Underdogs and Weirdos: A Six-week Nursing Internship At Hospice

By L. S. Harvey

SONIA LEARNS A LOT ABOUT LIFE FROM HOSPICE

 

A summer with terminal patients wasn't what Sonia had in mind when she signed up for her school's nursing internship program. With no previous exposure to death or dying, Sonia joins the ragtag team at Tender Hands Hospice (Your best last resort") and becomes the center of attention to the oddball nurses who work in end-of-life care. Over six weeks, Sonia finds herself passed around a variety of preceptors while facing her fears of corpses, patient nudity, and the strange quirks of one sugar-addicted nurse. Given the choice to sink or swim, Sonia struggles to keep afloat only to discover through a series of bizarre and heartbreaking patient encounters that it takes more than a set of skills to be a nurse. 

 

Six weeks of laughter, eccentric nursing humor, and bittersweet moments.

 

Six weeks to show what she's made of.

 

And six weeks to learn that there's more life in hospice than she thought.

• Language: English
• Publisher: Wordwooze Publishing
• Release date: May 12, 2023
• ISBN: 9798223736561

Book preview

Underdogs and Weirdos

A Six-week Nursing Internship at Hospice

L.S. Harvey

Wordwooze Publishing

wordwooze.com

© 2020 by L.S. Harvey

All rights reserved

Without limiting the rights under the copyright reserved above, no part of this book may be reproduced, stored in or introduced into a retrieval system, or transmitted in any form or by any means—electronic, mechanical, photocopying, recording, or otherwise—without written permission from the author or publisher. The scanning, uploading, and distribution of this book via the Internet or any other means without permission is punishable by law. Your support of the author’s rights is appreciated.

Cover by Margaret Loftin-Whiting

This is a work of fiction. Names, places, characters, and incidents either are the product of the author’s imagination or are used fictitiously, and any resemblance to any persons, living or dead, businesses, companies, events, or locales is entirely coincidental.

The following is a fictional story about hospice, hospice patients, and the special people who work in end-of-life care.

However, hospice is real.

If you or a loved one have questions about quality of life and comfort measures, please contact your local hospice agencies for further information. And feel free to shop around.

For my best friend, my other half, my loveable goofball, my delectable stud muffin.

xoxoxoxoxoxo

Chapter 1: Sonia

Sonia looked at the decal on the door and compared it to the one on her paper. They were the same.

Dammit.

There went excuse number two for giving up and going home. Excuse number one would’ve been running out of gas, but her traitorous car, normally dependably undependable, had made the journey on fumes. Excuse number three was a locked office door, and number four was falling and breaking a leg. After number four the excuses grew desperate. Relatives dying unexpectedly, vortexes opening in space, or developing spontaneous amnesia.

For the umpteenth time Sonia reminded herself how badly she needed this internship. Employers didn’t care about B average students. She needed references and experience. Any experience would do. Sure, this wasn’t her first choice or her second, third, or fourth. In fact, her input hadn’t been considered. Her teacher, Mrs. Wright, had made the assignments. The options were accept or decline, and decline wasn’t an option for Sonia.

A summer with dying people. Hurray.

If only she had a classmate to share in her misery, but the assignment was for one person only. It didn’t seem fair. Somehow, she’d been singled out again. Yes, it was true—she had the social graces of a brick and the anxiety of a paranoid squirrel, but she did what she could to be friendly. Unfortunately, her friendliness came off as desperate and awkward. For now, she was stuck with her study group of one and lunch dates with Thomas, her cat.

Sonia sighed and read the name on her paper again: Tender Hands Hospice. Of all the options for a nursing internship, why did it have to be morbid, depressing, gloomy ol’ hospice? And what kind of nurses would work there?

Weirdos and rejects, Sonia reasoned, then frowned. If that were true, what did that say about her? Were the terminally inept sent to work with the terminally ill?

Terminal. She shuddered. She hated that word. It sounded so irrevocably final.

Sonia had never seen someone die outside of TV and movies. She wondered what death would be like in real life. Were people really conscious to their last breath? What do dead people look like? How fast does rigor mortis set in? For every question without an answer, her pulse sped up a notch. She took a deep breath to calm down.

Facing the glass door, Sonia studied her reflection and grimaced. Olive Oil was staring back at her. She had a long, gangly body dressed in nursing school scrubs and stringy, black hair in a bun.

