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Night nurse burns midnight oil to keep the spark of life in hospital patients By
Rachel Marberger
OGDEN -- It is 10 p.m. and Marilynn Miller is just getting to work. The visitors are long gone. The doctors have left, too. It's just the nurses and the patients now, and a long night ahead for them both. Even the air suggested that no one should be up at this hour. The midnight hour is heavy with a sense of overwhelming stillness. All who enter the surgical floor of Ogden Regional Medical Center immediately softened their voices to whispers. Some doors are closed, some are open. Some rooms have patients in them, some are empty. One particular door is open wide with lights bright in the dark hallway. The sheets are turned down with a person's impression still present in the mattress. That patient just left to return to her own home and her own bed. At 4:30 a.m. reruns of Family Ties blare at sleepless patients trying to pass the time and keep their minds off of the pain. Other patients have successfully ignored the relentless pain going through their bodies and finally sleep has settled in. One doctor sits behind the desk, his wrinkled green scrub shirt un-tucked from his stained pants. Leaning over a patient's chart, he rubs his tired eyes and runs his fingers through his hair with one exhaustive sigh after another. Doctors do not work these late hours. He was called in because of a problem with a patient. Several nurses wander the halls and others sit at the station. They know that although their shift usually begins with a standard routine they have to be prepared for anything. Can they truly be prepared in these late hours night after night? Marilynn Miller can attest that it is not easy. "Cars
were backed up into the freeway and they couldn't wake her up honking
or anything." Miller works from 10 p.m. until 6 a.m. Monday through Friday. She always tries to sleep for eight hours, but it is never possible. Errands need to be ran and things need to get done before she heads to work for her usual shift. With or without enough sleep, patients are waiting. As shift coordinator, her staff would be lost without her. The minute Miller enters the third floor of the hospital the work begins and never ceases. Patients' vital signs need to be taken; their levels of consciousness need to be tested. Health histories and physical assessments for new patients need to be completed within an hour after admission. Many patients do not sleep and the nurses answer their calls throughout the night. Patients in critical condition need the nurses' undivided attention. Death is also an issue. All of these duties seem to extend beyond a nurse's human capacity. Along with medical care, nursing involves a lot of psychology, Miller said. At night patients can wake up and may be very confused because their families have gone home. The nurses are there to help orient them and make them feel relaxed. At times, patients think that nurses are being too hard on them when they are only doing their job, Miller said. "We're there to help people, we're not just trying to be mean," Miller said. "We're not there to wait on people. We're there to help them do as much as they can by themselves." "The basic purpose of nursing is to return a person to daily active living," Miller declared. Miller has been working as if the night is day and the day is night for 17 years, and she is still not accustomed to it. "I am always tired," Miller said. P.J. Frayser, a Weber State University nursing student, follows Miller's experienced footsteps into the night while fighting his own personal battles that come with working the night shift. Frayser has two children, 5-month-old twins. He is home with them while his wife teaches school during the day, then he goes to work at 3 p.m. until he has to go to the hospital for his eight-hour shift. "I've had to send him home before because he's been too tired to work," Miller said with a sigh. And Miller knows what it's like to be tired. Miller's youngest daughter, Jacque, knows quite well how tired her mom can get. Jacque laughs as she tells of one specific instance. "I remember one time when I was in Kindergarten, I was waiting at the bus stop along with my brother and sister and the other kids, and along comes my mom driving her car straight for us. She was falling asleep and ended up swerving her car into a ditch along side the bus stop." Jacque says that even now Miller is prone to falling asleep as soon as she parks her car in the garage. In another instance Miller was actually backing up traffic because she fell asleep at a red light. "A police officer had to come and knock on her window. Cars were backed up in to the freeway and they couldn't wake her up honking or anything," Jacque said. When Miller's children were small it was good that she was home during their waking hours even if it was not during hers, she said. Although she works the same number of hours that many other people do, the hours she is not at work seem to go by more quickly. Sleep is difficult when stores are open, other people are awake, and the sun is shining. Miller said she never sleeps as much as she needs to. "There are always interruptions," Marilynn said. "I only get around five to seven hours of sleep each night even though I know I need more." Because she works five days a week, eight hours a day, weekends always throw off any pattern of sleep she has attained. Her life is generally lived at night but no one else's is. Her children are grown but that doesn't mean Miller gets any more sleep. Miller's oldest daughter Lisa lives just five minutes away with her husband and 2-year-old child Rhett. Rhett is Miller's first grandchild. Lisa and Rhett love to visit Grandma. They go shopping and have picnics regularly. Miller's son Greg and youngest daughter Jacque are college students and demand their mom's time more often than you would think. "My mom is always willing to answer the phone when she knows it's me even if she just went to bed," said Jacque. On the weekend, Miller suffers to live a normal life, sleeping at night and being awake during the day, but on Monday it starts over once more, with or without her needed rest. So why would anyone want to be a nurse on the night shift? Miller can think of quite a few reasons why she has chosen to do it for 17 years. "My boss isn't there all of the time," Miller said simply. "I have more independence." Miller also likes that the confusion is less at night. Doctors and other departments are not there to take tests, giving Miller more interaction with the patients at night than she would have during the day. She also likes the quiet and calm the night shift brings. "I like the people I work with most of all," said Miller happily. Giving medicine for pain relief is a constant and important part of Miller's job. During her shift, nurses count of narcotics twice. Drugs have come up missing before. Nurses undergo mandatory drug tests and administrators are cutting down on the number of keys to the narcotics that are being given out. Drug rehab is being made available for nurses. Miller says that giving medicine needs to be done continuously with great caution. When nurses give patients their specified medications, they must do so very carefully. First, they must make sure it is the right patient, second, they make sure it is the right drug, and third, they make sure it is the right dose. Nurses who work late into the morning hours cannot blame mistakes on lack of sleep. Mistakes can mean someone's life. Miller said that the patient's safety is always the most important. Certain duties of a nurse, such as giving a patient blood, or giving a patient narcotics, needs to be done with extra care because of the late hours one works. "When people are tired they tend to make more mistakes," said Miller. "[A nurse] can kill someone if they are not getting enough rest." Nurses mainly deal with patients but along with patients come their families who sometimes need as much attention as the patient. "There have been patients' families who have tried to increase the dose of the narcotics machines," said Miller. "They tell me that their family member, [the patient], is in pain and needs more drugs." They don't realize how much damage they could actually be doing. "Society needs to realize that they can't take away all of the pain," Miller said. Pain control is a big issue on Miller's floor. The surgical floor sees patients that are recovering from sometimes highly invasive procedures and need a lot of attention. During the night nurses must periodically check the patients' levels of consciousness because of the great use of narcotics. "Medication can't take all of the pain away," Miller said. "It just takes the edge off." Miller is watchful about how much medication she gives her patients. "You can always give more but you can't take away," Miller said, speaking of narcotics. 6 a.m. has finally come and it is time to go home and go to bed. But first Miller is going to stop at the store, call her daughter, and she really needs to get to the post office sometime today. Looks like sleep is going to have to wait.
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