Chapter 15: Travel Nurse
I've been everywhere, man
I've been everywhere, man
Crossed the deserts bare, man
I've breathed the mountain air, man
Of travel I've had my share, man
I've been everywhere
I've been to Reno, Chicago, Fargo, Minnesota
Buffalo, Toronto, Winslow, Sarasota
Wichita, Tulsa, Ottawa, Oklahoma
Tampa, Panama, Mattawa, La Paloma
Bangor, Baltimore, Salvador, Amarillo
Tocapillo, Baranquilla, and Perdilla, I'm a killer
-Johnny Cash
It’s 6:30 in the morning. I sip from my 20 oz coffee cup as I ride the elevator with all the other bleary-eyed employees. I arrive at my floor and walk down the bare corridors, then enter the double doors of the ICU. It’s a different world in here. The patients here are at high risk of dying. Some are on ventilators to keep them alive. Some are on other devices to keep their blood circulation at a level that’s compatible with life. And there are many healthcare workers. Some are doctors, others are nurses. There are respiratory therapists, monitor technicians, physical therapists, various aides, and more. They all have different roles. They work hard. I believe that all of them want to do their best for the patients.
I walk into the break room. For the nurses, this room is our sanctuary. It’s the place we meet in the beginning and end of each shift. It’s where we often have our meals. Sometimes, it’s just a place where we can take a quick breather.
“Hey Kiva, grab a breakfast taco, they’re fantastic,” my colleague Joanne, a veteran ICU nurse offers, “then grab a seat. Have I got a sign-out for you.” This is known as a “handoff,” it’s when patients under the care of one healthcare worker are transferred to another. In this case, I am relieving Joanne, who is at the end of her night shift. Joanne proceeds to tell me about my patients for the day. One is a 50-year-old man with a severe gastrointestinal hemorrhage. Another is in respiratory failure due to chronic obstructive pulmonary disease. Also, I’m to expect a patient with pneumonia coming up from the ER. I pick up my stethoscope, take another sip of coffee and breathe in the aroma of breakfast tacos and nurse Sandra’s heated cinnamon buns before heading out into battle.
“I don’t know how they expect us to do so much with a shorthanded staff,” Joanne sighs, “but I hear we’re getting some help today.”
“I hope so,” I reply.
The break room door swings open. It’s a male medical student. “Who has Mr. Bailey?” the frantic fledgling asks. “His blood pressure is 80/40.”
Joanne gets up. “That’s my bleeder.”
“No, darling,” I protest. “He’s mine now. I got this one. You need to get home.”
Over the next hour, I’m at Mr. Bailey’s bedside with what seems like a hundred other people. We inserted a central venous line, an arterial catheter, sent labs, pushed blood transfusions, infused albumin, and dripped vasoconstrictors in his vein to maintain his blood pressure. Finally, he is temporarily stabilized and sent to the operating room for emergency surgery. All the doctors exit, leaving me with a messy room to clean, anticipating the patient’s return. Time for a breather.
“Excuse me, excuse me? Are you Kiva?” I hear a female voice address me from the hall, just outside the patient room.
“Yes, I am. How can I help you?” I answer instinctively as I turn around. I don’t recognize the woman. She appears to be about 30 years old, about 5’6” and slender. She has a pretty face with thin features. Her hair is long and black with stylish small curls and pulled back. She is dressed in jeans and a blouse with a light tan jacket.
“I was watching you work on that patient,” she started. “You know, that is not the proper way to lift a patient. You should never bend over like you did. Always bend your knees and squat. That’s why so many nurses have bad backs. They use poor technique. Didn’t you learn that in nursing school?”
“Well yeah, I know how to lift-“
“And I saw you insert that arterial catheter in the radial artery. You didn’t check first to see if the ulnar artery had a good blood flow. Some people don’t have an ulnar artery and you could have caused him to lose his hand.”
“What? That is super rare and beside this is was an emergency. And exactly who am I speaking to?”
“Is that your coffee cup on top of the crash cart?” This woman is on a roll. “Food and drink should NEVER be permitted in a patient care area. Especially on a crash cart. That is totally unacceptable.”
