The Making of a Nurse (28 page)

“How so?” I had just been regretting that I hadn’t warned the wife that might happen.

“Casey’s patient just died, so she’s free to take this new patient.” Roberta flips on the overhead light and the cardiac monitor, which emits a humming, then a buzzing, as if it, too, is gearing up for the action ahead. She goes out into the hall to stop Tariq, the respiratory therapist, to let him know that a patient is on the way. “She’s a twenty-five-year-old, found unconscious at home, with an empty bottle of Tylenol beside her. She’ll be here in a few hours by helicopter from Sudbury,” she tells him so that he can get a ventilator ready. “Yes, Casey will admit her,” she explains to me, “as soon as she finishes her arts and crafts project, or whatever it is she’s doing.” Roberta waves at Casey, who’s sitting at the nurses’ station, busy with yards of bright pink fabric. I stop to ask Casey what she’s up to and pull out yards of silky fabric from her huge shopping bag. There’s a salami sandwich in there, too, I see. Until her patient arrives, she’s working on a bridesmaid’s dress she’s making for a friend’s wedding.

Trina needs our help. In preparation, we don gowns, masks, vinyl gloves and with Jenna and I on one side of the bed, we roll the patient toward us. Trina is on the other side with a pile of wet, warm washcloths ready to get to work. It started with a few dabs, then a smear. Now, it’s a slow ooze.

“That’s it! I’ll never be able to eat chocolate pudding again,” Jenna whispers and looks away.

Shhh
, we say, suppressing our own equally unsavoury, naughty, uncharitable, unprofessional thoughts.
Thank goodness the patient is unconscious!

Now it’s morphing from dark squirts to bubbly ribbons. It’s flowing, gathering speed. I hand Trina more wet washcloths and picture the little Dutch boy with his finger in the dyke to stem the flood. I cough a little to expel the smell. Stay focused on the patient, not the smell or the sight, Frances used to say to me. It’s advice that actually helps. “You’re doing fine,” I whisper into the patient’s ear, whether he can hear me or not.

Now it’s a river, pouring out faster than Trina can wipe it away.
Rollin’, rollin’, rollin’, …
We stand there, waiting it out while it streams down the patient’s legs, into the folds of his scrotum, around his catheter. Our gloves are slippery and there are now flecks and streaks on the front and sleeves of our gowns. It’s a force of nature, like lava pouring forth still smouldering from inside a human cave.

This experience is no longer what it was for me in the past, but I had to overcome my own shame before I could help patients deal with theirs. I do not consider this work demeaning or degrading. It is not humiliating, disgusting, or repulsive. It is not boring or tedious or anxiety-provoking. I accept it. It is what it is. It’s life itself. It’s an opportunity to help restore dignity and I do it with as much finesse as I can. I put my hand on the patient’s shoulder. “It’s okay,” I say.

It has taken me such a long time to get here
.

We stay until the flow abates sufficiently for Trina to put the finishing touches on the job by herself and we hustle out of the room. We strip off our gowns and gloves and gather at the sinks and now that we are sufficiently out-of-range and “offstage,” we let loose, a little.

“That was a
poo-nami!”
Jenna says, laughing helplessly. “It reminds me of the time a patient shit on my head,” she says. “I’ll never forget it. It was purely accidental, of course, but I was leaning down to tuck in the sheets and out it came, spurt, spurt, spurt, all over me. Liquid poo was dripping down my bangs and forehead. I ran out and hosed myself down.”

“Why do so many of our patients have diarrhea?” I muse. “Is it from the antibiotics? The feeds? The stress?” (Note to self: Do an online search of diarrhea-related scientific literature.)

“What about my invention?” Theo comes over to tell us. “Before giving the patient a bedpan,” he explains, “first, line it with an incontinence pad. That makes it warm and cozy for the patient’s bum and afterward, voilà, you wrap up the entire bagatelle, that splendid little package, and dispose pronto. No rinsing or scraping. No spraying and having back splash comin’ at ya! Make sure you prepare another one all ready for the next event!”

“That is life-changing advice, Theo,” I say solemnly, sincerely.

