It is the way it could be.

Chapter 5

Burnt to a Crisp

:

How Nurses Cope–and Why Some Crack

“The nurse owes the same duties to self as to others, including the responsibility to preserve integrity and safety, to maintain competence, and to continue personal and professional growth.”

—Code of Ethics for Nurses, Provision 5

“Compassion fatigue made it so much harder to take care of patients. Here I was, using all of my might to drag myself out of bed and march on, and I’m seeing these people whining over hangnails and really minor problems while I’m holding back tears and contemplating killing myself.”

—A North Carolina ER nurse

“I love the free entertainment that patients provide. People say and do the most ridiculous things, and I’ve got a front row seat to the absurdity.”

—A Colorado travel nurse

SAM

  CITYCENTER MEDICAL, December

On weekend nights, Citycenter’s ER regularly saw hordes of boisterous drunken patients brought in by police, EMS, or, occasionally, friends. Many times, the patients demanded to leave, but hospitals were supposed to keep intoxicated patients because they could be a harm to themselves or to others; and many of them were injured but too drunk to know it. The staff was allowed to discharge these patients when they were clinically sober—able to follow commands, walk with a steady gait, and tolerate oral fluids—even if they were not legally sober.

One chilly evening, EMS brought in a patient who was particularly riled up.

“I’m leaving this fucking place!” said the patient, a large man in his twenties.

“No, sir, you can’t leave. You’re drunk,” Sam replied. She stepped to his bed and stood in his way, as nurses were supposed to, to prevent him from walking out.

“I’m not drunk!” He started to sit up.

“Yes, you are drunk. As soon as you sober up, we’ll let you leave,” Sam said.

“I am sober.” He swung his legs over the side of the bed.

Sam, composed, stood her ground next to the bed. “Lay back, take a nap. We’ll get you some juice if you want.”

“I don’t want any fucking juice!” the man yelled.

Sam looked him hard in the eyes. “I’m really sorry but you’re not leaving. That’s the way it’s going to go. You can sit down or we can have security help you sit down.”

The moment the man’s feet touched the floor, William was at Sam’s side. “Hey, buddy, you need to listen to what she’s saying,” William said.

The man eyed William’s imposing build and got back in bed.

In the hall, Sam said, “I didn’t need your help. I can take care of this myself.”

William looked amused. “You needed a little backup.”

Sam rolled her eyes and checked on her next patient. Police had arrested a man who told the officers that he needed medical treatment because he had “the shakes” from alcohol withdrawal. (If an arrestee told local police he needed his diabetes or hypertension medications, or even that he’d had abdominal pain for three weeks, the police would bring him in to the ER.) He obviously was looking for an excuse to decrease his time in a jail cell. Sam recognized the patient, a man in his midtwenties who’d come into the ER drunk the week before. As Sam entered the room, Dr. Bernadette Geiger, the compassionate attending with the high voice, joined her. A police officer was sitting in the visitor’s chair, bored to be babysitting his perp.

The patient, slouched in the bed, sat up eagerly when he saw Dr. Geiger. “Oh, Doc! You remember me from the last time I was here. You know my problems; you know I need to be admitted. I’m having a really rough go of things.”

“No, sir, I’m terribly sorry, I don’t remember you,” Dr. Geiger said as she conducted a quick exam. “I take care of so many patients every day. I’m sorry, but this is protocol. You seem fine to me.” The patient would go straight back to jail.

When Sam and Dr. Geiger left the room, Sam said, “Dr. Geiger, we had him last week!”

Dr. Geiger winked. “Of course I remember him, but he’s not going to play any games with me.”

Sam grinned, happy to learn a new tactic.

•   •   •

On their second date, Dr. Spiros cooked dinner for Sam at his apartment. She was already flustered when she arrived late, after getting lost and then spending an embarrassing amount of time attempting to parallel park in front of his building. Inside, she looked around while Dimitri drained ravioli and poured glasses of wine. It still felt strange to call him Dimitri.

Dr. Spiros’s apartment was decorated with matching earth-toned accents from the bathroom to the living room. Only the office was unadorned, with minimal furniture. Sam browsed photographs on the mantel to make conversation easier. They had seen each other at work only once since their last date; they had figured out tonight’s logistics via text. I should not be here, she thought, scolding herself for being unable to gently say no to a second date. When a guy cooks a girl dinner, he wants to get laid.

They sat down at a table complete with cloth napkins. She had to give Dr. Spiros credit: He had made the pasta and sauce from scratch. She wasn’t sure how to feel, though, when he started talking about his ex-wife. “She didn’t like my hours as a resident, and now she’s trying to get a hundred grand from me,” he said. “I’m not even an attending yet and she’s squeezing money out of me.” His phone dinged and he looked down at it. “Speak of the devil. An email about the money she wants.”

Sam looked down at her plate. Ohh, this is awkward, she thought. Not cool to have the phone at the table, either. Dimitri changed the topic by talking about his now-defunct relationship with the Citycenter tech. Was nothing private? Would he talk about Sam to coworkers, too?

After dinner, they chatted on the couch. There was a lot to like about Dr. Spiros. He was hot, although that wasn’t a priority for Sam. He had plenty of interests outside of medicine, yet could understand, as she said, “what it meant to have an awful, crazy day at the hospital.” But their conversations kept veering toward his plans to teach medicine in underdeveloped countries. He was barely a doctor and here he was, ready to share his supposedly vast experience with the world.

“Teaching is great and all, but I’m just trying to not kill people at this point,” Sam joked.

Dr. Spiros seemed to be trying to impress her, expounding on his work in the ER and talking about expensive nights on the town. He described his trips to far-flung locales, but Sam had never traveled outside of the continental United States. Sam noticed that he was nestled into the opposite end of the couch. Does he want me to jump his bones or something? she wondered. He made no moves, so neither did she. She decided he must have asked her out as a rebound after his relationship with the tech ended. Perhaps he was talking so much about himself because they had little in common besides Citycenter, and she was still so new to the hospital that she didn’t know their colleagues well enough to discuss them. She wondered if the great, suave Dr. Spiros was nervous.

After a while, she said it was late and she should go. Dr. Spiros gave her leftovers in a Tupperware container—a cordial, if grandmotherly, gesture. When they said good night, he went in for an awkward pat-on-the-back hug. “Okay, I’ll see you later,” he said, defeated.

On the drive home, she worried about how they were going to interact at work. The dates had been so awkward—were they even dates?—that she had no clue how to follow up on them. I need to not date anymore, she resolved. I’m going to just put my head down and do my job. Dating can come later in life.

During Sam’s next shift, William caught up to her in the hallway and wrapped a strong arm around her shoulders. The top of her head barely reached his chest. “So? How’s my competition?” he asked, cocking his head suggestively.