The Shift: One Nurse, Twelve Hours, Four Patients' Lives

by Theresa Brown

To avoid casting aspersions on a particular practice group I made up the incident where a procedure is done only because a patient requests it.

Like many nurses, the thing I’m always worried about is doing either too much or too little. If I sound an alarm and the patient is OK, then I over-reacted and have untrustworthy clinical judgment. If I don’t call in the cavalry when it’s needed, then I’m negligent and unsafe for patients. You don’t always know because what goes on inside human bodies can be hidden and subtle. This job would be easier if there weren’t such a narrow divide between being the canary in the coal mine and Chicken Little.

Time passed like liquid honey pouring out of a jar, slow and just sweet enough.

I remember the creamy taste of my latte, the electric connection between the two of them, the crumbs of bright green spinach wrap left on Ray’s plate, the future hanging pendulous, infinite.

I believed it, when I knew that, for better and for worse, time never stops for long.

I pick up the papers for my patients, fingering them with the contained apprehension of a poker player gathering in a hand on which she’s already bet more than she can afford.

When I taught at Tufts I was Theresa

We’re told the filters were put in place to keep nurses from using social websites at work and in general to keep nurses from surfing the Web when we should be working. I don’t honestly know if that’s an issue. Maybe it is. All I can say is that no nurse I know wastes time on the Internet when there’s work to be done.

Because cell death hurts, patients having heart attacks complain of crushing chest pain.

“Work is love made visible. And what is it to work with love?” the poet Khalil Gibran wrote.

I head down the hallway to the locked narcotics room, where I punch in the code, then key in my individual password to our Pyxis machine: the multi-drawer device that dispenses opioids and other pain medications. Rushing back, I stop and take the time to type the drug order into the computer. Paperwork delayed can end up forgotten and this is a narc. I need to do it right so it doesn’t look like I’m stealing drugs. I record that an MD ordered the drug and that Sheila got the correct dose on time.

It strikes me that my behavior with the escorts is not that different from the attending’s behavior toward me. Maybe that means the attending, like me, is just trying to do his job as best he can. Or maybe it means we should all try a little harder to see each other as human beings.

To see a World in a Grain of Sand And a Heaven in a Wild Flower Hold Infinity in the palm of your hand And Eternity in an hour William Blake wrote those lines more than a century ago and he was on to something.

She will have pain, her blood pressure will need watching, and her blood itself has already been revealed as untrustworthy. Getting the timing right is critical, so I’ll be following the rain, but looking for the light. I believe there will be light if only I can find it in the storm.

I hold infinity in the palm of my hand, and eternity in the next few crucial hours.

“They also serve who only stand and wait,” the poet Milton said.

If donated cells differ in blood type from the patient’s own, that person’s blood type will actually change after transplant and engraftment. I used to think blood type was as fixed as eye color or having dimples, but it isn’t. It can change, does change, as a side-effect of the treatment given to save someone’s life.

I want five minutes to collect my thoughts, go get some tea, maybe, not feel responsible, when— “There you are!” It’s Candace. She’s put a hospital gown over her sleek black yoga pants and has another gown on backward, ensuring that her back is completely covered.

She has to leave early. Has to? This nurse often leaves early while the rest of us scramble. Or maybe I just notice it, and mind, on the days I’m especially busy. The position she has is half regular nursing, half management and she’s salaried, not paid by the hour, so no overtime when she exceeds forty hours per week. If the idea behind getting a salary is to elevate the staff to a new level of professionalism it hasn’t worked for this particular RN. Truth is, she’s older, has some longstanding problem with her back, and never calls-off no matter how much her back hurts. Her straight brown hair is cut in a severe line at shoulder-level and her half-glasses hover halfway down her nose. She’s put in her time pushing the rock and now she’s tired. I understand. Of course I understand because I’m also tired and I’ve been a nurse a lot fewer years than she has.

Kisses in the hospital, real kisses, are as the six pomegranate seeds must have been to Persephone in the underworld: rare, enticing, a taste of life impossible to resist when you’re stuck in hell.