The shift started off like any other: taking report from the day shift nurses, keeping an eye out for the evening lab results coming off the printer, watching as family members left for the day, or traded shifts with other members. At this time of day, the manager was already gone. Deena left at five o'clock on the dot, every afternoon. I guess she figured she worked her share of twelve hour shifts over the years, and dealt with plenty of crap during the day to justify it. But what do I know… I'm just a lowly new grad night shift nurse, trying to get by.

A soon to be single night shift nurse. Jimmy had waited until I had my hand on the door handle to leave for work tonight to drop the bomb: he wanted a divorce. Lovely way to start the day, huh? I guess that's what I get for wanting an education. I guess you could say I knew it was coming, and in some way, it was more of a relief than anything else. Jimmy wasn't a bad guy, we just didn't want the same things anymore. A straight 8 hour day Monday through Friday sounds good, but I wanted something more: I wanted to help people, to know I made a difference. We'd argued bitterly these last few months. He thought that once I graduated and got my license, I would get a job in a doctor's office. No weekends, no holidays, no stress. I'd fired back with "Well what's the use of having a job you hate?". Being as he worked exactly that type of job, I'm pretty sure it's safe to say he took personal offense to that. In fact, he probably would have thrown a party and celebrated if I was the type of woman who would just stay home and take care of him. But that's not me, and it never has been. Sometimes I wondered what we had ever had in common.

Jimmy was the type of person who wanted to go to the same bar every weekend and drink the same beer with the same friends he' d had since high school. I would rather curl up in my easy chair with a good book and a glass of wine. He's into slapstick comedy, and I'm more of a George Carlin type of girl. He thought women were meant to be stick thin and perfectly made up all the time in heels and pearls. I'm a big fan of denim and cotton, barefoot all the way. Except of course, for my spiffy nursing shoes, which were currently carrying me down the hallway of Memorial Hospital where I worked.

So here I am with seven patients, just for me. Great, just great. I just got off of orientation, and I've got a full patient load. My preceptor believes I'm ready, but am I really? I guess you could say today was one of those days I just wasn't sure.

I checked my notes one more time as Kathy got up from the table in the small break room where shift turnover usually takes place. "You need anything else?" she asked me. Kathy was an okay person, I guess, but I didn't know much about her. "Nah, I'm good. You back in the morning?" I asked her.

"Nope, I'm off for three whole days" she said, smiling. Yeah, I should be so lucky. I haven't had three days off in a row since I started here. "Okay," I said, glancing at my notes again, "drive safe." She grabbed her purse and jacket off the chair next to her, sticking another piece of gum in her mouth as she went. I hate when people chew gum on the job. Just a pet peeve, I guess. Doesn't seem very sanitary, or professional to walk into a patient's room snapping gum and blowing bubbles.

With my stethoscope around my neck, pen clipped to the front of my shirt, and notes in hand, I dragged myself up from the table and went to go introduce myself to my patients. The first one was an LOLFF. That's "little old lady, frequent flyer" for you non-nursing type people. I braced myself. "Good evening Mrs. Brown. I'm Annie, and I'll be your nurse for this evening." I can be sweet when I want to, as long as I get to be bitchy in my head.

"Oh darlin', I'm so glad you're here. Could you get me some ice water and another blanket? I swear they're trying to give me the flu while I'm here. And tell that little aide girlie that my potty needs to be cleaned out. Oh, and on your way back, could you get me a snack too? That mush they called dinner near made me sick." Mrs. Brown lived in a nursing home not too far from the hospital, and she would 'fall', or have a 'change in mental status' when she felt like she needed a vacation. Nice lady, but what I politely referred to as 'needy'. The other nurses just called her a crafty old bat. Secretly, I agreed, but it didn't do me any good to advertise that. Some things just don't need to be said out loud.

Mrs. Brown pushed herself up in the bed, and dutifully let me listen to her lungs and belly, wiggled her toes for me, and made sure to let me know once more how cold it was in her room, and could I please also get her another pair of socks? "You know darlin', the ones with the little slippy things on the bottom so you don't fall? I don't want to fall again, you know it just scares me to death. They ought to do something about these floors in the hospital. Why can't they put some nice carpet in so I don't fall?"

