> Skip to content
  • Published: 17 January 2023
  • ISBN: 9781529157970
  • Imprint: Penguin
  • Format: Paperback
  • Pages: 400
  • RRP: $22.99

ER Nurses

Extract

PART ONE:

Day Shift

ANGELA PARAWAN

Angela Parawan was born in New York City and grew up in Virginia Beach. After graduating from nursing school, she did an externship at a cardiovascular ICU. Angela is a traveling nurse and currently lives in California.

I don’t think I’m cut out to be a nurse.

Growing up, I watched my mother take good care of my extended family, especially my grandmother. My interest in becoming a professional caregiver sparked, I toyed with the idea of becoming a doctor — until I shadowed one and found out how little time doctors spend with patients.

And I want the human interactions, so I chose nursing.

But nursing school, I’m finding, is hard. I’m struggling with the dual responsibilities of attending class during the day and working as a nursing assistant at night.

The hospital job is important because it’s a front-row seat to the reality of nursing. The nurses here run around at a hundred miles a minute, all the while projecting to everyone that they are cool, calm, and collected.

I admire their composure, because I’m an empath. I’m highly sensitive to what other people are thinking and feeling. I take on their emotions, their pain. A lot of the nurses here share that trait. They have more heart than they let on.

And then there’s death. It comes in waves, and lately we’ve had a lot. When someone dies, it really affects me, and it really affects the other nurses too because, deep down, like me, they’re nurturers. But they can’t show it. They have to be rational, steady, fully in control of their emotions.

There’s no way I can do this for a career, I think as a nurse delivers a new patient to one of the open rooms on our floor.

His name is Brian. His wife is with him. They both look shell-shocked.

“I came into the hospital tonight because I’m not feeling well,” Brian explains as the nurse and I get him settled. “I was holding a lot of fluid in my stomach, and I wanted to see what’s what. They ran a couple of tests, and it’s . . . I have pancreatic cancer.”

Brian is a professor at one of the colleges. He’s a super-nice guy, former navy, and really, really accomplished. He’s so kind to the staff — so thankful. The staff love him. I love him. We gravitate toward him because of his demeanor, how he handles himself as he tries to fight the disease.

One night, as I’m talking with Brian, I share my struggles with him.

“You can do this,” he tells me. “Going to school during the day, working nights — I know it’s hard. It’s supposed to be. Remember, nothing that’s worthwhile in life comes easy.”

I come from a family of nurses and doctors. They’ve essentially given me the same advice — to hang in there, be resilient. They’re supportive because they’re my family. But the conviction in Brian’s words and the confident way he says them leaves an indelible impression on me.

In the two months he’s with us, I watch his physical abilities decline. He can no longer walk, can’t even stand up or roll over in bed.

“We’ve been married for forty-five years,” his wife tells me. “I don’t know what I’m going to do without him — I don’t even know who I’ll be without him.”

Brian’s death hits me hard. I cling to his words as I continue my struggle through nursing school. I think of him when I graduate.

 

At twenty-five years old, I’m a traveling nurse. Every three months, I get to pick where I’d like to work. I’ve decided to finish up my stint in Colorado Springs, take a month off, then move to New York City. My family spent many summers there when I was young, and I enjoyed those times, but I’ve never been there as an adult.

I arrive in early March of 2020. The first two weeks are fun. I work three days a week and explore the city on my days off.

I’m aware of COVID. It’s on my radar, but it hasn’t hit NYC yet.

The travel company I’m working for calls me and says, “The hospital is going to transition you into overflow.”

During cold and flu season, hospitals can get overcrowded, so they often have designated areas to deal with a high volume of sick patients. On top of that, my hospital is also expecting an influx of COVID patients.

“Be prepared to work forty-eight to seventy-two hours each week.”

“Okay,” I say, wondering if I’m going to get an N95 mask and proper protective equipment. “Will do.”

The hospital gives us each a simple surgical mask. Because of the limited supply, the mask when not in use is to be stored in a brown paper bag and then reused until it’s soiled. Because I’ll be working in the COVID unit and the COVID ICU, I can wear my gown multiple times. When it’s soiled, I’ll be given another one.

We’re each given a respirator (a mask with a filter) in a bag labeled with our name. Respirators are designed to be used once and for no longer than one hour. But now, as long as they’re not soiled, we’re to reuse them until they fall apart.

COVID hits New York fast and hard. The hospital insists we wear our masks continuously throughout our twelve-hour shifts. The constant wear causes blisters on my nose and my cheeks. My skin breaks down. One day after work, when I take off my mask, the skin peels off my nose. It just rips right off.

During a thirteen- to fourteen-hour day, carbon dioxide builds up inside the masks. The gas is unsafe in high concentration. A couple of nurses on my floor pass out from inhaling

too much CO2.

I use the respirator I’m given for three weeks.

By April, the COVID cases have risen alarmingly. One day, we have close to eleven thousand cases.

If I don’t have COVID now, I think, I’m going to get it.

The majority of our patients who need to be intubated don’t ever make it out of the hospital.

