The Making of a Nurse (32 page)

She showed me the letter the family had written the College of Nurses. “What was the nurse’s motive in silencing the alarm?” they’d asked. “What was she trying to hide by pushing us out of the door with no explanation of what was taking place?” they wanted to know. “The nurse gave our mother a needle, then the monitor went flat and she told us to get out. Next thing we knew the doctor came to tell us our mother was dead. Why didn’t the nurse call him sooner?”

Jenna explained, “I got up on the witness stand and explained everything as best I could. Our manager attested to the fact that I was a safe nurse with a good record. The family were furious. I tried to tell them how sorry I was for their loss, but they turned away when I spoke.”

“What was the outcome of the hearing?”

“It’s still before the committee. They will announce their decision in a few weeks.”

As we said goodbye, I hugged her and wished her good luck. We both knew, but didn’t say, that if it did not go in her favour, Jenna could lose her nursing licence. I wished her well with the pregnancy and her health, because much more was at stake here than her career.

A month later, I called to see how she was doing and if she’d heard anything.

“The matter has been settled,” Jenna said wearily. “At least for now.”

“What do you mean?”

“The committee’s decision was to take no action. They said I had not breached professional nursing standards and that I had responded in a timely and correct fashion to the emergency, but the family is appealing the ruling so the final verdict is still pending.”

How conversant she had had to become in this forbidding language, relaying it without emotion, sounding neither encouraged nor vindicated, neither bitter nor disheartened, either.

“How are you feeling, Jenna?” I asked cautiously.

“I’m having problems with the pregnancy, bleeding and cramps,” she said dully. “I’ll be off for a while on bed rest to try to prevent a miscarriage like last time.”

“You must be relieved that this trial nightmare is over.”

“Yes, I am,” she said quietly, unconvincingly.

I thought about all that Jenna had done and not done. In my opinion, she acted professionally and competently that night, but what she had neglected to do was let the family in immediately. Perhaps if they had seen for themselves, they would have realized that everything possible was being done to save their mother. Jenna’s desire to protect the family from seeing a messy, frightening resuscitation worked against her, even though her intention was good. In the end, it was a sad story of a grief-stricken family trying to make sense of their loss and an aggrieved nurse caught in the middle. There were no winners.

Perhaps for some, the act of blaming others imparts a sense of relief. It may be that such a fight is a way for some people to honour the memory of a loved one, or is a part of their own healing process. For some people I even suspect it may be an attempt to avenge the bitter loss. But do explanations actually offer consolation? Does blame ever make anything better? I have experienced many losses, but never one that I attributed to someone else’s fault, so perhaps I don’t understand. I do believe that it is only by moving from anger and retribution to understanding and forgiveness that there is any hope of improving safety and building trusting relationships.

FINALLY, TIKKI RETURNED
from her vacation. We arranged to meet on a day that we both had off work, away from the
ICU
but at the hospital Starbucks kiosk, rather than at the usual Tim Hortons (or “Timmie Ho’s,” as some call it) because they had more comfortable chairs. Most nurses drank Tim Hortons on the run and if they preferred the darker roasts at Starbucks, it was always “to go.” In between cases, doctors may be able to make time to meet for coffee and others do so in between meetings, but for nurses, our time is not our own and we can’t run off from our patients, sit and linger
over café lattes at these blond wood tables, listening to piped-in jazz in the middle of the afternoon. Our work rarely allowed time for reflective pauses or discussions unless we arranged for it after hours, on our own time. As I waited for Tikki, I looked around. Sitting at the other tables were managers and administrators, wearing stylish suits and jackets of sophisticated hues. I overheard one telling the others that she had observed a nurse standing outside a patient’s door checking off a list of tasks. “Tick, tick, tick,” she said contemptuously. “Is that all nurses do nowadays?”

Tikki arrived and apologized for being late. She pulled her earphones out and sat down. “Wassup?” She seemed puzzled.

“Tikki,” I started. “You’ve been in the
ICU
five months. How do you like it?”

“It’s awesome. I love it. You’ve been a big help, Tilda. I really appreciate it.”