What the fuck? Is this woman a state safety inspector? A reviewer from Joint Commission? In casual clothes? Probably not. Maybe she’s one of those conspiracy nuts wanting to warn the world that healthcare workers kill people. She’s still not done.
“Why is a linen cart in the hallway? You would get a Joint Commission citation for that. And look at that ceiling tile. That looks like mold to me. Do you want to infect patients with-“
“STOP!” I interrupt her loudly enough to attract attention of half the ICU. “Just stop it? Who ARE you?”
“My name is Robin,” she replies. “Robin Price. I’m a travel nurse. I’ll be working here for the next month. This is my first day here. They told me to see you for a quick orientation. Where can I find scrubs?”
It would have been nice if someone told me I had to orient a travel nurse with the crazy day I’m having. “OK Robin, thank you for your suggestions. We will take them under advisement. Now come with me. “I’m Kiva Sheppard…or Kiva Raines for now.”
I wonder if this is how Robin starts all of her assignments. The nerve of this woman to criticize us before she even begins. Travel nurses are healthcare workers sent on temporary assignments all over the U.S. to help hospitals and clinics dealing with staffing vacancies. Typically, they can work as much or as little as they wish and they can accept or decline an assignment. The job of travel nurse is lucrative. They typically make about three times the salary of regular nurses. When on an assignment, they’re given free housing and meal allowances, and a rental car. The job offers flexibility. I know some travel nurses who work 6 months, then live off their pay to be home the rest of the year.
There are drawbacks to travel nursing. They are away from home for long periods of time. They must adapt to diverse geographic locations, different hospital cultures, each with their own electronic systems which must be learned. Then there is the challenge of always being the “outsider” in the work unit. The travel nurse is always the “newbie” in a staff of locally established nurses with their pre-existing cliques, relationships and hierarchies. The travel nurse is never “one of us.” Sometimes, they are given the worst assignments in favor of the regular staff.
For the right person, travel nursing is an opportunity to experience different places, find adventure, and make good money. Some travel nurses start early in their career before settling down and starting families. Others do it later in their careers when their kids are at least college age. Others do it out of financial necessity.
Most of the travel nurses I’ve worked with have been outstanding. I still keep in touch with a few of them. They did good work and had the required personality and adaptability to navigate blending in from place to place. So far, I’m not impressed with Robin. At least not her interpersonal skills.
As I show her around, I learn she is from Virginia, 31 years old and married. She takes time off after every assignment to spend time with her husband and she plans to have children in two years. Despite her dubious beginning at our hospital, I’m willing to give her the benefit of the doubt.
I introduce her to the rest of staff working this shift, find her scrubs, then take her to the break room.
“I don’t think the electrical outlet for the microwave oven meets standard regulations,” she says. “And these blue scrubs have got to go. Who do I talk to about changing colors.”
You’ve got to be kidding, I’m thinking. “Robin, look,” I firmly tell her. “Do you always criticize every workplace you go to on your first day? You’re here for one month. Just suck it up.”
“But I hold myself to high standards,” she protests. “And I expect everyone else to…”
I cut her off. “That’s great. I’m glad you have high standards. And I think you can help us out with your experience at so many other hospitals. We’d love to hear your suggestions, but there is a proper way to communicate them. We’ll talk later.”
I take Robin to her patient assignments and return to mine. I don’t hear anything more about her. I’m hoping her inappropriateness was due to a little anxiety about being in a new place. After this 12-hour shift, I go home. I’m off for three days.
Another morning, another shift begins. As I enter the breakroom, I hear voices engaging in what sounds like a lively roundtable debate.
“She’s a fantastic nurse. She’s smart. She knows her stuff.”
“She’s a pain in the ass. How dare she come in here and start changing everything.”
“She’s right about everything. We need changes.”
“Well. I’ll be glad when she travels the fuck out of here.”
“Ladies,” I interrupt. “Let me guess who you are talking about. Is it…travel nurse Robin?”
“You got it, Kiva,” Megan answers. “I like her. We could really use her here. Yeah, she’s a little rough around the edges, but she’s not so bad.”
“Not so bad? In three days, she filed four patient-safety reports, professionalism complaints against two of our nurses, Now, she wants to change our entire documentation policy.”
I sigh. “Look, I’ll talk to her. What does our director say about her.”
