My last patient

Written Saturday night

Watching the lines turn from scarlet to salmon pink, I jot down the last ten numbers for my flowsheet. I deftly clamp the patient's lines and strip them off the machine front while pre-rinsing it with water. After the double beep I drop the two jiggly wand connectors into the vinegar, which still smells like pickles to me.

I make a tight cinnamon-roll of gauze and press it to his arm while I ease out the first needle. I'm careful with the wiggly sharp and tube, like a one fanged snake. As I hold pressure on his arm I put my right foot back in tendu derriere, a trick I taught myself years ago to relieve back pressure when I have to stoop. A Spanish language game show blares on his TV. My gaze wanders over his shoulder to the window behind him. This hospital has the best views; I will miss it.

Today the snow has left a heavy frosting on downtown Denver. The trees in the park are drooping under the heavy dollops received today. The creek is swollen from the downpour. The traffic moves slowly along Denver's main thoroughfare, brown and slushy. Like usual, it's Saturday evening and I'm alone in the my unit with my last patient, waiting to close up shop. I wonder how long it will be until I can join those folks on the road to somewhere better. I wonder if I have will be coming back here in a few hours when I should be asleep in bed. But luckily no one needed plasmapheresis that night.

I shift my weight and put my toes on the base of the dialysis machine, right next to the bicarbonate jugs. A great way to stretch my calf; good to do several times during an ICU run. I only hold it a few seconds before switching to the second needle site. Luckily this patient is lucid and strong enough to hold pressure on his arm, so I get a jump start on wiping down all the equipment and telling his nurse on the floor how he did. Twenty minutes later they wheel him away and I tell him “Hasta luego,” even though it's a lie. After locking up the needles and paperwork I'm leaving here and not coming back. I'm not a dialysis nurse anymore.