“How do you think you’re doing?” I saw she had no idea that there was a problem. I took a deep breath. “Tikki, I have serious concerns about your work.” She looked shocked at the suggestion that her practice was other than impeccable. I spread out my notes on the table so we could look at them together. Her bad-girl tattoos and cocky manner now seemed like so much bravado. She looked like a lost little girl. I steeled myself to present my long list of complaints. When I came to the end, Tikki was no longer surprised or bewildered. She was enraged. She stood up.

“Fuck you, Tilda! You’re trying to ruin my career! I’ve only worked in the
ICU
such a short time and you haven’t stopped picking on me. Give me a break! These are such little things you’re finding fault with. This is harassment! I’m going to take it to the union and file a grievance against you.” She spat out the words at me. I sat there in silence and accepted the venom. It was such a small price to pay for the satisfaction of doing the right thing.

“R
emember the days when we used to work in teams?” Noreen asked. We were sitting in the staff lounge and had a few more minutes before we had to get back to our patients. I looked at her over the top of my newspaper. “Do I remember? How could I ever forget? Those women are my sisters.”

Christmas had been the last time I’d seen them. Now it was February and my birthday was coming up, so I knew we’d be getting together soon.

“You were on Laura’s Line, weren’t you?” Noreen asked. “Did Laura become a doctor?”

“No, that didn’t pan out, but she acts like one and still bosses doctors around.”

“Tracy was part of your team, too, wasn’t she, but what about the others?”

“Frances works with Laura in an out-patient clinic, assisting with angiograms and biopsies. Nicky moved to the States with her husband. She’s still a scratch golfer and now has three kids and works part-time in a cardiovascular
ICU
.”

“What about Justine? Now, there was a real go-to kind of gal! I always thought she would become a lawyer or go into politics. What a great sense of humour she had. Once, I got on an elevator with her and she called out, ‘Let me off at the liposuction suite!’ Everyone was in stitches!”

“Justine also has three kids. She’s a hockey mom, plays baseball on a women’s team, and has her own business. She’s doing great and looks fantastic.”

ON THE SATURDAY
closest to my birthday, we met for afternoon tea at a funky, bohemian place on Queen Street called the Red Tea Box.

“Who chose
this
joint?” Justine asked, rolling her eyes.

“Tilda, of course,” Laura gestured at me. “It’s artsy-fartsy.”

“Hey Tilda, are you and Tracy still torturing people in the
ICU
?” Justine asked. “D’you guys remember that patient’s son who called Tilda the Angel of Death? Say, isn’t it time to move on from the
ICU
? Haven’t you had enough?”

“Not yet. I still haven’t figured it all out,” I said.

“If that’s the case, then you’ll never leave.” Justine shook her head in amazement. “I can’t believe you two still work there. Do the families still call the shots and demand everything be done before their loved one croaks? If those patients could talk, they’d beg for a visit from Dr. Kevorkian!”

“Do you guys remember that patient’s wife with the weird hair that was all teased and matted?” I asked. “The one that Justine threatened, ‘I’m going to hold you upside down and use you for a mop!’ and instead of being insulted, she howled with laughter.”

We remembered that – and much more. I looked around the table at them and silently hoped there would be mentors like them for new nurses coming along. I told them about Tikki, how angry she was and how she was threatening to make trouble for me with the union.

Laura didn’t need a moment to think it over. “Get rid of her. Make sure she doesn’t come anywhere near patients. You have a responsibility to see she gets the boot.”

“She said I wasn’t giving her a chance and that I was trying to ruin her career.”

“Suck it up, princess. Get over it. The stakes are too high in the
ICU
to mess around.”

“I have to agree,” said Tracy quietly. “She’s a scary nurse.”

Only Frances felt differently. “Don’t give up on her, Tilda,” she advised. “Not just yet. Maybe she just needs more time buddied with you.” I suddenly remembered how hard Frances had worked with me and how patient she had been with me in my early
ICU
days. It was unthinkable to Frances to give up on someone. “Tell her you’re prepared to keep working with her and point out where she needs to improve. Oh, geez, I’m having a hot flash.” Frances pulled out a fan and flapped it madly at her face.