“She doesn’t know anything about her yet,” Megan answers. “But I say Robin rocks.” The argument in the room heats up again.
I notice that Beth, one of our most experienced nurses has said nothing so far. “Beth, what do you think of Robin?” I ask. I brace myself for her answer.
Beth Sullivan is a fair skinned, rosy cheeked, mildly chubby blonde woman of Irish ancestry. In her 40s, she is known for her boisterous manner and infectious belly laugh. She claims to be a descendent of John L. Sullivan, the first recognized world boxing champion, although many of us have our doubts, since the great John L.’s only known offspring was a boy who died during childhood. Like the “Boston Strong Boy,” known for his pugilism excellence and alcohol consumption, Beth never backed away from a confrontation and could outdrink any man or woman. You can find her and her husband with their friends in a sports bar on Saturday nights watching boxing or MMA. It would be impossible to miss Beth.
As a nurse, Beth is superb. I believe she is our longest tenured ICU nurse. In the hospital, she is always professional and patients love her cheery no-nonsense approach. But make no mistake about it, Beth can be short-tempered. She doesn’t adapt well to change. You definitely do not want to be on her bad side. Her answer to my question is predictable.
“I haven’t worked with her yet,” Beth explains, “but I don’t like what I’m hearing. You know me. If you’re good to me, I’m good to you. That travel twat needs to be reminded she’s a guest here. I’ll give her a chance. But if she crosses the line, I’ll send her back to wherever she came from a tearful little girl.”
I receive sign-out from the night nurse and go to meet my patients. “Good morning, Mrs. Snyder, My name is Kiva and I’ll be your nurse today.
“Well good morning,” the elderly woman returns, “I hope you’re at least half as good as the nurse I had yesterday.”
“Oh?”
“Yes, her name was Robin and let me tell you something. She was wonderful. So caring and so attentive, she was right on top of everything. I was so disappointed when I heard she was off today. I plan to write a letter to the nursing director commending her.”
Wonderful. At least the patients like Robin. As I reviewed Mrs. Snyder’s electronic chart, I noticed that Robin’s documentation was immaculate; her notes were very detailed and well written. I can’t say she doesn’t practice what she preaches.
Over the next few days, I notice Robin spending time with the younger nurses. I’m growing concerned that this travel nurse seems divisive. The older nurses resent her constant criticism and pointing out supposed deficiencies. The younger nurses seem to appreciate her trying to change the status quo. I’m in the middle. It’s good to have our unit viewed with fresh eyes and we should welcome new ideas, but this woman is just plain irritating.
Another day, another shift. It’s lunch break. I notice Robin furiously typing away in the break room. “Hey, what’s up?” I ask.
“I’m filing an incident report,” Robin answers.
“What happened?”
“Well, I relieved one of the nurses. The patient, Mrs. Williams, has orders to be turned every two hours. She hadn’t been turned in 2 hours and 30 minutes. Do you realize she could have developed a pressure ulcer? This is unacceptable.”
“Wait Robin, I don’t think this warrants an incident report. There may have been a good reason for the delay. Did you talk to the nurse?”
“And another thing,” she continues, ignoring my question. “Another patient was in contact isolation and she went into the room without gowning up. And she washes her hands improperly. That will go in my report.”
“Robin, just stop it right now,” I respond curtly. “An incident report is not appropriate for these issues. That’s like using a surface-to-air missile to kill a mosquito. And besides, this is not how you make friends.”
“I’m not here to make friends,” is her chilling reply. “I’m here to do my job”
Oh, good lord, I groan to myself. “Yes, you are here to do your job…but you are not here to do everyone else’s job. Every nurse here is trying her best. If you notice something that we can do better, fine, tell us. But you will not act like some ridiculous cop reporting every tiny thing…”
“Tiny thing?” she cuts me off. “You may think these are tiny things, but I’ve worked in many different places. I learned a lot. And let me tell you, if you start making excuses for tiny things, they’ll lead to bigger mistakes, and the next thing you know, patients are being harmed.”
She is exasperating. “Fine, we will talk to this nurse. I’ll do it alone or we can do it together. Just do not file an incident report. Now tell me, who was the nurse?”
