Mary sat up from her sleep in a panic. She felt herself breathing hard as she looked towards her phone beeping. Catching her breath, she turned off the alarm and looked at the time on her phone: Five am. She looked next to her, noticing Derrick snoring with drool puddled on his pillow. She felt herself moan, forcing herself up and walked into the bathroom. Mary started her cool shower, savoring the tender massage of each drop on her back, allowing her to wake up in a more gentle fashion. She still felt panic lingering inside of her. She wanted this panic to seep out of her body and go down the drain, but its claws are already wrapped around her, injecting itself into her veins. Mary looked at her hand shake as the panic made its way through her body. Mary wanted to fight it by staying in her massaging shower longer, but she would be late for work. Mary towel dried her hair, put her scrubs on and walked downstairs to the kitchen, still feeling the panic rush through each limb of her body. She put in her earbuds, allowing the tranquil sounds of piano chords mixed with soft waves from a beach enter her mind. Mary closed her eyes as she listened to the waves, imagining them going back and forth endlessly. She pictured the white crowns of foam atop each wave turn into sand as it collapsed peacefully onto a beach she has never seen before. She thought of each peaceful wave consuming her, rushing into her body to cleanse it of the panic invasion she gets before work. She looked at the clock. “Shit!” she whispered noticing it was 5:35 am. She quickly pulled out what leftovers she found in the fridge and grabbed her cup of coffee as she ran out the door to her car in the dark.
Mary arrived to her facility and stayed inside, listening to her waves, bottling each precious second she had to herself. Each wave called to Mary, begging her to come find them. She closed her eyes, thinking about what it would be like to leave her present life and go find these waves. Maybe they will stop her from waking up in a panic before work. Maybe she could be a nurse by the ocean. Maybe she can run away from this life she has already created. A life of bills, rent, student loans, crazy work hours and a live in boyfriend of 2 years who would always find something to do when the word ‘marriage’ was heard. Mary felt reality smack her across the face, forcing her to get out of the car and to leave her serene realm. As she left her pianos and waves, she walked into a brightly florescent hallway. The cream color hallway with a maze of tan and white lines forming squares on a linoleum floor glowed brighter to Mary as she forced herself down the hall. She looked ahead and saw the punch clock, making her want to walk slower. The panic started to run faster through her body. She knew it was excited, her hands started to shake with a little more aggression. This was day five out of six for her, and she did not feel ready. Mary slowly entered her ID, hearing the beep with each digit, making her officially surrendering the idea of leaving her current life to find the waves. Taking another deep breathe, she hit a silver button with a bunch of lines on it that tried to resemble a person sitting in a wheel chair. The doors slowly open, allowing her to enter the main floor of the West 18th Avenue skilled nursing facility.
“Are you clocked in Mary?” A little blonde girl asked as she ran by, not making eye contact.
“Yep,” Mary said as she put her bags down on the nearest table and ran with the girl down the adjacent bright green and brown hallway. Mary passed a maze of familiar doors with numbers that suddenly started to blur as she approached a very familiar room.
“Oh no,” she whispered to herself as she followed the little blonde girl to the familiar room. Mary saw an elderly man on the floor with a nurse’s aide next to him, struggling to keep him from getting up. Mary looked at the man as tears filled her eyes. He was laying on the floor next to a pool of blood. His bald pale head showed a huge red and black crack with spurts of blood gushing out. It was as obvious as an ‘X marks the spot’ that would be seen on a child’s pirate map. The elderly man was shaking all over, trying to raise his hands into the sky as if he was reaching for something right in front of him, trying to grab an object only he could see. Mary quickly put on gloves over her shaking hands, and helped the nurse’s aide while the little blonde girl started vital signs. The nurse’s aide had smears of brown strokes all over her scrub top, and her gloves dripped syrup thick red drops. Mary looked around the room, noticing the elderly man’s bed was too high off the ground and the faint smell of urine. She looked into his eyes noticing they were dilated, mixed with fear and confusion. Mary starred at him, suddenly flushed with memories of the times they would go outside for walks together, telling each other corny knock-knock jokes. She actually had a really good one for him today.
