Shift three of three is always the worst shift, a real soul-crusher. The fatigue, the grumpy coworkers, the patients that feel too comfortable with you by this point in the week, all culminating in a final hour of chaos. I stand in the darkness outside the automatic doors at the front of the hospital, the red fluorescent letters stinging my eyes.
I can do this, one shift at a time. Just one more shift.
I take a deep breath, cross the threshold, and begin to idle through the catacombs of the hospital. The scent of bitter antiseptic and cheaply perfumed soaps makes me bristle. I can’t get this smell out of my nose, my hair, my clothes.
I shuffle my rubber shoes along the underground tunnels, hidden underneath the public floors like a mass of writhing snakes in a crawl space. My eyes lose focus on the floor. The gray flecks speckled across the cream tiles blur into television static beneath my feet. I keep my head down as I walk past the morgue, my nose wrinkling at the pickled stench of formaldehyde, a brief interlude from the antiseptic.
Beeping IV pumps and clacking keyboards greet me as I approach my unit. Ten years on this unit and I somehow feel like a seasoned warrior and an impostor at the same time. That young girl who applied to nursing school to find meaning and purpose is so far away from me now. The shifts bleed into weeks, into months, into years and I barely have my eyes open through it all, drifting between restless sleep and sluggish consciousness, repeat. Ten years and this is possibly my last.
Just one more shift, then I’ll decide what to do. But who am I, if not a nurse?
I sit down under more fluorescent lights at the nurses’ station and start clacking my own keyboard, browsing my assignment for the day. I take report from an ancient crone of a nurse, a thirty-year veteran who is purposefully reticent when discussing patients so that the next nurse is unprepared. She scowls at me from beneath wizened eyelids.
You know what they say, nurses eat their young.
Deep breaths. Let’s go.
Room 6 – eighty-two-year-old female and her besotted husband. Sweet Mrs. Winters who metamorphosizes into a deranged, screaming banshee each night when the sun sets. Her disintegrating body clock is miraculously right on time this evening when she decides to stage a jail break. I am charting at the nurses’ station when I see a streak in the corner of my eye, fast as lightning, flashing past our Rubenesque security guard who doesn’t bother to put down her coffee during the pursuit because she has seen it all before and knows she won’t get far. I round the other corner and bring our prisoner of war skidding to a halt, her catheter ripped out and bedside urine bag waving like a revolutionary flag in the stale hospital air. Mrs. Winters realizes she has lost the battle and dropps her flag, urine spraying across the walls and my blue scrubs in the process.
Mr. Winters saunters over to his wild-eyed wife. With the help of two nurses, he manages to wrangle her into a wheelchair that she thinks is their old convertible; they are going on an imagined date to the drive-in. Mr. Winters wheels his now placid wife around the nurses’ station, waving to everyone and cheerfully chatting about their date. The happy couple passes by me on another loop of the station. I wave, but my long hair and small frame reminds Mrs. Winters of a prostitute that used to solicit customers in her neighborhood. She shouts “whore!” each time she wheels past me for the next two hours.
I dash to the next room, my charge nurse glaring at me on the way because I haven’t had time to chart my assessments, again.
Room 7 – twenty-two-year-old male, alone. Jacob – he asks me to call him by his first name, dying of liver failure. Do-Not-Resuscitate.
But he’s never even tried alcohol, it isn’t fair. Surely a transplant would come through at the last minute. Surely?
I check on his patient-controlled pain relief pump, which his parents have rolled just out of reach before leaving for dinner. I roll it back and secure the button within his reach. The doctors warned his parents not to leave tonight, this might be the end. A pained moan. A page to Room 8. “I’ll be right back.”
“Whore!”
Room 8 – sixty-nine-year-old male. The unit pervert, Mr. Davis, requesting assistance with his bed bath. Sixty-nine years old, how fitting. “If you can hold your own turkey sandwich, you can wash your own penis…sir.” I toss a washcloth and a bar of soap onto the bed.
Best of luck, sir.
A flurry of assessments, medication administration, charting, and ill-received health education culminates in a frequently interrupted, short-lived lunch at 1 AM, and then back to it.
Room 7 – vomit everywhere, the mild smell of alkaline bile mingling with harsh hospital cleaning products. I wash and scrub and then dab thick droplets of hot sweat from his forehead. “I’ll be right back.”
