Ashley rolled out of her snuggly bed into the dark cold while her husband, Jake, snored without missing a beat. She quietly stepped out of her cozy flannel jammies and pulled on her scrubs. The cold fabric hit her skin, justifying her sour mood. It wouldn't take much today.
She tiptoed past the kid's rooms like a robber but felt more like she'd been robbed. Robbed of Christmas with her family because she had to work. Robbed and guilty because she was leaving her 2 little ones without their mommy on Christmas of all days. Robbed and guilty and angry because how come a couple of new grads managed to get today off, but not her? They didn't even have kids. Well, at least Jake had said he'd bring the kids to the hospital for dinner.
An hour later, Ashley stepped out of the elevator onto her home unit, 4West. MedSurg with 10 separately staffed pediatric beds on the south end. At least half of the patient rooms were vacated, all but the sickest of patients having been discharged home or elsewhere in the days leading up to Christmas. 4West resembled a ghost town. Empty rooms with beds left in high position like soldiers at attention. Sanitized overbed tables guarding the beds. In the hallway, office doors were closed and locked, their half-door windows black. No hustle, no bustle. No chaos. It was almost eerie.
A couple of nurses were openly drinking their Starbucks at the nurse's station, daring anyone to say something. Not that anyone was about to- the rules were suspended today, CDC be damned. Jenifer, with one n, the relief charge nurse, was flipping her blonde hair even more than usual to show off her oversized purple Christmas tree earrings. Tacky, thought Ashley. She's always over the top. At least she wasn't wearing equally tacky scrubs but only because the official RN dress code was solid navy blue and the non-official dress code was Figs brand.
Ashley picked up the assignment sheet and saw that Rosa was her nursing assistant today. She rolled her eyes. Great. Rosa is old and slow and can barely speak English. She's also hard of hearing. Annoying. Why didn't she just get hearing aids? And a new hairstyle while she was at it. She just looked faded and tired, like her hair. Well. At least Rosa's patients all loved her.
Assessments and 0900 meds jump-started Ashley into her shift, and soon she was immersed in listening to lungs, troubleshooting IVs, charting, and fielding orders, interspersed with finger sticks, pain meds, and insulin coverage. She scribbled "clogged feeding tube 2014b" on her growing to-do list on her brains along with other notes, including to call a family for their loved one's POST orders and re-check the ACT on her heparin drip patient. She wondered if the wound care nurse could be reached today for a consult. Despite herself, the outside world faded away as it always did. And as always, she was surprised when whole chunks of time went by without thinking of her family.
CODE BLUE, CATH LAB! CODE BLUE, CATH LAB!
Ashley startled and then proceeded to mentally account for each of her patients. It was a reflex. She knew no one was off the floor, much less in the cath lab. It must have been a direct admit through the ED. Staff looked at each other knowingly, with small, imperceptible shakes of the head. A code in a diagnostic area? Not good.
Ashley looked down the hall to see one of the pediatric nurses pulling everyone's favorite patient, 11-month-old Mia, admitted 2 weeks ago for burns to her face, legs and left arm, in a little red wagon. Mia had only recently learned to wave, and all the staff oohed and aahed as she waved like a mini pageant princess. A little princess wrapped in gauze.
Not for the first time, it struck Ashley that Mia was the exact same age as her own little Olivia. Mia had been scalded in the bathtub while her mother was at work and the boyfriend of the month was babysitting. Ashley shuddered at the mental image, horrified. But no, she couldn't think about it. She quickly shutdown the picture in her head and compartmentalized her thoughts. She'd learned to do that. What good is a nurse with her heart always on her sleeve. She knew she could never work Peds. Too much compartmentalizing.
So far today, Mia's Mom had not shown up. But then, Mia didn't know it was Christmas- and she sure didn't know her future was filled with surgeries and burn scars, and quite likely, her lost beauty.
Finding a spare moment, Ashley went in to change the leaking IV site of her patient, Thelma, who had been extubated and transferred out of COVID ICU three days before. Thelma had been fluffed and buffed by Rosa. Her thin white hair with her pink scalp peeking through was combed and she had on old-lady red lipstick. "Thelma, you look beautiful today."
"That Rosa, she's …<gasp> really something, huh?” Thelma had to talk in spurts as she ran out of breath.
"Ummm...ya, I guess so,” said Ashley.
"I mean, how ..<gasp> many single Moms get their …<gasp> kids into Stanford medical school?”
"Excuse me..? Rosa has a kid in medical school?”
"Yes, her oldest …<gasp> daughter. One of her other girls got pregnant in …<gasp> high school. Rosa's raising her grandson, too". Wait.. thought Ashley. How did Thelma know all this?
Ashley's phone vibrated and she looked down to see Jake texting that they were about to leave and come visit. "Sorry, Thelma, I have to take this.” Ashley called him quickly "Jake? You know that fluffy white sheep I was saving for Olivia's birthday? In the closet? Could you bring it? For Mia.”
"Mia, the little burn girl?” "Yes.“
"OK"
"Wait...Jake?”
"Yes?”
"Thanks, babe. You're the best".
Next, Ashley stopped by the monitor tech's station. Lisa always had the latest info. "Hey did you hear about the code?” asked Ashley. "Ya…” said Lisa. "He went to ICU but coded again and didn't make it. A 42-year-old man with a wife and kids."
Ashley blinked and turned away. It felt like a sucker punch. What do you do on Christmas day for the rest of your life when that's the day your Dad or your husband died? Her problems suddenly seemed petty. Ashley walked to the break room for a breather and ran into Jenifer with one n. Jenifer looked at her and kindly asked, "Ashley, are you OK?” Ashley nodded, surprised that she was feeling emotional. "I'm OK. Jake and the kids are coming for dinner."
"Great! Take some extra time. I'll cover your side."
"Really? Thanks, Jenifer. I owe you.”
"Sure, girl. Just don't make fun of my earrings and we'll be even.” Jenifer whispered, "A patient's daughter gave them to me and she hasn't come in yet, so I have to keep them on. They're killing my ears, though."
It was now almost the end of her shift. Mia was asleep in her crib but Ashley tucked the fluffy sheep in close to her. She smiled to think of Mia waking up to find her present. Maybe when she came back to work in 3 days she could pretend the sheep had an owie like Mia and Ashley could wrap his leg in gauze.
After report, Ashley went to say goodbye to Thelma, who hadn't had any visitors all day. Come to think of it, Thelma never had any visitors. Ashley almost hated to leave her. She felt protective. It was one of those bittersweet end-of-shift goodbyes.
Rosa was clocking out just as Ashley got to the time clock. They rode down the elevator together.
" Rosa, are you having Christmas tonight with your family?"
"Not this night. Now I go to my other job. St. Agnes."
Ashley paused. She didn't know what to say.
"Rosa...I wanted...I just wanted to say thank you for all your good work today. I appreciate it. Thelma just loves you. Happy Holidays.”
Rosa smiled. "Feliz Navidad, mija.”