“Jim? Jim? Can you hear me?” Mary asked as she looked at him. All she could see was Jim opening and closing his eyes, expressing confusion and pain with each blink. The pool of blood glistened from the florescent lights underneath his head. Mary started to feel the same pain Jim was feeling as the tears stayed in her eyes, blurring her vision. “What happened?” she asked.
“One of the aides found Jim on the ground,” the little blonde girl explained as she finished looking him over, putting pressure on the wound. “Jim? Please do not move, you need to stay still until the ambulance gets here,” the little blonde girl voiced sternly with a strange hint of compassion. The emergency team suddenly entered the room, along with a nurse with long braids.
“Here is Jim, 75 years old. He was observed on the floor by one of our aides,” said the nurse with long braids. Mary stood up and stepped back as she let the emergency team take over, talking about him. All Mary heard was white noise in the background as she looked at Jim, her friend. Her Jim being placed in a stretcher and wheeled out of the room. Mary looked down at the pool of dark blood that Jim has left behind, noticing her own reflection starring back at her, realizing she did not even say good-bye to him as he left.
“I will get housekeeping in here to clean up, and make sure you document Jim left the facility in the ambulance at 6:10 am. Are you ok to finish this up?” asked the little blonde girl to the nurse with long braids. The only answer was a silent nod. Satisfied, the little blonde girl left the room leaving Mary alone with the nurse with long braids.
“Hi Patience,” Mary said. Patience acknowledged the greeting with another nod while starring at the pool of blood.
“I will meet you in the meeting room at the end of the hall and give you report,” Patience muttered between hidden sobs. Mary nodded and left Patience alone in the room, walking to a fake brown and black wooden desk that everyone dubbed as the nurse’s station. It was always surrounded with papers, charts, junk food, and water bottles of multiple colors forming a rainbow. Mary was barely able to get her gloves off her shaking hands. They continued to shake as she washed them, double checking for blood. She felt the panic inside of her flourish. Mary tried to calm herself by thinking of the beach she has never seen and the waves that would take her away. She grabbed her bag, attempting to get settled while hearing ‘Hi Marys’ all around her from the morning staff.
“Let’s go Mary,” she heard from the end of the hall. Mary looked up and saw Patience motioning to her. Mary followed her into the room down the hall where Jim fell. The hall seemed longer and colder now that he was gone. They sat down in the room and remained silent for a minute. Mary looked at Patience moving her long braids behind her back, noticing her flawless black skin and bags under her eyes that told stories of many sleepless nights.
“Are you ok Patience?” Mary asked. Patience nodded.
“I never had anything like that happen before on my shift. I was literally just in his room, stepped out, and before I knew it, I heard my name being screamed down the hall.”
“He is in good hands now,” said Mary. Patience nodded, dabbed her eyes that were turning red with her sleeve and composed herself to give report about the night shift which included behaviors, upcoming appointments, new doctor orders, and any out of range vital signs. When they were finished, Patience led Mary to the medication cart where they counted the narcotics.
“Thanks for all that you do Patience, I got it from here,” said Mary. Patience nodded, grabbed her papers and disappeared into a room full of computers humming in unison.
“Good morning nurse Mary,” said a young man, as he approached Mary’s cart. Mary smiled as she looked at the tall, brown skinned, and handsome Sandro. Mary loved working with him, he was the perfect combination of intelligence and enchantment, always getting what he needed with a smile. A lot of people would look at his height and boyish good looks, saying ‘He should have been a basketball player.’ Mary could never see Sandro in sports. To Mary, he was the definition of real kindness and compassion.
“Hi Sandro,” said Mary as they high fived. “Here are the vital signs that I need. Have you heard about Jim?” she asked. Sandro nodded.
“Yep. Crazy way to start work. Out of curiosity, was his bed lowered to the ground? I noticed in the past, if needs to go, he usually doesn’t wait for help.”
“Actually, it wasn’t. I noticed it was up when I was in the room, and I smelled urine too. I would have to ask Patience. So, let’s try to make sure we all pay attention to that today,” said Mary as Sandro nodded. “Who is helping you out today?”
“Evan,” he said. Mary rolled her eyes as she suddenly saw a short and skinny young man approaching them. He had neat blonde hair slicked back and smelled of what he called ‘3 Bleu de Chanel’. Evan made it clear to everyone that he liked the finer things in life. This was displayed by his multitude of Nike shoes and driving an Acura RDX. Though he broadcasted his greatness to everyone, he was one of the worst aides Mary has ever worked with.
