The Heart's Truth: Essays on the Art of Nursing

Talking to No One

20 Talking to No One As I drove to work, a sudden snow squall sparkled and swirled in my headlight beams, illuminating the road ahead of me. Beautiful, I thought. Then I pulled into the dark mouth of the parking garage and the snow suddenly disappeared, the night closed around me. It was 0:5 p.m. In fifteen minutes I would begin my eight-hour night shift in Intensive Care. Locking my car, walking into the hospital, riding up in the silent elevator, I brought the cold smell of outside with me. It clung to my coat, reminding me that there was indeed a world beyond the one that would now occupy my thoughts and my hands until dawn arrived to melt the dusting of snow that frosted the hospital walkway, the withered grass and the statue of Saint Joseph that stood just outsidethemain door. Here was work. Home waswheremyhusbandandchildren waited. Home was where, tomorrow, I would sleep while the children were in school; where I would dream about my patients. In dreams, their IVs would run dry, their hearts would stop, and they would cry out, startling me awake. This was my sixth straight night in ICU. I was really, really tired and, never a night person, had been thrown off-kilter by the odd hours I had to keep in order to keep my job. Soon, I told myself, a position would open up on days. I’d been telling myself that for months. I knew that the night shift wasn’t for me, but I knew something else as well. All these months on nights, I’d been honing my skills. I no longer trembled when the evening charge nurse gave me report. On nights, I’d been thrust over and over again into situations both critical and difficult. I’d had to use every bit of my training and every bit of my intuition. The night shift aides now trusted me. The night supervisor came around less often, knowing that I would call her if needed. On my watch, patients received better care because less of my attention was spent learning how to be a good nurse. During all these nights, something had happened, slowly and consistently. Most of the time, I knew what I was doing. Mostly, I made good decisions. I punched the silver disk that opened the doors to the ICU and the dim and talking to no one 21 silent hallway gave way to the bright, bustling ICU. Two nurses bent over a patient in cubicle six. A few aides scurried about finishing up their evening duties. The charge nurse sat at the desk running off monitor strips, her hair unraveled in curls around her face. I focused my gaze on cubicle five, for a moment holding my breath. Yes, there he was. Yes, the ventilator still worked its miracle, pumping oxygen into his lungs. Yes, his heart line still raged in great jagged spikes across the cardiac monitor suspended beside his bed. Joe had made it through another day. Now I would help him make it though another night. Rita, the charge nurse, looked over and waved as I disappeared into the lounge to hang my coat and lock up my purse. I stopped for a moment in front of the mirror glued to the side of the locker and finger-combed my hair, bobby-pinned on my nurse’s cap, its upswept white wings looking a little bit like a startled dove perched one inch back from my hairline. Then I went out to sit with Rita, pencil and paper in hand to get report. Mostly, I wanted to hear about Joe. Why do some patients remain indelibly in our hearts and minds while others fade? Why do these few persist, living on in our thoughts and dreams? What was it about Joe that made him any different from any other patient I cared for during the long ICU nights? There had been others whose stories were more dramatic and whose illnesses more perplexing. There were some who’d been fun to care for, some I’d come to know well, and some who’d broken my heart. In contrast, Joe was almost a mystery. A fifty-nine-year-old construction worker, he was both a widower and childless. I didn’t know if his parents were alive or dead in Italy, where he’d been born, and if he had any siblings, they never called or came to...