She went on for a few more minutes while I finished my assessments. I noted my findings on the sheet in my pocket, as well as scribbled what she wanted in the margin. She smiled at me, and I told her "Okay, I'll be back in a little bit, I have to go make my rounds".

It went on like that through the remainder of my patients. Always something they needed. And I dutifully nodded my head, smiled, and made a note of it. The fourth room I entered was so packed with people I almost couldn't get to the bed. Sometimes families like to camp out in the patient's room, and for the most part I don't mind, it's only when they start thinking that my only function is to bring them coffee and blankets that I get irritated. Not that I say that, of course.

I stepped carefully around the feet dangling from the end of the chair to get to Mr. Sims. He was new to me, so I took extra care to check him out from head to toe. He didn't speak, but put a finger to his lips, and then pointed towards the dangling feet. I nodded, and covered him back up. Note to self: check back on him in an hour or so.

 

Seven hours later, it hadn't gotten any better, but it hadn't gotten any worse. Three of my patients had dementia, one of whom insisted I was his wife and demanded to know why I wasn't in the bed with him, two were pre-op for the next morning, one wanted IV pain medicine every fifteen minutes, one had about five people camped out in his room, and apparently none of them believed in sleeping at night. I dropped my stack of charts on the desk, determined to get my charting done before five in the morning this time. It was not to be.

My body must have reacted to the static in the overhead announcement system, because I could feel my feet responding to the first strains of "CODE BLUE, ROOM 356, CODE BLUE, ROOM 356. ANY DOCTOR IN THE HOUSE TO ROOM 356 STAT". Not my patient, but I was the closest nurse to the room, so I sprinted down the hall and into the room.

The patient was a middle aged man with a barrel chest and a blue face that was pushing 350 pounds if he was an ounce. The terrified aide stood there with her mouth slack open, just staring at him. I could hear myself screaming at her without knowing exactly what it was I said… I know it was something to the effect of "Get the hell out of the way!".

I jumped onto the bed, locking my hands into position on his chest, pushing up and down in that weird death rhythm that only a person who has performed CPR correctly would understand. I heard the rush of tennis shoes squeaking on the worn linoleum behind me, blended with the wheels of the crash cart screaming, saw the dark curly hair of my friend as she slapped an Ambu bag over his face, her long dark fingers squeezing the bag to push oxygen into his lungs. I got lost in the count, lost in the rhythm of up and down…stop for two breaths, up and down, up and down. After the fifth set, stronger hands replaced mine, and I used that moment to take stock of the situation. I wasn't running this code, and that was fine. I was perfectly content to just do my part. I counted along with Tony, the burly ICU nurse who had taken over for me just a second ago, waiting for my turn to come again. Dimly, I could hear voices shouting over me, and I took a quick glance around the room. It never ceased to amaze me how many people could fit into one of these dinky little rooms. "Switch!" It was my turn again. Up, down, up down, up down, up down. Same rhythm, over and over. Stop for two breaths, then up down again. I heard an excited voice holler "He's back!". I stopped mashing on this poor guys' chest long enough to look up at the monitor on the crash cart, its creepy green line marching across the yellowed screen like a pissed off Grim Reaper. I looked down at the patient. "Sorry buddy, you don't get to die tonight" I whispered, and hopped down off the bed. Tony followed me out of the room into the hallway while the rest of them stayed in the room.

"You okay?" he asked me, touching my shoulder. Tony was a nice guy, great nurse, good friend.

"Yeah, I'm good. Just a little tired, that's all". Tony gave me that look, the one that said "I know you're lying, but I'm not gonna give you shit about it right now". My kinda guy. My third code in less than as many weeks. He knew, and understood. I wondered if I ever would. I dimly recall saying something about there rarely being codes called on this floor a few weeks back. Note to self: you aren't a student anymore. Stop wishing crap would happen just so you can get experience, because you just might get it, and maybe its not everything its cracked up to be.

