A FULL LIFE

A FULL LIFE

           Dr. Samuel swished the dividing curtain closed as he left. Nolla straightened the sheets and folded the frail hands over the ribcage. She reached in the bedside table for a comb and tried to arrange the hair. Nolla tidied the bedside area and made the woman’s remains as presentable as possible; it had been a long battle and Mrs. Grant’s gaunt face looked battle worn.

           “Mrs. Grant’s family will be coming soon; would you like me to take you to the sunroom, Mrs. Bordon?” Everyone had expected the ninety-one-year-old to die before Mrs. Grant, but you can’t predict these things with any accuracy.

           “No, I’m just not up to it. I need to offer my condolences anyway.” The voice was strained – grief, pity, fear, or possibly pain.

           “Do you need something for pain?”

           “Yes, I really do, if you have the time.”

           “Of course, and don’t be waiting for us to offer it; please, tell us when you’re hurting. I’ll be right back.”

           Nolla brought the injection within minutes of the Grant family’s arrival. She parted the curtain long enough for a brief condolence from the roommate, then left the family to say their useless goodbyes in semi-privacy. They hadn’t managed to get to the hospital in time for good-bye. There would be the usual grief combined with the guilt of not having been there, of not saying ‘I love you’ one last time.

           She gave them time to sit with the body, then brought in the paperwork. Did they have a funeral home choice? Did they expect or want an autopsy? She watched them kiss the cold forehead, pat the cold hands and weep their way out of the room. She had tucked a post-mortem kit under the mattress when she came in with Mrs. Bordon’s pain shot, so, with the curtain tightly closed, she and a co-worker turned the body, laid the plastic sheet under it, then wrapped the body. A third nurse came in with the gurney and together they moved the already stiffening body onto it and covered it all with a heavy sheet. One nurse would close all the patient doors as the other two pushed the gurney to the staff only elevator that would take them down to the morgue.

Nolla brought Mrs. Bordon a cup of tea and some snack cakes, made small talk with her, then checked in on her other patients before taking a ten-minute break. A handful of trail mix and a can of Pepsi and she was refueled for the busy morning. Skipping breakfast, as she had done, was not wise. She was prone to low blood sugar and was putting herself in line for the ‘roller coaster’ drop this sugar high would cause, but she needed something to give her the energy for what was going to be a difficult shift.  

Nolla checked in on Mrs. Bordon again. The housekeeping department had been called and was deep cleaning the side of the room Mrs. Grant had died in. They worked professionally, quietly, creating as little emotional distress for a roommate as possible.

           Quick updates in her charting and it was time for bathing, the next round of meds, answering calls for help to the bathroom, getting patients to X-ray or other departments on time, trying to maintain a close watch on the needs of her nine patients – several suffering through bad chemo reactions, and helping her co-workers.

Dr. Samuels was back, he’d made his rounds already, but he was standing in front of room 512 tapping his left toes in frustration. “Where’s my patient? I made it clear that she is to come directly to her room.”

It is never wise to say ‘I don’t know’ to a doctor but this was Nolla’s first notice of another patient on her assignment. She stepped past him into the room, turned down the sheets, and instead said, “Do you want me to prepare an IV while we’re waiting? I’m sorry, but I’ve been busy with other patients and haven’t seen the chart yet.”

“Normal saline, keep-vein-open for now.” He jammed his hands into his lab-coat pockets and tapped his toes harder. Nolla made use of her excuse to leave the room to get the IV bag and tubbing to ask the supervising RN who her new patient was.

“A young girl named Gretta – haven’t heard that name for ages. She’s just over the age limit for peds. Stage four metastatic brain tumor. Lots of TLC, I heard the family’s a wreck.”

           And who isn’t? Nolla wanted to ask her supervisor, and with ten patients just how much TLC can I pull out of the air? she would have added if the supervising RN were more approachable.

           Two call lights went on as her new room 512 patient was wheeled out of the elevator. “Kevin, can you get those for me? If it’s not urgent, just tell them I’ll be there ASAP. Or have Lynn go to them.”

           She knew Kevin was also struggling to keep up with his assignment, but there was no choice but to ask him. The family helped Nolla get the petite, blue-eyed girl into bed. Ever so briefly it floated through Nolla’s mind that the girl had probably been very pretty before her head was shaved for surgery and before cancer had ravaged her. With practiced competence, Nolla started the IV. The child moaned quietly.

           “Morphine, now.” Dr. Samuel thrust the chart at her, and Nolla rushed from the room. Running was forbidden, except in a code, and there were few of them on the oncology wing, so she double stepped, reading the orders as she went. It was a hefty dose, barely within the ‘safe’ limit. Dr. Samuel took the preloaded syringe from her, read the label, and administered it himself through the IV tubing. The blue-eyed girl closed her eyes and stopped moaning. Her mother made up for it by sobbing. Dr. Samuel took the family to the waiting area and described, in his quietly professional voice, what they should expect over the next hours and what would be done to keep their child comfortable.

           When they returned to the bedside, Nolla went through the routine of the call bell use, ‘don’t hesitate to use it’, can I get you anything - all the things she needed to do to settle in the family of the dying as the other part of her mind remembered the other two patients who were waiting. As she left the room, she mentally cursed the fools who had cut the budget for the hospice ward.

