The Nurses: A Year of Secrets, Drama, and Miracles with the Heroes of the Hospital

by Alexandra Robbins

  It was Erica. “Yay! Erica, I’m so glad to see you!” Juliette exclaimed.

  “I’m glad you’re here, too!” Erica said. “We’re staffed well today. Where do you want to be, with Mimi?”

  Erica assigned her to a zone with Juliette’s favorite tech, Mimi. A good tech could make an enormous difference to nurses; procedures went smoothly and nurses could use their time more efficiently. Mimi, a Filipina woman in her forties, was a conscientious tech who had been at Pines for twenty years. Mimi would do whatever a nurse needed without hesitation. It wasn’t uncommon for techs to stand around reading magazines when new patients were wheeled in, despite knowing that when a patient with chest pain arrived, for example, he needed an IV, EKG, and a monitor. Nurses had to ask most of Pines’ techs to do each task. They didn’t have to ask Mimi for anything.

  When a patient arrived in the ER with mild chest pain, Mimi ran an EKG. The patient had been waiting awhile. He was 55, the pain was on his left side, and he was sweating. Juliette made an executive decision to test his troponin levels, which could indicate damage to the heart muscle. At Pines, nurses were allowed to run advanced treatment protocols like this without waiting for doctor’s orders, if the doctor hadn’t yet seen the patient.

  When Dr. Preston came in, he reviewed the patient’s chart. “I wish you hadn’t run troponins on him. His EKG didn’t show any changes.”

  Clark Preston was an efficient doctor. He didn’t order more tests than necessary. He decided quickly on a patient’s diagnosis, then focused his testing on that diagnosis rather than conducting a broad spectrum of tests to make sure. This was easier on the nurses, who knew that his diagnoses were likely to be correct. But the nurses, who looked out for him because he was fun to work with, still worried that sometimes he was too brazen, too quick to assess. So far, he had not been sued. In this case, he wanted to examine the patient before running cardiac labs. Based on the EKG and the patient description of the pain, the problem could have been GI-related.

  Forty-five minutes later, the lab called Juliette. She found Dr. Preston in the doctors’ back office. “Troponins came back positive,” she told him. The patient likely was having a heart attack and required further cardiac evaluation.

  Dr. Preston leaned back in his chair, palms up, content to give Juliette credit. “Well,” he said with a disarming grin, “I’d rather be proven wrong than have to explain a dead guy.”

  Juliette laughed, and went to administer the patient’s cardiac medications and reassess his pain and vital signs.

  Midshift, Erica switched Juliette to triage to help improve patient flow. Knowledgeable, experienced nurses were more efficient at getting patients the right care. Soon afterward, someone from the Employee Health Department wheeled in a young, red-haired woman who was weeping uncontrollably. Juliette recognized her right away; she was a secretary who worked in the ICU. When they were alone, Juliette asked her name, per protocol.

  “Nancy. You know who I am.”

  Juliette smiled compassionately. “What brings you to the ER today?”

  Between sobs, Nancy said, “I’m stressed and I can’t work and it’s horrible up there and I just can’t take it anymore!”

  Juliette handed her some tissues. “What’s going on?”

  “I’m . . . having . . . boy problems,” she said through gasping breaths.

  Gradually, Juliette coaxed out the story. Nancy’s boy problem was that for nearly a year she had been dating Dr. Fontaine, a sexy charmer who worked in the ICU. That morning, Nancy had learned that Dr. Fontaine was also dating three nurses at Pines, and one of them was pregnant with his child. The pregnant nurse had told Nancy in person. Nancy was heartbroken. She couldn’t eat.

  As Juliette triaged her, diagnosing anxiety and a panic attack, she offered what consolation she could. “I am so sorry this happened,” Juliette said. “Try to relax and we will take care of you. We’ll get you a private room in the back so you don’t have to see anybody.” Juliette was glad that the ER doctor that day was sympathetic. The doctor gave Nancy antianxiety medication and discharged her.