"Hey, you call me if you need anything, 'kay?" He let his beefy hand drop from my shoulder, and headed back up the ramp towards ICU. Yeah, back to the patients, the ones that weren't trying to die on my watch. Laura came out next, and she looked at me with caring eyes. "Hey," she said, "at least it wasn't your patient this time." She had been there for me when it was my patient that coded. There's something strange that happens between nurses when you're trying to save someone's life. I hadn't put my finger on it yet, but hopefully it will dawn on me eventually.

I let out a dry little chuckle. "Yeah, not mine this time". I trudged back towards the nursing station. Back to business as usual.

By 6:30 am, I had somehow managed to carve out two hours of time to get my charts caught up. I looked at the schedule to see who was coming in. If it was Janine, I would hang all new bags of IV fluids in the rooms, and do the morning blood sugars. If it was Constance, I wouldn't. Call me bitchy, but it's one of those nursing things they don't tell you about in school: the nurse you are relieving is helpful to you in direct relation to how nice you are to them. It's a solid ratio, an absolute formula that cannot be messed with. Constance tended to complain about everything, and it was a pretty well known fact that she would throw you under the bus as soon as look at you, so I guess you could say I no longer went out of my way to make sure the beginning of her shift was peaceful. Janine, on the other hand, was an angel in scrubs. She had helped me out a lot in those first few months, so getting the extra stuff done before she came in was no big deal, because I knew she would return the favor. The black and white print of the schedule jumped out at me as I squinted my eyes against the stark fluorescent light bouncing off the white paper hanging on the wall: Constance. Screw it.

Dr. Mack chose that moment to walk in. "Well, well, well, if it isn't my favorite nurse" he sing-songed. "Will this be my lucky day? Will you finally agree to go out with me?".

"Ha ha" I said dryly, "when I get a corner office and a straight 9-5 making millions sipping margaritas and playing solitaire online all day". He shot me a crooked grin, and snagged three of my charts. "Shot me down again" he laughed, as he flipped the first one open, "break my heart, and never give me a chance".

Dr. Mack was what most of the nurses called our "Memorial McDreamy". He was good looking enough, I guess, if you went for lotiony hands and no muscles. Personally, I've always had a thing about a man's hands. If they didn't look like he worked for a living, I wasn't interested. He had a decent enough face, all Ivy League looking, and dressed like he thought GQ would show up at any minute to take his friggin picture. But he was a good doctor, and we bantered like this often.

I started to fire back a snazzy quip about his tasseled loafers, when Constance chose to make her appearance.

"Well, good morning Doctor" she said sweetly, all syrup and honey, emphasizing the 'doctor' bit, batting her fake lashes at him. "Aren't we just dashing this morning?"

I rolled my eyes in disgust as Dr. Mack obligingly eyeballed the cleavage currently attempting to escape from her low cut scrub top, and I wondered if that chick owned even one piece of clothing that wasn't three sizes too small.

"Good morning, Constance. Do you have any of my patients today?" he asked, quickly turning back to the chart in front of him. She looked a bit disappointed, and then shot a dirty look at me. "I think I'm taking Annie's patients this morning" she replied, giving me a cool eye. I stuck my tongue out at her, but didn't manage to yank it back before Deena slid around the corner. Her quick eyes missed nothing, and she tilted her head as she looked at me, kind of like the look my mom used to give me when she caught me doing something I probably shouldn't be, but didn't want to call my dad's attention to it.

"Constance", she said, "we are going to have a group of students here in just a bit, can you take a couple of them?". I groaned inwardly. The only thing Constance could teach those poor nursing students is how to bag a doctor in the break room and not get caught. No, wait, that's evil. I shouldn't say things like that. She was plenty smart enough, but she came from family money, and her main goal in life was to marry a doctor and spend her days spending his money. Color me confused, but I doubted that any of the doctors here at the county hospital were rolling in the kind of dough she wanted to have dibs on. Whatever, to each their own I guess.