Room 9 – sixty-five-year-old male, Mr. Miller, and his nine devoted children who are on a rotating schedule of breathing down my neck. None of them have been to nursing school, but they know more about my job than I do, apparently. Despite the tower of pillows and blankets adorning his hospital bed, another blanket is of vital importance to Mr. Miller’s recovery. “I’ll be right back.”
Room 7 – Jacob is sleeping. He is so still I check to make sure he is still breathing. I quietly empty his urine bag and sneak out of the room.
Room 10 – seventy-two-year-old disoriented male, Mr. Roberts, just waking up from surgery with his anxious, but well-meaning, wife. He writhes in pain, pools of sweat gathering in the bedsheets and serosanguinous fluid leaking from his drain with every twist and turn. He doesn’t remember where he is or why he is here. I, with my tray of pain medication, am deliriously dubbed his guardian angel. His suspicious wife, eyes narrowed, asks, “Did his doctor recommend that medicine?”
No, a random person I met in the parking lot did…?
“Of course, ma’am.”
I lean over to connect his doctor-approved IV morphine when a sharp right hook connects with my left eye. Whack. “Oh my GOD Bill, you just punched the nurse!”
Another black eye, great.
I back out of the room offering reassurance, “It happens all the time!”
All. The. Time.
A page to Room 6. No time to ice my eye.
Room 9 – “We’re still waiting on that blanket, NURSE!” I wave an apology and run by Mr. Miller’s room.
Room 6 – Mrs. Winters is refusing to take her medications. I crush her pulls and mix them with applesauce. Her husband pretends they are eating crème brûlée at their favorite restaurant. I watch her swallow every bite while my pager beeps on my waistband.
Room 7 – the end is very near. Two exhausted eyes stare out from waxy, yellowed skin. I call and call and call his parents.
When they finally answer, their only response is, “I don’t know what to tell you, it’s the middle of the night. We have lives too, you know.” I huddle in the corner whispering angry replies, begging them to come. They threaten to tell my supervisor I am harassing them. I return to Jacob’s bedside and pretend his parents are coming as quickly as they can.
While we wait, I prop him up with extra pillows, then take pillows away, then add more pillows. More blankets, too many blankets, take all the blankets off. His death rattle slowly, insidiously fills the room.
“Yes, I will stay. Yes, I’m here.”
He reaches for more water that can’t be swallowed. I grasp his hand as tightly as I can.
Perhaps if I hold on tightly enough, he can hold on too.
It is in these moments that I know why I am a nurse.
“I’m sorry your parents aren’t back yet, I’m sure they’ll be back soon.”
His damp hand goes limp in mine.
The flatline of asystole is quieter than I expect, every time. The echo follows me like a buzzing mosquito after each shift.
The noise and bustle outside of the room does not stop. A physician declares the time of death and moves on.
How do we keep moving and leave this moment behind?
I allow myself thirty seconds to cry, that’s my rule. Silent, shaking sobs with my hands clamped over my mouth, in the bathroom next to the patient’s toiletries that will be thrown away. I kick the tiled wall and sharp pain shoots through my toes.
On my way out, I brush my fingertips across the now-empty bed. The sheets are scratchy and still warm. A page to Room 9.
Room 8 – “Excuse me. I think there’s something wrong with my penis nurse, but you’ll probably have to get on your knees to take a closer look…” I walk past with my head down.
Room 9 - I have forgotten the blanket. “Why can’t I have a blanket, I asked for it almost an hour ago, what’s wrong with you?”
“Whore!”
I give report to the next nurse in a dazed but efficient fashion. I hope I’m not scowling, so I stare at the white bricks behind her instead of looking her in the eye. I stuff my mostly uneaten lunch back into my bag and clock out, winding my way back through the hospital. I check my phone for the first time in thirteen hours:
“Don’t forget to wish your cousin a Happy Birthday!”
“Someone online said I don’t have to take my blood pressure medicine every day. Do you think it’s safe for me to stop taking it?”
“Are we still on for date night tomorrow? Don’t say you’re too tired, we need to go out…”
“Your father has a strange rash. Can you take a look?”
“Are you coming to the farewell dinner tonight? The hostess won’t seat us until we’re all here, if you’re coming try to be on time…”
My phone buzzes with a new message: “Can you do xtra shift tmrw night? Super short staffed!”
I drop my phone back into my bag. My swollen, tender feet shuffle through the hallways, and I hitch my bag higher up on my shoulder, pain coursing through my lower back. My head pounds and my mouth is sticky from dehydration. It was too busy today to resign. And now I am too tired to resign. I step back into darkness outside the hospital.