“Beth,”
I can feel my blood pressure drop. Beth? Oh God help us. “Okay Robin,” I urge, “do not mention this to Beth. I will speak to her. And whatever you do, do not file a report. Do you hear me? Do. Not. Report. Beth. Understand?”
“Robin, you are needed in room 6,” A nurse calls from down the hall, ending our conversation.
“I gotta go,” Robin says as she turns away and walks. I watch her slim figure head down the hallway, her curled hair tied back, stride with a sense of mission down the hallway. I have never met someone so tightly wound in my life.
Three days go by. As far as I know, Robin has at least been tolerable. I haven’t heard any complaints. As far as I know, she had not reported Beth. Robin is off today. I head into the break room for lunch.
“What the Fuck?” a voice blasts as I open the break room door. It’s Beth checking her emails. What the FUCK? WHAT THE FUCK?...FUUUCK.”
“Beth?”
“That little piece of shit filed an incident report on me. Where is she? I’ll knock her fucking head off!”
Oh shit! I mumble to myself as I try to summon my soothing voice. “You mean Robin? She is off today.
Beth, listen. Nothing will come of this. Robin told me about this. I begged her not to do it. I didn’t know she went through with it.”
“They are giving me a citation. That little bitch! I’m gonna break her in half.”
Beth’s pale face is now crimson red as she makes a fist and pounds the table, causing the laptop to jump.
“Beth, calm down. Our director Beverly is going to be at our staff meeting. I have a good relationship with her as a middle manager. After the meeting, I’ll speak to Bev privately and tell her Robin can’t stay here. We’ll call her agency and send her back. I don’t want to get her in trouble but she’s just not a good fit here.”
“Is the little shit going to be at the meeting?” Beth asks.
“I think so, but please stay away from her. Please let me handle this. In a few days, Robin will be on a plane going back home.”
“Well. you better be right,” Beth’s gruff voice barks. “I want her outta here. You understand? OUTTA HERE! Get that fuckin little troll the fuck OUTTA HERE!”
I enter the conference room for the I:00 pm staff meeting. I see Robin quietly sitting among some other nurses. I take my seat feeling uneasy as I anticipate Beth’s entrance. Beth and I meet eyes as she walks through the door and sits down on the side of the room opposite of Robin. So far, so good. All I need to do now is get through the meeting, meet with Beverly and a crisis is solved.
Beverly makes a striking figure as she stands at the podium, a tall brunette woman in her late forties, dressed in a blue business suit and pumps. For the next forty minutes, we review quality data, get updated on relevant news, and hear a series of announcements. As is our custom, awards and recognition are bestowed on nurses who performed extraordinary service over the past month.
I should admit that I am not paying careful attention when Beverly drops a bombshell of an announcement.
“And I would like to call attention to an exceptional nurse who has been with us for a very short time, but has assisted us in making remarkable improvements in the ICU. Her knowledge and practice skills are breathtaking, her innovative mind is nothing short of remarkable.”
Who could this be? I wonder.
Beverly continues. “Just this week, she noticed that our patient education material on coronary artery disease was outdated and she rewrote all of it. We will now be discarding our old material and replacing it with this wonderful lady’s work immediately?”
Wow, I thought. Patient education material is Beth’s project. I’m glad Beth is finally being recognized for it.
“And it is my pleasure to present this ICU Nurse of the Month Award to …Robin Price!”
What? This can’t be happening. As Robin walks forward to accept her plaque, I notice some nurses applauding and others staring is disbelief. Predictably, Beth’s face is fiery red as she clenches her teeth and fist. Now what?
I head to the door as the meeting is dismissed. Beverly intercepts me. “Kiva, did you want to talk to me about something,”
“Um, no, not right now, maybe later,” is all I could get out.
A few nurses, mostly the younger ones congregate around Robin, offering congratulations. I notice Beth remaining in her chair, looking livid. I turn around to approach her as the room empties. “I’m sorry, Beth. I had no idea Robin was doing that. She should have talked to you first. I’ll try to get Bev and Robin together in the same room. Look, Robin is here for just a few more weeks, we can get through this.”
Beth isn’t buying it. “I’m gonna flatten her.” She punches her fist into an open hand. “Pop! Right in the kisser.”
