The Nurses: A Year of Secrets, Drama, and Miracles with the Heroes of the Hospital (3 page)

As Pines Memorial’s treatment of nurses deteriorated under Westnorth, Molly had toyed with the idea of leaving the hospital. Earlier in her career, she’d worked as a nurse for an agency that assigned her shifts at different hospitals. As an agency nurse, she could choose which days she worked, and the pay was slightly higher. To return to the agency, where she was a nurse in good standing, all she had to do was fill out paperwork and send in her latest certifications.

Molly had stayed at Pines because she enjoyed learning from her experienced colleagues. But lately, there had been too many days like today. That night, she called Priscilla and left a voice message about the day’s events. “I have gone home angry and in tears more in the last two months than I have in my whole career. If I leave work angry again, I will not come back.” It may not have been the best way to let her boss know that she was close to quitting, but she was too frustrated to care.

The next morning, Molly, the designated trauma nurse, was able to focus exclusively on her patients without having to deal with politics, or so she thought. A middle-aged woman had multiple injuries from a car accident, and the operating team would have to repair her ruptured spleen. Molly’s job was to keep her stable in the trauma room until the OR was ready. As Molly connected the patient to a monitor, a nurse sitting at a computer called out from the nurses station.

“You’re going to love this one, Molly,” she said. “Now we’re going to have to pay for fancy uniforms!”

Molly froze. “What?” She breathed deeply. She had a patient to take care of. “Just a minute. Let me finish what I’m doing and I’ll come over.”

While Molly continued to work on the patient, the other nurse read aloud the policy, which administrators had posted on the employee website without notifying the ER nurses. All staff would now be required to wear a standard uniform. But only the nurses would have to pay for the uniforms out of pocket.

“What about the doctors and the techs?” Molly asked.

“Nope,” the nurse replied. “They’re covered.”

That was the last straw. It wasn’t the uniform, specifically. It was what the uniform expense represented: Pines didn’t appreciate its nurses. Furthermore, management gave employees little motivation to work hard. Hospital employees weren’t held accountable for their actions, and the supervisors were either too wimpy to enforce important hospital rules (Priscilla) or played favorites (Charlene). Too frequently, certain nurses and techs called in sick, then posted vacation pictures on Facebook. Or they were unprofessional: Lucy, the laziest tech in the unit, had refused to do lab work on patients she deemed too “gross” to touch. As Molly said, “There are no consequences for poor work ethic and no rewards for good work ethic.”

Later that morning, Priscilla gathered the ER nurses to tell them about the new uniform policy. While the group splintered into side conversations, Priscilla brushed her dark bangs off her face and put a hand on Molly’s arm. “I got your message,” she said.

“This place is coming apart at the seams,” Molly told her.

“I know.”

“I’m holding to my word on my message yesterday.”

Priscilla nodded, placating.

“I’m not changing my mind,” Molly said. “I’m giving you one month’s notice. The uniform is just the last straw.” She could call the agency tonight, start the re-registering process, and begin orientation within weeks. She was giving Pines Memorial ample notice because she didn’t want to leave her coworkers even more shorthanded.

Throughout the rest of the day, nurses complained about the policy. “They’re kicking us when we’re down,” they said. “The changes are making things worse.” They looked at Molly because she was one of the most outspoken nurses.

“Doesn’t matter to me,” she said. “I just quit.” Her coworkers laughed dismissively. “No, I actually did, y’all. I gave notice.”

Generally, Pines Memorial’s schedules were flexible and fair, and Molly had come to value the nurses’ intelligence and ability to stay cool under pressure. But, she thought,
I can’t be angry at work every single day.

Molly had originally decided to make the career switch from occupational therapy to nursing after her mother had passed away. While in mourning, Molly received several letters from her mothers’ coworkers. The letters “talked about her being the best nurse they had ever known, how much fun she made work, and how much the patients and her coworkers respected her,” Molly remembered. Inspired, Molly became a nurse, too, at the age of 27—ten years ago. “I’m not that touchy-feely, but I truly love nursing. It’s a meaningful career, I’m good at it, and it’s flexible,” she said. “You can find work any time of day, any day of the year, which makes it mom-friendly.”

