Stepped Up [COMPLETE]

4

5 YEARS LATER

The morning routine unfolded with the familiar cadence of calling Elena to breakfast in our cosy two-bedroom house. She had turned five, and the passage of time prompted a significant decision—to leave behind the painful echoes of Trisha's passing. When Elena was just six months old, I chose to uproot us from Vermont, seeking solace in Amarillo, Texas. Attempts to work at the hospital where Trisha had died proved too daunting, compelling the move to a new beginning.

In Texas, I found my professional niche as a senior registered nurse with the US Veterans Health Administration. Nearly five years had elapsed since our relocation, and during this time, I earned a master's degree in nursing. The job provided financial stability, allowing me to purchase a single-story house at the end of the previous year—a haven that now belonged to us.

Our new home boasted three bedrooms, two bathrooms, a pantry, and a utility room. A spacious gated garden with swings, slides, and toys added a playful touch to our surroundings. The open-plan living room seamlessly flowed into the dining area, and a medium-sized kitchen was connected via an arch. The main bedroom with an ensuite bath reflected my sense of ownership, while Elena occupied the second most spacious room. The smallest bedroom doubled as a study/junk room, adorned with Christmas decorations and a collection of books. A beautiful stone fireplace decorated the living room, and the pervasive comfort of air conditioning and heating enveloped the entire house.

As Elena entered the hallway, her tiny feet on hardwood floors resonated through the space. She beamed at me from the kitchen, her heart-shaped face framed by bouncing brown curls. Adorned in a long-sleeved top, denim pinafore dress, and black tights, she exuded childhood innocence.

"I'm here, mama," she declared, and I reciprocated with a smile, handing her toast with peanut butter along with a glass of milk. The term 'mama' was a poignant reminder of our unique family dynamic, and I took the opportunity to share stories of Trisha, her other mummy. Pictures on the walls chronicled moments from our shared history; the last one captured when Trisha was 32 weeks pregnant—an image is frozen in time, depicting me kissing her bump.

With breakfast completed, the impending arrival of the school bus prompted a countdown. "The bus will be here in 20 minutes," I informed Elena, setting the morning timeline. As she finished her breakfast and rushed to the family bathroom, I followed suit, emphasizing the importance of shoes, a coat, and a bag. The routine continued as I donned tennis shoes and a coat, grabbing my backpack with essentials for the day ahead. The orchestrated morning I culminated in a shared moment at the end of the driveway, waving goodbye as the school bus approached.My role as a senior registered nurse awaited me. With a sense of purpose, I embarked on the day's responsibilities, navigating the delicate balance of professional and personal realms in the embrace of our Texas home.

The rhythmic routine of my workdays unfolded as a senior registered nurse in the Intensive Care Unit (ICU). I dedicated four days a week—Monday, Tuesday, Wednesday, and Friday—from 8 am to 5 pm. The hospital operated with overlapping shifts, featuring a team from 4 pm to 1 am and a night shift from midnight to 9 am. Patient handovers were conducted during the one-hour changeover, a crucial transition period between shifts.

Having spent the past two years stationed in the ICU, I assumed the role of a senior RN for the last year. Each shift had a pair of senior RNs responsible for overseeing the staff and ensuring the smooth operation of the department. The division of responsibilities involved one old RN handling rounds with the doctors while the other focused on caring for the team.

The day commenced with my arrival at the hospital, parking in the familiar lot and exchanging greetings with familiar faces. A quick detour to grab a coffee set the tone for the day ahead. Navigating the hospital, I reached the elevator, ascending to the ICU on a floor where I had become a steadfast presence.

Entering the staff locker room, I stowed away my bag and coat before donning the essential attire of a healthcare professional. The badge adorned with my name and title found its place, and the stethoscope, a constant companion, draped around my neck. With preparations complete, I ventured into the ICU changing area, where the ritual of donning a gown and gloves preceded my entry into the realm of critical care.

"Morning, guys," I greeted the teams, the seamless transition from the late-night shift to my team underway. Walking to the nurses' station, I surveyed the patient board, a visual representation of the challenges awaiting us that day.

"What are we dealing with today?" I vocalized my thoughts, addressing the collective consciousness of the ICU team. The bustling environment of the nurses' station buzzed with activity as we prepared to face the day's complexities, each patient bringing a unique set of challenges that required our expertise and dedication.

The familiar banter echoed in the ICU as I encountered John, my favourite Vietnam Veteran, who always greeted me with a touch of charm. His warm smile accompanied a playful question, "You ready to accept my dinner date, darling?" John, a sweet older man, found himself in the ICU due to a collapsed lung, a consequence of years of smoking. Despite the challenges, his spirit remained resilient. With oxygen support and a re-inflated lung, he had recently come off the ventilator, navigating the delicate balance of health. Tomorrow, he was scheduled for surgery to remove his damaged right lung.

I chuckled at his proposition, a lighthearted moment amidst the severe setting of the ICU. I performed routine observations and checked his blood pressure, temperature, and oxygen stats. The familiar ritual of changing the dressing on his IV and administering medication followed a task I undertook with the practised efficiency of a senior RN.

"You know I can't do that to Lisa, John," I responded with a jesting tone. Lisa, his devoted wife, made a daily pilgrimage by bus to visit John, standing by him with unwavering support. The playful exchange with John provided a brief respite, a reminder of the human connections that flourished despite medical complexities.

"You're too good a woman to be alone,"

"You know I'm not alone, John; I've got my baby girl,"

"How is she?"

"Good, she's enjoying school,"

"That's good; an education is good," John said.

"Breakfast will be round in 10; need anything else, John?"

"No darling, you go off; I holla if I need ya," I winked at him and went off to deal with my next patient, who unfortunately was not awake. The gravity of the ICU manifested in the form of a 23-year-old Veteran who had arrived through the emergency room, a victim of a dangerous fall down three flights of stairs. As per her medical records, she lay connected to a ventilator, grappling with a massive brain bleed that the medical team had attempted to address the previous night. I approached her bedside, compelled by the duty to assess her condition.

Carefully scrutinizing her vital signs and administering the prescribed medications, I navigated the routine tasks that characterized my role. The stark reality of her severe condition beckoned my desire to intervene, to extend a healing touch that could potentially alter her fate. Yet, the limits of my abilities restrained me. The ache in my fingers and the tingling sensation mirrored the internal struggle—a conflict between the yearning to heal and the understanding that such interventions couldn't be extended to everyone, especially those in such critical states.

The ethical dilemma loomed large, acknowledging that selective healing could raise questions and disrupt the delicate balance of medical ethics. Fate, with its erratic ways, often demanded a hands-off approach, an acceptance that, despite the desire to alter outcomes, sometimes the course had to run its natural course. The echoes of this realization reverberated within the confines of the ICU, a stark reminder of the challenging decisions that defined the realm of healthcare. In this domain, healing was both an art and a discipline, intricately woven with the threads of responsibility and limitation. The haunting parallel with the past, exemplified by Trisha's fate, lingered—a poignant reminder that, despite the longing to intervene, some paths must be left untrodden.