The Nurses: A Year of Secrets, Drama, and Miracles with the Heroes of the Hospital (16 page)

Not all assailants are patients who are mentally compromised. “I don’t have patience for the completely lucid adult patients who abuse us,” said a Maryland medical/surgical nurse whom patients have hit, kicked, and pinched so hard she developed bruises. “I’ve had trays, pills, and cups thrown at me. There was nothing done about any of these things. I told my manager and the general message I received was ‘This is the way it is. It’s just part of the job.’ You can call security and they’ll maybe tell the patient to stop, and then they’ll go back downstairs. There are so many restrictions that make it hard for nurses to stay safe. You can’t restrain a patient who is mentally competent, unless they’re hurting themselves. Police won’t arrest them because they need treatment in the hospital. If you assaulted a police officer or any other professional on the job, you’d be in big trouble. But nurses are assaulted every day and there is little to no protection or justice.”

Never mind that many hospitals aren’t providing counseling or other resources to help assaulted nurses cope with the distress that lingers after an attack, including insomnia, flashbacks, anxiety, and other symptoms of post-traumatic stress disorder. In nearly three-quarters of assaults against ER nurses, hospital management never even responds to queries from nurses who are attacked (according to those nurses). “They want the nurses to ignore it, partly because they don’t want the liability, but mostly because people outside of nursing just assume since the patient is elderly or mentally ill, they don’t know any better. Right. Let me sit here and get my ass kicked because ‘she doesn’t know what she’s doing and doesn’t mean it,’ ” Molly said. In hospitals, the shrug-it-off culture forces nurses to endure treatment that would not be tolerated in any other profession.

More assaults occur at acute-care hospitals than any other workplace, according to the Bureau of Labor Statistics, and the majority of these healthcare assaults target nurses. Yet many hospitals don’t train nurses how to manage violent people. As an Emergency Department chairman told me, “My residents get more training than my nurses do,” even though nurses are assaulted more frequently than doctors because they are more often at the bedside.

Hospital administrators aren’t the only people dismissing the victim. In 2012, Tennessee state senators debated a bill to strengthen penalties for people who assault healthcare workers. Senator Ophelia Ford gave an odd, rambling statement in which she complained about “mean and hateful” nurses during her own medical care and not getting a private room. She concluded, “To come before this committee and ask for this kind of thing is ludicrous.” The bill passed the committee anyway with a five-to-four vote, but attacking a nurse is still only a misdemeanor in Tennessee and twenty other states.

When workplaces put measures in place to protect their staff, the results can be impressive. The Veterans Administration Medical Center in Portland, Oregon, installed a computerized database to identify patients with a history of violence, so that staff members would know to take additional safety measures, according to the National Institute for Occupational Safety and Health. The program helped to decrease the number of violent attacks by an astounding 91.6 percent.

The prejudice against nurses is alarming and dangerous. In 2006, Brenda Coney, a patient in Jacksonville, Florida, pulled a knife on another patient. The hospital called the sheriff’s office, which filed a police report. Two months later, when Coney slapped a nurse twice in the face, the hospital ignored the incident. Later that same month, Coney returned to the hospital, where she shot and killed a pharmacist.

If nurses are ignored, blamed, or laid off when patients assault them, what happens to other hospital staff members? Consider the case of Paul Matera, who worked in Washington, DC. A trauma patient who had been stabbed punched Matera in the back of the neck, rupturing several discs. Matera, who continued treating the patient almost immediately, needed three surgeries (covered by workers’ compensation insurance) to repair his own injuries. He didn’t press charges because, he said, “He was a young guy under the influence of alcohol and cocaine and under duress from his own trauma, so I felt he likely did not know what he was doing.” But Matera wasn’t a nurse. He was an ER doctor. So his hospital didn’t fire him or fault him for the attack. Instead, Dr. Matera received an entirely different sort of response: The American Medical Association gave him the rarely awarded Medal of Valor for “courage under extraordinary circumstances in nonwartime situations.”

Now in her third month as a nurse, Sam was certainly more confident than she’d been back in August. She enjoyed the work, even if Citycenter’s ER was crazy. The patient load was enormous, but as a result, she had treated so many people that she no longer felt like a brand-new nurse. She relished learning something interesting every shift.