  Juliette would never be able to look at Dr. Fontaine the same way. Nurses liked him because he was friendly and didn’t order too many ER tests per patient. The ER nurses’ goal for ICU patients was to get them quickly upstairs, where they could be stabilized and receive proper care. Many specialty doctors asked the ER nurses to do the initial tests, or they ordered extra labs and tests for the sake of ordering them. Dr. Fontaine usually said, “We can do everything upstairs.” Oh, that’s why he didn’t order a lot of tests, Juliette thought. He wanted to get back upstairs to get busy with all of his girls.

  The Sexy Nurse: From “Yes, Doctor” to “Ooh Yes, Doctor”

  The outdated caricature of the sexy nurse—breasts straining buttons on a form-fitting white minidress, shapely legs slipped into fishnets and white heels—remains pervasive and global. Nurses say it also holds the profession back.

  A small (and strange) 2012 study published in the Journal of Advanced Nursing found that of the top-ten media-generated nurse videos on YouTube, six presented nurses as either sexpots or stupid. In a similar vein, on a 2010 Dr. Oz show, several women wearing sexy nurse costumes and red lingerie danced with Dr. Mehmet Oz. This came a few years after nurses objected to Dr. Phil McGraw’s on-air pronouncement that “cute little nurses” are husband hunters. Nurses strongly protested both doctors’ portrayals of the profession.

  Imagery that sexualizes nurses can depict hardworking women as frivolous playthings or present a difficult job that requires significant expertise as nothing more than a provocative cartoon. At times, this portrayal has slipped into the province of actual medical care. Near a Las Vegas diner, where waitresses dressed as sexy nurses push customers to their cars in wheelchairs, a real medical assistant at an actual medical IV therapy practice wears a sexy nurse costume with white fishnets as she ministers to patients. In England, a bus company advertised its route to a hospital by adorning buses with a giant picture of a sexy nurse in a skimpy, figure-clinging dress, captioned, “Ooooh, matron!” Not only was the ad disparaging, but it also implied that patients need only step on board to be transported to the healthcare provider of their fantasies; the ad seemed to beckon, “This way to hot, nursey sex.”

  Some hospitals aren’t above spinning the stereotype, either. A Swedish hospital recruiting nurses to work during the summer of 2012 posted an Internet ad that instructed, “You will be motivated, professional, and have a sense of humour. And of course, you will be TV series-hot. . . . Throw in a nurse’s education and you are welcome to seek a summer job at SÖdersjukhuset’s emergency department.” The hospital, which has the largest Emergency Care Unit in the Nordic region, completely trivialized nurses’ qualifications, tossing in a nursing degree as if it were an afterthought.

  Nurses laugh at the idea that their job is TV-series sexy. Instead of come-hither white dresses, today’s nurses wear scrubs that might be stained with blood, urine, or various other un-arousing substances. A male nurse in Virginia said, “We’re sweaty and smelly and covered in germs. Plus, we’ve all had patients die in horrible ways in pretty much every corner of the building. I would never be able to get it on in a hospital.” Similarly, former certified nursing assistant Erin Gloria Ryan, news editor of the popular women’s issues blog Jezebel, remarked on a nurse-related comment thread, “Nothing sexier than someone who is going to record the frequency and consistency of your bowel movements on a chart.”

  As a Michigan nurse manager pointed out, “Some nurses do fit the naughty nurse persona.” And some nurses are often happy to engage in tongue-in-cheek innuendo (or worse; see Chapter 5). But sometimes the sexy nurse seeps into the public consciousness as more than just a joke. Nurses told me about doctors groping them. An Oregon nurse said, “Some of the docs are lecherous old perverts.” Gail Adams, head of one of the United Kingdom’s largest unions, has note
d, “People are happy to sexualize the image of nursing but are then surprised when nurses are attacked or have lewd or indecent comments made towards them.”

  In 2010, a Dutch nurse union received complaints that male patients were requesting sex and some nurses were complying. Reuters reported that a 24-year-old nursing student told the union that she had seen a 42-year-old disabled man’s home care nurses sexually gratifying him. The man, who had a muscle disorder that let him move only his mouth and eyes, told her that his previous seven nurses had done the same. When the student refused his request, the man tried to fire her, claiming that she was unfit for the job. The incident prompted one newscaster to remark, “I’ve got to get myself a nurse in Holland.”

