The Tracks We Leave

Chapter 3: Stasia

I drove up to the base gate, two stone guard shacks side by side with a narrow lane between, and a pull off on the right. A large thoroughfare for departing cars was to the left. I had my registration, insurance, and state ID in hand. My foot tapped against the floor board, giving away my nervousness.

This isn’t the first time I started a new job, I don’t know why there was this weight in my gut. This was a great opportunity, the pay was outrageous, and so far everything I saw of Washington I loved. I hadn’t even started work, so it’s not like I could blame the hospital for this feeling. Regardless, something was triggering my fight or flight response. Maybe it was the dreams. They had begun to change.

Before I could dwell on that, the traffic moved forward. I took a deep breath, rolling my window down. As I pulled up to the gate a large black man, broad shouldered and decked out in camouflage with a M4 slung lazily across his front, leaned down to take my information.

“Morning,” he said jovially. Jesus, he looked like GI Joe, and sounded like Mr. Rogers.

I smiled easily, his energy putting me completely at ease. Holding my information in easy reach for him I said, “Hi, I’m here for the first day at the hospital. Ian Shaw is my liaison, he’s supposed to be meeting me here.”

The man, his velcro name tag said Jacob, said, “Ah, you were supposed to go to the Passing ID office.” He pointed towards a building I could now see just through the trees. I bit my lip, but turning back offered him a tense smile. I was going to be late. I hated being late.

“Thanks so much, I must have missed the turn off. Do I just turn around or…”

But Jacob was waving away my words. “Nah, I know Ian, I’ll just radio him to come to the gate. Pull into the turn off up there,” he said pointing, “I’ll let you know when he comes through and you can follow him out.”

Giving him a more genuine smile I said emphatically, “Thank you.” He winked, already talking into his radio. I moved forward where he had indicated, putting my car in park to wait for Ian Shaw.

He came through shortly after in a black sedan Impala. I saw similar vehicles around town with government plates, so I assumed this was the standard issue vehicle. He put down his passenger window and waved at me. Nodding back, I put the car in drive and threw a thumbs up back to Jacob, who waved. Jovially. Still looking like freaking GI Joe.

I barely registered the route we took through base to the hospital, so in my head about what could be causing this uneasy feeling. Since getting to Washington I had had to repeatedly ignore my intuition, which was unlike me. Yet, from the really great weekend I had with Angela, to the amazing hours I had spent nesting in my new home, everything in Washington seemed like a great change so far.

Ian Shaw, the liaison who was my point of contact for starting at the hospital, exited his vehicle and started to walk towards me. Not wanting to be caught in the car, I quickly grabbed my backpack with all of my work supplies from the passenger seat, and got out to meet him halfway.

“Anastasia!” I managed not to recoil, just. Something about him was…oily. I didn’t know how else to explain it.

I smiled tightly, hoping my revulsion didn’t show. He seemed so nice. “Stasia, please.”

“But Anastasia is so beautiful,” he widened his eyes dramatically, and this time I couldn’t help the cringe.

“Not a Russian Orphan.” I laughed, leaving it at that. No. Just a typical orphan. That though, I kept to myself.

Seeming oblivious to social cues, Ian went on, “Nonsense, but you’ll have a chance to change it on your badge if you want. He motioned for me to follow, and we started through the parking lot to the hospital building. Four stories, and set in boring angular lines, it was a typical hospital without much flourish. That impression continued inside, with plain white floors and walls, low hanging ceilings, and a musty odor that belied age.

Not turned off, it wouldn’t be the first old hospital with a low budget I’d worked in, we worked our way through the maze of hallways I knew I’d learn in no time, until we made it to HR. After the customary first day routines, I had my credentials, my I9 and tax forms done, and surprisingly was being pushed to the floor.

“I’ll introduce you to the charge nurse,” Ian was saying, “They’re very short today, and we heard you’d done some contracting and would be comfortable with little to no clinical orientation.”

I nodded assent because it was true, but was still surprised. Usually a permanent job loves to adamantly show you the difference between staff and contract work, insisting on orientation I didn’t need as a new grad, before they let me loose to do a job I was more than qualified to step right into.

Ian made quick introductions to a girl named Ava. Brown hair in varying shades, a little heavy in the waste, but with a pretty, made up face, she smiled at me looking harried. Fly aways came loose from a ponytail I doubt was usually less than immaculate. I smiled back because one look at her face told me exactly what kind of day she was having.

“Where do you want me?” I said simply.

She looked at Ian and said, “Thanks I’ve got it from here.” Dismissing him without another look she said, “What are you comfortable with?”

“Anything,” I replied, shrugging.