By focusing on the work rather than the environment, Sam could even put up with the spontaneously high-kicking CeeCee, whose personality continued to grate on her. Sam tried giving her the benefit of the doubt, because CeeCee was the type of nurse who jumped in to help without being asked (and even if her help wasn’t actually needed). Yet the way CeeCee went about helping made it seem as if she were doing so not to alleviate another nurse’s workload or to improve patient care but because she wanted her fellow nurses’ gratitude and adoration.

That was okay. Sam could let that go. One thing about being an introvert—because you avoided drama, it was easy to let petty matters go. And the other nurses were mostly gracious and willing to teach her. On rare occasions, Sam was lucky enough to share a shift with Shirley, a well-respected nurse practitioner who cheerfully answered any questions Sam had about being an NP. Shirley told Sam that she could do nearly anything in the hospital that ER residents did.

William, in particular, seemed to get a kick out of Sam. “You’re so funny, Sam,” he told her once. “You’re so quiet and then suddenly you speak up—‘Screw this!’ It’s like, tell me how you really feel.” Sam was enjoying getting to know him, too. They had several mutual interests outside of medicine, like biking and swimming, and he was easy to talk to.

But Sam was still disheartened by how difficult it was for nurses to find respect at Citycenter. “Nurses are really looked down on by residents. Some residents are amazing, but others you just want to drop-kick,” she said.

Dr. Spiros, who pulled ER night duty about every three weeks, continued to fall into the latter category for her, which was frustrating because everyone else seemed to love him. Sam’s style of speaking was casual, but Dr. Spiros’s was not. So when Sam asked, for example, her cheeks flushing, “Hey, Dr. Spiros, do you mind if I get some morphine for Mr. Neberz?” he was short with her. Half the time, he didn’t even look at her. Granted, she tended to run into him when both of them were stressed or tired. And her attempts at nonchalance probably didn’t mask how awkward she felt approaching the busy senior resident.

One night, a nurse mentioned that Dr. Spiros had helped her out of a tight spot with a seriously ill patient.

Sam scoffed. “He wasn’t an ass?”

The nurse looked at Sam quizzically. “Oh, no, no, no! He’s a nice guy who did right by my patient.” The nurse told her that Dr. Spiros had gone through a sad divorce the year before. “When he told me about it, he got all teary-eyed and said he just wanted to find the right person,” she said, shaking her head sympathetically.

“Really? I just find him pompous,” Sam said.

“Oh, but he’s so nice. Seriously, he’s Mr. Nice Guy.”

Sam doubted that. An hour later, when Sam went to the minor care nurses station to document patient information, Dr. Spiros was telling another nurse about his recent trip to Greece. The other nurse brought Sam into the conversation before she left.

“I’d love to go there someday,” Sam said.

Dr. Spiros pointed to the surname on her badge. “Where’s that name from?”

“I’m Greek, can’t you tell?” Sam answered.

“That can’t be right,” he said.

“My grandparents lived closer to Italy.”

Beneath his tousled hair, Dr. Spiros fixed his deep brown eyes on Sam as if she were the only person in the room. “Oh, really. So you’re supposed to be pretty fiery . . . ” He grinned at her. “And ‘Sam’? Not short for Samantha?”

“Salome.”

“Salome! It means ‘peace.’ Fitting.” He raised an eyebrow. “So, Sam. Why are you so quiet?”

Sam adjusted her glasses for a moment to avoid the intense gaze of this hunky doctor. Why was she quiet? There were several reasons. She liked to observe her surroundings, to soak them in, rather than to insert herself clumsily into them. Somehow the words in her head rarely exited her mouth as elegantly as she had hoped. She preferred to “feel things out” rather than charge headlong into a situation. And she didn’t believe in jabbering only to fill a silence; silence could be beautiful, and illuminating.

When she looked up, Dr. Spiros was still smiling amiably at her. “If I’m talking then I can’t listen, and if I’m not listening, I won’t learn,” she said, sincere.

“You’re like a little mystery,” he mused.

For the next ten minutes, Dr. Spiros gradually drew Sam out by asking her about local Greek restaurants. He had unknowingly hit her sweet spot. She found it easy to speak enthusiastically about food.