“Make sure he keeps up,” Mary whispered to Sandro before Evan approached them.
“No problem Mary, I am on it,” he said with a playful wink as Evan approached them.
“Good morning Evan. Sandro has the vital signs that I need before breakfast. Ready for a great day?” she asked. Evan shrugged as he took the vital sheet from Sandro with his freshly manicured hands.
Mary started her own work as she pulled medications that she knew by heart, organized her pill pass and times for her blood sugars. She went into rooms, delivered medications, checked bandages, and listened to the heart and lung sounds of her residents. Mary entered her work zone, and out of sheer habit, she started to pull medications for Jim suddenly remembering he was not there. Mary froze at her cart and looked up, finding herself at his door. She looked into his room. The blood was all cleaned up and fresh sheets were on his bed. The windows were open, allowing fresh air in room, making it more inviting. The knock-knock joke Mary was going to tell him today lingered in her mind along with the look of true fear she saw in his eyes. Mary ignored the tears she felt weld up in her eyes.
“Plenty of time for that later,” she said to herself, looking at her watch, realizing she needed to move her cart into the main dining room. Mary placed her cart next to the nurse’s station and observed the tables in front of her that were filled with wheel chairs, walkers, and oxygen tanks. Mary heard the sound of a piano being played on a speaker and the soft chit chatter of people talking and hearing aids buzzing. From the corner of her eye, Mary saw two other nurses come out of the other two halls with their carts. Mary said hi to them, stealing a glance at one of them named Constance. Mary watched her open her Davis’s Drug Guide book, reading about each pill before she put it into the cup with sweat dripping down the side of her face.
“You are not going to kill anyone Constance,” Jasmine sneered at Constance as she walked confidently to her med cart. Jasmine had a boy short haircut and tattoos going down one of her white arms, all topped off with a nose ring that shined from the florescent lights.
“I couldn’t remember this medication. I am not as fast as you Jas,” Constance said, clearing her throat. Mary suddenly heard her name from the charge nurse desk, and noticed the little blonde girl that was helping with Jim’s fall from earlier this morning.
“What’s up Julia?”
“Can I take you off the floor and put you in as ward? I am going to call one of our evening shift nurses to come in early and take your place.” Mary nodded, understanding she will now be working on a computer, putting in orders and digitally admitting new patients.
“Sure, just let me get started on some charting and then I will move on to ward,” Mary said.
“Thanks,” said Julia as she went to the phone, calling the evening staff. Mary went into the humming computer room to begin charting her assessments. Just as she sat down to chart, Sandro approached her.
“Hi Mary, Susanne needs a pain pill,” he said.
“Thanks Sandro,” said Mary, throwing her head back and taking a deep breath. Mary went to the cart, grabbed the narcotic and walked to Susanne’s room.
“About time you got here! I was getting ready to call my daughter and tell her that you don’t do anything for anyone around here!” she growled. Mary looked at the floor, trying to mentally grab what control she could from the situation. She started to feel her hand shake again. Susanne was a rich house wife of a famous surgeon in town, who recently died of a heart attack. Some say he died from a night of too much excitement with a young woman, Susanne said it was because he loved steak.
“Sorry about that Susanne, but I just now found out that you need something for pain, so here is a Norco for you,” said Mary, keeping to the subject, not feeding into Susanne’s accusations. Susanne glared at Mary as she grabbed the white pill with her acrylic red finger nails and her water jug.
“You want to know something? I hit that damn call light all the time and you know what happens? Nothing! My daughter will be here today. You know who she is? She is married to the Mayor, and she will tell all of you a thing or two about how to do your job,” Susanne threatened as she swallowed her pill.
“Ok Susanne, thank you for telling me. Is there anything else you need?” Mary felt Susanne’s heavy stare while showing no fear of her ‘who knows who’ threats. Mary tried to think of her waves as she felt the panic feed off of Susanne’s words, growing stronger.
“She will talk to you later,” Susanne said, pointing her finger slowly at Mary as she laid down in her bed.
“No problem Susanne. We will talk to her then,” said Mary as she walked out of the room, trying to get out of the thick smog of imagined superiority that Susanne bestows upon everyone. Mary went to go back into the humming computer room when Evan suddenly stopped her.
