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

by Alexandra Robbins

  One night, a nurse mentioned that Dr. Spiros had helped her out of a tight spot with a seriously ill patient.

  Sam scoffed. “He wasn’t an ass?”

  The nurse looked at Sam quizzically. “Oh, no, no, no! He’s a nice guy who did right by my patient.” The nurse told her that Dr. Spiros had gone through a sad divorce the year before. “When he told me about it, he got all teary-eyed and said he just wanted to find the right person,” she said, shaking her head sympathetically.

  “Really? I just find him pompous,” Sam said.

  “Oh, but he’s so nice. Seriously, he’s Mr. Nice Guy.”

  Sam doubted that. An hour later, when Sam went to the minor care nurses station to document patient information, Dr. Spiros was telling another nurse about his recent trip to Greece. The other nurse brought Sam into the conversation before she left.

  “I’d love to go there someday,” Sam said.

  Dr. Spiros pointed to the surname on her badge. “Where’s that name from?”

  “I’m Greek, can’t you tell?” Sam answered.

  “That can’t be right,” he said.

  “My grandparents lived closer to Italy.”

  Beneath his tousled hair, Dr. Spiros fixed his deep brown eyes on Sam as if she were the only person in the room. “Oh, really. So you’re supposed to be pretty fiery . . . ” He grinned at her. “And ‘Sam’? Not short for Samantha?”

  “Salome.”

  “Salome! It means ‘peace.’ Fitting.” He raised an eyebrow. “So, Sam. Why are you so quiet?”

  Sam adjusted her glasses for a moment to avoid the intense gaze of this hunky doctor. Why was she quiet? There were several reasons. She liked to observe her surroundings, to soak them in, rather than to insert herself clumsily into them. Somehow the words in her head rarely exited her mouth as elegantly as she had hoped. She preferred to “feel things out” rather than charge headlong into a situation. And she didn’t believe in jabbering only to fill a silence; silence could be beautiful, and illuminating.

  When she looked up, Dr. Spiros was still smiling amiably at her. “If I’m talking then I can’t listen, and if I’m not listening, I won’t learn,” she said, sincere.

  “You’re like a little mystery,” he mused.

  For the next ten minutes, Dr. Spiros gradually drew Sam out by asking her about local Greek restaurants. He had unknowingly hit her sweet spot. She found it easy to speak enthusiastically about food.

  That night, as Sam did her rounds, she reflected on the conversation. Okay, maybe he is a nice guy, she thought. He must have just been off whenever we’ve interacted before.

  When Sam woke up the following afternoon, she sent Dr. Spiros a Facebook message to reinforce their positive momentum. “Hey! Thanks for livening up the shift!”

  He wrote her back quickly. “Likewise. What was the name of that especially good Greek restaurant again? Perhaps we should go there together.”

  Well, this was interesting. She had not seen this one coming. Dr. Spiros was more than ten years older than Sam and had a strong reputation at Citycenter. She was hesitant to date someone she worked with again. She had dated a murse for four months when she was a tech at Pines, and had later regretted it; the murse was fun but too immature. After she broke up with him, she knew that he had spread rumors about her, blabbing to the staff that she was a wild woman in bed. Hospitals were small worlds. It was hard to command respect in an environment in which people assumed she was promiscuous.

  Dr. Spiros had already made the move, though, which meant that she was destined for awkwardness either way. Sam felt obligated to give him a chance because he had asked her. Maybe it could work out. After all, she had apparently already misjudged him as a pompous ass and he had proved her wrong. And she preferred relationships with medical professionals anyway, because they understood her interests and schedule better than anyone else.

  During her next shift, Sam did some subtle investigating. Dr. Spiros was supposedly dating a tech, but after some small talk with another tech, Sam discovered they’d broken up. The following day, he asked when Sam was available for dinner and they worked out the logistics.

  That night, Sam sought out William at the nurses station. She told him that Dr. Spiros had asked her out. “Is it crazy for me to do this? If this is a bad idea, I don’t want to do it,” she said. “I’m not in love with him or anything. I don’t need to make life tricky for myself.”