Blowing a strand of loose hair out of her face, she mentally prayed, Come on number three, and tugged on the door. Crap. Of course it would be open.

Air conditioning blasted her with a heavenly chill. She choked an orgasmic-like gasp. Ninety-two degrees at nine in the morning, the day would peak at one hundred and three. Summers in the California valley were hell.

Just short of a climate control induced climax, Sonia noticed a receptionist with an upturned nose eyeing her from behind an oak desk.

Can I help you? the woman asked kindly. She wore a telephone headset and a welcoming smile, and her voice was like honey to the ear. Her wooden desk name plaque read Debbie.

Hi. Uh, yes, Sonia began articulately and held out her school badge, which was clipped to her top. I’m Sonia. I’m here for the internship position.

With the flick of a switch, Debbie’s face fell flatter than road kill, and the honey in her voice turned to sludge.

Uh, hold on, she said, dialing an extension. Newbie’s here, she mumbled into the receiver and hung up. Chris will be out in a sec. Take a seat.

Sonia stared. This had to be a record. No one had taken such an immediate dislike to her before. That usually came after introductions. Backing away slowly, unsure what she’d done, she took a plush seat by the window. Her hands resting in her lap of two unbroken legs, she dismissed excuse number four.

Pinching her knees together, Sonia glanced around for a bathroom. She’d gone four times in the last two hours. Her bladder was working in overdrive. The canvas pictures on the walls provided some distraction. The trouble was her brain warped the images, distorting each photo with cynicism. Where a nurse held the hand of a sleeping patient in bed, Sonia saw a nurse checking for a pulse. The smiling faces of families were sneers of contempt, and the hospice employees were grim reapers in scrubs.

Swallowing dryly, Sonia stilled her mind and agitated leg bouncing up and down like a jack hammer. Her brain was running away with her again. How lucky were the other students in her class? While she waited here, panicking, they were at the hospital, or surgery centers, or, in one case, a GI clinic. Lucky Jacky. Six weeks of colons beat this. There’d be no IV insertions for Sonia. No G-tubes, J-tubes, tube feeding, or suction. No ventilators or high tech equipment. Sonia scratched her head, struck by a thought: What exactly did hospice do?

From out of the hall to the side of Debbie’s desk, a woman waddled over with a chubby arm outstretched.

Are you Sonia? she asked.

Sonia nodded, unable to speak. Visually, there was a lot to be processed. For starters, even sitting down, Sonia had the advantage of height. Her boss for the summer was a dwarf. As if that weren’t enough to set the woman apart, Christine’s outsides matched her insides; she outshined the sun. Short hair dyed to a crimson red flame topped a round head, and around her neck was a chunky, red necklace. She wore ruby-red eye shadow and lipstick to match along with glitter on her rouge-tinted cheeks. There were French tips on her nails, painted red with gold flakes, and her earrings shimmered and tinkled as they dangled. The woman’s flamboyance could blind a mole in the dark.

I’m Christine, she said brightly. I’m the clinical manager.

If smiles were contagious, Sonia said hello to patient zero. Christine overflowed with good cheer. Feeling uncomfortably tall, Sonia hesitated to stand, pondering proper little person etiquette. Christine sensed her reluctance and, yanking her up to her feet, embraced her in a hug around her middle. Stiff as a crow bar, Sonia froze at the contact. Her bubble of personal space had been popped.

Sorry. Christine let her go. We’re huggers at hospice.

Sonia’s gaze flickered to Debbie. Debbie didn’t look like a hugger.

Christine caught the quick glimpse at the receptionist and let out a chuckle. Don’t mind Debbie. Once you get past the resting bitch face, she’s really a very sweet person.

Blinking, Sonia couldn’t think of a response.

I can’t help it, Debbie replied and covered her face. The phone at her desk rang and, pressing a button on her headset, she answered, Tender Hands Hospice. This is Debbie. How may I help you? The switch flicked from grumpy to charming, her breathy voice sweet. Sonia watched, stupefied to silence.

Amazing, isn’t it? Christine asked blithely. We love her. Debbie uses her powers for good. She nudged Sonia with her elbow. Come on, I’ll show you the office.

