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Ya Gotta Be A Little Nuts
To Work The Nightshift

All limericks, poems and stories
by Betty Ann Cassano, RN, BSN

Page 2

Up-dated September 1, 2003

THE DAY WE AUTOCLAVED THE PIGS

Now that I have your attention . . . . . .

How It All Got Started

First of all, this is a true story. I know because I was there. Most of the other principal players are gone now. Even so, it is only because 40 years have passed that I dare tell the story in public. Thank goodness there wasn't such a thing as JCAH back then.

My mother, a registered nurse, was also the administrator of our small community hospital. This was back in the 1950's. The little 35-bed hospital was the pride of the town and the doctors, nurses and all the other members of the hospital team were as close as family. They not only worked together but they, plus all the spouses and kids, got together for parties during the year. It really was a lot of fun in those days.

One year Mom and two of her hospital friends decided to treat themselves to a holiday and bought airplane tickets to Hawaii. Well, they had a marvelous time and came back full of wonderful stories of their travels. And when summer came around, they decided that the annual hospital swimming party that we always had at our house would follow a Hawaiian theme.

Put Away That Damned Shovel! I'm Not Digging!

When Mom and the other gals started planning the menu for their version of a luau, they wanted it to be as authentic as possible. They thought about the pit-barbecues they had seen being used in the islands. But that idea was scrapped right away. I think my dad may have put an end to it since he knew he'd be the one doing the digging.

Then Lila, the surgery nurse, had another idea: Why not barbecue some suckling pigs on regular barbecues? Not only that, but she lived on a small ranch and raised pigs. She said she'd donate two pigs to the party and have them all ready for the barbecue. Then they all looked at Dad.

Poor Dad. He always got roped into Mom's projects. He may have grumbled but he always came through. So it was decided. Dad would be in charge of barbecuing the pigs. After all, how much problem could it be? All he had to do was put them on the spits and plug in the motors. Then just sit back and watch them go around and around for four or five hours.

A New Meaning to the Term "Hog-tied"

The day of the party, an additional Big Boy Barbecue was brought over to our house. We already had one barbecue so we were all set for the arrival of the two pigs. Now back in those days the motors on the barbecue spits were built tough. All metal. No plastic parts. Not like the spindly, wimpy little motors of today. They were strong enough to handle huge chunks of meat without even so much as a growl.

True to her word, Lila arrived with the pigs. Dad surveyed the two little porkers resting sedately on the metal pans. Lila had done her part. The pigs were ready for roasting. But they were a lot larger than what Dad had anticipated.

One thing you should know about my dad: He was a very methodical and precise man. When he did a job, no matter what it was, it was done right. So when it came to placing the pigs on the spits, it was done with precision. The weight was distributed evenly. The legs were trussed securely. And when the pigs were placed over the barbecues and the spit motors turned on, those pigs rotated with grace and beauty. The motors hummed contentedly without any sign of overload. All that was left to do was keep the charcoal replenished and the heat at an even temperature.

The Countdown

And so the hours went. An occasional basting was all that was needed. The two pigs roasted beautifully as the afternoon sun began making its descent. All the while Dad was keeping an eye on the pigs, Mom, some of her nurse friends and as many of us kids as she could keep track of, got the rest of the party preparations under control. When you've got 75 or more people arriving for dinner, there's a lot to do.

Things were going smoothly. That should have been a warning that something bad was going to happen. And we should have known that when it did, it would involve the pigs.

Why Are the Spit Motors Making That Grinding Noise?

As the pigs turned a golden brown and the wonderful aroma wafted down the block, Dad noticed that the spit motors seemed to be lugging down a bit. Then he noticed that the pigs were getting a little "sloppy" on the spits as the roasting meat started to soften.

The alarm bells went off in Dad's head. The weight was no longer evenly distributed. The spit motors valiantly ground on as they dragged the heavy side of the now obviously lop-sided pigs to the top. Then, as the heavy sides of the pigs started down the other side, they picked up speed. The only thing the poor motors could do is try to slow the pigs down as gravity took over. The roasting process was no longer even. The meat was getting too cooked on one side and not enough on the other. And the skin was beginning to burn in a few places.

Well, it was apparent to Dad that it was only a matter of time before the strain on the motors would cause them to give out altogether. So he pulled the plugs on the electric spit motors. He did everything he could to re-tie and rearrange the pigs on the spits to even up the weight again. But it just couldn't be done. So there he was with two pigs, only 2/3 of the way cooked. There was only one thing left to do: Tell Mom.

The Feminine Reaction

From the amount of cackling and fluttering that went on when Mom and her friends found out, you would have thought a fox had gotten into a chicken coop. What to do?? The pigs were too large for an ordinary oven.

Where There's a Nurse, There's a Way!

Then Lila, the surgery nurse, came up with a suggestion. Why not take the pigs down to the hospital and finish cooking them in the autoclave? They were almost cooked now. All it would take is about an hour more in the autoclave. After all, what was an autoclave but a big pressure cooker? It was stainless steel and could be scoured out after we were through. Then we all looked at Mom.

Well, Mom knew the idea was way off the wall. And I'm sure she knew that the board of health, or whoever it was in those days that kept track of hospitals, would scream bloody murder if they ever found out. She would probably lose her nursing license and her job.

But on the other hand, she had 75 people arriving in an hour and this was an emergency!!!

To heck with the "rules". Mom brought out the metal baking pans the pigs had arrived on. Dad took the pigs off the spits and carried the two pans to Lila's car for their trip to the hospital. Lila gave me a nod and I jumped into the car with her.

