*
The unit’s got sixteen patients tonight and a trauma case still in surgery; a self-inflicted gunshot wound. Somebody who shouldn’t have access to a weapon, it happens all the time. She’ll come to our unit as soon as they’re finished, if she doesn’t die on the table. Tim Rhodes is the TCIU charge nurse; we all call him Tonto. Tonto’s an old hippie, he doesn’t carry a gun. He don’t go heels, as they used to say in the wild west days. He wears moccasins and keeps his hair in a long gray braid down his back. Claims to have some Ute blood, or maybe it’s Arapaho, I can’t remember. Calls himself a shaman. Tonto has studied the healing ways of his people, he burns sage and sings Indian prayers, but he also knows the high-tech side of twenty-first century western medicine and critical care nursing. He’s boss, alright. They say he’s bad-ass with a bow and arrow and by the looks of his pectorals filling out the lose cotton sleeves of his scrubs, I don’t doubt it at all.
Tonto gives us our assignments then we all make rounds together with the off-going shift. I’ve got Mr. Sobee for like, the fifth night in a row. Coriolanus Sobee, a 43-year-old white male with multiple trauma, is what we call in this business, a train wreck. Meaning he’s a real mess, every system in his body is jacked up. Actually, he was in a wreck of sorts. Motorcycle meets bus; bus wins. Bus always wins. Sobee’s got a season ticket; he’s been in ICU nearly two weeks and isn’t going anywhere anytime soon. His life is on hold. He’s ventilator dependent, on multiple antibiotics, in traction, and in an artificially induced coma to keep his intracranial pressures down. Miranda, his wife, went home earlier today. Exhausted. I hope she gets a good night’s sleep because her husband isn’t out of the woods yet. It’s going to be a long haul.
I do an initial head-to-toe assessment on Mr. Sobee. Daisy, the off-going nurse, put on his tunes. Music is playing softly, Mozart, I think it is. Sobee’s wife says he loves classical music and requests we play it as much as possible. A Mozart-loving Harley rider, that’s kind of odd, isn’t it? But then again, maybe not. Why do I presume to know what sort of music a Harley rider would prefer? Maybe he writes poetry too, who knows? Maybe he likes to knit socks. I have noticed that when the classical music is on his heart rate drops to the seventies, his oxygen saturation improves, his blood pressure stabilizes. Is there a healing quality inherent in such elite music, or is it soothing simply because Mr. Sobee is familiar with it? Or is it just random chance? I should make a study, write it up for American Journal of Nursing. Yeah, right. Like I’ve got the time.
My other patient is Shanna Jackson, a sixteen-year-old gunshot victim. Poor kid got caught in the crossfire of a neighborhood shoot-out. Sure, she had a gun in her handbag, but she wasn’t really expecting anything. Just walking home from school with her girlfriend, they were probably laughing about something silly like teenagers do, when --bipbipbip -- she’s lying on the sidewalk, a bullet through her chin, another through her right arm, taking half her right breast with it, a rather messy mastectomy. Her quick-thinking bestie called nine-eleven on her cellphone and stayed with her, using her mittened hand to stop the blood pumping out of Shanna’s brachial artery. Now that’s what I call a BFF, that’s who I want by my side when the shooting starts.
Shanna’s condition is stable; she’ll probably go to the floor tomorrow, if all goes well tonight. And home in another couple of days. Back to school in a week or two. She’s one of the lucky ones. Her mother’s sitting in a plastic chair next to her, beside the IV pole. Her head’s resting on Shanna’s bed, she’s snoring. Usually we don’t allow family to spend the night in the room, not in TICU, but sometimes we make exceptions. Like tonight. It’s my call, I could boot her out if I thought it was best. But I let her stay.
Shanna opens her eyes and gives me that look. That look that says, please don’t hurt me!
“Hi, I’m Kit, I’m your night nurse.” I’m touching her right wrist below the dressing, feeling for pulses distal to her injury. “Just checking your vital signs, your dressings, your IV and all that. You’re in the intensive care unit.” I give her a confident smile.