Walking mutely after Christine, they entered a stark white hallway. The effort at décor had been confined to the lobby. Here the bland walls were blank slates framing doors.

Today we’ll go through the training videos and paperwork, but before we do that, I’d like you to meet some of our staff. There should still be a few hanging around. By the way... Christine peered up at her from below the cloud line. How old are you?

Twenty, Sonia replied, quite used to the question. No one ever believed she was in college.

Oh, good! I was worried for a second. Thought I’d mixed you up with a high school volunteer.

Yep, that sounds about right.

Christine held open a door at the end of the hall to a room encircled by cubicles. Decorated with knickknacks and newspaper clippings, each desk belied the character of its owner. They were tidy or sloppy, well-decorated or cluttered, and one teetered dangerously close to collapsing, bowing under a truckload of paperwork. A massive month-long calendar recorded time off for the staff, and a collage of thank you cards swayed from the ceiling. At a white plastic folding table in the center of the room, four women sipped on coffee and tea. They wore dark green scrub tops with plain black pants and had name badges clipped to their collars.

Come on, the beach? That’s boring! said one woman who spoke with her hands as much as her mouth. She spotted Christine and asked, Seven days to live. What would you do?

Hmm… Christine tapped her chin thoughtfully. I think I’d go to Vegas and get a lap dance. I’ve always wanted to get one. I was too chicken at my sister’s bachelorette party.

Now, that’s how you spend your last days on Earth! Your turn, Max. What would you do?

A middle-aged woman with platinum blonde hair rubbed her temples in a circular motion. It was too early for ‘seven days to live.’

I don’t know, Sam. Duct tape your mouth shut and savor one week of peace.

Please. You’d need the whole week just to catch me.

Sonia listened, bemused by the hypothetical game.

A young black woman with a flawless complexion raised her manicured hand.

Okay, I take back my answer. I’ll skip the beach and take a flight to New York and then Paris and shop until I pass out. While I’m doing that, I want a temple erected in marble, complete with a sarcophagus, and I want to be buried with everything I buy.

Sam applauded the alteration.

That’s more like it. You’ll be like King Tut but with Prada. You’re up, Seema.

That’s easy, said a woman with clove skin and dark eyes. I’d visit my family in Indiana. Sonia could tell by Sam’s scoffing expression that she was underwhelmed by the answer. Oh, fine. I have always wanted to stay at Hearst Castle with my husband. A night to ourselves. Maybe we could sneak into the pool.

Nodding her head, Sam high-fived Seema over the table.

Ladies. Christine called the women to attention. I wanted to introduce you to our first student intern. This is Sonia. She’s in the RN program at Western College, and she’ll be with us for the next six weeks.

Sonia looked at the group and waved hello, then lowered her arm, feeling stupid.

Sam spoke up first.

Chris, that’s a high school student. To Sonia she said, Did she kidnap you and promise you credits? Wink if you’re under duress.

Hush, Sam, Chris chided.

Don’t pretend you didn’t check.

I’m sorry, Sonia. We’ve taught her to sit, stay, and speak, but we’re still struggling with ‘no’.

Chris and Sonia took two chairs at the table, joining the small group of women.

Sonia, this is Max, Seema, Kelly, and Sam. She pointed to the individual women in turn. Max and Seema are RN case managers. They smiled politely. Kelly is one of our LVNs and Max’s partner. Kelly wiggled her fingers. And Sam is our admissions nurse. Sam didn’t look up from unwrapping a Snickers.

Oh, goodness! Look at those school scrubs! Purple and black, how nice. When I was in school, I had to wear all white. Max reached out and shook Sonia’s hand.

How can she live in this city and still be so pale?

Thirty years spent in the desert and Max was still as pale as a geisha. Laugh lines wrinkled the corners of her eyes, and she had the beginnings of white streaks in her hair.

Seema said, Hello, her voice mellow and soft. Lightly, she met Sonia’s grip.

You’re so young to be in nursing school.

I remember when I was a baby nurse, Kelly sympathized. She looked like nurse Barbie fresh out of the box, her black hair immaculately styled. Her scrubs were pressed, her skin was unblemished, and her makeup was utterly perfect.

This is not a baby nurse, Sam corrected to Sonia’s short-lived relief. Baby nurses have graduated. She’s more like a fertilized egg. Let’s call her Eggy!