What Do You Mean? This IS An Emergency!

Luckily, it was a Saturday. Everything was quiet as we pulled up to the emergency entrance. I stayed with the pigs while Lila went inside to make sure the coast was clear. Within a m
e she was back, pushing a sheet-draped gurney. We quickly loaded the pans with the pigs onto the gurney and threw another clean sheet over the top to hide them from view. Then we pushed the gurney up the ramp and through the doors of the small emergency room.

We closed all the doors after us to try to keep the aroma of the roasting pigs from traveling into the main part of the hospital. When we reached the autoclave, Lila quickly slid the pans onto the racks and pushed the round door closed and sealed it. She programmed in some settings and then we raced home to help Mom finish up for the party.

Return to The Scene of the Crime

About an hour or so later, Lila and I returned to the hospital to retrieve the pigs. By this time we were so tired we were getting a little goofy. The realization of what we had done was starting to sink in. We giggled and laughed all the way during the short drive to the hospital.

When we arrived at the emergency room entrance, nothing had changed. Thank goodness there hadn't been an accident or we would have been sunk. Anyway, we sneaked back into the surgery workroom where the autoclave was. So far, so good.

The gurney was standing by, ready to spirit the two pigs out of the hospital the same way they came in.

When Lila released the pressure from the autoclave, the aroma of barbecued pork burst forth like a genie from a bottle. We tried to confine it to the workroom but that was impossible. I don't know if the nurses on duty that p.m. shift were in on the caper or were simply too busy to check it out. Anyway, no one poked her head around the corner to see what we were up to.

When the round door of the autoclave swung open, the two pigs were every bit as gorgeous as any Sunset Magazine food layout. And tender. Definitely tender!

After hoisting the pigs back on the gurney and cleaning out the autoclave, we high-tailed it for home. We got there just a few minutes before the guests began arriving.

Mom's Threat: If You Know What's Good For You . . . . .

Well, the party was a tremendous success. Everyone said it was the best one yet. And the undisputed stars of the luau were the two succulent, golden brown porkers.

Many people remarked on how tender and juicy the meat was and tried to get Dad to part with his special barbecue technique. But, being a very wise man, Dad kept his mouth shut. There are some things in life that even your friends don't need to know.

Betty Ann Cassano, RN, BSN
Written December 27, 1996
Posted 1-12-97
Copyright 1997 - All rights reserved

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Miss Nina

I'll never forget Miss Nina. She was one of my patients when I worked the medical floor many years ago. Though getting on in years, she never lost her cheery outlook on life. The fact that she was not quite in touch with reality probably helped.

Miss Nina was a tiny woman, slightly over 5 feet tall with a trim little figure. Pretty good for a gal in her 80's. But the most memorable thing about Miss Nina was that, no matter how she was feeling, she never faced the day without a session with her make-up kit. An extensive array of make-up, I might add. And when she was finished with her beauty routine, she was as colorful as a summer flower.

Compared to some of the other patients, Miss Nina was indeed a breath of fresh air. A visit to her room was always something to look forward to. Over the days that she spent with us we learned part of her story.

Miss Nina told us she had lived in Southern California when she was young and had been "a Hollywood starlet" in the movies. She always smiled each time she mentioned her Hollywood days as if reliving happy memories.

As Miss Nina's condition improved, it was determined she was well enough to go home. But she had no family in the area and was not able to live independently. So her doctor made arrangements for Miss Nina to be transferred to Crestwood Convalescent Hospital until other arrangements could be made. He spent time with her and explained what he had planned and got her permission for the move.

Well, that night as I was catching up with some charting at the nurses station, I looked up to see a tiny, brightly made-up face smiling down at me. It was Miss Nina. She had obviously taken a lot of time with her make-up. Her magenta cheeks and bright red lips set off her big smile as she beamed down with obvious excitement.

I was a little concerned. Was there some sort of problem? When I stood up I noticed something else. Miss Nina was fully dressed. But the clothes weren't hers. She was wearing some sort of tent-like affair that was meant for a woman at least 3 times her size. The hemline of the huge "dress" dragged along the ground as the yards of material hung down in furls. Oh yes, the material was a bright Hawaiian print. Even though the hall lights were dimmed, she almost glowed in the dark. No, you couldn't miss seeing Miss Nina!

"No," Miss Nina assured us. Nothing was wrong. She just couldn't sleep because she was so excited.

Our second question was, "Where did you get the clothes?"

"Well," she answered, "they were in the closet so I just put them on."

That explained it. Miss Nina's roommate was a very large woman and apparently the over-sized dress belonged to her. But the make-up was definitely Miss Nina's!

The third question was, "Why are you up at this time of the night?"

That was simple, she answered with a happy grin. "I'm so excited that I just couldn't sleep. So I got up and got dressed so I'll be ready."

"Ready for what?" we all wanted to know.

"Well, my doctor told me that I'm going to Hollywood tomorrow and I don't want to be late."

"Hollywood?" we all exclaimed under our breath. Then we remembered about Miss Nina's scheduled transfer to Crestwood and understood what was going on.

But Miss Nina looked so happy. Who were we to burst her bubble? Besides, she probably would forget all about it by morning.

After a little visit at the nurses station, Miss Nina was ready to go back to her room. We helped her out of her "travel clothes" and tucked her into bed. By that time she had forgotten all about Hollywood. Her roommate slept through it all, never knowing that her dress almost went on a trip without her.

I'll have to admit that we all got a little chuckle over Miss Nina's misunderstanding. But, hey . . . . . "Crestwood" does sound a lot like "Hollywood". Especially if you were once a Hollywood Starlet.