  William gave her a look that she couldn’t interpret. “I guess there’s no hope for you and me then,” he said. For a moment, Sam gazed into his soulful eyes and wondered briefly if he was flirting or joking.

  She quickly dismissed the thought. “Get to the point,” she said. “We’re not talking about you and me.” She wished they were. William was the man of her dreams. Sam could see no reason why he would be interested in her. From what she had heard, his long-distance girlfriend was beautiful, generous, and a heck of a nurse.

  He had, however, made a point of teaching Sam some valuable nurse tricks, such as a way to outwit the Pyxis in order to get extra medication for a patient without having to wait for the pharmacy. She appreciated his subtle manner of instructing her. He would say, “You can do this your own way, but I like to do it like this.” He was the ideal nursing mentor: caring, approachable, and wise.

  William exhaled. “It’s fine to see Spiros. Just don’t go making out in the on-call room.” Sam had heard rumors about the on-call room. On a few occasions, while wheeling patients to the elevators, she had heard unmistakable rumblings from behind that door. Hooking up in the hospital was definitely not Sam’s style.

  JULIETTE   PINES MEMORIAL, October

  Nurses were buzzing about a cookout that Anastasia, the leader of the nurse clique, was hosting for hospital staff. Juliette could see Anastasia inviting several of their coworkers and mutual friends on their individual Facebook walls. She waited for Anastasia to invite her. Anastasia was calling it the Pines Memorial Cookout, for Pete’s sake. She had even invited Charlene, and Juliette knew that Anastasia didn’t like Charlene.

  Juliette had considered unfriending Anastasia so that her Facebook posts wouldn’t torture her anymore. But everyone at Pines was Facebook friends with one another, and the nurses were constantly Facebooking at the nurses station. Juliette had joined Facebook when she was hired at Pines specifically because the network was an integral part of those nurses’ lives.

  Juliette’s favorite tech noticed that Juliette’s mood had dipped. “What’s bothering you, Juliette?” asked Mimi.

  “The whole Anastasia thing about the party,” Juliette said. “I can’t believe she didn’t even invite me.”

  “Oh, I wouldn’t worry about that,” Mimi said.

  “I do worry about that!”

  “Anastasia’s the kind of person who will walk by me and not even say hello,” Mimi said.

  “Really?” At least Anastasia was cordial to Juliette in person.

  “Absolutely. She’s just part of that clique,” Mimi said, shrugging as she left to check on a patient.

  Juliette wished she could ignore the clique’s behavior like Mimi did. Then again, Mimi probably didn’t have Juliette’s insecurities; she was slender and fit.

  Juliette rubbed her temple and smoothed her auburn hair off her forehead. She had a terrible headache. She got migraines regularly, headaches that knocked her flat with pain and nausea. She had told only Priscilla, Molly, and Lara about them. Her primary care doctor didn’t believe in prescribing narcotics, but the medications he did prescribe rarely worked. In desperation, Juliette had asked for a Percocet prescription from a PA who had prescribed her antibiotics in the past. With the hours nurses worked, getting prescriptions at the hospital sure beat waiting for a primary care doctor’s appointment.

  The Percocet soothed the migraines within forty-five minutes, but the headaches returned at least on
ce a month and Juliette’s prescription was running out. Percocet was the most efficient, if not an optimal, solution. She did not have time to deal with headaches at work, and she certainly didn’t have time to deal with them at home.

  Priscilla, Pines’ nursing director, was the only person at Pines who knew about Juliette’s home life; this was one of several secrets Juliette had confided to Priscilla. Juliette’s husband, a data center manager, was an unrepentant workaholic. Juliette knew this when she married him, but the problem had accelerated over the years. Nearly every night after dinner, Tim went back to the office for hours, endlessly stressed about earning enough money. The rest of the day, Tim was an attentive husband and father, smart, interesting, and helpful; he took Michelle to and from school and got her ready in the morning. But his insistence on working nights had put a strain on their marriage.

