David is 38 years old. He has been a nurse long enough that almost nothing makes him gag anymore, but not long enough that he is annoyed if he misses lunch because of a cardiac arrest. In his mind, full of logic and order and straight lines, this is a not very precise measurement, but he understands that if he reaches the point where he’s doing CPR and wishing the patient could have waited until after he ate, then he’s been a nurse for a very long time.
On an average day doing charge on A6, David answers 32 phone calls, starts seven IVs and corrects four mistakes made by new nurses. He hangs eight new bags of IV fluid, questions fifteen new md orders, discharges four patients and admits five new ones. He helps eight people to the bathroom, cleans up six dirty beds and helps other nurses and tech to lift or reposition a total of one ton of human flesh. He clocks between three and seven miles on his fitbit. When he gets home at night, he lays on the couch and stares at the ceiling. Some days A6 is more work than the Air Force.
He likes it, though. Likes that he knows the answers, he can assist and correct, likes the way illness and disability don’t faze him anymore, because there’s something he can do. And he likes the way he moves. In a place where walking down the hall is a feat and so many are hampered by stiff knees, disease and extra weight, he walks easily, for hours, his body still lean and strong from years in the service, a lodestone of order and sanity in his cluttered and chaotic environment.
On Tuesday morning, after switching the assignment twice (the pregnant nurse can’t take the chemo patient and the patient in 20 door is suddenly refusing male RNs) David illegally eats a cliff bar in the med room.
Three call lights are going off. One will be 20 door, asking to page the doctor about her change in morphine dose. 16 door is probably ready to come off the bedpan and other, well, it could be anybody. He swallows his cliff bar and thinks he’ll make a break for his water bottle in the break room but as soon as he steps out of the med room, he is confronted by middle-aged man in a Vietnam hat.
“You know what’s going on with my wife?” he says.
“Who is your wife, sir?” His mouth is dry. 15 steps and he can grab his water.
“I’m Howie. My wife is Beatrice.” The man gestures towards 18. “She’s been here for a week and can’t nobody tell me what’s wrong. You doctors just sit around with your thumbs up your ass all day or something?”
David is thinking about Beatrice. He’s been hearing her rattling cough and raspy voice much longer than a week, and he’s pretty sure she’s dying. Then he realizes the man’s mistake. “Howie, I’m not a doctor, but I can page one for you.”
Howie peers at David’s name tag. “Oh,” he says. “What’d you become a male nurse for?” He looks David up and down. “You a homo?”
At the desk, the phone is ringing. There is no secretary today. The nursing tech hurries by, laden with linens. David bites back three ridiculous answers. “I’m not a homo.”
“Hmph,” says Howie. He looks at David’s ringless fingers. “You ever been married?”
David is puzzled now. “I was.”
“Ha! Wish I could say was. Damn woman is a pain in the ass.” He scratches his head beneath his hat. “Nevva mind callin a doc for me. They’re just gonna tell me the same stuff.” He glances towards his wife’s room. “I just thought you was a doctor and maybe…” His sentence hangs, fractured.
David lays a quick hand on the man’s shoulder goes for the phone. It is his manager, reminding him that the staff have mandatory empathy training over the next two days. Ok, he says, while scrolling through Beatrice’s chart. Chronic diastolic heart failure, non-resectable lung tumor, unstaged, history of smoking, DNR. He was willing to bet Howie knew all that stuff, and Beatrice did too. Sometimes people want a different answer.
At 3pm, staffing changes. He’s down a nurse and the supervisor is sympathetic, but sympathetic doesn’t help do discharge paperwork and turn total care patients. She sends him an LPN and he feels obligated to thank her even though that means he’ll have to look out for the LPN’s patients. At 330, the girl in 20 door has screaming meltdown because she’s in horrible pain and the pills aren’t cutting it. 16 window was all set to go home and then his discharge got cancelled because his insurance wouldn’t pay for a critical medication. A new patient arrives in 8 in from ED and when she arrives, her blood pressure is 65/40, confirmed, thank you and and it takes an hour to get her transferred to the ICU.
At 530, he finally checks on his patients. The LPN (who would think about lunch while doing CPR) gives him an update, he thanks her, and says hi to all of them. This is a little hazardous because there’s a pretty high chance that one of them will want something that will either be impossible or take a half an hour. But the LPN is good, she knows her stuff, and his patients are well cared for. He checks on Beatrice last.
As soon as he opens the door, he knows his mistake. There’s no rattling cough or raspy voice, and the room feels empty. He steps around the curtain. She lays alone in a quiet room. The light above her head is like a halo. He gets that queer dizzy feeling like the world is shaking a little beneath him. He knows what he will find, but he touches her anyway. There is no pulse at her wrist, her skin is waxy and cooling and the DNR bracelet confirms that his work with her is finished. If I checked on her earlier, he thinks, this might be different. But would it have? Was there anything else he could have done?
He hears a shuffle step behind him. Shit. He turns, and imagines how he must look to Howie. The male nurse, the potential homo, holding Howie’s wife’s dead hand, confirming her non-existence.
The man sits down heavily in a chair at the foot of the bed.
“Howie,” David says.
Howie grunts. His knuckles are tight, squeezing and releasing his legs. Men of that generation do not cry, nor do they show emotion. David slowly places the dead woman’s hand on her chest and walks to Howie. He squats next to the chair and touches Howie. The man stiffens and then grips the nurse’s hand tightly. They both look at Beatrice, beatific beneath the lone fluorescent light. Howie shudders and his head drops to his chest.
In a few moments, David will step out of this sacred moment and into the bright chaos. He will call the supervisor to let her know 18 window has passed. He will help bag the body and send her to the morgue. He will answer more phone calls and call lights, manage the assignment for the night shift. But right now, there is nothing more he can do. He is thinking about Howie, and that both of them will, tonight, be home alone. He is thinking about how, because he is a nurse, it is ok for him to hold hands with a complete stranger, and share sorrow. He is thinking about how it is not that he is a nurse and Howie a client, but that they are two human beings, grieving together for the beautiful temporary blink that is human existence.