And who's to say she didn't return to Hollywood? You don't always have to travel to go home again. When you have happy memories tucked away in the corners of your mind, anything is possible.

Hope you had a nice trip, Miss Nina.

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The Babysitters

I graduated from nursing school in 1961 with a Bachelor of Science Nursing degree and a public health nursing certificate. In those days it was the norm for new grads to start their hospital nursing careers on the night shift. Sort of a bottom-of-the-totem-pole, lack-of-seniority thing. And, for the most part, that kind of an arrangement worked out OK at a big hospital where there were lots of other RNs close by for back-up.

But my situation was a little different. My first job was as a staff nurse at the small community hospital in my hometown. I like to think the director of nurses saw something in me that told her there was "a nurse" lurking in there somewhere. At any rate, she was willing to take a chance and hired me.

I was assigned to the day shift. Looking back, I'm positive that one of the main reasons was so there would be more people around to keep an eye on me and help me stay out of trouble. It didn't take a genius to figure out that I wasn't ready to fly on my own yet. And certainly not ready to take on the responsibility of being in charge of the whole hospital at night. The evening and night shifts simply weren't appropriate for a wet-behind-the-ears kid with a brand new nursing license. Yes, I needed babysitting.

On p.m.s and nights in our small hospital, only one RN plus two or three LVNs and/or Aides worked on each shift. This bare-bones team had to take care of it all. Not just medical and surgical patients, but obstetrics, the newborn nursery, and pediatrics. Of course, I can't forget the two or three "chronic lungers" that smoked all day and then came to the hospital at night for their "standing order" respiratory treatment. All this and the emergency room, too. Whatever came through the front door or the ambulance entrance after the sun went down.

One of the biggest challenges was learning how to deal with doctors over the phone, especially at night. It wasn't easy to communicate with doctors who were groggy with sleep. And some of them were just plain stubborn about coming back to the hospital after hours.

The night and p.m. shift RNs, caught in the middle between patient needs and the doctors who yearned for a few uninterrupted hours at home, had to be very smart, experienced, self-sufficient, self-assured and capable of handling all kinds of emergencies. And willing to give the doctors a verbal kick in the pants over the phone to get them motivated to get their behinds down to the hospital when it was absolutely necessary. The last was often the hardest task of all.

The RNs I knew on p.m.s and nights had their acts together. No doubt about it.

I jumped into nursing with both feet, often working extra shifts if someone called in sick or wanted an extra day off at holiday time. I was young and healthy with lots of energy and enthusiasm. I worked hard, asked questions constantly and began learning what nursing was really all about. It sure was a far cry from being a student. The scariest part of all was finding out how much I didn't know.

The older RNs took me under their wings and taught me how to handle all sorts of procedures I had never had the opportunity to do in school or, in many cases, had never heard of. I became acquainted with the workings of all kinds of mechanical equipment that I never even knew existed.

The patients were real people, people from my hometown. Parents and other relatives of some of the kids I went to school with, teachers, neighbors, shopkeepers, farmers, business people, kids and friends. I finally had something to contribute. It was an intense and exciting time in my life.

When the ambulance showed up at the "back door" with an accident victim, I helped out in the emergency room. Or when a woman arrived to have her baby, I had to learn how to prioritize my other work so that I could keep close watch over her labor and notify the doctor when the birth was imminent. Sometimes the doctor made it in time, sometimes he didn't. For some reason, the doctor always felt like he could see "just one more patient" in his office before coming for the delivery. So presiding over births wasn't unusual for nurses.

Each day I felt more like a nurse. As I progressed with my real-life nursing education, the RNs who were keeping an eye on me gradually felt more at ease. I no longer felt like the day shift "pet." I was holding my own, dealing with everyday problems without constantly asking for confirmation.

But it wasn't until the LVNs and Aides began showing signs that they felt comfortable with my decisions that I knew I was finally getting the hang of it.

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How Did You Know I Had a Headache?

I suppose most nurses remember their first real boo-boo after getting their nursing license. Mine happened just a few months after graduating and, fortunately for everyone involved, was not a major, life-threatening blunder. But the mistake I made was just enough to knock any hint of the "I'm-an-RN-now" attitude out of me for good. Looking back, it was probably the best thing that could have happened.

One of my jobs was to dispense medications. The routine medications fell at specific times. But if a patient needed something for pain, he could have it any time as long as it fit within the doctor's orders. Most of the time the patients waited until you came into their rooms to request pain medication for minor discomforts. And that's what happened the day I made my first medication error.

As a bit of background: The small community hospital where I first started my nursing career was designed like a wagon wheel. The nurses station was in the middle and four wings stretched out from the center like spokes. At the end of one of the wings was the "solarium."

The solarium was originally intended to be a day room for ambulatory patients and families to use. It faced the east and was a very bright and cheerful room. But it had a practical purpose, too. If the hospital census was high, the solarium was licensed for four additional beds and could be converted to an overflow ward.

The day I will tell you about was one of those days when the hospital was fairly full. We had put the solarium into use as a patient ward and four very nice men patients were making it their home-away-from-home while they recuperated from various surgeries. All of them were doing well and the atmosphere seemed more like a party than a hospital room.

As I was dispensing the after-breakfast round of routine medicines, one of the men in the bed by the window mentioned that he had a headache coming on and asked if he could have something for it. I said I would check just as soon as I got back to the nurses station. That was back in the days when all the medicines were kept at the nurse's station and the nurse delivered the pills and injections via a tray rather than take a medicine cart with her.