Molly had wanted to be a mom for as long as she could remember. After three years of trying to conceive with her police officer husband, Trey, she had finally scheduled an appointment at a fertility clinic. As an agency nurse, she would be able to arrange her schedule around her clinic appointments.

More experienced colleagues kept telling Molly that once she worked at several other hospitals, she would realize that Pines wasn’t that bad. “Will I find out from working at other places that that was really as good as it gets?” she wondered. Experiencing hospital life at various institutions was the best way Molly could discover whether anybody was treating both nurses and patients right.

She gave herself a year to find out.

On her way to the staff locker room, Lara stopped in her tracks. The half-used vial of Dilaudid, a narcotic five to ten times more powerful than morphine, lay on a counter. It seemed to shimmer with energy and promise.
You deserve it
, coaxed a voice she remembered well.
You’ve been working fourteen-hour days. Your mom just died. She died in your arms. It will make you feel better. It’s sitting right there. No one will know. You want it. Take it.

Lara had been a drug addict. It had started so innocently. Nine years ago, as a single 26-year-old nurse, Lara was chatting with the other nurses on the night shift about paying off school loans, when one of them said, “Did you know you can get four thousand dollars per egg if you donate them? We should all go together.”

“That’s kind of cool,” Lara had said. “I’m young, I’m healthy, and it’s easy money.”

The next morning, the four nurses went to a clinic for the screening process. Lara, with her blonde ringlets and fair skin, was the only donor selected. After the multi-week process of egg retrieval, the doctor handed her a check and a prescription for Percocet.

The pill was the first narcotic she had ever taken. Within minutes, she was simultaneously giddy and calm, suffused with warm happiness, the world’s best buzz. She couldn’t stop giggling. Nothing bugged her. Her insecurities—about her dating life and her skinny boy’s body, which was never fit enough for her standards—dissolved. The next day, she took another pill. She didn’t think twice about it. It was her prescription, it energized her, and there were no side effects.

At work she was chattier and also more mellow than usual, and she managed to stay cheerful even while dealing with ungrateful patients and tedious charting. She skipped lunch breaks. When she finished the pills, a girlfriend who didn’t need her prescription anymore offered the pills to Lara.
Why not?
Lara thought. That week, she took three pills at a time.

A few days after the bottle emptied, Lara started to feel sick. That afternoon at work, she remembered that she had morphine in her pocket, 1 milligram left over from a patient. Back then, hospitals weren’t as vigilant about counting the “waste”—the surplus drugs left over from patients’ prescribed doses. Nurses went home, shrugged off their scrubs, and dumped their pocket contents into the trash.

She fingered the vial, running her thumb along the smooth, cool glass.
If the Percocet made me feel that good, maybe morphine will, too,
she thought. She returned it to her pocket to use at home. There was no inner voice asking her what she was doing, no angel on her shoulder imploring for restraint. It was just a little shot in the arm to take the edge off the day. She would never actually take narcotics at work, she told herself.

For the next several months, Lara conveniently “forgot to waste” leftover narcotics. Instead, she brought them home and stashed the Percocet, morphine, or Dilaudid in her underwear drawer. In the beginning, the drugs popped into her mind only occasionally, an elated realization like finding a twenty-dollar bill at the bottom of a purse:
Oh! I have extra narcs in my pocket!
She brought home vials about twice a week. It was too easy. Even once her hospital began requiring nurses to dispose of the excess in front of a colleague, the drugs were there for the taking. “Hey, I’m wasting this milligram of Dilaudid,” Lara would say, and the nearest nurse would hardly look up as she scribbled a signature. No one bothered to watch whether Lara actually threw out the vial, a procedure intended to prevent exactly what Lara was doing.

Not only was she able to do her job while taking the drugs, but she also had more energy than she knew what to do with. She worked additional hours for overtime pay. She justified the drug use by telling herself that her increased energy made her a more productive nurse. “You’ve heard about soccer moms being able to do everything on Ritalin? That was me. I could work! I could do ten thousand things and no one suspected why.”

