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Joy walked into the hospital where she worked, sipping her coffee as she checked her phone for email. There wasn't anything new, at least not from when she had checked an hour ago. There really wasn't ever much to read during night shifts, one of the perks of working such odd hours. She was never swamped with her email. She tucked her phone in the pocket of her blue scrub shirt as she walked behind the nurses' station, pulling her backpack from her shoulder.
Felicia was already sitting behind the desk, working on charting at the computer. She was a big black woman with a warm smile and a southern accent. They had started work at the hospital in the same week and become friends during orientation. Somehow, though, Felicia had managed to take Joy under her wing. "Twenty years of experience has to be good for somethin'," Felicia would say, shaking her head knowingly. "What else am I gonna use it for except to give advice to nursing students." It didn't matter that Joy had already been an RN for two years. Felicia always persisted in calling her a student. Joy didn't care, though. Felicia was too much fun to work with to spoil it with corrections.
"Evenin', Joy," said Felicia, looking up from the computer screen and smiling so widely that it made her eyes squint.
"Hey, hon," replied Joy, stowing her backpack under the desk. "Quiet night?"
"As much as it ever is," she said sarcastically. "Mrs. Jackson in three thirty-three is awake. I checked on her an hour ago, but it probably wouldn't hurt to check again. If I can just get a handle on this damn charting without being interrupted then tonight will be a good night." Felicia sighed, waving helplessly at the machine in front of her.
Joy nodded her head, sympathetically. "Save some for me," she said. "I'm gonna go put this away and I'll go check on Mrs. Jackson."
"Okay." Felicia hunkered down to her work again, shaking her wrist a few times to loosen it up.
Joy stopped by the break room and poured the little bit of her coffee that was left down the drain. No drink at the nurses' station made it a very dry shift, but that was the rule. She put her cup away in the cupboard and went out on the floor. Mrs. Jackson was awake, just like Felicia had said, her broken leg propped up on a pair of pillows. She was sitting up in bed reading one of the three books she always had with her. This was her third stay in the hospital. The severity of the fracture had resulted in surgery, but it hadn't healed well. She was back this time for an infection. It was all there in the chart, but Joy didn't need to read it. She had taken care of Mrs. Jackson through all three of her stays. She knocked on the door as she came in.
Mrs. Jackson looked up from her book as Joy walked in. "Well, hello there," she said.
"Hi, Mrs. Jackson. Can't sleep?"
"You'll find that you don't really sleep all that much when you're old. At least not during the night. It's all those naps that do you in."
Joy laughed. "It's okay," She said, leaning in to fluff the pillows. "Young people don't sleep at night either."
The patient laughed. "Is that why you're always here?"
"Yep. It keeps me from getting bored. Any pain?"
"Some," she admitted. She always said it as though she was ashamed. Joy remembered her mom, a nurse of the old school she liked to say, telling her that older people had been raised to deal with things quietly. It was part of their dignity and Mrs. Jackson, Joy thought, was as dignified as anyone could get. Even stuck in a hospital bed she had kept a cheerful air and no matter how much her leg hurt her, she was never snippy. Joy appreciated that.
"Do you need some more meds?" asked Joy, checking the chart. "It says you have a couple more doses if you want them."
"No, no. They make me too groggy to read."
She shrugged, making a note that the patient had rejected any more pain meds. She checked the bandage on the wound to make sure it didn't need changing, then checked the monitors. Everything looked fine. "Okay. Whatcha reading?"
"A devotional for Easter," the patient replied, holding it up for Joy to see.
She glanced at the cover. "Cool. Easter is getting close, isn't it?" She walked back to the end of the bed where  I've been so busy I haven't been paying attention." She went back to the end of the bed and wrote down the patient's vitals.
"Are you religious, Joy?" asked Mrs. Jackson. She seemed genuinely interested, which was refreshing. So many patients treated nurses like room service without the tips.
"Used to be. Lately I haven't had time," she admitted.
"So many young people today don't," sighed the patient. "It's too bad so many of us only find it again when we're old and mortality is creeping up on us."
"Have you always been religious?"
"All my life. It's been with me through everything. Sometimes it's been the only thing that helped me," she said, bobbing her head to emphasize the point.
"It's good to have that." Joy smiled and closed the chart. "I have to go finish my rounds. I'll come back and check on you later."
"Sounds good," she replied. "I don't think I'll be going anywhere."