At the sound of my voice her mother sits up and takes hold of her daughter’s left hand.
“It’s alright, baby, your mama’s here, your mama’s here. You’re gonna be alright, honey.”
I glance at Shanna’s monitor screen, reading all the information it provides. I make note of her intravenous solution; what it is, how fast it’s running. I examine the needle insertion site to make sure it’s patent and not infiltrating. I check her urine collection bag and note the quantity and color. Observation is a big part of my job.
“Are you having any pain, Shanna? Don’t try and talk, your jaw is wired. Just raise your left hand if you’re hurting.”
She pulls her left hand from her mother’s and raises it like an eager school child, a teacher’s pet. The mother’s eyes fly to mine. “Can’t you give her something, nurse? She’s hurting real bad.”
Nod my head. Pain relief is another big part of my job. Ask and you shall receive.
“What number is your pain, Shanna? On a scale of zero to ten. With zero being no pain at all and ten being the worst pain you have ever experienced.” I reach for the communication board on her bedside table and hold it so she can see it. It’s a dry erase board with a blue marker tied to it. At the top there’s a pain scale with numbers and cartoon faces making various expressions ranging from pleasure to agony. She points to the number 8, and a grimacing face.
“I’ll give you some pain reliever in your IV line and set you up with a self-administration pump. We’ll get you taken care of, don’t you worry, I’m here to help.”
She takes the board and manages to write Angel of Mercy in wobbly letters on the communication board. I’m not sure if she means me, or if she’s religious and is invoking the heavenly hosts, or maybe it’s her mother she’s referring to. But a dose of morphine and a pump and she’ll think she’s in heaven. Wish I could give the mother something to help her sleep, because this place sure ain’t the Holiday Inn.
Cid’s patient is the one we’ve got to worry about tonight. Hart Anderson is a twenty-eight year-old man who got run over by his own car this afternoon. It’s a strange story, but then they all are. Every time you hear the back story you think, that was dumb. I wouldn’t have done that. But the truth is we all do dumb things everyday but somehow get away with them.
Mr. Anderson was in his two-car garage this afternoon, jump-starting the dead battery in his pick-up truck, his eight-year-old kid in the cab. The kid accidentally put the truck in gear, the emergency brake didn’t hold or wasn’t on, and the truck crushed Dad against the wall. Quick-thinking kid calls nine-eleven first, then his mother. Anderson was flown in from Goodland, Kansas, not long before the snow started flying and all the choppers were grounded. Got out of OR at change-of-shift after six hours on the table; status post-surgical repair of his entire thorax, sounds like. Why the hell he wasn’t DOA is anybody’s guess; maybe his angel of mercy had a say in that. Anyway, his wife and kid and a neighbor, they drove here from Goodland through the snow storm. They’re all camped out in the waiting room with the families of other patients; it’s a regular Boy Scout Jamboree.
As soon as she’s sure Mr. Anderson is stable and presentable Cid sends for his family. She lets them come to the bedside for a few minutes, then hustles them back to the waiting room and tucks them in with Styrofoam cups of instant hot chocolate. “Try to get a little shut-eye,” she says. “I’ll come get you if anything changes.”
Cid is an amazing nurse. She’s Wonder Woman in red white and blue scrubs. Her good nature, her upbeat attitude, it rubs off on all of us. If I ever end up in TICU, I hope Tonto assigns Cid to take care of me. She’s my idol; I wish I had her life. A great husband, two blonde boys with straight teeth and a third kid on the way. It’s a girl, due in May. Perfect all-American family. Except John works days, they hardly see each other, but at least there’s always one parent home with the kids. They tag team it, gi
ving high fives as they pass through the door. Date night, once a month on Cid’s weekend off. I feel a little jealous ‘cause I want her life. I want somebody on my team.
Friday Night Knife and Gun Club Page 3
