Dead or Alive?

I stepped outside and felt a warm breeze brush my face, alone in my driveway with my head tilted to the sun I enjoyed the warmth as it soaked my freckled skin. After graduation, I spent the last three days basking in the sun, floating in the pool, and drinking margaritas. My mom finally said to me, “Hope, three days in a row? Shouldn’t you be looking for a job?” My heart nearly stopped. A job? That scared me even more than the thought of clinical used to. “Now that you are done with school you will have to pay rent.” I frowned at her and floated off with my drink in hand. Three days of margaritas had left me feeling sluggish and bloated so today I decided to go for a run instead. Tomorrow I would register for the nursing exam and then I would start looking for a job.

Tomorrow came and went and so did the next day and the day after that. I enjoyed the summer and procrastinated registering for the exam as long as I could. I told my mom I was studying for it; that I had to pass on the first try or I would never get a job. The truth was I picked up beers more often with my friends than I picked up the study exam. Finally the day came when my mom would not tolerate me jobless and living at home any longer. After two months of irresponsibility I was forced to take the exam.

I walked into the testing center with an inner peace and calm. Most were worried about failing but not me. In fact, I was secretly hoping that I would fail as that would buy me some time before I had to get a job. I really did not want my new found freedom to end.

The NCLEX which stands for National Council Licensure Examination is the test that all registered nurses must take and pass to get a nursing license. The test is computerized and once the minimum of 75 questions is completed, the test analyzes the results. If the person sitting for the exam is above the testing standard he or she passes or below the testing standard he or she fails. If the tester is too close to tell, additional questions will be given until the standard can be determined. The maximum number of questions is 265. Thus far Paige and Lisa had taken the exam and the computer shut down at 75 for both of them and they both passed. One of our other friends, Nancy, just finished the exam the day before and her computer shut down at 198. She is sweating it out right now at home waiting to see if she passed.

I sat down at the computer and began the exam. As I was custom to doing, I whizzed through it until I realized I was on question 70. Each question after that was met with anticipation. Concentrating was difficult.

71. Your patient admitted with a bacterial infection is complaining of ringing in the ears. You know that this is most likely due to

A. Lasix

B. Gentamicin Toxicity

C. Fluconazol

D. Phenobarbital

Forgetting what I just read, I read the question again. Hope focus. Concentrate on the question. Finally, I selected B then hit enter. Question 72 appeared before me, then 73, and 74. When I read question 75, it seemed too easy. I paused, my pulse quickened. I hit enter. I waited half expecting a trumpet to play, Da, Da, Dah! No trumpet played and the computer didn’t shut down. On the computer screen in front of me was question 76. For a moment I was baffled. Question 76? I’m not supposed to get more than 75 questions! Oh god what if I get all 265 questions? I sat back in my chair and prepared for the long haul. I answered 76 and pushed enter. The screen went blank. I held my breath. Then the hour glass appeared. I thought I was dreaming when I read the words on the computer screen:

Your exam is complete. Please take all of your belongings and exit the testing room quietly. Thank You for using the Testing Center .

About a week later, Lisa’s red car came barreling around the corner with Tracy in the passenger seat. I had a blanket in hand waiting for them to pick me up. We stopped at the little store up the hill for sandwiches. I still called it Rudy’s but the name was different now. We headed to the forest preserve for a picnic lunch. There were mostly three types of people at the forest preserves, lovers looking for a place to neck, boys in their late teens or early twenties looking for a place to drink, or perverts. It was never a place that you wanted to go alone. We pulled into a parking space across from a white van. From the motion of it, someone was in there having a good time.

“Lisa! Do you have to park so close to the motion van?” I asked.

“Oh!” She giggled. “I wasn’t paying attention. Here I’ll move.” Before I could speak another word we were parked further down and away from the van.