“Now Beth, let’s just…”
“I’ll tell you something, Kiva. That little cxnt and I shouldn’t be in the same room together. I’ll eat her alive, then puke her out and stomp on her. Then I’ll go out and get drunk.”
She is right. At least about the part about keeping them apart. There’s nothing left to do now except trying to keep an uneasy peace.
Another day at work starts. I walk inro the breakroom and need to adjust my eyes. The nurses are all wearing maroon scrubs, instead of the usual blue. “What’s up with this?” I ask.
“Maroon is our new color.” Krista explains. “Beverly ordered it. She said nurses need to distinguish themselves from doctors and the other disciplines. It wasn’t good for all of us to be wearing blue.”
“What brought that on?” I ask. Personally, I hate maroon.
“Robin suggested it,” she answered.
I take a deep breath and bite my tongue. This is going too far. The frustrating part is that Robin is an excellent nurse. We need her skills. Unfortunately, she’s turning our unit upside down.
“I am not fucking wearing maroon,” Beth growls as the break door forcefully swings open. “That bitch is definitely pushed me far enough. I’ll get her out of here. Wait! You’ll see! She won’t know what hit her!”
As if this couldn’t get worse. For the next few days, the tension between Robin and Beth is palpable, both of them essentially ignoring each other, except for their posturing body language. Beth defiantly continues to wear blue scrubs, while the rest of us acquiesced to maroon. I tried to juggle their schedules to keep them apart as much as possible. We just need Robin to finish her stint here, then leave, so we can get things back in order again.
Today, Robin and Beth are scheduled. My shift is 12 noon to 8 pm. Hopefully, there was no drama this morning in my absence. Something is off in the breakroom.
“Kiva, you missed the excitement,” Brianna tells me with a hint of a giggle.
“Yeah, Kiva, you should have seen it,’ the other nurses join it. “Unbelievable.”
I’m fearing the worse. “Where are Beth and Robin?”
“Well, um…Robin went home early.”
“Oh, Good Lord, what happened?” I demand to know. “What did Beth do to her?”
“Well, we don’t know for sure if it was Beth,” Lisa replies.
“Did someone hit Robin? What HAPPENED?’
The group of nurses look at each other for a second until Joanne begins to explain, “Robin took her lunch out of the refrigerator. She took a bite out of her turkey sub. The next thing you know, her face turns beet red, her eyes roll back into the back of her head, she breaks out in a sweat. She couldn’t speak. We didn’t know what happened. We were ready to take her down to the ER. She started running around in a circle, frantically flapping her arms around, making these gasping noises. She ran into the bathroom, stuck her head under the sink, and drank as if that was the only water in the world. She was there for half an hour, just gulping and gulping. Then she took all the ice cubes out of the freezer. She drank everyone’s juice and sodas. We didn’t know what was going on. She refused to let us take her to the ER.”
“Alright! What happened!” I demand to know again.
“Someone spiked her sub with Carolina Reaper Pepper.”
”What?”
“Carolina Reaper Pepper,” Joanne repeats as she hands me her cell phone with the browser open.
I read, “Carolina Reaper Pepper holds the Guiness Book of World Records for the world’s hottest pepper. 1,000 times hotter than jalapeno.”
“And Beth did this? Oh God, she’ll get fired. That’s workplace harassment. She could get sued by Robin.
“Well, no one actually saw Beth do it.”
“Where is Robin?”
“Her mouth burned so much she took the rest of the day off.”
Fuck! Now what. This place has become so toxic. As much as I love Beth, I’m now wondering if she shouldn’t go.
I march onto the unit and confront Beth. “Beth, this is so juvenile. Do you realize how much trouble you could get into?”
“So let them fire me,” Beth, still wearing blue scrubs, snarks when I confront her.
I’m done. I’m finished trying to be diplomatic. I will not defend Beth. Whatever happens will happen. So be it.
Robin and Beth are both off today. At least I’ll have one day without their bullshit. But that doesn’t stop the nurses chatter in the breakroom.
“Beth will kill her. She’s twenty pounds heavier,” says one voice.
“I don’t know. I saw Robin boxing in the gym. She’s quick and looks like she can take care of herself,” says another. More voices join the discussion.
“I hope Beth wins, I can’t take Robin’s superiority bullshit.”
