The Night Shift



The first snow fell at the end of October, and amazingly, it also turned out to be the first major storm of the season. Tree branches were weighed down with wet snow, so that some of them were even touching the ground. I think by late evening there was at least 10 inches on the ground, and the snow still kept slowly piling up. Even though they tried very hard, the plow trucks couldn’t keep up with nature and clean the roads fast enough; so the ride that usually takes me about 5 minutes took a whole 15 that night. I got out of the car and ran to the back door of the building through the parking lot that was heavily covered with a thick blanket of blinding white snow. From the side I looked like I was trying to cross a shallow river jumping from one stone to another to prevent my clothes from getting wet.
The time clock showed it was a quarter after eleven - I was late. I took off the leather jacket I was wearing and underneath I had on a light blue Gap tee-shirt and a comfortable pair of white cotton pants. I prefer wearing tee-shirts and cotton pants to work instead of scrubs, since even the smallest size of them looks like the largest on me, and I am very conscious of how comfortable I feel in my clothes. The bottoms of my pants and my feet inside the clogs I was wearing were cold and damp from running through the snow. My long dark brown hair was pulled back in a high ponytail, and the dark circles under my eyes were matching my mood. I felt tired and a bit irritated, I could say I was simply exhausted because I had already worked 44 hours that week. The only thing I dreamed of was crawling under my three warm blankets and going to sleep for the next 24 hours without being disturbed. But I already promised my friend Birsen that I would work with her that Friday night. I should admit though, that it was quite comforting to find out that we were fully staffed, which rarely happens, and the full moon was a week away. Everybody working at the nursing home knows what full moon brings to the facility - somehow it disrupts the residents’ physiological cycle, especially of those with mental diseases like Alzheimer’s, and there’s hardly a quiet minute on the nights like that.
So there I was, standing at the Nurses station with a bag of “Almond Joys” in one hand and a can of cola in the other and hoping for a peaceful night. The charge nurse went through my assignment sheet - nothing extraordinary - a few patients with cold symptoms; Mrs Warner was on comfort care; and Mr Hinder was congested since the morning. By 1:30 a.m. I had finished my first check, took all the required temperatures and was about to do the necessary skin treatments, when Mr Hinder’s call bell rang. I found him sitting at the edge of the bed, holding his walker in front of himself. “ Hello,” he said, “ I didn’t want to bother you and I know you are busy, but for some reason I feel weak tonight and falling is not on my list of things to do. Would you, please, help me to get to the bathroom?”
“Sure, Mr Hinder, that’s what I’m here for,” I replied cheerfully, and helped him to the bathroom. Later I brought him some tea with artificial creamer and “Sweet&Low”(just the way he likes it), because he couldn’t get back to sleep right away.
I was not particularly close to Mr Hinder, but I really liked him and had a lot of respect for him. I thought he was in his late 70s until I pulled up his chart and found out he was 93. He was a tall man - probably six foot two and in a fairly good physical shape for his age. Also, Mr Hinder was a very independent man and almost didn’t require any assistance with daily tasks, so I wasn’t even sure why he ended up at the nursing home. I hoped it was for some sort of a rehabilitation purpose. During the day, you would find him sitting in his huge dark green leather recliner with a copy of “Adirondack Daily Enterprises” in his hands. When you stopped by to say hello, he would look up at you through the thick gold framed glasses and smile. His dressing style was immaculate - the colors of his shirts, pants and jackets would always match and every night, before going to bed, he made sure to fold everything neatly and put them away. I didn’t see much of him during the day, because I work at night, but I knew from the assistants that worked the day shift, that most of the day Mr Hinder spent in his room behind the closed door. He wouldn’t go to the main dining room, as most of the residents did, instead he’d eat all the meals in his room. Only twice a day would he get out of the room to walk along the hallways with a rolling walker in order to get some exercise. Otherwise he kept to himself and the only visitors he had were his daughter Charlotte, his granddaughter and the Golden Retriever Allie.
Mr Hinder had hard times sleeping, he would wake up in the middle of the night and would not be able to fall back asleep for hours. On a few occasions, when it wasn’t busy, I would go into his room to talk with him about his family and what it was like growing up in Austria and moving to the states during World War II. I enjoyed his stories, told with a distinct Austrian accent, and I liked spending time in his room. A typical room in a nursing home smells like a hospital and has a few boring pieces of furniture - like a bed, a bed-side table, a chair and a closet for clothes. Mr Hinder’s room was different though - it had character. First of all, it smelled like Christmas, that sweet smell of tangerine peels that brings out happy childhood memories. It was very thoughtful of his family to bring a set of his own bright blue and yellow sheets and comforters, rather than using the white hospital linen. Right next to his favorite recliner he had a table, made of dark wood, which had a few scratches and the legs had marks from his dog chewing on them. On top of the table you could find a stack of daily newspapers, a bowl of fresh fruit, a bag of “Andes” and a box of “Sweet&Low”. Then there was an old heavy bookcase with glass doors on it that was full of books, both in English and German. He didn’t have a TV in his room, unlike the other residents; he spent his time reading newspapers and books and listening to the radio. There were some framed family photos on top of the bookcase. One was a picture of him with his wife, probably taken in the 60's (judging by the hairstyle and clothes), another picture was of Charlotte in her teens, a recent picture of Charlotte and her daughter and a few photos of his best friend Allie, his Golden Retriever.