Some days, instead of working in the COVID ICU, I’m floated to other floors with COVID patients who need lower levels of care. It’s there I get word that one of my ICU COVID patients has been taken off the ventilator and is breathing on his own. He’s being transferred to me.

His voice is really raspy, and he’s still very weak and very, very sick. He shouldn’t be alive — I was sure he was going to die. He may very well still die.

This guy not only survives, but in a couple of weeks he’s up and walking. Healthy. When he leaves our hospital, people line up in the hallways to cheer him on. He’s the first patient who’s gotten off the vent and made it out of here.

One day I have five patients, all young guys. Four of them die.

It’s one of the most horrific things I’ve ever seen. I’ve never had so many patients die in one day. It’s the worst thing emotionally that’s ever happened to me. When I leave the hospital at nine p.m., I’m physically and mentally exhausted. I’ve got nothing left.

I live a mile away and walk home every night. This area was, not that long ago, very busy and had high foot traffic. Now it’s completely empty except for homeless people. And rats, which are at an all-time high. They’re everywhere you look.

The emptiness of the streets . . . it’s such an eerie feeling. Stores are open, their lights on, but there are only a few people around. When they see me dressed in my scrubs, they turn away or move to the opposite side of the street because they know I work at the hospital and they think I’m probably infected with COVID.

Usually, I feel proud to be a nurse. Now I feel like a leper.

When I get home, the stress I’ve been under these past six weeks — waking up at four every day to go to work, the long, grueling hours, the deaths, the suffering and trauma — all of it finally takes its toll. I call my mom and tell her what’s happening.

“Are you okay?” she asks.

“This is so much harder than I expected.” Then I lose it. I start crying hysterically. “I don’t think I can do this. All of my patients are dying — I can’t handle it anymore, Mom. If I catch COVID and I’m on a vent, please just let me go.”

My mom listens patiently and does her best to console me.

“A lot of nurses are just up and leaving New York,” I tell her. “They don’t even show up for work. Today, I was supposed to be working with a guy named Paul. I couldn’t find him, and when I asked where he was, I was told, ‘Oh, he’s not coming in. He’s on a plane right now going back to wherever he’s from.’ ”

“Can they actually do that? Isn’t that — what do you call it again?”

“Abandonment. In any other time, yes, it would be reported to the board of nursing. But this is COVID, so they’re ignoring it because when someone leaves, the hospital has another warm body who is willing to fill that spot almost instantly. There are so many nurses flooding into the city to help.”

“Do you want to leave? Come home?”

A part of me does. Of course a part of me does. Who wouldn’t want to get away from this stress, exhaustion, and death?

Then I recall Brian’s words: I know it’s hard. It’s supposed to be. Remember, nothing that’s worthwhile in life comes easy.

I’m doing something others can’t. I’m still here, and I’m able to hold my head high because I know who I am, and I’m not a quitter. Running away isn’t an option.

My years in nursing have taught me resiliency. I’ve stayed the course through uncomfortable situations that had me questioning who I was, doubting my skills as a nurse. Each time, I emerged on the other side stronger from my experience — stronger mentally, physically, and emotionally.

I will handle this pandemic because I can handle more than I give myself credit for. I’m a nurse. I can handle anything.


ER Nurses James Patterson

In this extraordinary work of non-fiction, we hear the unforgettable stories of everyday heroes who look after our families, our friends and ourselves in the most challenging circumstances imaginable

Buy now
Buy now

More extracts

See all
Diana, William and Harry

Lady Annabel Goldsmith, who describes herself as an “incredible mother, rather a good mistress, but not a very good wife” to billionaire financier Sir James Goldsmith, is hosting a birthday party.

James Patterson: The Stories of My Life

My writing career unofficially began at McLean Hospital, the psychiatric affiliate of Harvard Medical School in Belmont, Massachusetts.

The Kennedy Curse

The frail old man wakes screaming, tangled in an American flag—the same one that draped the coffin of his slain son, President John Fitzgerald Kennedy, three days after his November 22, 1963, assassination.

Triple Cross

Suzanne Liu lived for days like this, days when her world seemed like a great game and the sweet smell of opportunity and cash hung in the air like lavender and sage.

The Twelve Topsy-Turvy, Very Messy Days of Christmas

What is the worst present you’ve ever received for Christmas?

The Girl in the Castle

It starts with a girl, half naked and screaming.

Blowback

It’s a brisk autumn day in June in one of South Africa’s largest cities, and thirty-year-old Benjamin Lucas is enjoying an off day from his South African Diamond Tour.

Escape

He’s here somewhere. I know it. And the girl might still be alive.

Death of the Black Widow

Could a building sweat? If someone were to ask him, Walter O’Brien would say no.

Run Rose Run

AnnieLee had been standing on the side of the road for an hour, thumbing a ride, when the rain started falling in earnest.

Steal

CARTER VON OEHSON MIXED himself a tall gin and tonic from behind the polished mahogany bar of his father’s billiard room, topping it off with a squeeze of lime.

The Horsewoman

THE VIDEO SHOWS a little girl alone in her bedroom.

penguin pop image
penguin pop image