“No, I think Robin changed a lot of things for the better. Beth is just an old alpha bitch who needs to be taken down a few notches.”
“Forget it. Beth will crush her like a grape.”
“STOP!” I shout. “What is going on here.”
The nurses look at each other and smirk. Krista speaks up.
“Beth and Robin are going to fight”
‘Oh, for the love of…You’ve got to be kidding,” I moan.
“Yup”, Megan chirps in. Today at 4:00 at Hampton’s Woods. No one but us will see it. I think it’s awesome. Irish Beth Sullivan vs. Rockin’ Robin Price. We should sell tickets. We’re all going. Kiva, do you need a ride? You can come with me.”
“No, I’m not going,’ I retort. “Because there will be no fight. I’m calling Beverly. I’m calling Robin’s agency. I’m putting an end to this. This is inappropriate.”
“No, DON’T,” several nurses protest. ‘Let them fight. If you tell, they’ll both get in trouble. If we all swear secrecy, they can settle it and no one else needs to know.”
I excuse myself and call Beth. Then I call, Robin. They both give me the same message. They will fight regardless of both of them getting fired. It’s a done deal and nothing I can do will stop them from fighting.
I feel a heaviness in my gut the rest of the afternoon, but I need to focus on my patients and the job at hand. I debate with myself back and forth. Should I report them? Should I call the cops? The younger nurses seem giddy with anticipation as our shift ends at 3:00 pm.
“Well Kiva,” Megan says with a grin, nudging me in the ribs. “Almost fight time. Hampton’s Woods awaits.”
By the time I wrap things up and hand off my patients to one of the night shift nurses, it’s already 3:30. I hurriedly change out of my scrubs and back into my jeans, sweatshirt, and T-shirt. I race to my car. It’s 3:45. Now’ it’s on to the fight site.
Hampton’s Woods is a small forested area bordering a municipal park. There are a few small clear areas for picnics that are seldom used and hidden from the park itself. I suppose Beth was counting on no one being there this time of the day as is usually the case. As I pull into the park’s parking lot, I notice some of the cars belonging to my staff nurses. Fuck, I’m thinking, they’re already here.
I dash across the park to the woods in a full sprint, hoping I can do something to thwart this calamity. I hear them. Women’s voices. Then I see the gathering of people I recognize from work. They are here – Beth and Robin, surrounded by six work colleagues who have come to witness this spectacle.
“Oh Kiva, glad you made it,” Megan smiles, as if I just arrived at a community softball game or a round of golf. But no, these are two women who want to hurt each other. I glance through the bodies. I see Beth loosening up, wearing a T-shirt and gym shorts, her blonde hair pulled up in a tight bun. Several yards away, Robin is stretching dressed in a sports bra and short yoga pants, revealing she has a toned body and sharp abs. Her long black curly hair in a ponytail.
.
“Girls,” I shout, “Please tell me you’re not really going to go through with this. Think about what you’re doing, how this is going to have consequences.”
Beth gives me a silent look that says, ”Stay out of this.” Robin ignores me completely. I resign myself that I am thoroughly defeated and now I will watch this fight and hope no one gets hurt. The aftermath, however, terrifies me.
“Okay ladies, are you ready?” Megan asks, apparently assuming the role of mistress of ceremonies. Beth, you stand over there, Robin, you are there. Wait for my signal.”
I can’t help but notice the size difference in between these two women. Beth is about twenty pounds heavier. Robin looks fit and is at least ten years younger, but it seems to me that once Beth gets control of the fight, it will be over.
“One, two, three, fight!” Megan orders.
As I expected, Beth lunges right at Robin. With quick reflexes, the travel nurse sidesteps and dodges a wild swing from Beth’s meaty arm, and counters with a swift solid kick to the stomach. Beth stumbles backward but doesn’t go down. She grunts and stares at her opponent with anger.
The two women circle each other. Beth charges again, this time her movements are more deliberate. Robin looks confident, her body coiled, waiting for the attack. Beth swings her right fist and Robin, again, steps aside and throws a jab to the ribs. Beth stumbles and Robin sees her opening. She moves, in, wrapping her arm around Beth’s head in a headlock. But with brute strength, Beth lifts up Robin and drives her legs forward, pushing Robin’s back into a tree trunk, resulting in a collective gasp from the nurse spectators as the travel nurse grimaces in pain and arches her battered back. I’m already worried about an injury. Beth pulls Robin away from the trunk and swings her to the ground, tumbling on top of her. “Fucking bitch,” Beth grunts.