Monica’s gone on her break. I check on the patients and then dash out to get some supplies. On the way back I run into Jenna, who looks worried and I’m fairly certain it’s not about her ovulation cycle. “Take a look at this.” She hands me a clipboard upon which her patient has written a note to her. “Ever since I lightened his sedation he’s been frantically trying to tell me something.”

It’s a wobbly scrawl, but we make out “daughter” and “alone.” Jenna’s patient has pneumonia related to
HIV
he got from sharing needles. “I asked how old his daughter is and I’m pretty sure he held up six fingers.” Jenna looks worried. “Do you think he’s trying to tell me she’s been left alone?”

Roberta comes over, flipping through the chart for clues. “He was brought in by ambulance to emerge. No one came with him.
There’s nothing in the chart.” She sighs. “They could look into it on the day shift,” she thinks aloud, “but on the other hand, it might be urgent. I’ll call the police and ask them to check into it,” she decides and hurries off.

Midnight is 0000 hours in our digital world. Is it the end of the night or the beginning of the next day? Is it today’s date or tomorrow’s? So far, this night is allowing me to consider such imponderables. I listen in on Roberta talking to a family member at home. She’s trying to soften the blow after the doctor called to tell them their eighty-four-year-old father died. (It’s not in her to fabricate by telling people their loved one has “taken a turn for the worse,” even if they have just died so that they won’t drive crazy on the way in like many well-meaning nurses do.) That must have been Casey’s patient, I figure. He had an abdominal aneurysm and was scheduled for surgery the very next day, but the family doesn’t seem shocked by the news. Roberta offers them the opportunity to come see the body, but they decline. “I’m sorry for your loss,” she says.

I get up to stretch my legs and set off, on the prowl for something sweet or salty to nibble on, out of a vague restlessness. I see the nightly congregation about the nurses’ station has begun. We’re a few steps away from our patients’ rooms and can be there in a jiffy if needed, but for a few moments it is as if we are a world away. It’s our communal campfire and there’s no denying that at times, there’s a festive, party atmosphere that must seem so heartless to anyone passing by. Here we sit with our jellybeans and pretzels and over there are the patients, stretched out with their tube feedings and
IV
bags. We are chatting and laughing while they are intubated and unconscious. Not for one moment are we oblivious to the fact that they are not exactly having quite as merry a time as we are, but somehow, that brief, frivolous interlude fortifies us to return to our patients. Perhaps at times we do get carried away. I remember a patient on the floor telling me once, “I heard you guys and dolls whoopin’ it up last night. Having a party, were you?” I apologized
for keeping him up. “Yeah, but it was also kinda nice hearing your young voices and knowing at least someone is having a good time,” he admitted.

Tonight we’re worrying about our hands, the tools of our trade. We examine them for cuts, abrasions, contact dermatitis, and rashes. We bemoan the antimicrobial hand lotion we have to constantly use, and how it dries the skin.

“It’s the powder inside the gloves that irritates them, makes them itchy.”

“My hands are raw! Worse on the days I work and on my days off, they kind of recover.”

“All the handwashing we do is rough on the skin.”

“I can’t stand wearing gloves. It’s not the same, you know, when you touch a patient through vinyl. It’s like wearing a …”

“Yes, yes, we know, we get it.”

We moisturize. We debate the merits of glycerine, lanolin, shea butter, and plain old Vaseline. We vote for the most effective barrier cream, the best emollient, and estimate the number of hand scrubs per shift. We keep our hands in good shape, the way a chef cares for his set of knives or a musician tunes his instrument. We were impressed when we heard about a hospital that gave out leather manicure kits for Nurses’ Week – much preferable to the coffee mugs with the hospital’s logo, pizza vouchers, or free doughnuts, we all agreed.

I greet Chandra, who’s also on tonight. She’s dipping her fingers into an industrial-sized pot of something called “Bag Balm,” working it into her hands. It smells like a barnyard. “Have you seen what it says here?” I read the label. “For veterinary use only. It’s a ‘soothing, penetrating, healing ointment for caked bags, sore teats, and chapped, hard milkers. Apply to udders before the night milking and again before the day milking.’”

“If it’s good enough for Shania Twain, it’s good enough for me.”