Anyway, as I made my way back up the hall to get something for the fellow's headache, several other patients caught my attention and asked for small favors and attentions. So by the time I got back to the nurse's station at least 10 or 15 minutes had passed. Also, some family members had arrived for morning visiting hours.

I checked my patient's rand card to see if he had something ordered for minor pain. He did so I put the pill in a little medicine cup and headed back down the hall to the solarium. When I got there I found my patient's bed completely surrounded by relatives.

Not wanting to disturb them, I snaked my way toward the head of the bed. I slid my arm between the visitors and handed the pill to the patient.

"Here's something for your headache," I said.

I got a glimpse of his quizzical look as the patient popped the pill in his mouth. Something seemed wrong with the picture but I couldn't quite figure out what it was.

"How did you know I had a headache?" he asked.

"Oh, no!," I thought to myself. Suddenly I knew what was wrong. This guy was the wrong patient. I must have looked dazed as I stood there trying to figure out what was going on. It was the right bed. I was sure of that. I was too young to be going senile. It just didn't make any sense.

The patient, observing my confusion, started to chuckle. It turned out that there was a very plausible explanation for the whole situation.

While I was gone, the men had talked it over and decided that maybe the man with the headache would be better off if he was away from the sunny window. In the 15 minutes between the time I left and came back, the men had done some furniture moving. The man who had the bed by the window (and the headache) and the fellow I had given the pain pill to had decided to switch places. With great efficiency, they had rolled their beds, tray tables and bedside stands across the room and were completely settled in by the time I got back. The trouble was, they hadn't told me.

What to do? My patients had no idea that their efforts to save the nurses some extra work had caused me a great, big problem. So, after getting another pain pill for the original man with a headache, I trudged back down the hall to find the nurse I was working with that day.

After I explained what had happened, the RN in charge told me what I already knew I had to do: call the doctor. I didn't know what was in store for me as I dialed the number of his office. Would I be fired? I cringed as I waited for the doctor to come to the phone.

After blurting out the circumstances and what I had done, the doctor didn't say anything for what felt like a long, long time. When the doctor finally spoke, he told me to write a one-time order in his patient's chart for the medication I had given by mistake. And then added a prn order for another brand of pain pill in case his patient needed something for headache in the future. Then he hung up. And that was it. I was stunned. I had expected to be verbally shredded at the very least.

I really don't know why I was let off the hook so lightly. Perhaps it was a combination of things. First of all, the patient didn't suffer any harm. And number two, I was honest and reported my mistake to the doctor. Or maybe my story was so off-the-wall that he gave me an A for originality.

But I learned my lesson about checking IDs. The incident happened over 40 years ago and I've never forgotten it. Sometimes one good scare is enough to last a lifetime.

Great Escapes, Hospital-Style

Written June, 2003

Some patients never adapt to hospital life. Either they don't understand how sick they are, or are confused due to disease or medication, or feel they have things to do that are more important than being in a hospital. Whatever the reason, they have one thing on their minds: getting out of there! And sometimes they do.

When a patient turns up missing you'd think a bee hive had been kicked over in the nurses station. The adrenalin pumps, the heart flutters, cold moisture pops out on your brow. "Where in God's name did the guy go?! He was here just a little while ago!"

And, yes, in my experience, it's always been a guy.

Then the hunt is on. Nurses quickly mobilize. They check every room on the floor. Every closet, no matter how small. Every bed that should be empty in case the patient got confused and sacked out in another room by mistake. Every bathroom, all the linen closets, the utility rooms. Absolutely every place a person could possibly be.

At the same time, someone gets on the phone. Notifying security, the nursing supervisor, the patient's doctor. Others fan out checking with nearby floors to see if anyone has seen a patient that doesn't belong to them wandering through.

Losing a patient is a pretty scary thing. And when it happens to you, you never forget it. I have that cold, nervous sensation in my chest right now just thinking about it. If there's a good part to this story, it's that we never lost anyone completely. Just like the Mounties, we always managed to get our man. Sooner or later.

I'll tell you about one of my patients that took off. It happened a long time ago but the adrenaline-charged memory of that day will be with me forever.

I was working p.m.s at the time on a medical floor. Afternoon report had just finished and I started making rounds to get a look at all my patients.

One of the beds was empty. The gentleman who was assigned to that bed was ambulatory and had bathroom privileges. I could see a little sliver of light coming from under the bathroom door. Rather than bang on the door, I decided to give him some privacy and catch up with him when I came back from rounds.

A short time later, one of the nurses spotted my gentleman, now dressed in his patient gown, trousers and boots, at the end of the hall and heading for the exit. She took out after him and tried to get the patient to stop. His response was to pick up the pace and push past her. From where I was, at the other end of the hall, I could see what was happening but was too far away to effectively join the chase. And within seconds both patient and nurse rounded the corner and disappeared.

Frantic calls to security and the nursing supervisor were placed as the rest of us rushed to catch up with the action. But we were too late. By the time we reached the exit, the nurse who had been in hot pursuit was returning. Without the patient.

The nurse had finally given up when the patient reached the edge of the parking lot and plunged down a gully into some brush and clomped through the mud until he was out of sight. Evening was closing in and it was getting dark. To top it all off, it started to rain.

By this time quite an uproar was in progress. Every available person was outside trying to locate the run-away patient. The police were patrolling the area. All the authorities had been alerted. Not only was it fully dark outside, the weather had turned nasty.