“Mary! We had a fall! It’s Michael,” he said panting. Mary followed Evan into Michael’s room and saw Julia with another aide named Ginny getting vital signs started. Mary suddenly had a flash back of Jim from earlier in the morning.
“What happened?” asked Mary as she looked around, seeing a puddle of urine on the floor, reminding her of the pool of blood.
“He got up to go to the bathroom and fell,” said Ginny as she put the blood pressure cuff around his upper arm. Julia was looking into Michaels eyes with her pen light.
“It was an unobserved fall, so we need to start neuro’s,” she said. Mary nodded and looked at Evan.
“Can you get the neuro sheet? We need to do vital signs q 15 for one hour, than q 30 for one hour…” started Mary as Evan interrupted her.
“Yeah, yeah Mary, I know…,” Evan growled as he ran out of the room to get the neuro sheet. Julia and Mary looked at each other as Julia rolled her eyes.
“Michael, can you move your leg?” asked Julia.
“I am fine, just had to pee and for some reason, my legs wouldn’t let me go,” Michael complained as he tried to sit up.
“Did you hit your head?” asked Mary.
“No, just fell on my bottom,” he said as he touched his right buttock, feeling it to make sure it is still there.
“Ok, let’s get you on the toilet. We need to look at your bottom,” said Mary, as she and Julia started to get him situated on the wheelchair as Ginny just finished the first set of vital signs. They rolled him into the bathroom and put him on the toilet.
“Ok, Ginny can you get him off the toilet when he is done?” asked Mary after he was situated.
“Sure, no problem,” she said.
“I need to get my assessments charted and I will get started on the paperwork with Michaels fall,” Mary explained as she and Julia walked out of Michael’s room.
“Great, I will call the family and physician,” said Julia as they parted. Mary started back towards the singing computer room when she noticed the time was 11:27 am. Mary needed to get her patient’s afternoon blood sugars. Turning around, she started to walk back to her medication cart, when a little girl that was no more than 5 feet tall and 90 pounds approached her. She looked to be about 18, but wore as much makeup as a forty year old woman. Mary realized she was now no longer in any kind of control with her day. It now belonged to a perky child that called herself the admissions coordinator.
“Hi Mary! I am super stoked about today. We are having two admits! Winner Winner Chicken Dinner! So, we have a right knee and a left hip both coming together in the same van ride at 2:15,” she exclaimed with the bouncy personality of a cheerleader, gleefully handing Mary a stack of papers.
“I can’t start on that right now, I am still on the floor passing meds,” Mary said in a deep tone that she wanted to sound like a growl but tried to remain professional. The peppy little girl shrugged.
“Not my problem, they told me to give it to you,” she said as she shoved Mary the papers and walked away with her long hair moving left and right behind her. Mary sighed from feeling overwhelmed, grabbed the admission paper work, the stack of notes she still needed to chart about her residents for the day, and the paperwork on Michaels fall. She walked to her cart to get the glucometer when she was approached by another nurse.
“Oh my god, Aspen, am I glad to see you,” said Mary as she looked down on the young girl. Aspen was about five foot five, compared to Mary who was almost six feet tall.
“Here to save the day. Come give me report really quick so that you can get started on those admits,” Aspen said as she gathered her paperwork and walked into a private office area. Aspen sat down and put her hair in a ponytail as Mary got organized.
“Thanks again for coming so early,” said Mary. Aspen shrugged.
“Shift starts at 2 pm, and it is only 12:30. Besides, my boyfriend and I are trying to take a trip together, so I can use a little overtime.” Mary smiled, thinking about the last time she actually did something nice with Derrick, she could not remember. Mary went ahead and gave Aspen a report about the day, talking to her about Susanne’s accusations, Michaels fall, and finalized the report with Jim. A chill ran through Mary as she realized she has not heard anything about him from the hospital. They walked back to the cart, counted the narcs and Mary handed over the med cart keys to Aspen.
“Thanks Mary, I got it from here,” said Aspen, as she wheeled the medication cart down the hall high fiving Sandro as she approached him. Mary walked away to the other side of the nurse’s station to an open desk that consisted of a printer, computer, and a dead plant.