Beth tries to leverage her weight on Robin and lunges her hands at her throat. Robin does have her legs around Beth’s waist and struggles to keep her away while grabbing Beth’s wrists. Beth frees her right arm and swings at Robin’s head like a sledge hammer. The punch misses wildly, its momentum throwing Beth off balance, allowing Robin to use her legs to dislodge Beth. The two of them roll around on the ground to the sounds of crinkling leaves and snapping twigs. I notice that the nurses present are unusually quiet and seem to be neutral as if they’re careful not to risk ending up on the wrong side of a power dynamic determined by the fight. Beth attempts to press her weight advantage on the ground, but Robin manages to fight her off, rolling away and rising to her feet.
Beth springs from a crouching position and like her idol John L. Sullivan, rushes at Robin, her fists swinging wildly. Robin, despite her size disadvantage, looks unfazed and calculating. She ducks and weaves, dodging each blow, then shoots a few quick jabs to older nurse’s face. Beth snarls, her fair complexion marked by redness to her face and eyes burning with rage. She presses her attack, landing a hard blow to the ribs and an open-handed slap to the face, resulting in a loud smacking sound. Finally, Beth tackles her opponent to the ground, pinning her down. Again, Robin doesn’t panic. I suspect she has had fight training of some sort. She twists, bucks her hips, scissors Beth at the waist, turns and reverses their position. They roll through wet leaves, their skin and clothes becoming stained with soil and moisture. Robin manages to get on top, straddles Beth and begins raining punches. Beth grabs hold of the travel nurse’s arm and uses her superior power to yank Robin off of her.
Robin pushes herself up. Beth, with her eyes locks on her adversary, rushes at her again, fists swinging more wildly then ever. I notice that Beth’s breathing is becoming labored and her movements seem slower. I’m thinking she could be in trouble if she doesn’t end this soon. Robin prepares for the onslaught with her fists up as Beth goes on the offensive. The bigger blonde lands a right fist to the side of Robin’s head, sending the smaller brunette staggering backward. A second right hand knocks Robin backward on her butt.
Beth seems to sense she is close to finishing off her opponent. Robin looks a little shaken as she gets to her feet. Beth is in her crouching position and it’s obvious another bull rush is coming. The Irish nurse lets out a war scream, lowers her head and with her arms out dives at Robin with all the force she can gather.
As Beth lunges, I hear a crack. For a moment, time seems to stand still. Beth falls face first into the dirt. Robin is standing. I don’t know what happened. All is silent, except for the chirping of birds. Beth’s body lies motionless. All I see is her back and legs and her blonde hair as she lies on her belly. One of her legs is involuntarily twitching. Robin is in front of her, standing at her head, looking confused. And Beth?
“Beth,” I scream out. “She’s not moving. Oh fuck, she’s out. What the fuck happened?”
“I threw up my knee and she ran right into it,” Robin explains. “My knee got her in the jaw.”
“Holy shit! She’s knocked out,” I cry out. The nurses gather around Beth’s fallen hulk. “Everybody move back,” I order. “Let’s turn her over, be careful with her neck. Is she breathing?”
“Yes, we having respirations,” Megan answers. “And we have a pulse.”
I suppose no one brought smelling salts. I’m concerned and I am livid. “So, is this what you came to see?” I scold my nurses. “Are you satisfied now?” I next direct my anger at Robin, “And you…you.”
“I didn’t want this,” Robin protests. “She forced me into it.”
“She’s waking up,” Megan informs. Beth’s eyes flutter and she is showing signs of purposeful movement. After a minute, her eyes open but are glazed. I keep her on her back and test if she can follow simple commands such as squeezing my hand. She is confused and has no idea what happened.
“You better leave,” I instruct Robin. “We’ll talk later.”
Over the next several minutes, Beth regains more consciousness, but can only remember the beginning of the fight, a clear sign of amnestic reaction to a concussion. Eventually, we get her to her feet. She refuses to go to the ER, but I have one of the nurses drive her home. I can’t even think about what will be the aftermath of this fiasco.
