Authors: Ken Murphy
“Simple. Heads, I have to be in charge and do orientation. Tails, you do.”
“Oh no you don’t. This is not my week to be in charge.” Mark stopped writing and placed the clipboard down on a table beside the assignment board. He turned with a scowl on his face. He stood up straight as if to emphasize the difference in their heights. At five foot eleven, he stood well over her five foot four.
“Come on, Mark. You’re practically already doing it anyway. You know I hate to be in charge, especially on orientation day.”
“That’s because it’s a pain!” Mark retorted. “I’m not ‘practically’ doing anything. I’m only writing assignments because
someone
couldn’t get here until a minute and a half before the shift starts. The natives were getting restless.”
“Yeah, well. You try getting three kids ready for school and see how on time you can be. Hell, you don’t even have a dog.”
“What does a dog have to do with anything?” Mark looked at her, puzzled.
“You don’t have to do anything but get yourself ready and come to work,” Carla snipped. “Anyway, you’re almost done making assignments. You might as well go on and be in charge for the shift.”
“I don’t think so. I was just making assignments to help you out. Besides, I gave the orientation last month.”
“Exactly! And you’re so good at it. They always like you better than me.”
“How would they know? They never get you. I always get stuck with orienting the newbies. Why can’t I have a quiet day?”
“Because they like you,” Carla replied, shrugging as if it were the most obvious thing in the world. “And you don’t mind answering ten million stupid questions. You don’t mind repeating everything five times.” She made a show of counting on her fingers for effect. “Anyways,” she continued with a twisted smile, “you’re the pretty one.”
“Flattery will get you nowhere.” Mark rolled his eyes, turning back to pick up the clipboard.
“Come on!” Carla pleaded, placing a hand on Mark’s forearm. “You know you secretly like it.”
“Nobody likes doing newbie orientation, secretly or otherwise.”
“But you’ll do it, right?”
Mark huffed in disgust. “You are a vile, evil, nasty person!”
Carla grinned, knowing Mark was giving in. “You know you love me,” she added with a big toothy smile.
“I don’t even like you right now!” Mark quipped, and then he beamed as an evil thought came to mind. “I hope your next baby is born white.”
“Fat chance of that happening!” Carla snorted. “That shop has been shut down for a while now. And even if I did, I’d just tell everybody it was yours.”
“Uh-huh. Good luck finding a sucker who’ll buy that story.” Mark laughed, turning back to the assignment board. “You know, payback is a mother!” he said over his shoulder. He swung around to look at Carla, grinning. “I’m telling the newbies that you’re the unit resource nurse.”
“You can tell them whatever you want!” She chuckled, playfully slapping Mark on the arm as she shrugged and walked away. “It’s not like I intend to be seen today, anyway. I plan to be locked away peacefully in my patients’ rooms. Please have my relief knock on the door when it’s time for me to give report and go home.” With that, Carla disappeared into one of the patient rooms.
Mark spent the next half hour walking from room to room with the night shift charge nurse, getting updates on each of the unit’s twenty patients and making notes of any special treatments planned or resources needed. The Surgical Intensive Care Unit, or SICU for short, was arguably one of the busiest places in the hospital. A twenty-bed unit was pretty small for a hospital with more than a thousand beds. Only the patients with the most critical injuries or serious surgeries were assigned to the SICU. Each nurse provided care for only one or two patients. Even so, it was easy to get overwhelmed caring for an unstable patient. Everyone worked closely together and frequently checked on one another. It was a very tight-knit unit.
The primary function of the charge nurse was to ensure everything flowed smoothly. This might include making sure patients were moved to another unit as soon as their condition required less intensive care, setting up clean rooms for the next patient, assisting in transporting a patient to a test or procedure, or any number of other tasks that might pop up. The charge nurse was required to coordinate meals and breaks for staff. Also on the list of responsibilities was “other duties as required.” That could, and did, cover almost anything.