“What the hell?” she mumbled. In front of her was a mound of resident charts, a stack of papers from the fax machine, and sticky notes littered all over the computer screen. Mary sat down to the disorganized mess. “Where do I start?” she asked herself. She was suddenly interrupted by the admissions coordinator.
“Mary, the new resident Bill is here and he is not even in the system. Can you put him in?” she asked. Mary looked at her watch questioning the time, feeling the loss of control.
“It is 12:45 pm, I thought he and the other admit are coming around 2?” Mary asked. The admissions coordinator shook her head.
“Change of plans, a driver was able to get one of them early, which is super awesome because now we can get started on everything early,” she exclaimed with a smile and walked away. Mary scrambled to get organize and put Bill in the system when she was approached by Ginny.
“Dude! Mary, I have no paper work about our new admit and he is coming in through the door right now. Who and what is he?” she asked. Mary grabbed the admission paper work.
“Bill Thorn, 83 years old, A&Ox3, in for a left hip, diabetic, um…that is all I know right now,” Mary read as Ginny wrote everything down.
“Right, I will get him a wheel chair for now, let me know if you hear anything else,” Ginny said as she quickly left Mary’s desk. Mary put all of her charting notes to the side, and started to get Bill’s paperwork organized just as he was brought into the building by the van driver.
“Hi Bill, welcome to West 18th Avenue,” Mary said with a huge smile. Bill waved and smiled as the driver took him to his room, handing Mary another stack of paper work as the phone rang.
“West 18th, this is Mary,” she said.
“Hello Mary, how are you?” said a male’s voice with the hint of a South Dakota accent.
“Hi Ed, I am hanging in there, how are you?” she asked smiling. She loved talking to Edward the pharmacist, he always had a positive look on life and was never angry when there was too much going on.
“Working on my sixth admit for the day,” he said.
“Ouch! Well, I guess we both have some job security here, we have two coming in,” she said as they started to go over Bill’s orders, talking about each medication, checking the dosage, allergies, and times. After Mary got off the phone, she looked at the clock, seeing it was 1:30 pm. She has not gone to the bathroom since she got there.
“Crap!” Mary mumbled, as she ran into the bathroom, closing the door, giving herself a little bit of peace. There, she tried to calm herself down, trying to get control of the day, and realized she has not eaten. Mary took out her leftovers and sat at the ward clerk desk, finishing Bill’s admission and eating at the same time. It was 1:50 pm when she was suddenly surrounded by ‘Hi Marys’ again as the evening shift entered the building. This shift was always more chipper and ready to work. Mary continued with her work as she heard the background noise of reports being given between aides and nurse. Mary was surrounded again by ‘Bye Marys’ as the day shift left the building. Sandro made a special attempt to say goodbye to Mary, giving her his playful wink, followed by Evan.
“Hey Evan! Where are my neuro’s?” Mary asked, stopping Evan from leaving.
“Oh yeah, sorry Mary,” said Evan as he rolled his eyes with a huge sigh, handing over a folded piece of paper with the vital signs.
“Thanks,” she said as Evan left without saying goodbye. Mary looked over the vital signs when she felt someone slowly approach her desk. Mary looked up at Julia, starring at her with a deep look of regret and sorry.
“Don’t say it,” whispered Mary.
“Jim died.”
“Oh no!”
“Family was there at the hospital, they were able to say goodbye.” Mary put her head in her hands. “They will be here shortly to get his things. Sorry Mary.”
“Thanks,” Mary whispered. She felt more tears wanting to explode out of her. She wanted to run out of the building and cry, find Derrick and beg him to take her away to the waves of her piano beach and tell her silly knock-knock jokes. The panic surged in her body, making her hand shake again. The phone rang and Mary composed herself to answer it, hearing Edward on the other line. Mary slowly regained control over herself and the situation, putting Jim at the back of her mind, and talked to Edward about the second admit. One hour later, her second admit entered the building and she finished her admission paper work.
“Great!” she explained and prepared to work on all of the physician orders from the morning shift, document all of her assessment findings and Michaels fall. She was suddenly interrupted as the admissions coordinator approached her.
“Hey Mary, we have another admit. 79 year old female at 6 pm,” she said, handing Mary more paperwork.
