My Nursing Rotation at a County Hospital

My Nursing Rotation at a County Hospital

Was I ready to care for a patient in the ventilator unit? I would soon find out.

It was early morning at the county hospital.  I was in my patient’s bathroom, measuring his urine output.  He was a comatose patient, part of his head blown away by a gunshot, his body curled in upon itself with contractures as bodies do when they no longer work in the world.  They seek a smaller space, hunger for the womb.

My body was very present, tense, moving quickly though not always deftly to care for this man who breathed with the aid of a machine, a man among many in the ventilator unit at the county facility–Oak Forest Hospital.  This was my job, my current rotation for nursing school.  And it had its consequences.

My stomach cramped each morning as I pulled on white pants and shirt and my student smock.   I arrived at my son’s sitter early—a reflex I couldn’t explain.  Maybe this rotation held echoes of those fear-filled dreams when your legs won’t work and you can’t run up a hill or walk down a street.  Because when I parked my car each day for this six week period, I wasn’t sure I would make it into the building.

Oak Forest had history.  The maze of hallways and equally confusing basement corridors revealed its original existence as a U.S. Army Base, later used to house the poor and mentally ill of Chicago.  Health care in those early years was custodial at best and many of the patients ended their stay in a monument-free potter’s field behind the thick-walled buildings.  Now it was a county medical facility whose reputation had changed for the better.

And I had a history with Oak Forest.  In high school I joined an organization whose Sunday project was to wheel Oak Forest patients to chapel.  I knew little of hospitals, except for a childhood surgery.  I signed on.  I was sixteen and in the end a complete failure.

The hallways echoed with footfalls and the cries of people in pain or people just needing to cast their voices into the air hoping for something—a few words from another human who would come to their lonely rooms, spend precious moments with them.  That only morning a feeble woman collapsed against me, her cane clattering to the floor.  I grabbed at her, feeling her boney arms and chest.  She wore the same blue and green floral bathrobe that hung in my closet.  I never went again.

Now I was back at Oak Forest.

I looked up and saw my face in the mirror above the sink.  My forty-five year old face.  Pale skin, hair disheveled, my eyes staring.  I said aloud, What am I doing here?   I loved nursing school.  But this?  Maybe I wanted an answer that would allow me to wash my hands and walk out of the room.  I could escape to my car where with the windows down I would drive out of the endless parking lot, blast my radio, then look up at the budding trees in the true-blue sky.  Really, what was I doing here?  I wanted to bolt.

I rinsed the bedpan.  I had two amazing daughters, one in high school, the other in college.  I had a loving husband who worked long hours for us in an office in the city.  And I had my son, born when I was 42, a longed-for child.  Why was I leaving him with a sitter to plunge myself into the intricacies of anatomy and physiology, to memorize the Krebs cycle and the bones in the body, to understand the workings of each human organ?  Would I truly remember the myriad pathologies I was being exposed to and the medications and protocols used to cure them?

I must.  Medicine had become an obsession which had its roots in my father’s death.  Well, that was the most logical explanation.  He died of a myocardial infarction, better known as a heart attack, when I was three.  As I grew, I plagued my mother with questions trying to understand why he died, why he left me.  Coronary artery disease brought on by genetics, stress and a high cholesterol diet—eventually those were my conclusions.  Some logic entered my life when the pieces of such an overpowering puzzle began to fit.  But it wasn’t enough.  Something pushed from inside me—a yearning that might also help me care for the greatest gift each of us possesses—our own human body.  For me it was always more than brush your teeth if you want to keep them; eat carrots to help your eyes; wear sun block.  A psychologist might analyze my present career choice and accuse me of trying to trade the sorrow of my father’s loss for some control over my own life.  That person might be on track.

But right then in that patient bathroom my goals were illusive and shaky.  I knew there was a square of sunshine falling on the wooden floor in my family room.  I could almost feel its warmth, see my garden beyond, the daffodils shaking their bright heads, the grass bravely reaching to the spring sky as my son and I ran through the yard laughing about lunch under the apple tree or a bike ride.  Did my patient in the next room still have some amazing pictures of his past life floating around?  Maybe a woman he loved, her hair dancing around her face.  Maybe a stream where he fished with a friend.  Could that portion of his brain that still made his heart pump and his blood perfuse his organs, could it give him something besides unconsciousness and contractures and a look on his face that wasn’t about peace yet wasn’t about anger either?

You don’t learn about death in nursing school.  Surely you are able to list the things that cause the human body to give up—fluid filling the lungs, heart muscle dying.  Merely words.    In the hospital, you come face to face with death; you see its relentless grip.  Like caring for an old woman whose chart predicted she could die on my shift.  I monitored her vitals and breathing.  I knew what to do if she did die, physical things—wash the body, wrap it.  I remembered lectures about the importance of kindness toward family members as they witness a loved one die.  But this woman had no one.  And death hovered.

There can also be endless struggle.  Ronnie’s chart read: Twenty-two year old black male, gunshot wound to C-2, quadriplegia.  When I stood by his bedside he was groggy from drugged sleep.  He looked at me and something like a jolting pain flashed across his face.   Then it was gone.  It wasn’t physical pain but the pain of awareness and remembering.  He could only move his head.  He forced a smile, then fought the ventilator tube, riding breaths to get his message out— “Nice, nice.  They like me here, see.  They send you.  Ronnie gets what he wants.”  Snappy and cool, setting the limits the way he saw them.  Giving him some control, because he had none over any other part of his life experience.

Oak Forest Hospital.  Death, but also life.  I fumbled for the list of notes in my pocket—the report given to me by my nursing teacher when my shift started.  Those few scribbled words described my patient, the man in the next room, the life I was caring for.

He had me.  But again, that was all he had.  I had a family.  I had power over my arms and legs.  I could enter nursing school at 43 and learn about the filtering capabilities of the kidney, the powerful functions of the brain.  I could plant a garden, make love to my husband, enjoy a glass of wine.  I could turn from my tired face in the mirror and complete my duties for this man—bathe him, push nutrients through his stomach tube, talk to him.

I learned about living in nursing school.  On that particular day,  because of those few hours of caring for a solitary man, because of those days of my rotation at Oak Forest Hospital, because of the years beyond when I would continue to love and help people as a nurse and as a person living in the world, my life moved forward not backward.  A single fortunate day that made me a better mother to my baby son and my family.  One that would color and affect all the other days—birthdays, graduations, weddings, the landmarks of life.   For then I was able to wipe away a past failure, to steady and tighten a loose bolt in the foundation of my character.   Each of us has such a day in our living.  We only need to search for it and then hold on to it—a precious gift.

I walked back into my patient’s room.  Now I truly knew what I was doing there.  He had me and I had him.  He relied on me and I stayed and helped him.  In doing so, I helped myself.

Thanks to Google Images