  The union launched a campaign reminding the public that sexual services were not part of a nurse’s job description. The campaign, “I Draw the Line Here,” featured a young nurse crossing her hands in front of her face. According to the union, in response to the campaign, the managing director of a patient interest group argued, in all seriousness, that patients “are free to ask. You are free to refuse.”

  For now, let’s set aside the idea of happy-ending healthcare and tell it like it is. Like men and women in any other profession, nurses have sex. And yes, many of them boff their colleagues. In an unscientific poll for the purpose of this book, I asked more than 100 nurses whether they or any of the nurses they worked with had engaged in a sexual relationship with a doctor, nurse, or other coworker. Eighty-seven percent of them said yes.

  Depending on the hospital and the unit, a nurse’s relationship landscape can range from “I feel like I’m actually living Grey’s Anatomy” (Washington State) to “Hospital life is so damn far from Grey’s Anatomy, it’s not even funny. Our doctors aren’t that hot, supply closets almost always have two doors and they never lock from the inside. And no one has time to go make out with a doctor anyway, because we’re usually behind in charting, haven’t peed in nine hours, and are fighting hypoglycemia on a constant basis because we don’t get the time to eat” (Colorado).

  Nurses describe affairs with married doctors, trysts with residents, techs, and fellow nurses, and certain units that are more infamous than others. “Some places, everyone is banging each other and it’s an incestuous circle,” said a Delaware nurse. “ERs are notorious. The nurse is hooking up with the medic, who is also seeing the case manager, who just got the physician pregnant. It happens whenever you put young, money-strapped, stressed-out people together for long hours with few breaks.”

  It also happens on hospital property. Nurses have gotten intimate in on-call rooms, equipment lockers, storage closets, linen closets, family conference rooms, stairwells, visitor bathrooms, libraries, patient rooms, offices, and parking lots.

  Nurses offer several reasons for their coworkers’ allure, beyond what a Washington nurse who slept with a cardiology tech called the “heady” feeling of conducting an illicit relationship in a taboo place. In any situation when people constantly spend long hours together, they are more likely to consider each other potential romantic partners. “Sexual exploits are bound to happen,” said a Virginia nurse practitioner who dated a med student. “When I worked in the ER, there were always residents who’d try to convince younger nurses to join them in the call room at night.”

  The medical setting adds an intoxicating variable: Surrounded by reminders of mortality and infused with the adrenaline rush of tackling emergencies, medical professionals can get caught up in the enticement of sex and affairs. A Pennsylvania nurse attributed some of her nursing expertise to a mild flirtation with a resident: “I wanted to be in the same room with him, so I tried to predict what cases he would be attending and ask to be assigned. Those were big cases—partial gastrectomy, abdominal aneurysms, thoracic procedures—and I grew as an OR nurse because of that.”

  Nurses said they hook up with coworkers for the same reason they are drawn to police officers and firefighters: They “get it.” Emergency personnel understand what it’s like to save a life, to face a trauma, to try to help, to fail. “It’s like any kind of trauma: Those who survive the experience have memories in common. It’s harder to go home to a spouse who has no idea what the trenches are like,” said an advanced-practice nursing professor in Texas. “When people work under stress, they bond, and sometimes the bonding crosses over to sexual activity.”

  Hospitals carry a longtime tradition of nurses marrying doctors. Years ago, when most doctors were male, “residency was all-consuming, so the only women they met were at the hospital,” said a Michigan women’s- health nurse who married a resident. “Every year in June, teaching hospitals distribute pictures of the residents. When I was a young nurse, the pictures would become marked with ‘M’ or ‘S’ for married or single, so we would all know who was available. Of course, now that more women are residents, doctors marry other doctors.”

  If colleagues can remain discreet, as in any workplace, are their relationships such a bad thing? “We’ve gone to a quiet stairwell, or outside when it was dark, listening for someone coming,” said an Indiana psychiatric nurse who has dated a security guard and a cafeteria worker at her hospital. “People are able to keep it a secret unless they work directly with one another and act like awkward idiots.”