Tearing open a Reese’s, Sam inhaled the treat whole. Despite the obvious addiction to candy, Sam’s scrubs were loose fitting. The onrush of sugar made her speak in fast forward, and her voice projected with the power of a bullhorn.

Indoor voice, Sam, and we’re not calling her that, Christine countered, patting Sonia reassuringly on the back.

This declaration had zero impact on Sam, who henceforth dubbed Sonia as Newbie.

Don’t worry about Sam, Max said graciously. She’s annoying, but I think you’ll have a good time.

Maxine will be one of your preceptors, Christine explained, scooting around in the chair with some difficulty, unable to reach the floor with her feet.

So, you got stuck with hospice. Where did everyone else get to go? Sam asked tactlessly, ignoring Christine’s shushes.

Sonia replied to the table, not raising her eyes. Most went to St. Matthew’s. They had the most spots. A couple of people went to a surgery center on Wilkes, and a few others were assigned to home health. One girl went to the GI clinic on First Street.

Seriously? Six weeks of staring at rectums? Sam mimed shooting herself in the head. Well, too bad you’re stuck here with us.

Sam! Christine and Max yelled at the same time. This had to be a frequent occurrence, because she didn’t even flinch.

She’s not stuck here with us. You’ll make her sad that she came. Christine tried to frown, but it didn’t come naturally. She settled for pressing her lips into a thin line.

What? This isn’t the place people want to go for an internship. We don’t do any of the invasive stuff they do in the hospital. Plus, hospice? Really? For Christ...

Uh-uh! Max and Kelly cut her off, Max fingering the cross on her necklace.

What I’m saying is college teaches jack-shit about hospice. Unless she’s had a family member on service, no chance she’s not clueless. Am I right?

Shrinking from the expectant gazes of five sets of eyes, Sonia mumbled weakly, I know it’s end of life care.

That’s right! Christine exclaimed, clapping her hands.

Sam licked and sucked candy bits out of her teeth.

Ever see a dead body?

Sam! Mortified, Christine shooed her away. I know you have work you should be doing.

As if on cue, Debbie’s monotone voice slumped out through the office PA. Sam, phone call line one. I’m not saying it again.

Shrugging, Sam stood and picked up the phone at a cubicle.

Max, Kelly, and Seema got up, as well. As Sonia watched them head out to work with Christine at her hip, she came to a conclusion about hospice.

Definitely weirdos.

Six weeks with these weirdos to go.

Chapter 2: Shelly

Monday dragged by in eight mind-numbing hours. The hardest part had been staying awake through videos dating back to the eighties when women wore shoulder pads and had perms, and the men grew Tom Selleck mustaches.

For the rest of this week, I have you with Shelly, Christine told Sonia early Tuesday morning in her office. It’ll be a nice way for you to get your feet wet.

Recovered from a harrowing level of boredom, Sonia sat, her limbs compressed to her body, in a middle-class temple to Etsy. Metal signs with witty phrases were strewn on the walls. The frames on the desk were handmade. There was an assortment of artwork described euphemistically as eclectic or, less politely, as an epileptic trigger. Having personally hung every piece in her office, a mezzanine of white space encircled the room, marking the limit of her reach. The overwhelming décor seemed to shrink the cramped office further. Between the two women, two chairs, the desk, and a shelf, the door couldn’t close all the way.

Shelly is a hospice aide. She helps our patients with bathing, Christine continued, squeezing through a tight passage to get out from her desk and scuffing her chair on the wall.

The line in the paint aligned perfectly with her diminutive height.

Feeling slightly hysterical, Sonia joked inwardly, You must be this tall to be manager. She dipped out of Christine’s way and into the hall, body pulsating with a sudden onrush of first-day jitters.

Christine took her to the staff room and the eight AM morning madness. Unfamiliar faces glanced at her from every which way. Sonia smiled the smile of a self-conscious teenager forced to play the kazoo for their peers.

Hey, Chris! called a Hispanic woman, hobbling towards them. She had a headset like Debbie’s and favored one leg, puffing for her breath while she limped. We had another one.

Another one? Suppository or catheter bag?

Suppository.

Oh, boy. Who was it?

Dwight Parker. Max asked his wife Cynthia to give him the suppository yesterday. She called this morning to say it didn’t work and she didn’t want to give it again. The woman giggled. She says she’s too worried he’ll choke.