It was around 2 a.m. when I finished doing skin treatments and saw the light still leaking out under Mr Hinder’s door. “I guess, he’s having trouble sleeping again,” I thought to myself and knocked on his door. He was sitting up on the edge of the bed again, but even with my help he wasn’t able to stand up, saying that he felt extremely weak and lightheaded. He was breathing fast which was unusual of him, so I helped him lie down and raised the head of the bed 45 degrees, and left his room to notify the nurse. She came back right away to check his vital signs - his blood pressure was higher than usual and the oxygen level in his blood was dropping. She gave him some medication and put him on 2 liters of oxygen. I stayed with Mr Hinder for another 10 minutes until he finally calmed down and his breathing returned to normal. I left his door open and started my second round - a few call bells here and there, Mr Hinder seemed to be all right, so I finally sat down at the table to fill out my assignment sheet and have a snack . It was a quarter after three and I was looking forward to my half hour break, which I usually take at 3:30. All of a sudden the light in Mr Hinder’s room went off and I rushed to turn it back on and check on him. His breathing became very fast again, but this time he was complaining of chest pains. Instead of leaving the room, I reached for the room phone and paged the nurse. When she checked his blood pressure and it was very high, so she left to consult the Supervisor on treating him here or sending to the ER. Mr Hinder grabbed my hand.
“Please, can I hold your hand?”, he asked gasping for air. “Sure, you can, Mr Hinder,” I answered, squeezing his hand. “It’s hurting so much. Don’t leave, please, stay with me,” he kept saying. “I am right here and I am not leaving you,” I responded. “I don’t know what’s happening, I can’t breath,” he kept saying again and again. I started panicking, suddenly I realized, that he was going to die right here and right now. I saw his chest going up and down, his right hand was pushing on the middle of his rib cage as if trying to make the terrible pain go away. A few seconds later his eyes rolled up and he stopped responding. I kept yelling his name in hopes that he would hear me and say something, but it didn’t happen. Tears started running down my cheeks and I started praying. At that moment my friend Birsen, the nurse and the Supervisor ran into the room. I reluctantly let his lifeless hand go, I thought if I kept holding it, he would come back. I couldn’t believe what was happening. How could he die? Why now? The Supervisor started checking his pulse, Mr Hinder wasn’t breathing any more. “That’s it. It’s over now,” I kept whispering. Then there were those 2 last breaths, each about 30 seconds apart and he was pronounced dead by the Supervisor. I was sobbing, Birsen hugged me, trying to console me. I couldn’t believe that Mr Hinder was gone! How unexpectedly and quickly he passed away(atleast for me). I will never see the light coming from under his door in the middle of the night again, or walk into his room to find him sitting with a newspaper in his hands, or bring him a cup of his favorite tea, or listen to the stories he told with his Austrian accent, that I became so familiar with.
After we got Mr Hinder’s body cleaned up, dressed and ready for the funeral home to pick up, we started cleaning his room. Only then did I realize that his clothes were not neatly folded, but thrown on the chair and the apples that were in the bowl on the table had small brown spots on them and had already started to rot. While I was trying to sort out the stuff on his table I came across a notepad with Mr Hinder’s writings. I began reading the notes. It was like a little journal. It had dates and described how he had a nice warm bubble bath, with which he was very pleased; how caring and helpful the girls were here; about having tea in the middle of the night and getting orange sherbet that he didn’t ask for, but enjoyed it anyway; and other things that the staff was helpful with. Tears gushed out of my eyes again.
How often do we take things for granted and forget that it’s not just a job, but that these people depend on us to do things that they used to be able to do, but now aren’t able to do on their own? The little things we do for them turn out to be not so little to them and they truly appreciate our efforts. I wished I could do more for Mr Hinder, to spend more time with him, but it was too late.
It was four in the morning and I was wide awake, sitting on the couch and staring at his shut door. It was hard to imagine that within an hour people would start waking up and another busy day would go on as if nothing had happened, when all that I could feel was numbness. The walls were closing in around me, I felt like I was suffocating me, I just wanted to leave this building and go for a long walk in the woods.