. “Well, I gotta go and see if the detective has any new information for me. If she’s cleared for now, is it okay if I send the mother in to see her kid?”

“Sure.”

“Well, Nurse Niki, if you have any questions about the case, or information for that matter, feel free to give me a call. Here’s my business card.”

I watch Officer Mike leave the PICU, holding his card in my hand. He seems like a nice guy. Maybe in a few weeks I will call him. Maybe it’s time I stop wearing my wedding ring on my right hand and take it off altogether. I put his card in the pocket of my jacket.

Half an hour later, my patient’s mother enters the PICU. She’s young, early twenties. She’s wearing grey sweats that hang from her slim hips over a pair of black plastic flip-flops. A blue and black hoodie drapes over her ribbed white tank top, revealing an equally skinny torso.  She looks like she doesn’t get enough to eat, but her acrylic nails sport elaborate nail art. She’s wearing huge gold hoops in her ears too. ‘Go large or go home,’ comes to mind.

Mariella, our social worker, accompanies her, and introduces me to the mother, who looks me up and down suspiciously before noticing her unconscious daughter on the hospital bed with all the tubes connected to her. She starts to cry. This is the cue I depend upon in order to form some sort of therapeutic bond with parents of abused children until who hurt the child? is established.

I drag a lounger from the other corner of the room to the child’s bedside, and Mariella settles the mom into it, and then fetches a cup of coffee, and a blanket from the PICU’s warmer. She wraps the blanket around the mom’s shoulders, before handing her her card, and leaves the unit.

An awkward silence fills the room.

“So. Do you have any questions?” I begin.

“How long is she going to be in the hospital?”

“We don’t know that yet. Hopefully, she’ll come off the breathing machine sometime tomorrow. She’ll probably stay another night here, then be transferred to the regular pediatric unit, and spend some days there too. She’ll go home when there’s no bleeding and the surgeon lets her up out of bed.” I avoided adding, “Unless social services removes her to their custody.”

“Why would she bleed? I thought the surgeon fixed her?” She eyes me suspiciously again.

“She repaired your daughter’s liver, that’s right, but a lot of the body’s blood travels through the liver. There’s always a chance that the wounds will still bleed. She could lose a lot of blood again if that happens. We’re watching her closely to prevent that. That’s what all of these machines are helping us do.”

“Oh.”

In my experience, parents involved in their child’s abuse take one of two stances with nurses: They are either angry and argumentative, or they campaign to win our sympathy. This mom chose the latter.

“He didn’t kick her, you know. He works hard, and when he comes home he expects things to be in order. Sasha isn’t a good girl. She doesn’t do what she’s told. I have to get on her all the time. She lies too. I don’t know why they think he kicked her. Maybe she’s got cancer and it’s making her bleed.”

“Sasha doesn’t have cancer. The doctors can see that with all the tests, and during the surgery too. He’s not Sasha’s father, right?”

“Naw. He left before Sasha born. He was no good.”

I fall silent taking in this information.

“Has he hurt you or Sasha before?” I know I’m going to have to chart her answer.

“He’s only mad when we deserve it. He don’t hit when we do what we should.”

“Have you ever thought that you and your daughter deserve to be safe in your home? That a man shouldn’t hit a woman or child, ever?”

“You got a man, Nurse? You know how hard to raise a child alone is?”

A sudden realization slapped me in the face: This woman and I are both single mothers, wanting to have relationships with men who are not the father of our children. I could be her. The thought chilled me.

We didn’t talk much the rest of the shift. In the morning, Mariella returned with a female police officer. They escorted the mother out of the PICU. Soon afterwards, Mariella returned.

“They’re taking her down to the station. The boyfriend is saying she kicked the girl. He says he tried to stop her.  We’re hoping she’ll file a report against him with the details of the assault, so he can be charged.”

“You might want to know,” she added, “The mom is known to us. We have an open file on her. Sasha was the result of rape by her mother’s boyfriend. And our boyfriend, we’ve seen him before too, when his father was arrested for breaking his arm.”

I can’t believe Mariella earned a Master’s degree to do this kind of work. I think her job is more difficult than mine.

Later, I talk to Liz about it. “I hate when the lines between victim and abuser are blurred like this. I don’t understand how a mother wouldn’t choose a better life for herself, and especially for her child.”

“You’re new at being a single mother Niki,” she said. “You’d be surprised how lonely it can be out there.”

Something about the way Liz says it makes me shudder.

I know I won’t be giving Officer Mike a call anytime soon, either.

Small and Scattered (Niki makes another decision)

Chapter 20

The next day was Saturday. Simon and a buddy drove the rig with the jet skis back to the dealer.

I hadn’t slept well.

I kept telling myself:

  • It’s no big deal; anyone can have a lapse in judgment.
  • People spend more money than they make all the time. I shouldn’t get so upset.
  • Simon had good intentions. The gift was meant to bring us closer together. Isn’t that what celebrating an anniversary is all about?

Then why am I so angry?

***

I made coffee. In the family room, Maddie sat on the floor watching TV with her chin resting on  the coffee table, intermittently scooping spoonfuls of cereal and milk up and over the edge of a bowl into her mouth.  Her backpack leaned against the sofa beside her. She’s spending the day with her friend Kaylee, and staying overnight. Kaylee’s mom will pick her up soon.

After Maddie left, I went for a bike ride, took a shower, and thought about lunch.

Simon returned without the rig. He smiled sheepishly.

“The dealer agreed to resell the rig for us. It was already a great deal, but now that it’s priced as used, he says it will go fast. We’ll probably only make one, maybe two payments before it sells.”

“How much of a loss will we take?”

“Less than $10,000, I figure.”

I had nothing to say.

“Okay, Niki, I get it. I was wrong to buy the jet skis, and cancel the Coronado trip without talking to you first. I get it. I won’t do it again. Can you just get over it, and let’s move on?”

I felt anger rising like a pot boiling over. I steeled myself to say the words I’d rehearsed,

“Simon, I want a divorce.”

“WHAT! Over jet skis? What’s wrong with you, Niki?

That’s right Simon, it’s me not you,” sarcasm escaped my mouth.

“Damn right it’s you! How can you break apart a family? Our family? Over jet skis!”

I paused before blurting out, “A family? Yeah, a single parent family! You’re impulsive, Simon. It’s like being married to a child. You’re a crisis about to happen. You only think about your needs, your wants. Putting us in debt without talking to me about it is just a part of our problems.

I take care of people all night long at work, then I come home and take care of you. The kitchen sink is always full of dirty dishes from the night before, and the garbage overflows. I get up, clean house, and go back to work, while you watch sports on TV.

If I go on like this, I’m going to shatter, Simon, and the pieces will be so small and scattered, I’ll never gather them up and put myself back together. I need a partner Simon, not another child. For all I do around here, I may as well be a single parent. It can’t be any harder than this already is.”

Well, it’s not like you work five days a week like I do, Niki.”

I hissed at him, “I want a divorce, Simon. I want to be happy.”

“Is this about that ER nurse, what’s his name? Are you sleeping with him?”

“No I’m not sleeping with him. Corey’s married. I’m not a home wrecker!”

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