About a half hour later we got a phone call from the unit secretary in pediatrics. She had just received a call from a woman who lived several blocks away. The lady had spotted a strange man in her front yard. And since he was dressed in a hospital gown, she thought he might belong to us.

"Yes, yes! He belongs to us!" we told her. After getting the address, the police were notified.

A little while later, I saw my patient being rolled down the hall in a wheelchair by a police officer. The patient was cold, covered with mud and looked exhausted. But he was back and we were all relieved.

After checking him over, it didn't appear that he was injured in any way. Just very cold and extremely muddy.

I decided that a warm tub bath would be the quickest way to get him both clean and warmed up. We filled our old fashioned bathtub up as far as it would go and helped our patient in. Two of us quickly bathed him and then tucked him into his clean, warm bed. His color came back to normal and the shivering stopped. He dropped off to sleep almost immediately. One thing for sure, his wandering was definitely through for the night!

It wasn't until the next day that we found out why my patient had taken off. Apparently he had become agitated when his family had come to visit. He couldn't understand why he couldn't go with them when they got ready to leave. Because of his illness and related confusion, he didn't understand that he was in a hospital or that he was sick. All he knew was that it wasn't his bed and he wanted to go home.

So when his family left, the patient took matters into his own hands. He had it together enough to put on his pants and shoes but it simply hadn't occurred to him that he lived over 10 miles away. Or that he was taking off in the wrong direction.

Although the gentleman ended up with some additional respiratory problems and had to spend a few extra days in the hospital, he eventually did get to go home.

Thank goodness for that lady over on Placer Street. If she hadn't been looking out the window, she wouldn't have seen the guy in a hospital gown wandering around her yard in the rain. And this story may have had a far different ending.

The Midnight Stroll

Written June, 2003

It's not hard to get out of a hospital. Just choose a door and leave. And sometimes that's what a patient decides to do. The problem comes up when the patient takes off without telling anyone he's going. Nurses, who are responsible for the patients assigned to their care, get very upset when they are left out of the loop. A missing patient is definitely a big deal!

Every escape is unique. Here's one that occurred in my home town many years ago.

The whole thing started on the night shift. Usually only one RN and two LVNs were on duty during the 11 to 7 shift at the small country hospital. It was unusual to have any admissions during the night.

On the rare occasions that someone needed to be admitted, they came through the front door. For this reason, a night bell had been installed to alert the nurses that someone was at the front desk.

Sometime after midnight, the nurses heard the night bell. Expecting an emergency, they went immediately to see what was the matter. There at the front desk stood the man who drove our town's one and only taxi. He informed the nurses that he had someone in his cab he thought they should take a look at.

The taxi driver told the nurses that he had been driving through a nearby subdivision when he spotted a fellow walking down the sidewalk. Taking a walk at that time of night was extremely unusual for our little town so this sparked his curiosity right away. When the cab driver got closer he noticed that the midnight walker was dressed in a short hospital gown. And that was all. No shoes, no pants, no jacket. Just a flimsy, flapping gown. With his bare bottom hanging out.

The cab driver pulled over and asked the guy where he was going. It didn't take long to figure out the fellow was not firmly connected with reality. But he was amiable and aware enough to know he was getting cold. So when the driver offered him a lift, the guy climbed into the taxi.

It didn't take long for the driver to figure out that the man was a patient from the hospital. The gown stamped with the hospital's name confirmed that. So the wandering patient was kindly returned to the hospital.

When the nurses looked into the taxi and saw one of their patients sitting there, it was quite a surprise. He had been snoring peacefully the last time they made rounds less than an hour before.

The patient was quite willing to be tucked back into his bed after being checked over by the nurses. He was cold and tired.

Who knows what prompted the patient to get up and go for a stroll in the night air? It could have been a lot of things. Perhaps a reaction to his medications. Or confusion brought on by his illness. Maybe he had a history of wandering or sleepwalking. Or it could have been he was just hunting for the bathroom.

It doesn't take very long for a confused patient to slip out a back door. Especially since all exits must remain unlocked from the inside and unobstructed to meet the fire code regulations. Unless every potential sundowner has someone with him every moment, occasionally one of them will wander off. It doesn't happen often, but when it does, it sure does cause a ruckus!

San Francisco General Hospital

1959-1960

Written August, 2003

It was summer and I had just turned 20. I was a nursing student living on the third floor of the nurse's residence at San Francisco General Hospital. My friends and I were beginning our third year of the Chico State College (now named California State University Chico) nursing program. Most of us were used to being away from home but living in a hospital was a new experience.

The summer session was a scheduled part of our nursing program. We had completed two years of book work and were about to get a taste of the practical side of nursing.

My first clinical assignment was surgery. It wasn't long before I found myself in the O.R., scrubbed, masked, gowned, gloved, my hair bound up in a white cotton turban and standing on a stool beside an anesthetized patient. Elbow to elbow with doctors, nurses, residents and medical students. Craning my neck to see what was going on and holding a retractor until my arm turned numb. It was scary. It was thrilling. I loved it.

All the days ran together. I know we had the weekends off but I really don't have strong memories about any routines we may have had during the school week. I suppose we did some assignment reading and occasionally did ward visits in the evening to either choose a new patient or find out what was wrong with the ones we had been assigned by our instructors. Then, if we were smart, we went back to our rooms and researched the medical problems we would be expected to deal with when morning rolled around.

We ate all our meals in the hospital cafeteria and our uniforms were washed by the hospital laundry. We didn't really need to leave the hospital for anything. We could get anywhere in the hospital by using either the regular halls or the dimly lit basement hall that ran from the nurse's residence, past the hospital morgue, all the way to the other side of the hospital grounds, ending at the psych. building. We washed our underwear and stockings out by hand so we only had to walk to the neighborhood laundromat once in a while.

