Moriah Erickson, 4/9/2012

Current Occupation: respiratory therapist

Former Occupation: hairdresser at a funeral home

Contact Information: Moriah Erickson lives in Duluth, MN with her husband, 7 children and one very hairy hound dog. Her work has been published in numerous journals. She is currently pursuing a MFA from Fairfield University in CT. Her hobbies include laundry, vacuuming and cooking for mass consumption.

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HOUR ONE

Nurses are the only people I know

who have purses big enough to carry their lunch,

a clean set of clothes, and all their regular “purse stuff.” I think

as elevator doors close.

I am surrounded by gigantic purses. Water bottles poke their snouts out

tops of some, others rolled-up gossip mags.

Bags mirror holders, each stretching

into a seperate brand of tired.

Most too big to snatch, I observe, plus few hold cash:

Nurses are more “debit card” people.

I clutch my own giant bag tight, my tools

a well-kept secret I know I hold inside.

I too fight sleep that tugs at me, the welcome fog

that couldn’t wedge its talons in quite deep enough last night.

Eight’s not lit.

Six and four are–Psych and cardiac. Sad that I know each

floor, but no faces.

Stranger in a strange land, indeed.

Doors open at four.

* * *

One grossly obese nurse and one nurse with Ronald-McDonald-red hair cut into what can only be described as a longish crew cut get off. They face the elevator until the doors close, as is the custom on Psych, to make sure a patient doesn’t sneak on and escape.

* * *

I poke 8 and it lights.

Doors seal my stainless steel tomb

I am forced to share with cardiac nurses.

On 6, more purses exit, banging against each other, school children

forming alliances for their day. I am left alone

on the elevator with one person, the housekeeping woman,

a leftover from night shift. Short Mexican woman hiding

behind a big cart cannot take her almond eyes off me.

I close my own, say a little prayer

she won’t talk to me.

Can I handle conversation

this early? She doesn’t take the hint, subtle or not.

* * *

“You a nurse?” she asks, accent thick.

Jesus. “Yes.”

“You make lotsa money?”

Why, oh why, is that all the ancillary staff seems to think about nurses? “Compared to what?” I ask, hostility coloring my tone a fierce, fiery orange.

That shuts her up. I open one eye. She is still staring at me. I pull my purse closer, watch the doors seal us in together.

Please God, or Otis, or whoever is in charge of elevators today, please don’t let the elevator stop before I get off. Elevators are prone to stopping or breaking down between floors at St. Mary’s of the Sea, the doors won’t open, and folks get stuck. Sometimes its for minutes, sometimes hours. I can barely stand seconds in the elevator with the housekeeper, who I noticed is wearing a nametag that reads “Conchita.” If the elevator were to stop now, before my third cup of coffee, its possible I’d become Penny the homicidal nurse, instead of just Penny, R.N.

Ding. Doors open. I swoop out, leaving Conchita in my dust.

“Hey!” she calls after me. “Hey Nursey! We not on 8 yet. This only 7.”

* * *

I keep going head for the stair.

My big purse tucked between my rib and my arm, secrets safe inside.

Conchita’s gone. I have my feet on the stairs ascending to 8.

Tears threaten. I know why, and I’m not telling.

I’ve had coffee, put my purse away, rehomed my lunch in the cavern

of staff refrigerator. One contraband item

stashed in my scrub pocket for later use burns like gasoline

through thin cotton.

* * *

Now Conchita pisses me off. I read her nametag, think of her not as “Housekeeping” but as Conchita, that little Mexican broad who was too illiterate or ignorant to read my nametag. I am not “Nursey,” I am Penny, RN. I am going to change this profession, for better or worse. I am going to rock the foundation of St. Mary’s by the Sea.

* * *

To everyone else, everyone on the outside, I am just “Nursey.”

No one thinks of me as capable or smart. I just do what the doctors tell me.

Just the nurse. With the purse.

But you’d be surprised what I have in there.

* * *

Doctors have their exclusive club, the one nurses only know snippets of the secret language to. We don’t know the secret handshakes. Nurses learn fast though, and we are picking it up.

* * *

Report, a barrage of acronyms, is all part of that secret language.

Acronym after acronym, maybe UGIB is easier

than Upper GastroIntestinal Bleed, my YouGuy for the day.

Its certainly shorter.

I tune out Senara’s toneless song, heavy-eyed night shifter droning on about things that don’t matter

to me, shouldn’t matter to her.