Joy laughed and left. The rest of the hospital wing was abuzz with the usual night sounds that accompany all skilled care units. This was one of the places that they sent geriatric patients, either to await surgery or recover from surgery, and that carried with it a variety of challenges. Some patients would wake up and cry out in confusion. Then she would have to go calm them down so they didn't hurt themselves. A lot of people were just awake because they didn't sleep that much, because as many of them as were still awake, more than half couldn't hear very well. Honestly, it was a wonder anyone got any sleep on the floor. Then there would be the blare of a TV turned up loud so they could hear it. Joy preferred the ones who liked to read because they were quieter and, somehow, generally less cranky than others. If you were in pain, you couldn't really concentrate on anything except the most mindless pursuit of all, television. Maybe that was why the cranky patients watched TV, she thought.
After her rounds were over, she went back to the nurses' station to finish up her charting. Joy hated charting with a passion, but then all nurses did. The letters started to swim before her eyes and her handwriting got steadily worse the longer she was writing. She hadn't written this much ever, even in college. That was something her professors had neglected to tell her in school. Oh, she thought to herself sarcastically, you're going to have carpal tunnel by the time you're thirty because you have to chart so much. Thanks for the warning, guys. Despite the pain in her arm, she kept working for the next couple of hours.
Around three in the morning, Mr. Gomez came strolling down the hall for his morning constitution, as he called it. He wheeled the IV machine in front of him with one long, bony arm, his slippered feet scuffing the carpet with each step. As usual, he'd forgotten to put on his robe. The hospital gown was open in the back, so she had a lovely view of his backside as he passed her. She'd seen it many times before in the three months he'd been stuck in the hospital. She smiled to herself, shaking her head. His presence was her cue to make her rounds for the last time that night.
"Rounds?" asked Felicia when she saw Joy stand up.
"Yeah. Gotta make sure no on runs off during the night."
"Half these people don't even know it is night, darlin'," said Felicia, shifting herself in the chair. It was one of the rolling ones that everyone hated. For the few minutes of a shift that you got to sit down, it would be nice to have a comfortable chair, but that would never happen.
"It's gotta be done, though," sighed Joy. "Be back in a sec. Do you want anything from the machine?" She said, walking backward down the long hall.
"Can of coke would be great. I'll buy tomorrow night."
"Kay. I'll leave it in the fridge for you." Joy turned around and walked casually down the hall, hands stuffed in the pockets of her scrubs like she always did. She had at least three pens in the right pocket that she played with and her keys in the other. She tucked her finger through the key ring to keep them from jingling and waking people up. There were always some light sleepers on the floor and they had enough trouble sleeping through all the noise as it was. Sometimes a small sound was all that was needed to push them over the edge.
Everyone was pretty much asleep and unchanged from her rounds a couple hours ago. She'd gotten lucky tonight. They were quiet compared to most nights. As she went into the neighboring room, she noticed that Mrs. Jackson's light was still on. Her mother's words occurred to her once again, almost like a mantra. Patient care isn't just taking care of bodies in beds, Joy. It's taking care of their hearts and minds, too. Never be too good to have a chat with your patients. She had always been saying things like that when Joy was growing up. Joy had gotten over that idealistic attitude in nursing school where you learned how things were out in the real world, but every once in awhile it would crop up again. Joy checked her watch. I have a little time, she thought. I'll save her for last. It couldn't hurt this one time.
When she'd been around to see everyone else and a couple extra, she knocked on Mrs. Jackson's door. Mrs. Jackson looked up once again from her book, smiling. It struck Joy that at one time, Mrs. Jackson had been a pretty woman. Her smile was bright and happy. Behind her reading glasses, her eyes were a deep blue and her skin was still smooth and full of color at the cheeks. She had aged well. She looked almost like a benevolent grandmother, but Joy thought there was some steel in her still. Something in her posture made her think that Mrs. Eileen Jackson had never bent herself over backward for anybody. She was not a compromiser and she wasn't a jerk about it either. She was simply experienced.
Mrs. Jackson closed her book, a finger tucked inside to save her place. It was a different book than the one from before, so Joy asked, "Whatcha readin' now?"
"Bible commentary on the Last Supper from Luke. It's absolutely fascinating," said Mrs. Jackson. Joy couldn't understand how she could sound so genuinely interested in such a boring subject.
"Sounds cool," she lied dutifully.  "Tell me about it." Joy reached up to adjust something for the IV.
"Why don't you tell me about you instead?" suggested Mrs. Jackson. "St. Luke's been around for about two thousand years, I think he'll wait a little while longer."
Joy laughed, relieved at not having to hear a dry dissertation about the Bible, and sat down in a chair nearby. "I'm not that interesting."
"Oh come on," insisted Mrs. Jackson good-naturedly. "Tell me a story about yourself. Don't people generally enjoy talking about themselves?"