I shared a room with Sharon. Our room was on the third floor of the nurse's residence at San Francisco General Hospital on Potrero Avenue. It was an ancient brick building that was directly connected to the main part of the hospital. My mother spent part of her nurse's training there in the 1930's and she said it hadn't changed a bit.

Our room faced Portrero Avenue and was located right across the hall from the "roaring toilets". I referred to the bathroom that way because of the loud sounds that bombarded us when the toilets were flushed. The whole bathroom area, walls as well as floor, was tiled with those tiny white hexagonal tiles with black tile accents. Since there were no towels left hanging, no curtains, and no bath mats on the floor, the simple act of turning on a faucet, taking a shower or flushing the toilet caused the water sounds to bounce around the room until the din was quite impressive. The noise had no problem reaching our room since the two doors were right across from each other and our transom was usually open for ventilation. We simply had to get used to the noise. And we did.

The rooms were very small. Just large enough for two old-fashioned metal twin beds and two tiny desks. Even so, one bed had to be pushed up against the wall to make enough room to get around.

The bed springs were old and saggy. Rosa, the housekeeper assigned to our floor, took pity on us and located some boards to slide under our mattress. The mattresses themselves were thin and solid, but at least they didn't sag anymore.

All of our clothing and personal items were stored in the built-in closets and drawers in the wall at the foot of our beds. Right in the middle of the closet wall was an indented space with a small sink and mirror and a place for our toothbrushes.

The whole storage space was very small. But since we really had no need for a lot of civilian clothes, the closet space was adequate for our uniforms (which came back from the laundry wrapped in a flat, paper bundle that fit perfectly on the high shelf), a dress or two and our coats. Anything more than that would have prevented the closet door from closing.

The only extra thing I had in the room was an 18 inch wide wire, collapsible bookcase under the window on my side of the room. The top was just wide enough to hold my portable hifi phonograph I had received for Christmas the first year in college. Having a little music once in a while was a great comfort.

There was one window in our room. It faced toward Twin Peaks. I can remember standing in front of that window at night watching the lights and the cars going by.

Twin Peaks was more than just a landmark to me. It represented the way to get to my Aunt Marge and Uncle Ernie's home in the Sunset District. I almost always used the Twin Peaks route which included the climb up 17th Street hill when I went to see them. So it represented an escape route and respite from hospital life.

I was lucky that I had my little '57 Chevy while I was going to school in San Francisco. So I never felt completely trapped. Having my own car made taking public transportation an option rather than a necessity.

There was a small parking lot on the hospital grounds very near the nurses residence. Most of the time I could find a parking space there. But when that lot was full, I parked my car along the street by the official entrance to the nurse's residence.

Maybe I was lucky but I never had anything bad happen to my car. I never worried about it being stolen or vandalized. There was a different kind of morality in place back in the 50's. There were a few bad eggs circulating around but most of the people were respectful and didn't bother you or your property.

The county hospital was located in the Mission District. At that time, the Mission was not the most elite part of town. From stories I have heard, the Mission District had been quite a fashionable and respectable part of town in the early days. But old age had taken its toll and many of the buildings had become run-down.

The one thing that it still retained was the best weather in the city. It could be blanketed in fog all day in the Sunset District and we had sunshine in the Mission.

Sometimes we decided to gather up our dirty clothes and walk the two or three blocks down to the corner laundromat. Young people today would think we were a little nuts but we always looked forward to this outing. We never had more than a washer-load apiece. When we got the clothes loaded into the washers and were satisfied that we hadn't gone overboard with the laundry detergent (soapsuds weren't pouring out of every orifice of the machine), we took a one block long tour of the neighborhood shops.

We always spent part of the time in the used bookstore. It was just a couple of doors down from the laundromat and was run by an older lady. She didn't seem to mind us being there at all. We browsed through all the old volumes and occasionally bought a book if it didn't cost too much.

Then we window-shopped and sometimes looked at the "antiques" (old, cast-off furniture) in some of the shops. We always ended up in the same place: on the opposite side of the street at the candy store.

The candy store was on the corner right across from the laundromat. It was a combination soda fountain-candy store. All the candy was home-made right there in the kitchen and the smells were thick and chocolatey. Pat and I always bought 1/4 pound of candy each.

I don't remember what kind she liked but there was no mistaking my favorite: chocolate mint. The chocolate mint was absolutely perfect. It had just the right proportion of mint. Not overpowering like some candies and ice creams. And it was poured into wafer-thin sheets and then broken into pieces when it had cooled and hardened.

After purchasing our small white bags of candy, we crossed the street back to the laundromat. By this time it was time to transfer the clothes into the dryers. Then we sat back and enjoyed our candy.

We always ate the whole bag. I don't recall ever having any left to take back to the nurses's residence. I suppose I should have felt like a pig.

But there was a good side to this indulgence. By the time we had consumed the 1/4 pound of chocolate, we were completely satisfied. My sweet tooth and craving for chocolate was in complete submission. And I didn't eat or crave candy for at least another month.

Speaking of eating, I have to tell about the hospital cafeteria. You would think that the cafeteria in a county hospital would be pretty bad. Well, I can assure you that during the time I was a student there (1959-1960) it was a great place to eat. And since we were living right there full-time and eating all of our meals in the cafeteria, I know what I'm talking about.

We even got to tour the kitchen one day and it was clean and very well organized. The kitchen crew was always friendly and nice to us. And on one occasion they even made a picnic lunch for us to take on an outing.