What business of it is hers or mine if Subdural Hematoma is homeless,

only visited by his “bar family”? Will it change the way I hang SubDude’s IV?

The way I lather his face for his daily shave?

She says goodnight, even though its morning,

and is gone. Just me now. Just Penny, and the day shift nurses.

Sounds like a bad ‘80’s band.

Being in a band never occurred to me like it does to so many teenagers. My desire

to be a nurse shielded me from chasing boys and coveting fashion.

Everyone I knew worked at the mall when I worked at the old folks’ home.

I never folded sweaters at the Gap.

I never swept hair at a salon.

I never lifeguarded at summer camp.

I changed beds and clothes and fed people convincing myself that nurses were glamorous.

Ha. Even then I knew the truth, somewhere inside.

* * *

It didn’t occurr to me then that there might be something else for me. Something that would lead to recognition, and even to valor. I always thought those two letters behind my name, R.N., were enough. Now I know I want more than that, those forbidden objects in my purse prove it.

“Lawson wants you in her office.” John’s voice before I see him. Sweat beads up along the neck of my scrubs and all down my back. I feel my face go pale. She can’t know. There’s no way. Breathe in. Hand in pocket, my fingers trace one edge of the recorder, one of the two items I know I shouldn’t have at work.

“Bullshit,” I say quietly. John Simbiq wants nothing more than to have me get myself in trouble again. He smirks at me from beneath his handlebar moustache.

“Damn, Penny, I almost got ya. You’re getting wise to my tricks.” I sigh relief as he strides away, feel my face flush with alleviation. I thought he was on to me, but no. False alarm.

John has already seen both his patients. Overachiever.

Simbiq likes to see if I will rat myself out about the chapstick I swipe from the supply closet, or the personal copies I make on the ICU’s machine, or the extra 40 minutes I took for lunch last week when I got caught up in yet another John Sanford novel. The other things I won’t give up, not without a fight.

I tip the remains of my jet-fuel coffee into my mouth, slap my cheek, and check the pockets of my scrubs for a pen and the questionably acquired chapstick. YouGuy and SubDude await, but they aren’t going anywhere. I’m not in a hurry yet today.

* * *

YouGuy has no lights on in his room.

Outside his window the town is waking.

Streetlights shut off one by one, traffic lights eight stories down and blocks away

syhnchronize at seven, allowing an influx into downtown. Red, red, red,

yellow,

green, green, green all down Third Street.

The sun, like any good drunk,

has not risen yet, has not spewed any of its pink morning vomit upon this ICU.

I close the drapes against the Outside World,

the one neither of us lives in today.

YouGuy sits up in bed, I hear the crinkle of sheets behind me. I turn

already he has a firm grasp on his NG tube, secured by slash of silk

on the tip of his bulbous nose.

“You don’t want to pull that,” I say, foreseeing both our futures

in this dank split-pea room.

Him, coughing and gagging, held down by Simbiq and Brad Mackinaw.

Me, feeding a new tube down one nostril, hoping to hit his gut

before he vomits blood all over clean linens, himself,

and me. YouGuy looks ambushed, I raise the weapon of my title.

“I’m Penny, your nurse til seven.”

He drops his hand, the tube stays in place.

He moans, lurches forward, a stream of irony vomit spews past his ground-down nubs

of teeth, past the NG tube that is clearly not hooked to suction as Senara claimed.

Most of it hits the basin in his lap, another relief.

But this?

This is not the war I want to go out fighting.

I wet a washcloth, St. Mary’s of the Sea’s standard issue. White. Scratchy.

YouGuy looks at it with bleary eyes, then looks at me, questioning. As if it were somehow foreign.

I dump the basin into the hopper and flush, take the cloth

and wipe his face, though I know he is capable. I fold

the blanket in on itself, collecting his washcloth inside, origami

so none of the bloody emesis sneaks out.

I stuff it into the hamper for dirty linen, rinse the basin, hand it back to him. He reclines

back in the bed, and I feel spared.

YouGuy will not vomit again if I can help it. The IV bag

holding Zofran is attached to a pump that is on standby, the line still snaking into his arm.

I poke the screen, turn the rate back on.

I flip the suction from “off” to “intermittent.”

“That’s what we like here, Penny.” John Simbiq’s voice from outside the door, thick with his honest brand of sarcasm. “Compassionate care.”

I check my patient quickly. YouGuy’s eyes still closed, I give John Simbiq the finger,

smile on my face.

Ditch the gloves, the scrubs.

No more Nurse Penny.