Straight ahead was a man made lake. Several ducks were swimming and enjoying the summer air. To the right was the picnic area with benches and grills. There sat a man alone. He looked to be in his 60’s. He was scruffy looking and had a nervous demeanor about him. We decided to go down toward the lake, away from the lonely man and the motion van. I spread out our blanket and Lisa turned on the radio and Pearl Jam’s Yellow Ledbetter played.

“So what are we going to do this weekend?” Lisa asked.

“I can’t afford to do anything!” I replied.

“I know I am broke too. Have you started looking for a job yet?” Lisa asked.

“No. I still haven’t heard if I passed the exam yet,” I said.

“How long has it been?” Tracy chimed into the conversation.

“Almost a week.”

“I’m sure you passed. Where do you want to work?” Lisa probed.

“I don’t know. I did really well on the telemetry floor and my Aunt knows the manager there. Maybe I’ll go work there.”

“You did do well there,” Lisa said. “I always wondered how you could be so calm. How you always seemed to know what you were doing.”

“Lisa, I played nurse. I just pretended to know what I was doing I didn’t know any more than you or anyone else did.”

“No. I bet you did. I still couldn’t tell you how the heart and circulatory system works.”

“WHAT! How the hell did you pass nursing school without knowing that?” I asked, completely amazed again at how much Lisa got away with in school.

“I don’t know lucky guesses I guess.”

“Lisa. You are kidding right?” Tracy asked.

“No I am serious,” Lisa said guiltily.

“Lisa. It is easy. I will give you a run down of the circulatory system.”

“That’s okay you don’t have to.”

“Yes! I do. If you want to call yourself a nurse, you have to have a little understanding of the cardiac system. Don’t worry I will make it real simple.” I paused as Lisa handed out our sandwiches. “Think of the circulatory system as a transit system. It can be any transit system you want – a bus, a train, a taxi. Whichever form of public transportation you prefer.”

“Actually, I prefer to drive myself.”

“Well your car is broken down. Shush!” I said pushing her over on the blanket. “In your transit system, the lungs are the central station where the passengers are picked up. The passengers are oxygen and the red blood cells are the trains, buses, or taxis. So the vehicles – the red blood cells – pick up the oxygen in the lungs and drive them to their destinations which are all of your organs. They go through the arterial system which is kind of like the main highway so they can get there the fastest. But before they get to the main highway they have to go through the underpass – the left atrium and left ventricle. Once through there they enter the arterial system. So some passengers are dropped off at the kidneys and some in the heart and some in the brain and some to your skin. Then the empty trains or buses or taxis, whichever you prefer, take the venous system back to the heart. The empty vehicles, which are unoxygenated blood cells, must enter the heart through the Superior and Inferior Vena Cava which are the roads that lead to the right atrium, the right ventricle, the pulmonary artery and finally back to the lungs or grand central station to pick up more passengers or oxygen.”

“That’s it?” Lisa asked.

“For lesson one, yes,” I replied.

“Wow! That was real simple! Why did they have to make it so complicated in class? You should apply to the college and become an instructor!” Lisa gasped.

“Yeah, right. I never want to step foot in that place again,” I said.

“You should work on telemetry. Those cardiac patients will benefit from you.” Tracy said. “You did just teach Lisa the cardiovascular system in less than five minutes. The patients need that.”

We were just finishing up our sandwiches when Tracy glanced over to the picnic tables. “Hey, did you guys notice that strange man earlier hanging out by the picnic tables?”

“Yes, why?” I asked.

“Look over there.” Tracy pointed to the tables. “Do you think he is just lying like that to take a nap?”

Lisa and I looked over to the tables. The man was lying awkwardly on the ground. It looked like he tried to sit on the edge of the bench but then fell face first. He didn’t appear to be moving.

“Let’s go see,” I said.

The three of us ran over to the picnic area. The man was lying on his belly with his face buried in the dirt.

“How can he breathe like that?” Tracy asked.

“For some reason I get the feeling that he is not breathing.” I said. Just to check, I yelled to the man. “SIR, SIR. Can you hear me?” The man did not respond.