Sonia’s eyes widened.

She can’t mean…

And you told her? Christine asked with amusement.

I didn’t know an anus could gag, she said, bursting with laughter. No, I asked her not to let her husband swallow any more suppositories, and Max is going out to see them today.

You called the doctor?

I texted Dr. Mohr.

Thank you. By the way, this is Sonia, our student nurse intern. Sonia, this is Maria, our triage nurse.

Nice to meet you, Maria said, vigorously shaking Sonia’s hand and subsequently, her entire arm.

Triage, line one. Triage, hurry up, Debbie ordered through the PA.

Maria pressed the button on her headset and gimped away, disappearing behind a row of cubicles.

Has that happened before? Sonia inquired, somewhat baffled.

Swallowing a suppository? Christine guessed her meaning. Sure has. Doesn’t happen too often, but it gives us a good laugh.

How? Sonia thought, summing up several questions in one.

Christine read her mind and perplexed expression. Giving a suppository to your husband or wife can be an uncomfortable concept for spouses. The more uncomfortable they are, the less likely they’ll think. People can make silly mistakes when they’re pushed outside of their comfort zones.

Sonia bit her lip. She had exited her comfort zone the moment she accepted this internship.

Great. Can’t wait to see what I screw up.

Christine pointed to a desk occupied by a lithe young woman with long brown hair tied back in a clip. Wearing an olive green scrub top and engraving a pencil with her teeth, she quietly read aloud a list of patient names.

Shelly, Christine prodded. Shelly paused and looked up, focusing her gaze on her boss’ chin. I’d like you to meet our summer intern, Sonia. She’s from the RN program at Western.

Hello, Shelly said, her murmuring now the normal volume of her voice.

I’ll have her stay with you for the next few days. Sonia, Shelly will take great care of you. She’s one of our best! With that, Christine went back to her office.

Remembering when her parents introduced her to babysitters, Sonia shifted side to side awkwardly. She supposed there was little difference in the roles of babysitters and preceptors. One was responsible for a child’s safety and maintaining order; the other protected patients from clumsy nursing school interns.

Here, you can sit next to me, whispered Shelly, indicating a chair at the neighboring cubicle.

Thanks.

Sonia cradled her bag in her bouncing lap, her leg pumping up and down against the floor. The first day in the field. She couldn’t sit still. Would she see someone die? Bile rose in her throat.

They wouldn’t send Shelly out to bathe a dying patient, she rationalized, and the logic felt sound. As long as I’m with her, I won’t have to see people die.

The hospice aide resumed making notes on paper, moving her lips in concentration.

These are the patients you’re seeing today?

Mm-hmm, she replied laconically.

Sonia read the names of items under each name.

Are you making a list of the supplies that they need?

Uh-huh.

Do you check it twice? Sonia jested lamely. Shelly, understandably, ignored her.

More comfortable in her head than she was with the world, the hospice aide had an aversion to small talk. There were six names on the list, and all needed supplies to be delivered. Wiggling a finger for Sonia to follow, she launched out of her seat to a rolling door closet. Packed perfectly to the brim, the supplies were stacked like a real-life version of Tetris and as stable as a game of Jinga on the San Andreas fault.

Wordlessly unfolding a large plastic garbage bag, Shelly held it out to Sonia. Here.

Wha...?

Shelly tossed chux (disposable sheets), diapers, wet wipes, shampoo, body wash, mouthwash, hand wash, and sticks with little sponges on the end into the bag as if it were a basketball net. When the first bag was full, they filled another and another until they had as many bags as they had patients to see.

Water? Shelly asked Sonia’s purse rather than make eye contact.

Uh, no. I’ll be okay, Sonia replied.

Shelly tied off the last bag and left without a word of explanation. Opening Sonia’s bag, she dropped in a cold plastic water bottle. They lumbered out of the office carting seven burdensome bags that smacked against their legs as they went.

The pine scent in Shelly’s lukewarm minivan had all the subtlety of a shower in Pine-Sol. Head pounding, stomach churning, Sonia opened the van window choosing heat over suffocating pine. She sipped the water bottle gratefully as they parked in front of a townhome in the shade of a crepe myrtle tree.

Okay? Shelly asked faintly. Sonia almost didn’t hear.