We
were
getting older, weren’t we?

“It used to be all you had to say was ‘panties’ to make Frances blush,” chortled Justine. “Hey, Frances, have you been following the case of the Recipe Robber? There’s this thief who goes around making demands for cash on the back of recipe cards. ‘Gimme $1,000,000’ on one side and ‘Mom’s Chocolate Cake’ on the other!”

Frances had a predilection for collecting recipes, following weird crimes in the news, and reading the obituary column in the newspaper too, word for word.

“Mmm … chocolate reminds me of Nell’s classic candy diagnosis,” Laura said with glee.

(I don’t think we’d ever gotten together and not exchanged tales of our colleague super-nurse Nell Mason, whose legend lives on, long after her untimely death.)

“That was one of my faves,” I chuckled, but Tracy didn’t remember it so Justine filled her in.

“That was when Nell was running an Emergency department single-handedly and a woman came in with an unusual gynecological problem. Nell figured out she’d stuck a Mars Bar up there!”

“The tip-off must have been the nougat and caramel dripping down her legs,” said Laura dryly, with a snort of contempt for Nell’s outrageous confabulations, her brilliance as a nurse notwithstanding.

Justine remembered another tall tale. “How about when Nell was an outpost nurse on a native reserve, delivering babies and performing appendectomies – according to her – and this old Cree woman came in with a foul stench? Nell examined her and found a festering crow inside of her. She said she had to remove feathers and little bones.”

“What about her claim that she never went to the bathroom at the hospital in all her years working there? I suppose she adopted the water-retention ability of her pet camel,” Laura said, “the one she used to ride to school, dontcha remember? Imagine, riding a camel in Thunder Bay! Did she really think we believed those stories? Hey, did she ever tell you about her practice of scatomancy?”

“What the hell is that?” asked Justine.

“She claimed she could tell people’s fortunes by examining their feces.”

“Eeewww!” we all exclaimed, laughing helplessly.

“Well, I always said old Nell was full of shit,” scoffed Laura, but then looked a bit remorseful for making fun of Nell once again. I think we all regretted that we hadn’t recognized that Nell was seriously ill. In the end she died at home alone, after a long and private battle with alcoholism.

“None of us ever really knew the late, great Nell Mason,” I said.

“Yes,” said Justine sincerely. “Nell was Über-Nurse.”

“Let’s have cake,” said Frances. “It’s Tilda’s birthday.”

THE NEXT DAY AT WORK
, Tikki was back and I found a moment to speak with her privately. “Listen, Tikki, if you are willing, we can continue to work together and if we review some of the …”

She shook her head. “At first I was upset with you, Tilda. I don’t usually let anyone push me around like that and I really took it hard but now I feel,
whatever.”
She gave a wave of indifference. “I’ve decided to go back to school for my Master’s in Nursing, so I can teach or do research.”

I was blown away. Did I look as astonished as I felt?

“Don’t worry, it’s no biggie,” she said with a shrug and worked her last shift without incident.

I wasn’t sorry to see Tikki go but we
had
been losing a lot of nurses lately. Chandra had left and Jenna was still off work for health reasons. Monica would soon complete her Master’s degree and was already looking for a position in management. Even Tracy had been thinking of moving on and trying something different, such as public health nursing, after nearly twenty years in the icu. The loss of experienced nurses had been putting a real stress on the icu. We were short-staffed on almost every shift and sick-time and overtime costs were cutting deeply into the budget. The
ICU
had been crazy-busy for more than a year and we’d been working non-stop. The moment one patient was discharged, another was right there. Nurses were complaining they were feeling like factory workers on an assembly line, trying to keep up with the pace that showed no signs of letting up.

It was easy to see why more patients needed to come to the icu. You only had to walk through the wards to see that the floor patients were sicker than ever. In today’s hospitals, patients who used to be treated on the floors are now being discharged home “sicker and quicker,” nurses on the floor always say. More and more, patients who are in the hospital need closer monitoring, quicker intervention, and the attention to detail that we are able to provide in the icu.