  In the evenings, Juliette would rush around, trying to manage the household herself. She would go to bed later than she should, hit the snooze button in the morning, and fight traffic on the long commute to the ER. She often arrived at work five to ten minutes late.

  That afternoon, after giving a patient a dose of Dilaudid, Juliette palmed the half-full glass cylinder. It was the length of her index finger and about 3 millimeters in diameter. It would be so easy to take this home, she thought. Prescription costs added up. No one will know if I take some. It’s not like I’m shooting up at work. It would just be a home injection of a med that we were going to throw out anyway. Patients often came into the ER seeking narcotics, and got them. Why couldn’t a nurse who truly needed the medicine have it, too?

  When a new patient arrived, Juliette put the Dilaudid in her pocket. She would think about it later. The patient, a middle-aged woman with orange-tinted hair, was complaining of back and neck pain and trouble with urination. She told Juliette and the ER doctor that she had waited for an hour in the lobby. “This can’t take very long, because my dog’s in the car,” the woman said.

  “Why did you bring your dog?” asked Dr. Mark Kazumi, a generally pleasant man. Juliette liked working with Dr. Kazumi. Other nurses teased him because he ordered a lot of labs. But Juliette appreciated that he tried to do right by his patients.

  “I didn’t think it would take very long,” the patient said. Many ER patients assumed that service should be like fast food: Get in, get your orders, get out.

  “Well, it’s going to take a little bit of time,” the doctor said. “I can’t make it quick for you. I’ve ordered a urinalysis and a CT scan.”

  When Dr. Kazumi and Juliette left the room, he turned to her. “Juliette, I need you to check on the dog.”

  “Are you serious?” Juliette asked. It was a balmy, breezy October day.

  “Yeah. The dog can’t be left outside alone. It’s against the law,” the doctor said. “The dog could suffocate out there; it could be stolen. You need to find the dog, and I’m going to call the police on her if it’s not okay.”

  Juliette sighed. “Don’t call the police.” She returned to the patient’s room.

  “Where are you parked?” she asked the woman as she wheeled her to radiology.

  “In front of the ER.”

  That was helpful, Juliette thought. “Can you give me more of a description?”

  “No. I’m in front of the ER.”

  “What kind of car?”

  “Accord.”

  “What color?”

  “Silver.”

  While the woman was in the CT room, Juliette went outside. There was no silver Accord in front of the ER. There were, however, several silver Accords throughout the parking lot. Juliette grumbled to herself. I have four other patients but I’m out here searching for a Bichon in an Accord.

  After ten minutes and eight empty silver Accords, Juliette called the tech in the CT room. “Can you please ask Mrs. Swirsky where exactly she parked?”

  Juliette could hear the patient saying, “The dog is fine. I knitted him a blanket and he’s sleeping on it.”

  The tech came back on the line. “She doesn’t remember.”

  Juliette continued to wander the parking lot, her headache now weightier beneath the disappointments of drudgeries that had little to do with her job.

  LARA   SOUTH GENERAL HOSPITAL, October

  On a crisp afternoon, Lara’s friend Juliette called to say hi. After some small talk, Juliette mentioned her migraines and her struggle with them at work and at home. “It’s really inconvenient, because my regular doctor won’t prescribe narcotics, so I got Percocet from a PA. It wouldn’t be a big deal if I took a wasted vial from the ER now and then, right? They’re just going to get thrown out. I still have one in my pocket because I forgot to waste it.”

  Lara froze. This sounded all too familiar. “That would definitely be a big deal. I’m really worried about you,” Lara said. “You’re talking intramuscular use.”

  “Oh, it’s just occasional,” Juliette said. “I was thinking I could give myself a shot of Dilaudid to get rid of my headaches. But only if they’re really bad.”

  “Yeah, but I’m really worried. Narcotics are a slippery slope.”