I just get a little car sick. I’m okay, Sonia answered. Never had she wished more to be back in her own cruddy car with its non-irritating smells.

Shelly, great to see you, said a prune-faced woman at the door. A brown snout with gray streaks poked out from her legs. One second while I put Molly away. She closed the door, and they listened to the sounds of nails scraping on a tile floor.

Hi, Margot, Shelly said when the woman invited them in.

The surroundings were infused with the indescribable smell of a grandparent, and the furniture looked comfortably worn in. The shelves in the living room were filled with dusty old books and sepia pictures in frames.

Introducing Margot to Sonia, Shelly raised her voice from butterfly wings to the ear-piercing volume of sleepy librarian.

Nice to meet you. Are you new with hospice?

I’m their summer intern, she spat out and snapped her big mouth shut before she could say, And this is my very first visit.

That’s wonderful. You couldn’t have a better partner. Shelly’s the best.

Two people in an hour claiming Shelly’s the best. Sonia had to see this for herself.

What’s so special about a bath?

Margot lead them to her mother’s room and said, Mom’s been tired today. This morning I could barely move her. She’s too weak to help me. It’s a good thing there are two of you.

Laying in a hospital bed perpendicular to the window was Margot’s skeletal mother. Propped up on a mountain of pillows and enveloped by a dense comforter, her mouth hung open and her eyes stared at nothing.

Holy crap! She’s already dead! Sonia thought, sucking in a breath and preparing to sound the alarm.

The bony chest moved with a shuddering lurch, and the moment of uncertainty passed. Sonia thought she saw the barest glimpse of relief on Shelly’s face, too.

She’s been like this since yesterday, said Margot, anxiously gripping the footboard on the bed. I haven’t been able to get a bite of food in her. She just wants to sleep. She looks comfortable, though, don’t you think?

Shelly nodded and caressed the woman’s head tenderly, her calm disposition slackening Margot’s grip.

We won’t move her too much.

Removing supplies from the plastic bag they’d brought, Shelly stacked them on top of the dresser.

I had Seema put a catheter in Mom during her last visit so I wouldn’t have to change her so often, Margot told Shelly, seeing the new delivery of diapers. She lifted the comforter, and there was the catheter bag, hanging from the side of the bed, collecting a trace amount of dark amber urine.

Would either of you like something to drink? she asked sweetly. They shook their heads no. Well, I’ll be in the living room if you need me.

Rolling a bedside table from out of the corner of the room, Shelly positioned it at the end of the bed and began opening the drawers of the dresser. Absorbed in her task, she worked in meditative silence. Sonia floundered uselessly in the middle of the room. Should she help, or would she only get in the way?

A pink basin was removed from the bottom drawer of the dresser, and Shelly took it to the bathroom across the hall. There was a whoosh in old pipes from a water spigot having been turned on.

Sonia yawned out of nowhere. They were in a room that functioned like a sedative. The only light came from the morning sun through the window, and all the lights in the room were off. Piano music played a soporific tune from a tabletop radio, and lavender mist drifted down from a diffuser. It was the perfect place for a nap, and Sonia resisted the temptation to close her eyes.

Shelly returned with a basin filled with warm sudsy water and tossed a stack of washcloths into it.

How long have you been doing this? Sonia asked and startled Shelly right out of her trance. Ten minutes in and she’d forgotten Sonia was there.

Three years. She gestured to Margot’s mother with a guilty expression. Wanna help?

It was the invitation Sonia had been waiting for. Gloving up, she asked, What can I do?

They undressed Margot’s mother, starting with her shirt. Shifting and folding arms, elbows, and shoulders, the top came off their limp patient, who didn’t react in the slightest. Repeating the steps with the rest of her clothes, Sonia mirrored Shelly’s calculated movements. In school they’d learned to give tumbling bed baths by turning people this way and that. Shelly’s methods were less jarring, her touch firm and careful, and there was something soothing in her quiet disposition.

Sonia chuckled to herself.

Somewhere a spa is missing their masseuse.

Beneath the layers of blankets and clothes the exhausted woman was scrawnier than she initially appeared. Jutting out from under her skin, the bones of her ribs and pelvis stood out like mountains over the concave abdominal valley. There wasn’t an ounce of fat on her. Shelly draped a dry towel