“6? But that will put me into overtime,” Mary explained patiently but inside her mind she was screaming.
“Admitting her will give the facility more money, which will guarantee your pay check with the overtime,” she said as she skipped off, flipping her hair from side to side.
“Fucking cheerleader,” mumbled Mary as she finished her doctor orders from the morning shift and started the new admit. She finished her paperwork with the third admit and saw that it was 5:36 pm. She suddenly realized she had to use the bathroom again and there was no food for dinner. She went into the bathroom and ordered herself some delivery online with her phone. As she walked out, she saw the third admit come to the facility.
“Hi Edna! Welcome to West 18th Avenue,” she said, smiling as she took the paperwork. Edna did not acknowledge the greeting. Mary sat down to go over the paperwork, when she heard a tapping of long fingernails at her desk. Mary looked up to see a lady with long streaks of blonde going through her dark hair. She carried a Louis Vuitton bag and had a display of long gold loops that dangled from her neck, forming a necklace that got lost in her leopard print blouse. Mary studied her longer, realizing she one giant exhibit of gold decoration.
“Glad I finally got your attention,” the lady exclaimed.
“Hello Lydia, how can I help you?” Mary asked.
“Were you the nurse down my mom’s hall today?” Lydia asked. Mary nodded. “I don’t know what your problem is with my mom, but you and this so called staff here do not know how to take care of her! What do you do all day? Sit here while she is in pain?” she yelled.
“Lydia, Susanne received her pain pill when I was informed about it,” said Mary.
“This is an ongoing thing with you people! Nobody ever gives her what she needs in time. You need to get your act together. Where is your charge nurse?” she yelled. Mary rubbed her eyes and pointed to the opposite desk.
“She is over there, Lydia,” said Mary. Lydia grabbed her bag and threw her shoulders back as she strutted to the charge nurse desk. Mary looked over and realized Julia was gone. As Lydia talked to the evening charge nurse, Mary’s sandwich was delivered. Mary grabbed the bag and looked at Lydia pointing to her, complaining about how the staff just sits around eating food while her mom needed care. Mary looked at the clock, realizing it was six pm. She was finally able to chart her morning assessments, Michaels fall, and put in some extra information about meeting Susanne’s needs during the day.
“Hi Mary, can you put these orders into the system? Dr. Beckett was here and wrote a whole bunch of new orders,” said the evening charge nurse as she approached Mary, putting down a stack of charts on Mary’s desk. Mary sighed and went back to work, putting in the rest of the day’s orders. By the time she finished, she looked at the clock: 9:48 pm. Mary finally stood up and got her stuff to leave. As she went to the time clock to clock out, she saw Patience walking in for her night shift.
“Mary? You are still here?” she asked. Mary nodded, feeling exhausted. She felt exhausted from all the orders she had to put in, from waking up at 5 am and working since, about losing control of her whole day, and about losing Jim. She did not have time to cry for him. Mary looked at her hand, realizing that it was not shaking. This made her smile.
“Hey Patience, knock-knock,” Mary said. Patience rolled her eyes.
“Who’s there?”
“HIPAA.”
“HIPAA who?”
“I cannot tell you that.” Patience starred at Mary and then giggled. “See you in 8 hours Patience.” Mary walked to her car in the dark and put on the same relaxing music she had on earlier that day, listening to the waves calling to her. She sat in the driver’s seat for a few minutes, realizing she was back in control of her life for eight hours and can do whatever she wanted. She knew exactly what she wanted to do. She drove the slow fifteen minutes home in the snow not realizing that it snowed. She also realized she has not looked out of a window all day. She parked her car and slowly walked into the two-story apartment. All she wanted was Derrick to talk to her. She wanted him to hold her while she cried about Jim, about forgetting to use the bathroom, and being yelled at by over privileged women. She smiled imagining his big arms around her, holding her, telling her it was going to be ok. She excitedly opened the door to their apartment ready to scream his name, when she saw him asleep on the couch with three empty beer bottles on the coffee table. Mary stood there watching him sleep through the sound of a hockey game on the TV. She wanted to wake him up and make him listen to all that she has been through today. Instead, she went upstairs, took out her contacts, brushed her teeth, and laid down in bed alone. She set her alarm for 5 am, preparing herself to be invaded by the panic again when the alarm goes off.