The hospital food was good and nourishing. We ate three meals a day there and none of the girls in my class ever had bad words to say about the food. You would have thought we would have gained weight but we all stayed within our normal range. I guess that eating meals regularly does help to keep a person's weight stable. Of course, one of the secrets was that we didn't eat between meals or in the evening.

Our breakfast was at 6:15 in the morning, lunch came right at noon and we usually had dinner at 5:00. After that, no sodas, no potato chips, no goodies of any kind.

For one thing, there wasn't any place to conveniently go to get snacks. And none of us had money to spend foolishly, anyway. Besides, with good nourishing food in our systems, we didn't have any cravings to combat.

We had access to desserts at every meal if we wanted them. Sometimes we indulged but most of the time we just skipped the sweets. It was no big deal and we didn't put a lot of importance on desserts.

All the days ran together, classes in the morning and ward time in the afternoons. In the evening during the "work" week we did our assignment reading, wrote our papers and occasionally did ward visits to either choose new patients or find out what was wrong with the ones we had been assigned by our instructors. Then, if we were smart, we went back to our rooms and researched the medical problems we would be expected to deal with when morning rolled around.

Every once in a while we threw nursing to the wind and escaped the hospital setting altogether. It was on these infrequent forays into the outside world that we sometimes fell into an adventure. Like the time we went ocean fishing with a bunch of "older men."

(See next chapter: Adventure on the High Sea)

Adventure on the High Seas

Written August, 2003

Two of the girls in our small nursing class were cousins. They had an uncle in the bay area who owned a charter fishing boat and earned his living taking people out in the ocean between the Golden Gate Bridge and the Farallon Islands. The uncle decided to invite all the student nurses in his nieces' class to go fishing.

We all thought it was a splendid idea and accepted with great enthusiasm. So the date was set and we were instructed to show up at Fisherman's Wharf on Saturday at around 6 in the morning. All we had to bring was warm clothes and a lunch.

We started planning. We divided up the responsibility for getting the lunch together and planned what we were going to wear.

Then someone brought up the subject of seasickness. None of us had ever gone out on the ocean in a boat before so we really didn't know how we would react if the seas got bouncy. We decided to play it safe and trooped down to the hospital pharmacy to get some advice from one of the pharmacists.

There was no doubt in the pharmacist's mind as to how to handle the situation. He outfitted us with Dramamine and instructions to take it about a half an hour before getting on the boat and then to repeat the dose about 4 hours later.

So we were set. We all knew we were going to catch fish. I don't think any of us gave a thought as to what we would do with the fish if we should actually catch any.

The day of the fishing trip found us up well before daylight. We dressed, grabbed our lunch and jackets and took our Dramamine. Then we drove to Fisherman's Wharf and found our way to the right dock.

When we got there, Uncle was waiting with a big grin on his face. For one thing, we weren't late. And it looked like we were properly prepared.

Uncle introduced us to the other members of the party. There were about 5 men, all between the ages of 60 and 80 years of age. Then Uncle told us the story about the selection of our companions.

Apparently Uncle had mentioned to his fishing buddies that he was taking a group of student nurses out that Saturday. Well, this sparked great interest among the guys and before he knew it, he had dozens of offers of "help" to babysit these neophyte fisherladies.

Uncle knew that he would need some help, that was for sure, but he began having doubts about the intentions of some of the younger volunteers. It didn't take long to arrive at a solution.

All the fishing assistants had to be at least 60 years of age, preferably older. They were not to fish themselves. Their whole reason for being on the trip was to keep us out of trouble.

We boarded the fishing boat and put our more than ample lunch in the cabin below. Then we went back up top as the boat pulled away from the dock and started chugging toward the Golden Gate Bridge.

We left the younger men, who had gathered to get a look at what they were missing, standing on the dock. The morning fog gradually blotted them from sight. We 20-year-old gals and our 60- pluser escorts were on our way to an adventure.

We girls were enjoying the whole experience immensely. Our hair quickly succumbed to the fog and went limp and flat under our hats and scarves. But we didn't care. By the time we got to the Golden Gate Bridge, the men got quiet and began watching us closely as if waiting for something to happen.

We didn't pay too much attention. We were all wound up with excitement. When we hit the choppy waters under the bridge, we just hung onto the railing around the edge of the deck, chattered and laughed and enjoyed the ride.

When we reached the other side of the bridge, one of the girls demanded to know where the lunch was because she was hungry. We all agreed that we were starving and someone went to bring the lunch up from the cabin. It was only about 8 o'clock in the morning.

It was at this point that all the men started laughing and began to loosen up. And the story came out.

The thing that the men had been worried about was that we would get seasick. The rough water under the bridge was usually a good indicator of how well the passengers would handle sailing in general.

The day before, a fishing trip had been cancelled because the men who had chartered the boat all ended up hanging over the side of the boat by the time they sailed under the bridge. They were so sick that they had to be brought back to the dock and the trip was ruined.

So all eyes had been on us to see how we would fare. And when we started wolfing down our lunch, the guys all knew we were going to be fine.

We didn't tell them we had taken anti-nausea medicine before we got there. Why tell all our secrets? As far as they knew, nurses were obviously made of strong stuff. There were no hilarious seasick stories to tell about nurses that day.

After a half hour or so of plowing through the waves, the men started getting the fishing gear out. Before long all the girls were put in charge of huge fishing rods and were positioned at various points around the back of the boat.

I have absolutely no idea what kind of bait was on the hook. I'm not even sure there was any bait at all. The men took care of that part of the preparation.