"Um, okay. Jeez," said Joy, looking up at the ceiling as she tried to think of something interesting about herself. "I'm from California. That's where I went to nursing school."
"Oh really? Where in California?" asked Mrs. Jackson, smiling encouragingly.
"San Francisco."
"That would be a big change, going from the beach to the Midwest. Nebraska isn't anything like California."
"No," agreed Joy, with an expressive sigh, "no, it is not."
Mrs. Jackson turned her book upside down over her leg to save her place and folded her fingers together on her lap, settling into a slightly more comfortable position. "I remember when I was, oh, about forty and we moved here from Dallas. That was a bit of a transition, I tell you. Less of a Southern accent and I heard people calling bags sacks. You can imagine how confused I was when I first heard that."
"Oh my god, yes!" exclaimed Joy. "And they call sodas pop. I thought, this place is insane."
Mrs. Jackson laughed. "Oh I know. It takes awhile, but you get used to it. I did and now my friends from back home say I have an accent." They laughed about that, pointing at each other as if to say, "Yeah, you, too."
"What made you leave Dallas?" asked Joy, curious now that they were calmer.
The older woman leaned her head back, looking up at some obscure corner as she remembered the past. "Oh, a lot of things," she said wistfully. "There was my husband's work, which was the main reason. Our kids were old enough, too, that we thought it wouldn't hurt them to have a change of scenery. You know how parents are always concerned that their kids are going to do something completely wrong and screw up the rest of their lives? The truth is," she said, leaning forward a little bit, "that they're probably not going to screw themselves up too badly until later on in their lives. You'll find this out when you have kids," she added, nodding knowingly. Joy smiled the way young people do when old people make wild predictions about the future.
"Anyway," Mrs. Jackson went on, "it worked out well enough. We had family in Nebraska, so we weren't completely alone. It took awhile to settle in, but we all felt better once we found a new Parish."
Joy heard that and cocked her head to the side. "Religion is very important to you, isn't it?" she observed.
"Faith is," clarified Mrs. Jackson. "If you don't believe in anything, you don't have much to make your life meaningful. Belief is the basis for everything, including love, family, even work. Honestly, would you be here in the middle of the night if you didn't believe your job was worth doing?"
"I guess not," she admitted.
The older woman went on as if she hadn't said anything. "So many young people I talk to today don't believe in anything," she lamented, "or, when they do, they believe in a negative. My eldest grandson calls himself a nihilist and says that he believes that the world is nothing but a dead end. He doesn't have much hope that one, but I never met a philosophy major who really did. I think it's because they spend so much time pondering the imponderable. Faith is easier because you don't have to prove it."
"I wouldn't know. I spent more time in biology class than anywhere else."
Mrs. Jackson laughed. "Ah, the scientific brain. I always loved thinking problems more than technical ones. I was terrible at math, too."
"So where did your grandson get it then?"
"From my husband, more than likely. He's an engineer." Mrs. Jackson smiled to herself, a secret smile that Joy couldn't quite figure out. "We've been together more than forty years. I can't imagine life without him. I remember there was one time that-"
Joy couldn't remember enjoying work so much in awhile, she thought as Mrs. Jackson talked about her husband and the good times they had had together. Sure, you could take care of your patients' bodies and even be nice and talk to them and find out about what kind of people they were, just like her mom said. But there was always the added bonus of enjoying them in the process.
A little while later, someone's call light went off and Joy had to go take care of it. She was just as sad to leave as Mrs. Jackson seemed to be to see her go. Joy promised to come back when she could, but her shift was almost over.
Mrs. Jackson apologized for rambling and added, "It was lovely talking to you, my dear."
"I really enjoyed it," Joy replied, smiling broadly to let her know she meant it. The night had gone by fast talking to Mrs. Jackson, but that didn't leave much time for charting. She rushed through the last of it, finishing five minutes after her shift was supposed to be over. She clocked out, satisfied with her night. Somehow a happy feeling had stumbled over from her time at work and she crawled into bed next to her love with a smile on her face.

Joy came to work the next night, cheerful and energetic. She had slept well, she had had a nice dinner with her love, it was finally Friday, and now she was ready to enjoy a quiet night at work. Felicia wasn't at the nurses' station tonight. She's probably out doing rounds, thought Joy as she stowed her backpack under the desk. She looked up at the assignment board and found a bunch of tasks that didn't get done during the day shift. Day shift nurses had a tendency to dump on the night shift, even though it was one of the busiest times. It was annoying, but no amount of complaining made an impact on the problem. Feeling a bit put upon, she took note of what needed to be done and started working on clearing the list. At least all the patient records were on the computer and they couldn't leave a pile of them on the desk for her to put away. That had been the worst thing.