"Of course Deena, whatever you need." She made sure to let her fingertips brush along Dr. Mack's shoulders as she passed by him on her way to the break room. He flinched just a bit, but didn't look up. I wondered how many times he had sampled from that particular buffet. Just thinking about it made me want to gag. Probably enough to avoid seconds.

Deena watched her sashay into the break room, then turned her hawk eyes to me. "Annie, can I see you in my office after you give report?"

I didn't say anything, just a curt nod. Thankfully, Deena was the kind of boss that wouldn't ask questions in front of everyone else. I signed my name with a practical flourish to the last set of orders, and dumped my charts on the unit clerk's desk. Cindy was a sweet girl, and I liked working with her. More than once, I had tried to talk her into working nights with me, but her husband didn't want her out that late at night. At least she had a husband who cared. Mine was probably busy getting busy with whatever little bleach blonde tramp he had picked up at the bar while I was here working my ass off. I shoved that thought out of my mind as I headed towards the break room.

Constance wasted no time. She had perched herself on the end of the long table, one hand holding a silver compact while the other applied lipstick the way most of us put barrier cream on an old man's butt: thick and heavy. I sighed, and flopped myself down in the rickety chair, remembering to lean to one side and avoid the chair tipping over on the side where it was missing a wheel. It's a real bitch to look pissy when you are sitting in a three wheeled chair that is supposed to have four. Since I knew she had no intention of taking notes, I fire shot report to her. She just kept on with her war paint, as if she weren't wearing ten pounds of that crap already. Just as I was getting up, she spoke. "So what did Dr. Mack want this morning? He's usually not here until around ten." Figures that would be the one thing she would ask about. I sighed. "I don't know, he got here just before you did".

She smiled, and then bared her teeth to check for lipstick. "He must have wanted to see me first thing in the morning. A little glimpse of happiness to set the mood for his day". This chick was something else.

"Yeah," I said, "that's it. Because how could any human being with a penis resist a Barbie Doll wannabe in scrubs?" I rolled my eyes as I walked out, but I had to grin when I heard her hiss behind me. I'd probably pay for my comment later, but sometimes I just can't help myself.

Deena's office was a study of the woman herself. You can tell a lot about a boss by the way they keep their office. Deena's was the way I imagined Bill Gates's office probably looked: cool and efficient. The walls were beige, with only her diplomas in neat dark wood frames. Her desk was pristine, not a speck of dust anywhere. Since our housekeeping staff was sometimes hit and miss, I knew she probably kept a feather duster in a drawer somewhere. "You wanted to see me?" I asked, as I poked my head in through the doorframe.

The woman herself could have been a poster child for professionalism. Her scrubs were beyond clean, always crisp like they just came off the ironing board, white shoes with nary a speck on them. Not a spot of makeup either, and her hair was a neat bun. With her personality, the stray hairs were probably afraid to come loose. Either that or she used an ass ton of hairspray. I glanced down at my scrubs. They looked like I had slept in them, and my tennis shoes had definetly seen better days. She looked up at me over her glasses, a pair of those half rim affairs that always made her look sort of teacher-ish. I wondered if she knew we called her "The Professor". Probably. That woman knows every damn thing.

"I'm thinking of putting you on days. We could use the extra help. I know it would mean a pay cut, but I could move you over to ICU." She let me chew on that for a minute. Being on night shift had been really good for me. Days was organized chaos. ICU was where I wanted to be. "I'll let you think about it for a while", she said, and turned back to her desk. Hmphh.. some discussion.

My feet were screaming as I shuffled to my locker, pulling out the oversized tote bag my kid sister called 'the suitcase', and my jacket. At home, an empty bed awaited me. Jimmy had left a text message on my phone saying he would be gone by the time I got home. Nice, real nice. I ignored the message for now, shoving the phone into my pocket.

It was raining when I stepped out of the sliding doors. The black and gray storm clouds seemed to reflect my mood as I got soaking wet into my car. I leaned my head back and just closed my eyes for a minute, listening as fat drops of heavy rain crash landed onto the roof of my ten year old Honda. I sighed heavily, and jammed my foot down on the clutch, cranking the car over and dropping it into gear.

Nursing school did not prepare me for this.