No, this is Investigator Penny, who writes exposes about the trenches of the hospital,

the war that goes on every day in its ICUs.

Penny still drinks coffee, sure.

Incompetent doctors are stars in this show, in this story,

the nurses are the heroes.

But mostly it is about the war, the deep thick

trenches filled with beauracracy and bullshit.

* * *

SubDude wears his beanie like a turban. A sign above his bed proclaims that he has “No Left Bone Flap. No Pressure.” I almost laugh at that, taking it the wrong way. Whomever wrote the sign in their prim, black script intended for this to mean no physical pressure on SubDude’s head where there is no skull. I take it to mean something else entirely. I place great pressure on myself, even though I know every single nurse in every single ICU in every single hospital everywhere has made a bad decision or a mistake. These staggering truths frighten me, since I know that nurses are the one and only buffer between bad doctors and patient harm. I don’t want to be the only checkpoint. I don’t want to be responsible, even if its only in my own mind, when things go wrong. No pressure, though. No pressure at all.

* * *

SubDude is sedated, sleep so deep a ventilator has to breathe

for him. The Zoll keeps time with his heart, an erratic beep thrown in

between the steady beats, normal sinus with a PVC

to keep me on my toes. Sunlight glintis off the IV poles, the ICP monitor.

I can’t see numbers. I see only people.

Numbers are the nurses’ favorites,

so I shut the shades.

* * *

Now, importantly enough, I can see the TV, left on Senara’s favorite, the country music station. Thank God for cable TV in the ICU. Patients don’t care, but nurses would go crazy without it. Distraction can sometimes mean everything in a shift, especially a 12-hour shift.

There’s no talking to SDH, at least if you want an answer. The ET tube and sedation put a quick stop to that. I’m not sure how much of a conversationalist SDH would’ve been before his current injury; this is his third fall from a barstool. I talk anyway, out of habit. “Ok, Mister. You have got to quit this falling down business.” I adjust one of the heel protectors, a sure sign that he has been in the ICU for a while. No heel ulcers here, not if I can help it.

I can. Help it, I mean. I wish I could help patients more than I do. I wish I could tell them the magic spell to keep them out of the ICU in the first place. But it doesn’t seem that I know that spell either, since I am here too.

“Quit daydreaming. Get to work. You’re making me look good and the last thing I need is Lawson thinking I am some kind of hard worker.” John Simbiq again.

“Help me turn this guy,” I reply, taking advantage of John’s presence. He grabs the sheet, pulls SubDude up on a shoulder while I tuck a pillow behind him. John lets go, SubDude rolls back and I straighten the sheet over the pillow. “Thanks.”

* * *

I wonder who will play me

in the show. I hope for someone glamorous and sexy,

the Katherine Heigl-type. My luck, I’d get stuck

with Roseanne Barr or Kathy Bates, have no say in the matter.

I know who’d play Simbiq, though, no question

about it. He’s David Duchovny from Californication,

not the wimpy, whiney David Duchovny from the X-Files.

Can David Duchovny can grow a handlebar moustache?

What does David Duchovny have in his purse, and what will be his pennance

if he gets caught?

* * *

Investigator Penny has nothing to do with Nurse Penny. Nurse Penny is kind and quiet, well-mannered and gentle. Investigator Penny says what she thinks, she doesn’t bite her tongue like the other Penny, the one who shows up at St. Mary’s of the Sea ten days out of every 14. She stands up to the egotistical neurosurgeons and the ramrod trauma surgeons, the doctors that had ridiculous expectations for their patients, and when the patients didn’t produce the results they wanted, took it out on the nurses. She exposes the horrors of the ICU.

Nurse Penny just smiles and nods. Yes, Doctor.

Investigator Penny knows what’s in store for them all. She knows what her purse holds, not 30 yards from the nurses’ desk, tucked safely in her locker, lock secured, key tucked into her scrub pocket with her pens and her kelly clamps and the forbidden recorder.

“Care Rounds are total bullshit,” John whispers to Penny as they stand in front of the door to Room 1. His patient, not hers, but everyone needs to know as much as they can about all the patients in the ICU. They’re all standing around, waiting for the trauma surgeon to show up for Care Rounds.

John Simbiq smirks at Penny again, the corners of his moustache raising, the corners of his eyes collecting in pinched crow’s feet. “You don’t fool anybody with your nicey-nurse act.”

“Better a smartass than a dumb ass,” is all Penny can think of. She says nothing, but wonders if Simbiq knows what she is up to.