Chicken Soup for the Nurse's Soul (6 page)

I engaged myself in the care of my new patient, dressing Mr. Mendoza in the standard patient attire of EKG, blood pressure and oxygen monitors. His physical assessments were normal: vital signs checked out normal sinus rhythm; blood pressure stable; respirations nonlabored; breath sounds clear; oxygen saturation at 99 percent; good capillary refill in all four extremities; abdomen soft, with bowel sounds present; surgical dressing was clean and dry.

But his neurological status remained in question: “Mr. Mendoza, Mr. Mendoza.” Not a stir. Not a flinch of a response to my voice or to touch.

His wife came in to see him. Mr. Mendoza didn’t respond to her either. I continued closely monitoring my sleeping patient, charting, “clinically stable, assessment unchanged . . . remains nonresponsive to voice or touch at this time. . . .” Definitely, it was not prudent to chart, “Responds like a brick wall.” I continued to engage every effort to waken him.

“Mr. Mendoza, Mr. Mendoza,” I called over and over again. Soon I had an uncomfortable sense of an audience.

The other half-dozen or so semi-conscious patients and their nurses were clearly annoyed with the echo of my persistent badgering.

Yet, I was determined to get any elicited response—a groan, a hand squeeze, a bat of an eye. Art, my trusted and bilingual colleague, finally came to my aid. He suggested I ask Mr. Mendoza to “wake up” in Spanish. I nodded my head as Art repeated the Spanish phrase I was to repeat to my patient. Art assured me it would elicit a response.

Trusting my rescuer, I didn’t question Art for the English translation of his tutorial. As I repeated it in my head, I was comforted by the cohesive support I felt from the other patients and staff looking on with eager anticipation. I assumed they sensed the emergent need for Mr. Mendoza to respond, lest he fail his neurological assessment.

With my hands on his shoulders, I leaned over the side rail, twelve inches from his face. In my Midwestern dialect, I articulated the Spanish words in a desperate cry,
“Beso mi, Senor Mendoza, beso mi!”

To this day, I am not sure what startled me more: the chorus of laughter of my colleagues or Mr. Mendoza, eyes wide open, shooting up in bed! Dazed, I turned to question my instructor, Art, who was buckled over in laughter. In between breaths, he provided me the English translation: “Kiss me, Mr. Mendoza, kiss me!”

Kathleen Dahle

The Night Al Heel Broke Loose

T
he ability to laugh at life is right at the top
with love and communication, in the hierarchy
of our needs. Humor has much to do with pain;
it exaggerates the anxieties and absurdities we
feel, so that we gain distance and through
laughter, relief.

Sara Davidson

In a certain northern city, in a certain regional hospital, a story is still whispered about the “Legend of Wanda May.” It has grown some over the years, but as one of the few witnesses to the entire chain of events, I will try to stick to the facts.

Wanda, a rookie nurse, was a mighty mite of sorts. Standing four feet, eleven inches, she couldn’t have weighed more than ninety pounds, yet every inch of her screamed spitfire! With her green eyes and shiny black hair, Wanda was a looker. Even her cap, which conjured visions of the flying nun, and her oversized scrub suit added to her allure.

Our fifteen-bed ICU ran like organized chaos. With whirring ventilators, beeping monitors, blaring code sirens, ringing phones, glaring lights and chatting nurses, sensory overload was a common problem for our patients. A unique phenomenon known as ICU psychosis afflicts about 10 percent of those treated in this environment. Without warning, a sweet and kindly grandmother could morph into a Linda Blair clone right before your eyes. With proper medication, the condition usually lasts only twenty-four hours. Still, the poor patients are often mortified by their reported behaviors.

On the night in question, the unit was unusually quiet. With only three patients, I stayed at the desk to read the cardiac monitors while Phyllis, a jolly seasoned nurse, looked after two patients. This left Wanda to care for Alan Heel. Al looked much older than his twenty-seven years; he’d lived a hard life. Kidney disease and his penchant for alcohol proved a difficult combination. His heart strained to pump the extra fluids his body couldn’t eliminate. Weekly dialysis is a hard lot in life. Long deserted by family, you could almost understand the root of Al’s addiction. He was a frequent patient in our unit, and we all knew it would be a miracle if Al saw thirty. This huge grinning fellow with an unruly shock of black hair loved the attention he received in the unit. And he was never happier than when Wanda was his nurse. He swore she looked exactly like his favorite stripper, and we teased and regaled him with “Hey Big Spender” whenever Wanda was at his bedside. In spite of all of his shortcomings, Al was easy to like.

By midnight on this particular night, the patients were settled and the checks were done. Sitting at the desk, Wanda entertained us with the latest chapter of her ill-fated romantic life. Suddenly, multiple monitor alarms screamed. In the time it took to look up, there was Al, looming over us, huge and naked—except for the monitor leads flapping from his chest. We could have taken his pulse by watching the blood spurting from his thigh where he’d yanked the arterial line. If not for the blood, the absurdity of Al dragging his urine bag might have been comical—but there was nothing funny in his eyes.

Wanda and Phyllis tried to cajole him back to his room. Grabbing the phone, I paged security and then put in a call to his doctor. The next few moments unfolded like a scene from the Keystone Kops!

Al ran, followed by Wanda, Phyllis, two seventy-year-old security guards and several nurses from the step-down unit. He charged from room to room, fleeing a demon only he could see. Patients screamed, guards yelled, staff raced in all directions. The arrival of three police officers and his doctor only added to the chaos. Cornering him in the hallway, they nearly subdued him, but the power of his psychosis proved too great.

When he darted into the four-bed ward in the adjoining step-down unit, panic reigned. The screams of the four elderly female occupants almost drowned out the alarms from their collective heart monitors.