I drive to work the next morning, fearing what I will be walking into. I’m angry at Robin, at Beth, at my staff, and myself for allowing this to happen. For all I know, this may be my last day at work. Contrary to popular belief, nurses can get fired for public conduct outside of work. At least Robin will be leaving later this week. But Beth? No doubt, the entire hospital will hear about this. What does that mean for her future here. As soon as I step off the elevator, I receive a text from Beverly, “Come to my office ASAP.”
I prepare for the worst as I enter the director’s office. “Good morning, Kiva,” Beverly begins. “There are a few important things going on that you should know.” Oh, good lord, here we go.
“First,” she starts, “Beth called in. She requested a leave of absence and doesn’t know when she will be back. She stated it is for personal reasons. I granted it, but that means we are down another position and will be without one of our best nurses. So, we may have to get ourselves another travel nurse.”
“And…you and I need to have a serious discussion about Robin. I have concerns.”
Finally, I think to myself as I breathe a sigh of relief. Our feckless director has finally caught on to Robin.
“You see, Kiva, Robin’s contract expires at the end of the week and she’ll be leaving us. I think she has been a breath of fresh air for us. As you know, she is exceptionally talented and nurses like her don’t come along every day. I’d hate to lose her.” Personally, I think she’s a breath of another kind of air.
“So,” Beverly continues, “I offered her a contract to stay with us permanently. She seems very excited about it and will discuss it with her husband. Of course, we’ll throw in a signing bonus and pay for her moving expenses.”
“You…what?” I mutter, hardly getting the words out.
“Now, there is one more thing. Robin asked if she could have a managerial position. Now, I think Robin would be a superb manager, and I would like to entice her to stay here. But I told her we already have an excellent manager, and that of course, is you. So…what I’m proposing is that…we can have two managers. You and Robin could run the unit together. We’ll have her share your office with you and have you both working side by side. I think the two of you will work great together. What do you think?”
“Oh, fuck no,” I blurt out.
“Kiva,” Beverly says, her eyes opened wide with surprise. “Is something wrong? Is there something going on that I should know about?”
“Um…no,” I answer. “I’ll think about it and give you my answer.” It occurs to me that my lack of truthfulness is part of how we got into this mess.
Today is an administrative day for me. I spend it in my office trying to focus on staffing, budgets, regulatory paperwork and so forth. Robin is on the unit today. The nurses act like nothing happened. I’m angry at everything. To top it off, Robin wants my job. How do I resolve this? I know I’m not thinking rationally. I’m getting ideas, but I know I’m just diving into deeper dark water. I open my hand bag and glance at my catpin. It’s the end of shift. I call Robin into my office.
“Congratulations bitch,” I tell her. “You’ve managed to make sweeping changes to our unit, you’re the director’s favorite, and you got rid of Beth all in just a few weeks. You came, you saw, you conquered. You put Julius Caesar to shame. And now you want my job. You are very impressive.”
“No Kiva, that’s not exactly right,” Robin objects. “I told you I didn’t want to fight Beth.”
“And oh, by the way, you’re a good fighter. I bet you have one of these,” I say as I show her my catpin.
“Well, yes,” she replies, “I learned how to fight, but I never wanted to cause trouble here.”
“Seriously,” I shoot back. “Shit Robin, you practically own this unit now. And…I want you out of here. So, I want to settle this with you, catpin to catpin.”
“Kiva, I’d rather not. I don’t like to mix work with…”
“This isn’t about work, Robin,” I retort. “Beverly told me about your offer. Congratulations again. But the two of us can’t be here together. You go or I go.”
“What are you saying?” she asks.
“I’m saying that we fight it out. If I win, you will go home and never come back. If you win, I resign and you can have my manager’s job. Sound good?”
“I don’t know,” the travel usurper responds, “can we talk about it?”
“Robin, I’ve been trying to talk all month and it’s only gotten worse. Let’s just settle it. You go or I go.”
“Okay, fine,” she sighs. “If you want a fight, you got one. Where?”
“I want this private,” I tell her. “Just the two of us. I have the house to myself this weekend. Be there Saturday.”
To be continued.