  Or unless they’re caught in the act. At one East Coast hospital, a camera captured a nurse giving oral sex to a surgeon in the library. “They were both reprimanded and the entire hospital staff found out about it, which had to be the most embarrassing thing ever,” said a travel nurse assigned to the hospital. “CCTV is a bad, bad thing for a secret hospital rendezvous.”

  As happens anywhere, intimate relationships can strain interactions with coworkers, who may feel they have to take sides, keep secrets, or avoid drama. An Arizona oncology nurse’s coworker dated several doctors in the same hospital. “She became a joke among the docs,” the nurse said. “Everyone in her department lost respect for her. At multiple social events, she showed up clinging to the arm of a different doctor each time. Bad social move, bad career move.”

  After a Louisiana oncology nurse accidentally walked in on her preceptor having sex with a doctor, the preceptor criticized the new nurse daily until she drove her out of the job. “Usually, it only causes issues when there’s a breakup or jealousy. It makes it hard to work when they are fighting,” said an Indiana nurse whose unit included two nurses having affairs with three doctors. “We do have fun, but there have been times when it has gone too far. The younger nurses aren’t that discreet and can get distracted by drama. A new nurse had an affair with an older nurse’s husband, a respiratory therapist, and flaunted it. Needless to say, the new nurse found it difficult to work here and transferred.”

  The double standard

  It takes two (or, in the case of nurses caught having sex in a Scottish hospital’s geriatric ward closet, three), but the nurse commonly suffers more consequences than the doctor. Upon learning that a nurse manager was sleeping with a doctor, Virginia administrators fired the nurse and eventually promoted the doctor, even though the couple got married. When a resident and a nurse were caught having sex in an Eastern Maryland hospital supply closet, the hospital gave the resident a slap on the wrist but fired the nurse.

  There is an odd dichotomy by which the public seems to want to sexualize nurses yet keep them from having sex; they can be whorish angels but not angelic whores, nor anything in between. In the U.K., a writer remarked, “As Britons, we are obsessed with the ‘naughtiness’ of nursing.”

  When a group of nurses posed in their underwear for a calendar, the U.K.’s Nursing and Midwifery Council (NMC) threatened to remove them from the register (roughly equivalent to rescinding their licenses). An NMC spokesperson said, “Nurses are expected to uphold the good reputation of their profession at all times. This is clearly stated in your Code of Conduct, and failure to comply may bring your fitness to practice into question.” First, this happened in the same c
ountry in which buses advertised a nurse wearing not much more than the calendar models. And second, to expect a nurse to follow an employer’s rules “at all times” is ludicrous. The NMC sounded like college sorority officers, vetting clothing, demanding pages’ worth of arbitrary codes of conduct, and attempting to govern members’ nonsorority activities. Like any other professionals, nurses have independent lives outside of work. Why should a regulatory organization expect to control nurses’ lives when there is no comparable oversight for, say, accountants?

  The double standard struck again when radiology staff at another U.K. hospital posed nude for a charity fund-raising calendar: The Nursing Times reported that there were no complaints. And a London hospital knowingly rented out a ward to a company that shot a big-budget pornographic film inside.

  Britons do seem to obsess over the topic. Lord Benjamin Mancroft, a Tory peer (similar to a senator), delivered a House of Lords speech in which he complained that nurses at the hospital to which he was admitted were “promiscuous.” (His evidence was that he overheard his nurses chatting about their social lives.) He made this announcement a couple of months after the Council for Healthcare Regulatory Excellence issued “sexual boundaries” guidelines to health professionals, whose failure to comply could result in loss of license. Among other stipulations, the ruling banned doctors and nurses from dating patients.

  Nurse-patient sex

  Nurse-patient relationships open a new can of controversies. Minnesota’s Mayo Clinic fired a male neurology nurse for “maltreatment of a vulnerable adult” because he had sex with a patient several times in her bathroom. But the Minnesota Health Department subsequently determined that the man had not violated state rules because the relationship was consensual.