I felt Lisa grab one of my arms and Tracy grab the other. “Shit! What should we do?” Tracy asked.

“Shit! I don’t know? Turn him over and see if he is breathing?” I said.

Lisa started jumping up and down, “You do it.”

“Ahhh, I’m not going to do it! You do it.” I replied.

“Let’s do it all at once,” Tracy suggested.

“Okay,” I said, “on the count of three.” We all knelt down beside the man.

“One, Two, Three.” Lisa and Tracy ran back a few steps while I turned the man over. He was really stiff and took more strength to turn him than I anticipated, especially since my two helpers bailed on me. My heart was beating through my chest. His face, white as a sheet, had abrasions across his nose and forehead where he took the brunt of his landing. Dirt stuck to his abrasions hiding the blood and flesh underneath. His mouth was open and bloody and where his face once lied was a pool of blood with his two front teeth floating on top. His eyes were open and fixed to the sky. I had seen that look only once before. I stood up and screamed and we all ran as fast as we could.

“Holy Mary Mother of God!” Lisa was praying as we ran. “Hope, what do you think his circulatory system is doing now?”

“I think it is stuck in a traffic jam!” I yelled back.

We all got to the car at the same time and realized we left our purses on the blanket.

“Shit our stuff.” Tracy said.

“Shit! My keys,” Lisa gasped between breaths.

We ran as quickly as we could and grabbed our purses, leaving the blanket and the remains of our lunch for the ducks. Lisa pulled out onto 95th street and in a panic asked, “Where should I go? Where should I go?”

I was beginning to feel calm again. “Go to Tracy ’s, it is the closest.”

“How? How do I get there?” Lisa asked still in hysterics.

“What do you mean how do we get there? You drive to my house almost everyday. How can you not know where to go?” Tracy asked.

“I just don’t. Someone just tell me.”

“Oh my gosh,” I muttered under my breath. If we weren’t in a hurry I would’ve made her guess but since we were in a crisis I gave her directions. Within five minutes we pulled up into Tracy ’s driveway. We all ran in and Tracy dialed 911. In the middle of her call my beeper went off. It was my home phone number with 911 after it.

“Ha!” I said. “Some one from house is beeping me with 911! They have no clue what an emergency really is.” We all burst into laughter. I called home and my sister answered.

“Hope! It came! The letter from the nursing board. Do you want me to open it?”

“Yes, yes! Open it.” I said anxiously. The pause on the other end of the phone seemed to last forever. “Well did I pass? Did I pass?”

“Wait I’m reading! I don’t read as fast as you. Oh there… Yes! Hope you passed! You are officially an RN!”

“Yes! You guys I passed.” I hung up the phone and we all jumped up and down in celebration.

When we calmed down, I remembered our blanket and picnic supplies were still at the woods. “You guys we have to go back to the woods and get our picnic blanket.”

“Oh no! I don’t think I can go back there,” Tracy said.

“What? It wasn’t that bad!” I said.

“Yeah, it was. You guys go. I think I’m going to stay here.”

“All Right,” Lisa and I said in unison.

“That man sure did ruin a good lunch,” Lisa said as we got back in her car. “Right when I was about to eat dessert.”

As Lisa’s red car pulled into the parking lot of the forest preserve, the paramedics were just loading the stretcher into the ambulance. I could see the paramedic doing chest compressions as the doors closed. I knew that the man’s chance of survival was extremely small. I wondered what kind of nurses we were going to be when faced with our first emergency we all ran. If nothing else, should we have at least done chest compressions on the man? Would that have changed his outcome?

We gathered up our picnic supplies and Lisa drove me home. I decided three things that day. One was the next time I found myself in that situation I would not run. Two, that I never wanted to unknowingly stumble upon someone dead ever again. And three, that working on telemetry, where the hearts are monitored constantly, would pretty much guarantee that. In the very least it gave me comfort knowing that I would know before walking into a room if the patient was dead or alive. The next day I applied and within a week interviewed and accepted my first nursing job on the telemetry unit.