She had just finished with someone's wound dressing when the alarm went off calling a code blue. Joy had been a nurse for a grand total of almost two years, but she hadn't seen too many code blues. Every nursing student knew what they meant though. Code blue – cardiac arrest of a patient requiring immediate resuscitation. She checked the alarm and ran to the room.
In the back of her mind as she helped Felicia administer CPR, Joy remembered that this was Mrs. Jackson. Mrs. Jackson who she had so enjoyed talking to last night; who had been funny and interesting; Mrs. Jackson who had wanted to know more about her, an uninteresting nurse. Some caring part of her remembered that this was a human being that she liked as a person. But the nurse Joy who was pumping at the woman's chest was only taking care of a body that didn't work. Like a mechanic pumping up a tire, she pumped air into the lungs to make them breath. She made the heart beat with her hands like the mechanic would rev an engine, waiting for it to flare to life again. Less than a minute in to the CPR, the patient started breathing on her own, coming back to consciousness again with a deep, ragged breath and a gasp.
Joy stood back from the bed, breathing deeply from the effort. "Call the cardiac unit and tell them we have a SCA," she said to Felicia, standing on the other side of the bed.
"Okay," Felicia said, rushing out to make the call.
Joy stayed with Mrs. Jackson until the cardiac team came to move her to their unit. The woman was unconscious but breathing steadily, if shallowly. It wasn't uncommon for older to people who had been stuck in the hospital for a while. They sat in the bed all day and didn't get enough exercise, which caused strain on their hearts. Joy had seen it a couple times before. She'd seen it before and the patients had been fine later. They were fine, she thought to herself, she'll be fine, too. The cardiac team came and took Mrs. Jackson away, leaving Joy standing aimlessly in the hallway.
"Hey, darlin'," said Felicia, coming  up to the nurses' station. "Are you gonna chart the incident or am I?"
Joy snapped out of it and went to the computer. "I got it, hon, thanks." She started logging in at the desk.
"Whew! That'll work up an appetite," the older nurse sighed. "I'm gonna get some chips. Want a coke?"
"Uh, yeah," Joy answered, distractedly. "Leave it in the fridge in the break room and I'll get it in a sec."
Felicia walked down the hall to the break room. It went back to being quiet on the floor once the door shut behind her. Joy looked up from the computer screen for a moment and just listened. Silence. Then a patient moaned, calling out confusedly in his sleep. She typed a couple short sentences to summarize the event and ran off to make sure he didn't hurt himself in his confusion. As she helped the patient go to the bathroom, she thought about the code blue and what she had written in the chart. Someone almost died and it could all be boiled down to paperwork, she thought. Then she put the patient back in bed, tucking the blanket up around his shoulders as he fell back to sleep. Thank God her shift was almost over.

On her way home in the tiny little Honda that had been with her since college, the windows rolled up against a light drizzle, Joy pulled out her cell phone and called her mom. It was early, too early for phone calls really, but she knew her mom would be up. She was always up. It was probably because she was getting old and didn't sleep, just like Mrs. Jackson had said. The only difference was that her mom never took naps. She was fundamentally opposed to them. So despite the insanely early hour, she knew her mom would be awake and unsurprised by a phone call from her. It had happened before and would most likely happen again.
"Hello?" her Mother answered. It always sounded like a question when she answered the phone.
"Hey, Mom," she sighed, surprised at just how relieved she was to hear her mom's voice.. She was still very much awake, but getting tired. Her mother noticed.
"Hey. Just get off work? You sound tired."
"Yeah. We had a code blue tonight. One of my favorite patients." She squeezed the phone between her ear and her shoulder as she made a left turn at the light.
"You have favorite patients now?" her mom asked. "I thought you didn't play favorites." It had always been a thing between them that Joy didn't get personally involved with her patients.
"I don't. I just-" Joy stuttered. "I don't know. I like her."
"There are patients who do that to you," she said understandingly. "Sometimes it just happens and there's nothing you can do."
"Yeah. I don't know. All that stuff you used to tell me about being a nurse, about taking care of hearts and bodies, it makes sense. But, Mom, it makes it hard to do my job."
She knew her mom was nodding on the other end of the line, a gesture she had seen her make many times before. There was nothing but sympathy in her voice. "Caring does that to you, hon," she said, "but it makes you do your job better, too. I bet your patient doesn't regret liking you. You should never regret liking your patients."
"I guess you're right." She sighed again as she pulled into her driveway and turned off the car. "Okay, I'm home."
"Okay, go to bed, hon. I'll talk to you later."
"Kay. Night."
"Love you."
"Love you, too. Night."