Jumping on top of the nearest bed, Al took a hostage. Now debate often ensues about the weapon Al used. I hear tell now that it was a butcher knife, but to the best of my recollection it was a letter opener he picked up from the patient’s tray table. Flipping the poor woman so she was perched on top of his naked body, Al held the letter opener to her neck. The frantic look in his eyes gave us all cause to believe he would use it. Backing off as he demanded, we all tried to think of a way of getting a shot of Valium into him. In this truly desperate, life-threatening situation, the legend of Wanda May was born.

Holding us at arm’s length, Wanda stepped forward. Slack-jawed, we watched as she flipped off her cap, undid her braid and fluffed her long, luxurious hair. In a sultry voice, she belted the song, “The minute you walked in the joint. . . .” With her eyes focused on Al’s, she pulled her scrub shirt over her head and sent it sailing across the room. His wild eyes softened as she shimmied closer. It was plain to see that the occupant with the “knife” to her throat didn’t know which of these evils was greater. In two more seductive moves, Wanda was down to her skivvies. With a crooked finger, she beckoned Al to follow her. As if in a trance, he put down his weapon and rose from the bed. In utter silence, the assembled onlookers parted and Wanda, clad only in bra and panties, walked through the center, with a docile Al directly behind. She continued humming the strains of “Big Spender” all the way back to the unit. Patting Al’s bed, she prompted him to lie down. Now I was frightened for Wanda’s safety. But instead of venting aggression or male energy, Al began to cry. With his head nestling on her chest, Wanda held him and stroked his hair while the doctor and I started an IV and a flurry of drugs. In moments, an exhausted Al drifted off to sleep. Extricating herself from his grasp, Wanda casually asked, “Could someone get my clothes?”

She may have been small of stature, but Wanda May will forever remain a giant to those who continue to whisper her legend.

Elizabeth Turner

Jelly Hearts

T
he years teach much which the days never
knew.

Ralph Waldo Emerson

I was in my second year of nurse’s training at Children’s Hospital when I fell in love with Jimmy. His eyes were the purple of a full-moon sky. His golden hair tossed rings of curls onto strawberry blush cheeks. He looked like a cherub in the stained-glass cathedral windows. But he had the wail of a lonely, frightened, orphaned baby, which he was.

Jimmy was in the communicable diseases wing, isolated with measles and pneumonia. He had to be enclosed in his oxygen-tent–covered crib most of the time. When he wasn’t sleeping, he was crying to get out. But he always stopped crying when I entered his room because he knew I would cuddle, rock and sing to him. The Children’s Orphanage had been his only home most of his fifteen months of life. I knew he was well tended there, but no institution care can replace a mother’s love.

As I hummed a lullaby, I fantasized. “Jimmy, I promise you that as soon as I finish nursing school, I will find a way to become your full-time mommy. You will be my special little angel.”

My mind eagerly formed wedding plans for right after graduation. The man I married would just have to love this beautiful baby as much as I did.

The door opened a crack. My supervisor hissed, “Miss White! Have you completed all of your work and finished charting?”

“Almost, Miss Stickleby.”

“It’s nearly time to go off duty. Put the baby down now. Check on your other patients, and then go help Miss Nelson. I believe she had an extra patient today.” The door closed before I could answer. Suzie Nelson did not have an extra patient. I did. Suzie was assigned as Jimmy’s nurse, but I asked to have him added to my patient load. I wanted the extra time with him since I’d be on vacation the next three days.

Deliberately I dawdled, massaging his thin little legs, playing peek-a-boo with his yellow ducky blanket, urging gurgly giggles between his raspy breaths. He was more responsive and playful than I’d seen him before, and his grasp was stronger. A good sign of improving condition.

A loud tap rattled the ward window. Stickleby.

Quickly, I gave Jimmy his favorite squeaky bear and an extra farewell backrub. As his eyelids closed over his pansy eyes, I tucked the oxygen tent around his crib and whispered good-bye.

Back at the nurse’s station, Miss Stickleby glared as I signed off Jimmy’s chart.
Who was she anyway?
I wondered. We students couldn’t fault her as a teacher and supervisor. She saw to it that we were all as conscientious in our duties as she was. But although the hospital policy encouraged staff and students to hold, play with, read and talk to all the children in our care, we never saw her cooing over a baby or reading to a toddler. By the end of the shift, our pink student uniforms were always rumpled and damp. Miss Stickleby’s looked as starched and clean as at the start of the day. Unlike my netted unruly locks, no wisps of auburn hair escaped from under her square pillbox nurse cap. She was such a proper, capable nurse. Why did she hide her heart?

I waved good-bye to Jimmy’s room as I hurried off duty, excited to have a holiday of mountain fun. But at the same time, I was eager to return to my bright-eyed, nearly recovered Jimmy.

While on vacation, I bought several silly, washable toys for “my little guy.” He had only the disposable ones given by the local children’s societies. Before he went back to the orphanage, everything would be burned, of course, to prevent cross-contamination.

Holiday over, I rushed back to work and eagerly peeked through Jimmy’s window on my way to the ward station. His crib was clean and empty.

“Where did you move Jimmy?” I asked the night nurse.

“Oh, he died Saturday night. Didn’t you know?” Such a casual answer.

My body turned to clabbered milk. I fell into the chair, crushing the toy bag.

“I’m sorry, Joy. He was a special little kid.” She released a long, exhausted sigh. “Saturday was a bad night.”

Beyond consolation, I stumbled into the nurse’s lounge where I could release a great wash of tears.

“Miss White!” It was Stickleby’s clipped, stern voice. “Time for report. Dry your eyes and get on duty. Now, please.”

All of the emotion I felt for Jimmy poured out like boiling oil over this cold, unfeeling woman.