Today, those “other duties as required” would entail providing orientation to the unit for the new surgical residents, or “newbies,” as the nursing staff called them. The surgical residents were licensed physicians completing their training by focusing on a selected surgical specialty. The residents rotated each month through one of the five regional hospitals affiliated with their university, including Atlanta General. On the first day of their rotation through Atlanta General, the residents received a brief orientation to the SICU. The main goals of orientation were to acquaint them with the general layout of the unit and to provide a basic overview of some of the applicable unit policies and procedures.
Mark walked back to his locker to get the folder he kept with the orientation information he liked to cover. Keeping a folder helped ensure he gave each group of residents the same information. Next, he went to the unit manager to get the list of names for this month’s surgical residents. List in hand, Mark went to the supply closet and began the tedious process of creating and recording access codes for each of the physicians. Creating the codes wasn’t a difficult task, but it was time consuming. Each physician’s name had to be entered into the system, and then he or she was assigned a unique access code. Assigning codes was necessary so that each resident could access the storage closets for supplies when they needed them without having to pull other staff away from their duties. Although the nurses and physicians worked closely together, a certain amount of autonomy was required.
“Damn!” Mark cursed, looking at his watch. He mentally chided himself for taking so long getting the access codes set up. The morning was getting away from him too quickly. Walking back out into the main desk area, he approached Joan, one of the other nurses.
“Can you please cover for me?” Mark asked. “It’s almost nine o’clock. I need to run next door for orientation.”
Joan agreed to keep an eye on things, and Mark gave her a brief rundown of things going on in the unit. He gathered up his notes and took a couple of deep breaths to compose himself as he left the unit.
The conference room was already full when Mark arrived.
This is a nice change,
he thought, smiling as he entered through the only door, at the rear of the room. Normally the physicians trickled in, and he usually had to stop and start over a couple of times. The four round tables placed equally throughout the room each had three or four people already sitting at them. Mark guessed they had likely segregated themselves according to their subspecialties. About a dozen of the surgical subspecialty programs from the university trained at Atlanta General, but only the trauma, thoracic, and open-heart services were allowed to admit their patients to the SICU. Some of those in the groups were new to the hospital; some had rotated through before as interns or junior residents. But because of their common areas of study, they tended to know each other beforehand. After walking up to the front of the room, Mark wrote his name and a cell phone number on the chalkboard.
He turned to face his audience. “Good morning! My name is Mark Smith, and this is the contact number for the unit charge nurse. Welcome to Atlanta General.”
An hour later, Mark had covered the information he felt most important and provided the residents with a brief tour of the unit. He then sat at one of the tables at the front of the conference room and began issuing the supply closet access codes to each of the residents. One by one, they came up as he called their names. Mark gave each physician a small piece of paper with his or her handwritten access code on it. As he issued each code, he made a note on his list. Once they had received a code, each physician went out to get started with the day and learn more about the patients for whose care they were now responsible. After he had issued all the codes, Mark took a moment to make a few additional notes on the list so he could turn it in for the unit manager.
A voice interrupted his thoughts. “I think you forgot someone.”
Mark looked up and his eyes widened. Standing on the opposite side of the table was the most beautiful man Mark had ever seen. He had thick reddish-brown hair, cut short and brushed back off his forehead. His face was framed by a neatly trimmed beard. But it was his eyes that held Mark’s attention. The man had huge brown eyes, like twin pools of caramel and gold. Mark realized he was staring and felt his face flush. He looked down at the paper in front of him. “There must be a mistake,” Mark replied, swearing he heard his voice squeak. “I don’t have any other names on my list. Are you certain you are supposed to be here this month?”
“I sure hope so,” the man said and grinned. He dropped to one knee and leaned on the table so he was eye level with Mark. “I made a long trip for nothing if I’m not supposed to be here. My name is Trevor Hayes, and I’m the new cardiothoracic fellow.” Mark looked over at Trevor and found himself again getting pulled in by his eyes. He swallowed involuntarily. Suddenly feeling a little claustrophobic, he stood up and backed away from the table.