  “There’s nothing to worry about! It’s just for my headaches. You know how bad my migraines get. The Dilaudid would be only point-five milligrams at a time.”

  “It’s still narcotic use and you’re talking about stealing,” Lara pressed.

  “Only one or two times a month,” Juliette said.

  “Juliette, listen!” Lara said. “You are using drugs. You’re using drugs! You’re softening it too much. I’m afraid you’re going to end up in a situation like I did where you have to have it or else you’re sick. When you use narcotics, you get rebound headaches. They’re the worst.”

  “Oh, it’s just intramuscular. It’s not in a vein,” Juliette said.

  “That’s bullshit,” Lara said. “No normal person brings home narcotics and gives themselves shots.” The first few times Lara brought narcotics home from the hospital, she, too, had rationalized it as “just occasional.” Then she told herself she did it because “I like the buzz.” And then “That guy was a jerk.” Eventually, she didn’t bother with excuses. Lara decided that Juliette had told her about the Dilaudid because she wanted help.

  She took another approach. “From my history and experience, I’m afraid for you to go through the same hell I went through. It’s a nightmare. I don’t want that to happen to you. Throw it out.”

  Juliette was silent. “Well, maybe you’re right,” she said. “I have enough issues with eating, anyway. I don’t need to have anything else. And I don’t want to get in trouble or disappoint Priscilla.”

  That’s the least of your worries, Lara thought. Lara believed Juliette cared too much about what Priscilla thought of her because the nursing director was Juliette’s only confidante at Pines. Sometimes Lara wondered if Juliette was confusing Priscilla’s managerial tendency to let employee transgressions slide—in Juliette’s case, late arrivals to work—with friendship. Lara wished Juliette had more faith in herself. Juliette was a fantastic, knowledgeable nurse who was an unwavering advocate for her patients. She shouldn’t need to seek her supervisor’s approval to validate her self-worth.

  A few days later, Juliette texted Lara. “I’ve been thinking about what you said. I threw out the vial and I’ll go ahead and look into some other options for my headaches.”

  Relieved, Lara would pray for Juliette, both because she didn’t want anything bad to happen to her friend, and because she was grateful. “Listening to her downplay it reminded me I don’t want to be there again,” Lara said. “The whole Nurse Jackie thing is so prevalent. Not just nurses, but doctors, PAs. One of the NA meetings I go to is specifically for firefighters, nurses, doctors, and policemen. They don’t know who can help them watch their back.”

  Chapter 4

  When Nurses Bully Nurses:

  Hi
erarchies, Hazing, and Why They Eat Their Young

  “The nurse treats colleagues, employees, assistants, and students with respect and compassion.”

  —Code of Ethics for Nurses, Provision 1.5

  “I knew the minute it came out of my mouth that I had just ‘eaten my young.’”

  —a pediatric oncology nurse in Arizona

  MOLLY   November

  Riverport Hospital

  One day, for variety, Molly took two shifts at Riverport, a highly regarded local hospital, despite another nurse’s warning that “some of the charge nurses try to set up agency nurses to fail.” Molly didn’t mind; the timing worked with her fertility schedule. Her first IUI had been unsuccessful and she was now preparing for her second.

  She didn’t let the results get her down. Her fertility treatments affected her work life only in that she cared even less about the drama among coworkers. She had always been a diligent, focused nurse, but now that conceiving a child was at the top of her priority list, she wasn’t about to spend time or energy getting emotionally involved with non–work-related nonsense. Her goal was to come in, do her job, and go home. At Academy and South General, she could do this well. At Citycenter, it was more difficult because the conditions were so unsafe.

  At Riverport, Molly learned quickly that the warning about other nurses was accurate. The charge nurse assigned Molly four critical Priority 1 patients, each of whom needed one-to-one care. When Molly said the patients needed more attention, the nurse snapped, “I just figured you could handle it. I guess not.”

  Molly gave report that night to an incoming nurse who happened to be someone she had worked with at Citycenter. Molly told her what had happened.