“I have no psych nurses today, and our homeless/psych population is out of control. Our regular staff really aren’t great with them, a little too jaded. Can you go to that hall?”

Psych was actually where I excelled. My ability to sense people, or my good intuition, had helped me to become a pro at deescalating. I could pivot between a schizophrenic and a borderline patient like a pro. “Sure thing, what room numbers and I’ll head over.”

She waved that away, “I’m not going to throw you away that badly. Let’s do a quick tour of the ER, stock rooms, your closest Pyxis, and then I’ll introduce you to Shelly. You can shadow her for an hour or two just to get the ropes. She leaves at eleven, so then you can take over her assignment. Sound good?”

“Yeah, that’s actually perfect.”

Her stressed face had relaxed the more we spoke, her energy lightening from the frenetic quality it had been when I first walked up to her. “Fantastic, I’m so sorry you’re getting no more introduction than this your first day.”

I shrugged, not bothered. Answering truthfully I said, “I prefer it this way, lead on.”

After being shown around the Emergency Room and being introduced to Shelly, we made short work of catching up with her patient’s on all their orders. Eleven had come by in a blink, and I was taking care of a four room psych assignment. An easy day, really. As I thought this, the alarm sounded for an incoming ambulance. I finished off the charting I was doing, and got up from the desk to go prepare the room, while reading the page. Violent patient, in restraints with police, history of schizophrenia.

Making sure the room was cleared of sharps and projectiles, I had just finished up when the EMT’s began rolling the patient in the room, police hovering at the door. The room quickly filled with people, security and patient care technicians, another RN and the physician. The EMT’s gave report, as everyone moved the patient to the ER stretcher. They began to go about the typical duties involved in triaging a psychiatric patient. Vital signs, change the clothes, take the belongings. The process was abruptly stopped however, by shouting from the patient.

“I don’t wanna be here! This is bullshit!, Stop, get the FUCK away from me you BITCH, fuck you!”

Dr. Ferris attempted to interrupt the tirade aimed at the patient care tech, who was backing away fearfully. I stayed at my computer, feeling the patient’s panicked and confused energy. There were already too many people in the room, this man didn’t need anyone closer to him. The other RN I was working with didn’t seem to realize that though.

When Dr. Ferris’s attempts to explain the process didn’t work, the RN stepped up next to him and began explaining, “You need to stop yelling. You aren’t the only one in this hospital. Security, get the restraints. Listen if you don’t stop yelling I’m going to have to put you in restraints.”

My mind boggled. That was assault. She hadn’t even given the patient time to respond. Not to mention he wasn’t currently being aggressive. Sure he had screamed profanities, and no it wasn’t acceptable. But she was making it worse. She was actively threatening the patient. And she was aggressively handling a paranoid schizophrenic who was in psychosis. I felt the aggression coming off of her. She seemed to almost get a high from her position of power.

Dr. Ferris merely shrugged, looking almost bored, and said, “Emily when you get it handled come and get me. B52 if you need it.” That was it. Then he walked out. He hadn’t even spoken to me, the primary nurse.

“Alright, let's get the locked restraints,” she was saying to a heavy set older man. The type of security guard who looked like he was ten years retired from the force. She walked out with him to retrieve them, confusing me even more. If she was so worried about this patient’s aggression, why would she leave the room. With one of the security guards?

Looking at the door I hoped I had time. I looked at everyone else in the room, and said, “Let’s clear the room. You and you stay, everyone else: mind stepping out the door?” I had indicated to the patient care technician who had seemed scared, and one of the three security guards left to stay.

There were a lot of grumbles, and plenty of incredulous stares, but my confidant tone encouraged them to obey. Instead of walking into the patient’s space, sensing his panic and distrust, I instead walked over to the sink and leaned against it, facing his stretcher. The side rails were up, giving me a barrier, and time to get out of the room if he were to erupt.

“Hi, I’m Stasia,” what’s your name?

He ignored me, not making eye contact. Typical, but it was important to know he was concentrating on me, not the voices I’m sure were speaking in his head. “Hey bud,” I said using my usual moniker, “Bud look at me. Can you look at me?”

Finally, he did. I smiled warmly, but didn’t stare him down, keeping my gaze on his eyes briefly, then shifting to his chin. “Hey, I’m Stasia. I’m going to be one of your nurses. Do you know why you’re here?”

He yelled again, “Yeah it’s bullshit. My dad called, I wasn’t doin nothin! I was just fuckin chillin!”

I nodded as if this was perfectly understandable. “I get it,” I said, using my calm voice in low tones, purposefully designed to put him at ease. “Are you having thoughts of hurting yourself or anyone else today?”

“NO, Fuck! This isn’t fair, I want to go!” His eyes were wide, panicked to even the casual observer, and the feeling I was getting from him was terrifying. Not violence or meanness, soul deep fear.