I don't think we even got any bites at first. We really didn't care. We were laughing and having a great time. If fish are able to "hear" at all, I'm sure they were all well alerted to our presence for at least a mile.

As the sun burned off the early morning fog, we started shedding clothes. First came the scarves. Next the jackets. By noon the day had turned absolutely gorgeous and we were down to jeans and blouses.

We had tired of fishing so we decided it was time to break out the lunch basket again. So we trooped down to the cabin and finished off most of our lunch.

After our stomachs were comfortably satisfied, we decided to go back up top and take in the sunshine. Remember, we had been living in foggy San Francisco for a while and we had learned to enjoy the sun whenever it was available. So we traded places with the guys and they went down to the cabin to have their lunch and a cup of coffee.

I guess they had decided that we were trustworthy and wouldn't fall overboard in their absence. So the engines were cut and the boat bobbed gently along on the swells of the Pacific Ocean.

Once we were up on deck, someone suggested that it was so warm and sunny that we may as well go all the way and ditch our jeans and shirts. We all had our bathing suits on underneath so there wasn't any need to find a private dressing area.

It was an easy sell and we all started shedding our excess clothing. We heard a few muffled male laughs coming from inside the cabin but we didn't associate them with us. In minutes we were down to bathing suits and bare feet. Some of the girls sat down in front of the sloping windows of the cabin and leaned against them as if they were on a beach lounge.

Days later, Uncle confessed to his nieces that he and the rest of the guys had been enjoying the floor show through the front window of the cabin. All they could see was a bunch of female legs emerging from various layers of long pants. Then a few shapely bottoms positioned against the window. Being gentlemen of advancing years, they were wise enough to know when to keep their mouths shut.

The rest of us roamed around the boat, inspecting everything and enjoying the view of the Farallon Islands in the distance. It was then that we noticed that some of the other fishing boats were moving closer to our position.

"Hmm," we thought. "We must be in the prime fishing spot to have all those other boats wanting to be here, too."

Within fifteen minutes we were completely surrounded by fishing boats. It looked like the whole fleet had moved in on us.

It wasn't long before we noticed something else. Several of our new neighbors had binoculars, and they were all pointed in our direction.

By this time we were also getting the picture. It wasn't fish they were interested in.

A few of the more brazen fishermen began issuing invitations of various kinds. Some wanted us to have a drink with them, beer bottles held aloft to let us know they were serious.

Luckily, our escorts finished their lunch and came back up top in time to put a kibosh on any further uninvited interaction. Our briny admirers took the hint and gradually drifted away.

By late afternoon we were all pretty well worn out. A couple of the girls had caught a fish. Two were under-sized salmon and were released back into the ocean. Someone else caught a sting ray.

The only thing I managed to snag was an empty beer carton that some fisherman had thrown overboard. So we chugged back toward the Golden Gate and Fisherman's Wharf.

Soon after entering the bay we came upon a large sailboat that was floating upside down. Only the hull was above the reach of the waves. As we approached we could see that there were two men in the water holding onto the side of the boat. They looked half drowned.

Uncle carefully maneuvered his boat as close to the men as he could without crushing them. This was a very tricky and dangerous maneuver due to the size of the waves that were pushing both the upturned sailboat and the fishing boat around like corks. But we could all see that chances had to be taken because the men appeared extremely weak from hypothermia and couldn't hold onto the boat much longer.

Uncle radioed the coast guard for help. But it was apparent that the situation was too severe to wait for a coast guard boat to arrive. If the two men in the water were to be saved, something would have to be done at once.

As the men on our boat got organized to make the rescue, another discovery was made. One of the men in the water was holding onto a woman. Only her head was visible above the water and she appeared to be dead.

Luck and experience were on our side. Uncle was able to get close enough and hold the boat steady so that the other men could grab hold of the woman and pull her on board. Next came the two men.

The woman seemed to be in the worst condition. She was never more than barely conscious and was not able to talk. We could not be sure if she was aware of anything that had happened.

The woman had been trapped under the boat when it tipped over. When they couldn't locate her, her sailing companions had dived back under and searched until they found her. They brought her to the outside and held her head above water until we arrived. We don't know how long they were in the water before we discovered them.

The woman was carried down into the cabin and placed on a bunk. She was still alive. Then our men backed off and let the student nurses take over.

We immediately turned the woman over on her side. She began throwing up large amounts of water. We took off as many of her wet clothes as we could and covered her with blankets. There wasn't much else we could do except protect her airway and keep her from aspirating the water she was vomiting, and try to preserve whatever body heat she had left.

In the meantime, Uncle had made arrangements via radio to meet an ambulance at Sausalito, the nearest docking place. The fishing boat plunged ahead through the water on a mission of mercy.

After evaluating and attending to the woman, we did what we could for the men. They were still oriented and able to talk but they were shivering violently. They offered no resistance as we stripped them of as many wet clothes as we could and wrapped the men in blankets and an odd assortment of women's jackets.

I slipped off my jeans and put them on the bare legs of one of the men. He did not resist as I dressed him. The jeans didn't go up all the way but at least his legs were surrounded by soft material and possibly a little warmth left over from my own legs. His still chattering "thank you" let me know that he appreciated the help and small comforts from strangers who cared.

Before long we docked and an ambulance was waiting. Our "patients" were taken to a hospital. We never did find out where they were taken or how they fared.

We didn't see any mention of the mishap in the paper so we will never know how the story turned out. But I am sure the outcome would have definitely made the headlines if we had not come along when we did.