That night, as Sam did her rounds, she reflected on the conversation.
Okay, maybe he is a nice guy
, she thought.
He must have just been off whenever we’ve interacted before
.

When Sam woke up the following afternoon, she sent Dr. Spiros a Facebook message to reinforce their positive momentum. “Hey! Thanks for livening up the shift!”

He wrote her back quickly. “Likewise. What was the name of that especially good Greek restaurant again? Perhaps we should go there together.”

Well, this was interesting. She had not seen this one coming. Dr. Spiros was more than ten years older than Sam and had a strong reputation at Citycenter. She was hesitant to date someone she worked with again. She had dated a murse for four months when she was a tech at Pines, and had later regretted it; the murse was fun but too immature. After she broke up with him, she knew that he had spread rumors about her, blabbing to the staff that she was a wild woman in bed. Hospitals were small worlds. It was hard to command respect in an environment in which people assumed she was promiscuous.

Dr. Spiros had already made the move, though, which meant that she was destined for awkwardness either way. Sam felt obligated to give him a chance because he had asked her. Maybe it could work out. After all, she had apparently already misjudged him as a pompous ass and he had proved her wrong. And she preferred relationships with medical professionals anyway, because they understood her interests and schedule better than anyone else.

During her next shift, Sam did some subtle investigating. Dr. Spiros was supposedly dating a tech, but after some small talk with another tech, Sam discovered they’d broken up. The following day, he asked when Sam was available for dinner and they worked out the logistics.

That night, Sam sought out William at the nurses station. She told him that Dr. Spiros had asked her out. “Is it crazy for me to do this? If this is a bad idea, I don’t want to do it,” she said. “I’m not in love with him or anything. I don’t need to make life tricky for myself.”

William gave her a look that she couldn’t interpret. “I guess there’s no hope for you and me then,” he said. For a moment, Sam gazed into his soulful eyes and wondered briefly if he was flirting or joking.

She quickly dismissed the thought. “Get to the point,” she said. “We’re not talking about you and me.” She wished they were. William was the man of her dreams. Sam could see no reason why he would be interested in her. From what she had heard, his long-distance girlfriend was beautiful, generous, and a heck of a nurse.

He had, however, made a point of teaching Sam some valuable nurse tricks, such as a way to outwit the Pyxis in order to get extra medication for a patient without having to wait for the pharmacy. She appreciated his subtle manner of instructing her. He would say, “You can do this your own way, but I like to do it like this.” He was the ideal nursing mentor: caring, approachable, and wise.

William exhaled. “It’s fine to see Spiros. Just don’t go making out in the on-call room.” Sam had heard rumors about the on-call room. On a few occasions, while wheeling patients to the elevators, she had heard unmistakable rumblings from behind that door. Hooking up in the hospital was definitely not Sam’s style.

Nurses were buzzing about a cookout that Anastasia, the leader of the nurse clique, was hosting for hospital staff. Juliette could see Anastasia inviting several of their coworkers and mutual friends on their individual Facebook walls. She waited for Anastasia to invite her. Anastasia was calling it the Pines Memorial Cookout, for Pete’s sake. She had even invited Charlene, and Juliette knew that Anastasia didn’t like Charlene.

Juliette had considered unfriending Anastasia so that her Facebook posts wouldn’t torture her anymore. But everyone at Pines was Facebook friends with one another, and the nurses were constantly Facebooking at the nurses station. Juliette had joined Facebook when she was hired at Pines specifically because the network was an integral part of those nurses’ lives.

Juliette’s favorite tech noticed that Juliette’s mood had dipped. “What’s bothering you, Juliette?” asked Mimi.

“The whole Anastasia thing about the party,” Juliette said. “I can’t believe she didn’t even invite me.”

“Oh, I wouldn’t worry about that,” Mimi said.

“I do worry about that!”

“Anastasia’s the kind of person who will walk by me and not even say hello,” Mimi said.

“Really?” At least Anastasia was cordial to Juliette in person.

“Absolutely. She’s just part of that clique,” Mimi said, shrugging as she left to check on a patient.

Juliette wished she could ignore the clique’s behavior like Mimi did. Then again, Mimi probably didn’t have Juliette’s insecurities; she was slender and fit.