“She uses it? What’s wrong with
her
hands?”

I put to them a question I’d been thinking about. “Could you be a nurse if you were blind?” They ponder a moment then mostly agree. Even in a wheelchair, you could be a nurse, they say. “But what if you didn’t have use of your hands?” Ahh, that’s different, they agree. No, without hands, you couldn’t be a nurse.
“That’s what I think. No gadget, device, piece of equipment, or trained monkeys will ever replace the hardworking human hand, for its capacity to soothe,” I say, bringing them around to my foregone conclusion.

Roberta makes like she’s playing the violin to my sentimental observations.

“Oh, cry me a river!” says Jenna.

Theo joins us and we admire his beautiful hands and the elegant gold and sapphire band he’s been wearing on his ring finger since his recent wedding to his partner, Phillip. “Boop-boop-dee-boop,” he sings out, giving a little skip and kick of his heels before plopping himself down onto Roberta’s lap. He has shown me pictures of when he was a drag queen and won the Ms. Gay Halifax Pageant and, I must say, he looked stunning in his pale blue ball gown.

At the start of every shift, Theo swoops into the
ICU
and envelops each person he encounters into a huge embrace and plants a kiss on every cheek of each doctor, nurse, hospital assistant, porter, housekeeper, respiratory therapist, ward clerk, family member. “I darn near got a hernia leaning into your bed to give you that kiss,” I once heard him say to a patient. No one is left unhugged or unkissed by Theo, whether they like it or not, and most everyone does. (And if at first they aren’t completely comfortable with such florid demonstrations of affection, they soon get used to it and even begin to crave it.)

I’ve often wondered why there aren’t more men in nursing. Back when I graduated in 1983 about 2 per cent of nurses were male. Nowadays, they say it’s about 5 per cent – not much progress toward gender balance. I have worked with only a few dozen men over the years, most of them decidedly straight, quite a few openly gay, one (that I knew of) who was transgendered, and a few undecided – but who cares? What difference does it make? What is really mind-boggling is that there are not more men in nursing, still in 2007. I once asked Theo how he chose nursing.

“It drove my father crazy when I told him,” he said, “but I think he’s come around. I’ve always known I wanted to be a nurse. The guidance counsellor at school spent two hours one day trying to get me to change my mind. He said, ‘Theo, what about medicine
or law?’ But I didn’t want to be a doctor and I knew I wasn’t a good enough liar to be a lawyer!”

“Why aren’t there more men in nursing, Theo?”

“It’s different for gay men. We don’t feel we have to hide our soft, caring side, but most straight guys are afraid it will make people raise questions about their sexuality.”

I can feel my own soft, caring side beginning to flag at this time of the night, so I ask Roberta to recite one of her latest poems to perk us all up. Not many know that in addition to her vast store of rock ‘n’ roll trivia, Roberta has another talent. She is secretly a poet. “I tossed this one off this morning, before going to sleep.” She pulls a sheet of paper from her pocket. “It’s called ‘Just One Shock.’”

How true
, we murmured, appreciatively.
At least someone has the guts to tell it like it is
.

Theo gets up and stretches his arms over his head. “Tootle-loo, chums. See ya, later.”

Chandra returns to her patient so that her partner, Tikki, can get away for a break and Jenna has already left. She seems in a much cheerier mood since her pager went off a few minutes ago and she showed me the text message from her husband, who is a policeman, also working the night shift. “I … LOVE … YOU,” the digital letters spelled out. I don’t think I’ve ever seen anything more romantic.

I stay behind with Roberta, who is quiet. She has told me about her latest family worry. In addition to one son with autism, her other son was just diagnosed with Tourette’s Syndrome. “I used to call us the A-team, but I guess now, we’ll be the ‘T and A’ team,” she says.

I want to tell her again that I admire how she deals with her challenges, but it makes her cringe whenever I do. “You gotta do what you gotta do. You’d do the same if you had to,” she’s told me. “It’s like being a nurse. You don’t want to be thought of as a hero or an angel. You’re an ordinary person doing a difficult job with good days and bad days.” She gets up to make her rounds, but before she goes, I can’t resist.