Today was terrible... I made a difference today.
I hobble to the subway station, sidestepping rats and piles of rubbish on the way.
I am exhausted... I will sleep tomorrow.
A train thunders into the station a few minutes later and I squeeze my way onto the car with the other straphangers. The rickety subway car shudders back to life along the pitch-black tunnel, rocking us back and forth in unison like members of a dance troupe. I survey my face mirrored in the dark windows of the subway car. Even in the dim reflection, I see my eye swollen and circled by a purplish hue. A child nudges her mother and points to my battle wound.
I can’t do this anymore... I want to do this every single day for the rest of my life.
Cashiers, investment bankers, nail techs, fashion models, are all packed in elbow to elbow on their way to work. Delicate spritzes of Chanel No. 5 reluctantly mingle with the rancid stench of human filth. And I am there with them, but on my way home from work instead.
I’ll do one more shift, then I’ll decide. Just one more shift.
We unexpectedly screech to a stop between stations. The lights from our windows illuminate scrawling graffiti on the concrete walls of the tunnel.
I just want to go home.
To a dark and empty apartment. Where I will sit and stare into space until I fall asleep. Because I am too tired to wish anyone a Happy Birthday or to offer medical advice that will be ignored or for date night or to look at my dad’s rash or to go to a farewell dinner, or watch TV, or fold laundry, or do anything, really.
A baby begins to wail as an unhinged busker beats an arrhythmic tune onto a metal pole with a ladle. He jingles his cup of coins apathetically. I rock my shoes back and forth, peeling the soles off the sticky floor. A crackling announcement fires through the ancient speakers.
“ATTENTION PASSENGERS. WE HAVE A MEDICAL EMERGENCY ON THE TRAIN. IF THERE ARE ANY DOCTORS OR NURSES ON THE TRAIN, PLEASE –”
I close my eyes. I used to imagine that if I witnessed a medical emergency, I would immediately spring into action and save the day, friends and strangers alike cheering me on. And it was like that, the first time. I was on holiday with my family in a cozy restaurant overlooking a farm in the countryside. Someone at the table next to me was choking, so I leapt up to valiantly perform the Heimlich maneuver, quickly dislodging the offending potato wedge. The woman thanked me through terrified tears, followed by a round of drinks for everyone from the manager. My aunt was so proud of me that she cried.
“– MAKE YOUR WAY TO THE FRONT OF THE TRAIN.”
But today, I hesitate. Because ten years down the road, I am not the same person anymore. I am not the bright-eyed nurse who was excited to make a difference, determined to save everyone, who arrived early and stayed late, studied the medical conditions of every patient on the unit, volunteered for extra shifts, packed fresh fruits and vegetables not realizing they would rot in an unopened lunchbox over the course of several shifts.
She has been slowly, systematically beaten out of me. Because I am tired. Because it won’t be long before I am the bitter, reticent nurse unsettling her coworkers. Because I’m not sure if I can go on. Because it has always been hard, before the PPE shortages, before watching our coworkers die from a virus we didn’t understand, before the thank-you-healthcare-heroes! Because you all ask too much of me. Of us.
‘I REPEAT, WE HAVE A MEDICAL EMERGENCY ON THE TRAIN. IF THERE ARE ANY DOCTORS OR NURSES ON THE TRAIN –”
I look up. Sixty pairs of expectant eyes scrutinize my scrubs.
Now or never.
I brace my knees and slowly stand. A quiet, collective sigh of relief resounds through the car while I hitch my bag back onto my shoulder. I open the car door and step onto the rickety metal platform connecting the two cars, chain links clinking as I wobble across. At the next door I am greeted by big white letters on a bright red sign: STOP. Do not stand or move between cars.
No holds barred for a medical emergency.
After pushing through tangled seas of passengers and tottering across more metal platforms, I peer through the next grubby window and see a crowd of worried bystanders huddled around my next patient. My hand hovers over the sticky metal door handle, then drops back down to my side. I inhale deeply, taking in the dusty, metallic air from the tunnel. I urge myself forward, but my arm hangs limply at my side.
I can’t do this anymore
My shoulders slump under the weight of my bag and so many other things.
…Just one more shift.
I place my fingertips back onto the cold metal. I grip the handle tightly, my knuckles turning white, and shove open the door.
Lydia Yeager