I smiled slightly, “It’s not. I’m sorry. That’s good you aren’t having those thoughts. You’ve been here before for stuff like this right?” I asked, just assuming. I hadn’t had a chance to look up his chart, but I didn’t have a lot of time before Emily got back with restraints.

He nodded. He had begun to tear up, his aggression making way to his underlying emotions. Perfect. That meant I was making progress. The fear I had felt rolling off of him was beginning to lessen in intensity, corroborating my assessment. I continued, “So you know the drill bud. Just let us get all the necessary stuff done. The sooner we do, the sooner you can talk to psych and get out of here. How about we get your vitals, your lab work. Let you get changed. I’ll bring a turkey sandwich and some apple juice, you can chill and watch tv, or whatever you want to do in the room.”

I was careful to word it so he understood he had boundaries, but options. It would make him feel more in control, but also help prevent him from pushing his limits.

“I’m hungry,” he said instantly. This was typical, and I used it as a bargaining chip. “I’ll get you the food as soon as we get the vitals, blood work, and clothes.”

He seemed to think about that. From my vantage point, I saw Emily coming from up the hall, and moved to intercept her at the doorway. Leaning casually against it, as if waiting with all the time in the world, for his decision. In the meantime, also cutting her off from abruptly busting into the room.

Just in time he nodded, “Ok.”

I looked over at the patient care tech as I felt Emily at my back. She was looking at me like I was a voodoo priestess, which made me have to force back a laugh. I smiled at her and said to the patient, “This young lady will help you get started, just a second.”

Feeling comfortable leaving her with the security guard in the room, I turned to Emily, who had barely left me any personal space. She had locked restraints in her hand and a pinched face. Animosity rolled off of her in waves.

“He’s good now,” I said, “consenting to care.”

Her pinched face became derisive, the portly guard at her back. She said, “Bullshit, I don’t trust him, the way he was yelling. I’m going to tie him down for a while.”

The guard at her back looked bored, like he didn’t care either way. I was beginning to feel a little violent myself.

“Excuse me?” I said, moving so that she had to back up, further from the door.

“That guy was just yelling like a lunatic,” she said, her own voice rising. “I’m putting him in restraints!”

I breathed through my nose, and out through my mouth. This was something I had seen all too often in healthcare. So it wasn’t just that she didn’t know how to handle psych patients. She really did get off on the power. As if violating someone's body, someone’s autonomy, was as simple as her convenience, and not actually about safety at all.

“This is my patient. You are going to back away. You are going to stay away from the room if a Code 8 is called.” I didn’t say anything else, I didn’t trust myself to. I felt tears burning at the back of my eyes, but not because I was sad. Just as forcefully as the tears, anger was burning my chest, up to my throat.

Her eyes bugged out and she said aggressively, “I’m going to get the charge nurse. You’re new here, maybe you didn’t handle psychs where you came from but…”

I cut her off abruptly. “Get the charge nurse.” My tone was flat, without room for argument. She stormed off to do just that.

-0-

Later, on my way home, exhaustion weighing down my shoulders, I realized this must have been what the stone in my stomach had been about. The charge nurse had been underselling it when she said her typical ER staff weren’t good with psych patients. One of the most vulnerable and misunderstood populations, but also one of the largest any ER saw, and they were treating them with borderline abuse.

The charge nurse, after hearing our argument, far away from the ears of the patient in psychosis at my insistence, had sided with me. It helped my case that for the rest of the shift he was an easy patient, sweet even. Emily was going to hate me for life. Considering this was a permanent position that could prove to be a problem. Especially because I hadn’t even gotten a sense of the culture at the hospital yet, it had been too busy.

It was worth it, though. Even if I ended up having no social life at work, that wouldn’t be much of a change from Florida, and I felt like I had done what I had gone into nursing to do. Made my patient’s condition better.

Pulling into the driveway of my home on the ocean, I looked to the right. Jack’s home was filled with lights, but all the curtains were drawn. I imagined at this time they were busy eating, or cleaning up after dinner. I imagined it was warm and welcoming inside, full of family. I hadn’t had a chance to meet his parents the other day, and I hadn’t run into anyone from the family over the weekend. He had been noticeably absent from the back deck in the mornings. Maybe he was the type who preferred his privacy.

Stepping out of the vehicle with my backpack in hand, I started up the walk. My head was hung from exhaustion, my lower back and calves aching from being on my feet for twelve hours. I looked up as I hit the walkway to the front door and looked into the front windows out of habit. I stopped short and dropped my bag, starting to laugh at the absurdity. Flynn, in the window, the blinds down around his neck like a coat, panting excitedly to see me.