Within months, Lara’s tolerance increased and her main concern at the hospital became collecting more drugs to bring home. One milligram wasn’t enough to spark a buzz, and she felt fatigued if she tried to go more than a day without taking something. So she signed up to work every day—zero days off—to get access to the meds because she didn’t want to feel tired. She was often sick to her stomach, but didn’t make the connection between her stomachaches and the drugs.

If you had asked Lara before she donated eggs what she thought about people who took narcotics, she would have responded, “Why on earth would someone do that?” Now it did not occur to her that she had become one of those people. It didn’t even occur to her that she was doing drugs (as opposed to taking medicine), let alone stealing them.

Lara was a superstar nurse, energetic without being perky, unfailingly positive, and constantly volunteering to help other nurses. Nobody questioned her, nobody told her it wasn’t healthy to work seven days a week. There was always a need for more hands. She would call the nurse manager and ask nonchalantly, “Hey, can I come in for four hours this afternoon?” Nobody ever said no.

About a year after she took her first Percocet, the workday started to seem longer. Lara was eager to get home so that she could inject herself. The first time she shot up in a staff bathroom, a voice broke through her thoughts: “It’s getting bad if you can’t even wait to get home.”
I have a hard job and it’s a long day
, she told herself.
If other people saw what I see at work, they’d need something to take the edge off, too.
“You’ve crossed the line you drew for yourself.”
I can stop at any time.

Lara took sixteen-hour shifts, sailing through them with midday bathroom breaks to insert an IV, eventually injecting up to 8 milligrams of Dilaudid at a time, an enormous dose, but, for Lara, just enough to keep her alert. Once, she put a heparin lock in her foot to give her quicker access to a vein. She wore it the entire workday, attending meetings and caring for patients. She told coworkers she was limping because she had dropped a weight on her toes.

Because the medications helped her to excel at her job and to work extended hours, Lara didn’t admit to herself that what she was doing was dangerous.

One afternoon, she realized that she hadn’t wasted a single narcotic in five consecutive workdays. Somehow, over the past several months, her maneuvers had shifted from secretive to sloppy. Surely, she worried, someone would catch on to her. She took a swig of Pepto-Bismol to calm her stomach, which was shaky as usual. She blamed her nerves, because she was applying for a position as a flight nurse on a medical trauma helicopter, her ultimate career goal since nursing school.
Ugh, if I could just get another vial, then I won’t feel sick
. Then it hit her.
Oh my God, it’s not because I’m nervous
. It had taken her that long to see, or accept, the link between her stomachaches and her addiction.

Many addicts say that there is often no single defining event that leads them to want to stop using. For some, there simply comes a point when they are ready to admit to themselves that they have a problem and they don’t want to have that problem anymore. That’s how it was for Lara. That day was no different from the day before, except that a layer of her denial suddenly lifted. Later, she would be amazed that she had ignored the signs of addiction for so long.

Once it clicked, she was petrified. She was ashamed of herself and afraid of what people would think; she didn’t know which was worse. She vowed to do everything she could to quit her addiction. Lara tried calling in sick to force herself into withdrawal.
Okay, I kicked this. It’s cool
, she would say to herself after a few days. But then she would return to the hospital to find that her desire for the drug was stronger than she was. After hours of trying to tough it out, she would grab a vial and a needle, so easy, so irresistible, and run to the bathroom.

She attempted to discourage herself by calling her brother, whom she didn’t want to disappoint. She wrote herself letters: “This isn’t how you want to live your life.” She tried stipulating that she could shoot up only at night to help her sleep, or she could use only morphine so she wouldn’t get as sick. She told her roommate, Angie, a fellow ER nurse she loved, so that someone else could hold her accountable. Lara and Angie had been ER nurses together for six years. Angie was the type of strong nurse that other nurses wanted in the room with them. When they started out as new nurses together, they had leaned on each other to endure the ER sink-or-swim craziness the way many nurses did if they were lucky enough to find a competent, likeable partner. Lara and Angie had combined their strengths and pulled each other through stints at two hospitals.