“Okay, well, let me find out what we need to do to get you settled,” Mark said as he walked toward the door. “I’m sorry I didn’t know we were getting a new fellow.”
“Not a problem,” Trevor said, reaching out to grasp Mark’s shoulder as he matched his stride.
Mark felt the heat from Trevor’s hand on his shoulder, and without thinking, he picked up his pace, walking briskly back into the SICU.
“Where’s the fire?” Trevor asked, working to keep up with him.
Mark looked at him, but ignored the question. “First, let me set you up an access code. That I know you will need. Then I’ll page the chief for you. He probably has some idea of where he wants you to get started.”
Mark walked into the supply room, and Trevor stood to one side, just behind him. Mark pulled out the control panel and began typing on the keyboard. He cursed under his breath as the red error light illuminated. Mark took a deep breath and repeated the entry. He huffed and flushed as he realized his hands were shaking.
“Are you all right?” Trevor asked, stepping a little closer, until they were almost touching.
“Yes.” Mark exhaled, shifting away to place some distance between them. He could have sworn he felt Trevor’s breath on his neck. This time, he correctly created the code. He almost groaned with relief. Mark wrote the code down on his list and then transcribed it to a piece of paper for Trevor.
“Thank you, Mark,” Trevor said as he took the paper, folded it, and tucked it in his shirt pocket. He moved until they stood facing each other. He looked into Mark’s eyes and smiled.
“You’re welcome,” Mark replied, breaking eye contact. He blushed again when he realized that not only was he gawking at Trevor, but his gaze had migrated south. Trevor was at least three inches taller than him. His green scrub uniform did little to conceal the considerable bulk underneath, most of which appeared to be pretty solid. The V of his scrub shirt revealed a forest of short silky chest hair, the same cinnamon color as his hair and beard. Mark blinked and looked away, chastising himself for paying attention to such things.
What’s wrong with me today?
he thought. Work was not the place to be checking out the boys.
As if he was aware of Mark’s discomfort and amused by it, Trevor leaned against the glass door of the supply closet, bracing himself on one extended arm. The gesture once more brought him closer to Mark. “Now what?” he asked, smiling.
Mark huffed and took a step back, putting a little more space between them. “Let’s go find your chief.” He turned and quickly exited the supply room.
T
HE
rest of the morning went by in a flurry of activity. Two patients were moved out of the SICU to other areas of the hospital, and one patient was admitted to the unit after surgery. Another patient had a procedure performed in the unit. Someone else needed to be accompanied downstairs for some tests. Mark could barely complete one task before moving on to another one. This was the best kind of day, with something always going on. He liked being busy—it made the day more interesting. That was one of the things he liked most about the unit: it was rarely slow. Because the patients in the SICU were so sick or seriously injured, he always had something to do. He also found he learned new things all the time. The pace and the variety kept him motivated and interested. His current position was only the second one he’d held since graduating nursing school a little more than eleven years earlier. His enthusiasm had not waned over the nine years that he had worked in the SICU.
At two thirty, Mark realized he had forgotten to go to lunch. He checked around to make sure there was nothing urgent going on. He asked Becky, one of the other nurses, to cover for him so he could go downstairs to get something to eat. After giving her a brief update on what was happening in the unit, Mark left and took the stairs down to the cafeteria. Thankfully, the lunch crowd had died down. Unfortunately, most of the food was gone as well. The hot line and pizza station were closed. The salad bar had been picked over and looked unappealing.
Burger it is
, Mark thought as he walked over and took his place in line behind a small group of students from the vocational college.
After what seemed like an eternity, Mark’s turn came up. He placed his order for a cheeseburger with lettuce, tomato, onions, and pickles. Smiling at the cook, he declined the customary side of french fries. He grabbed bottled water and paid for his purchases.
Great, only ten minutes left of my lunch break
, Mark thought, debating whether to eat in the cafeteria or take his food back upstairs. He opted to eat in the cafeteria, knowing it was unlikely he would be able to eat without being interrupted if he went back up to the unit.