           Her feet kept moving in the endless loop. On one hand it seemed more fair to assign patients according to difficulty, but on the other hand keeping them close meant fewer miles during the shift. Today was one of those marathon days.

She returned the favor and helped Kevin wrap a patient in the plastic sheet and push the body to the elevator. She spent as much time as possible with her blue-eyed girl – although it was really more a matter of spending time with the family as the girl was slipping farther from consciousness.

Mrs. Bordon became more of a concern; “Imaging watching two room-mates die in one day, and that’s what she’ll be doing,” Nolla said to Lynn after assisting her in transferring a non-ambulatory patient to a wheelchair for the volunteer who was taking him to CT scan. “Imagine being at the stepping off point and watching your room-mates die.” Nolla made it a point to check on the woman as often as she could.

           Murphy seemed to be proving just how much could go wrong in one day.  Lynn was muttering about that transfer she’d put in for months ago. Nolla was beginning to feel shaky and fuzzy headed. It was after two; she’d had no lunch break and the sugary snack at nine AM after skipping breakfast was proving just how foolish it had been. “Even a twenty-minute break; I think my blood sugar level is in my toes.”

           “Go, but don’t be late, there’s no-one to cover and I’m up to my ears here too.” The supervising RN with her cold professionalism was not wrong in reacting crossly. Everyone was having a bad day and the timing for asking for a break was very wrong.

           The pre-made sandwiches from the machine were unappetizing, but flavor wasn’t the issue. Nolla put her money in the machine, took the sandwich and a container of milk from the other machine and sat briefly on one of the plastic chairs in the cafeteria. With one half of her lunch in her stomach, she continued to eat as she headed for the elevator. It wasn’t the first time she wouldn’t get a real lunch break, nor would it be the last.

           “I’m back. Thank you. Anything I should know about during my absence?”

           “Yes,” the supervisor said with no emotion. “We’ve had two call outs; I need you and Kevin to stay.”

           Nolla’s knees threatened to buckle. Oh, not today! went through her mind like a last wish, but her mouth said, “Do you want me to remain on my present assignment?”

           The empty bed on Kevin’s assignment filled, one of Lynn’s patients slipped into a coma just before the change from first shift, the blue-eyed girl was given more morphine when she began to moan again, and several other patients had setbacks. Dr. Samuel was on call tonight, and it was obvious that he’d be eating in the cafeteria tonight rather than going home.

           A shriek followed by sobbing erupted from room 512. Nolla forgot the rules and ran from the med room where she was preparing the next round of meds. The wife was crumpled next to the bed; her husband was trying to contain his own sobs as he wrapped his arms around her. In the corner was a teenaged boy, his face a vacuum of emotion. It’ll hit him later, Nolla thought as she went uselessly to the bedside.

           #

           “Why do you work here? Surely there are other jobs.” Mrs. Bordon actually asked for her pain shot this time. Nolla knew it meant her pain was bad.

           “I’m not sure.” The question took her by surprise. “This has been a particularly difficult day - how are you, Mrs. Bordon? You’ve watched two people die today. This must have been very hard for you.”

           “Hard’s not the word, dear. Here I am, praying God will take me home and instead he took a middle-aged woman and a child. I’ve outlived all my family and friends; no one will miss me like those families will do. I don’t understand. But then, we’re not meant to be able to understand His ways. We’re meant to trust Him. You look tired, dear; have you had your dinner?”

           “I’ll get a break a little later, when Kevin comes back from his. He’ll be here for you while I’m away.” She settled Mrs. Bordon more comfortably in the bed, watched her relax as the pain subsided, and went to answer a call bell.

           She saw Kevin getting off the elevator. “Hold the door. I’m off. I was told to let you know you’re covering my break. Everyone should be OK for thirty whole minutes. Nothing to report on your assignment.”

           Nolla bought an actual meal. She sat back in the chair. She chewed before swallowing. A real break, sitting in a chair! Dr. Samuel was in the physician section, she nodded to him, he nodded back. He wasn’t the easiest doctor to work with, but he knew his stuff, and he always insisted his patients got excellent care, not just sufficient, excellent.

           The evening shift became more routine, calmer. The man in the coma didn’t wake, but his family was saying all the right things about him not suffering anymore. The clock was ticking, and it was so close to striking eleven. No one else called off, not that anyone could be asked to work more than sixteen hours straight.

           Nolla was making the loop, settling her patients for the night. She walked past the empty bed in 512 and wordlessly her mind wondered how the family was surviving their loss. She didn’t get all the way to Mrs. Bordon’s bed. It was obvious. Oh, there was the legal routine. Dr. Samuel would be called to pronounce the death and sign the certificate after listening for a heartbeat with his dark blue stethoscope that hung perpetually from his neck. But it was so needless. One look and it’s obvious. See dead once and you can recognize it in an instant. Once the spirit is gone, the emptiness is so – obvious.

           “She had a full life,” Dr. Samuel said as he left the room.

#

           Nolla was walking her sore feet down the hallway, her shift finally over. Dr. Samuel was waiting alone by the elevator, leaning by the corner, his shoulders shaking. Nolla kept walking. She’d take the elevator in the east wing. She swallowed hard. She snatched some Kleenex from the box at the nurses’ station as she rushed by. There was a small group at the elevator, so she slipped into the rest room instead. She leaned her forehead against the wall and began to sob.