But they get paid more to do it. According to the U.S. Census Bureau, male nurses ride the “glass escalator”; although they are in the minority, they receive higher wages and faster promotions than women in the same jobs. The wage gap is smaller in nursing than in other professions, however. Compared with men, women earn ninety-one cents to the dollar in nursing occupations, versus seventy-seven cents to the dollar on average across other fields.

Some men become defensive about being in a field with mostly women, but the majority of the murses interviewed for this book didn’t consider the disparity to be a problem. “Yes, I’m in a job where I am surrounded by women. But guys, come on, I’m in a job where I’m surrounded by women!” said the Army nurse, who is now stationed at a base in Europe and engaged to a female physician. The murse’s female coworkers and the “sixty-five sisters” in his nursing school class provided him with “access to some pretty big answer keys,” he said. “I dress better than most of my male friends, I understand what I did or said to make a woman upset or happy, and I have an endless supply of opinions on gifts and date ideas.”

The murse, however, cautioned other potential male nurses, “As a general rule, you aren’t in the nursing field to get laid.” Instead, “If you’re the caregiving type of guy, you should join us because of the wide range of nursing opportunities. You could work in a hospital or nursing home, dabble in management and administration, you can travel, or you can stay put,” he said. “Don’t let the female-dominated work area intimidate you. Want to know what brings a smile to everyone in the ER? Seeing that big burly wall of muscle and testosterone who’s good with kids. There’s nothing like a nurse’s feeling of satisfaction at the end of the day.”

SAM

  CITYCENTER MEDICAL, August

One night, the charge nurse found Sam in Zone 1 to give her a five-minute heads-up that a trauma was on the way: a pedestrian who was struck by a car and thrown several feet. Five minutes was a decent amount of time for nurses to prepare for a patient; typically medics didn’t call Citycenter until they were practically on the back ramp. Sam arrived at the trauma bay at the same time as CeeCee. Before Sam could open her mouth, CeeCee announced, “I’ll be bedside and you can document.” CeeCee thought bedside nurses got all of the glory, but Sam didn’t believe that one nurse was less important than another.

Sam shrugged, uncomfortable about working with CeeCee. At least CeeCee had just returned from a three-week vacation and seemed relaxed and ready to work. Sam crossed her fingers for a drama-free night.

When the already intubated patient came in, a physician conducted an assessment while various doctors hooked the patient up to the vent and inserted a chest tube. Sam recorded all of these procedures while CeeCee took the patient’s blood pressure.

The moment the patient began to wake up and fight the ventilator, Sam pulled drugs from the Pyxis and handed them to CeeCee. CeeCee continued to monitor blood pressure and assist the doctors as Sam recorded. When the patient stabilized enough to move him to the CT room, Sam helped CeeCee hang units of blood before, during, and after the scan. (“The scaredy-cat doctors were all behind the glass watching us get irradiated,” Sam said.) Sam was surprised to notice that she and CeeCee worked well together, managing the flow of various doctors’ orders and dispensing medications.

Once CeeCee took the patient to the ICU, Sam began her hour-long stint at the computer to document the series of procedures coherently. When CeeCee returned from the ICU, she sat down for a few minutes to help. Sam hated to admit it, but CeeCee was a good nurse under pressure. She finished documenting with a newfound respect for CeeCee.

Sam had come a long way in only a year. She had realized that “everyone is going to come to the table with different opinions and personalities, but the goal is to take care of patients, so everyone getting along is important. As I learned, it’s hard to be on your best behavior for twelve hours when your coworkers are pissing you off. But you work extremely closely with them. I’ve worked with people who’ve touched my butt more than guys I’ve dated (it’s totally normal for people to take my trauma shears out of the butt pocket of my scrub pants). Patients come and go, but your colleagues can make or break your shift. So I can at least give everyone a chance.”

Sam’s next patient was an intubated man with carbon monoxide poisoning. She monitored his propofol, a powerful sedative that required just the right balance: enough to keep the patient sedated, but not so much as to lower his blood pressure excessively. Within a few minutes, the man started bucking the vent, agitated. His chest raised, his head strained against the stretcher, and his heart rate increased. Before the man could wake up, Sam increased the propofol. Three minutes later, the man’s blood pressure dropped. She lowered the propofol. Ten minutes later, the man became agitated again. Sam called in a tech to help her hold the man’s arms down so she could increase the propofol once more.

Sam paged the attending doctor. “The propofol isn’t really working,” she said. “I think we need something else to sedate him.”

The attending nodded. “Good call. How about a Versed drip?”

Sam nodded and prepared the drip. He actually listened to what I said! He took me seriously! she thought.

After a few hours of standing by the patient’s bedside and watching his monitor, Sam noticed that he was having longer and longer runs of bigeminy, a heart rhythm that, while not immediately threatening, could lead to more dangerous rhythms. She checked his labs, saw that his magnesium levels were slightly low, and found the attending. This doctor was a reasonable man who had worked at the hospital for decades.

“His mag is one point two,” Sam said. “I think we should give him magnesium.” Low levels of magnesium could cause irregular heart rhythms.

“Good call,” the attending said. “Why don’t we give him two grams of mag.”

Sam hung the bag of magnesium on the IV pump. She was pleased. For so many months at Citycenter, the charge nurses had assigned her to zones that didn’t see seriously sick patients, making Sam feel as if the staff didn’t think she knew what she was doing. “Now I have a sick patient and the doctors are listening to me,” she realized. “Maybe I kind of do know what I’m doing after all.”

Everything seemed to be falling into place. Sam and William were happy together as a couple, but they kept their relationship under wraps at work. She didn’t want to fuel any more rumors, especially when she was finally gaining respect as a nurse. Her professional reputation was becoming, in her words, “I’m a no-nonsense hard-ass. We’re going to do things the right way and efficiently and don’t give me any crap.” She liked that reputation because it minimized drama. “If everyone is clear that’s the way it’s going to go from the start, then staff are less likely to sit around and have social hour.”

Even she and Dr. Spiros had gradually thawed. The gossip about Sam had tapered off, probably because of CeeCee’s vacation. Sure, nurses made comments here and there about Sam’s supposed love life, but Sam could let those remarks slide.

A woman in her early thirties came in one night with stress-induced supraventricular tachycardia, a dangerous arrhythmia in which the heart raced at more than 180 beats per minute. To treat SVT, staff first tried getting the patient to bear down as if having a bowel movement. This was a technique aimed at activating the vagus nerve—called a vagal maneuver—to slow down the heart. If that didn’t work to bring down the arrhythmia, the next step was to administer adenosine, a drug that stopped the heart for a few seconds so that it would hopefully resume at a slower rate. In the ambulance on the way to Citycenter, the medics fortunately had been able to use adenosine to convert the patient’s heart rhythm back to normal.