The Nut Hut Page 3

  "Chop chop," John shouted at the stragglers coming out of the bathroom still pulling their pants up. He sent an exasperated look in our direction.

  Sharon took John's attitude in stride. She shooed one of the boys who had lingered at the desk. "You want to go to the dance tonight, Bobby?" she asked. "You better move."

  "Did he used to be a drill sergeant?" I asked Sharon quietly as Bobby trotted off and John yelled some more.

  Sharon shrugged. "That's just his way. The boys know the routine. They’re just excited because you're here."

  John finished counting heads. He shouted, "Thirty-two. Right on the money."

  Sharon noted that fact in the day book.

  Suddenly the ward became a hive of activity. Some of the boys pushed the couches, chairs and other furniture to the far side of the day room. John unlocked a door and handed out dust mops and white rags to others, who began dusting the floors and furniture industriously. Those without mops or rags sat quietly out of the way with their feet tucked up underneath them.

  "Come on," Sharon said, with the air of someone picking up a familiar but heavy burden. "We’ll put up meds in the office while they clean."

  She unlocked a door by the phone and flipped the light switch inside. "Go ahead and hang your coat up."

  The fluorescent light flickered, illuminating a small, windowless room that smelled of dust and rubbing alcohol. At the far end was a tall wooden cupboard with locked upper and lower doors divided by a shelf that stuck out in the middle. It was old and plain, strictly utilitarian.

  Against one wall sat a sewing machine stacked high with torn clothing. Above the sewing machine was a cork bulletin board which had memos and pictures and handwritten notes thumb-tacked to it. A coat tree stood just inside the door next to a bank of floor to ceiling shelves labeled for office and cleaning supplies. Beyond that was an old refrigerator.

  "Have a seat." Sharon pointed to the wooden chair next to the sewing machine. I tried not to wonder why none of the attendants had sent me to fetch a dry chair at shift change.

  "So, you haven't had any Inservice?" Sharon asked as she unlocked the upper right door of the wooden cupboard and opened it. She reached inside, unlatched the other door and swung it open too.

  "Nope," I said. "I don't have the slightest idea what I am supposed to do. I just guess. Unfortunately, I keep guessing wrong."

  Sharon laughed. "Well, if it's any consolation, I'd pay you to sit in pee just to see old lady Peterson's face turn inside out again."

  "Gee, thanks," I said, peeking back through the doorway. The boys were already dusting the other half of the day room. John supervised from a recliner in front of the TV.

  With the ease of long practice, Sharon pulled a wooden tray from the cupboard and placed it on the divider. The tray held twenty-four small plastic pill cups set into holes. A slot positioned by each cup held index cards of differing colors.

  "These are medicine cards," she said, holding some up. “Each resident who gets regular medication has his own slot. Each medicine, with dosage and frequency, is written on a separate card with the boy's name at the top. See? Blue cards for QID, pink for TID, white for BID, green for everything else."

  "QID?" I said, confused.

  One of the boys stepped into the office and said, "Hi, Becky!"

  Before I could answer, Sharon whirled around and glared at him. "Bobby," she said sharply, "get out of here right now!"

  Bobby looked abashed and left. In the distance, John shouted some more.

  "The residents are not allowed in here, and they know it," she said by way of explanation. She went back to her lesson as though nothing had happened.

  "QID means four times a day. The resident gets the medicine listed on the card morning, noon, night and bedtime. TID is three times a day. BID is twice. PRN means as needed. It's an easy system." She pulled some bottles off a shelf inside the cupboard and continued. "Each pill bottle is labeled. Just dump the right number of pills into the lid and then into the cup without touching them. If you drop some on the floor, toss ‘em, but write it down. We’re supposed to keep track of losses."

  Deftly she read cards and filled cups. Some of the boys took an alarming number of pills. Phenobarbitol, Dilantin, Thorazine, Stellazine, Valium. Blue pills, white tablets, banded capsules of all colors went from bottle to lid to cup with no wasted motion.

  "Are you a nurse?" I asked, amazed at her knowledge and skill.

  "If I were a nurse, do you think I'd be working in this joint?" Sharon asked bitterly. "On the dorms, for crying out loud?”

  My desire to work at Byerley had been fueled by a sense of adventure. The Peace Corps didn't want me without a college degree, so it seemed like a good way of earning my keep while considering my next move. That workers might view their employment as drudgery had never occurred to me.

  "There aren't enough nurses willing to work for the state's slave wages,” Sharon continued. “So we hand out the meds. As long as you follow the cards, you won't make a mistake."

  "But what if I give pills to the wrong resident?" I asked. To me they all looked alike. "I'd just rather not do it all."

  "You don't have any choice." She slid the tray back into the cupboard. "Handing out meds is part of the job. The easy part."

  "I never knew this was going to be so complicated," I said, exhausted already.

  "You ain’t seen nothin’ yet." Sharon pulled a thermometer from an open-topped vial, wiped the end on a gauze pad and shook it down. "You got a watch?"

  I flashed my brand new Timex with a Twist-O-Flex band, a going-away gift from Mom.

  "Good. We have a couple of sick boys who need their temps taken. That's a dandy job for new mom."

  I was pleased to have an assignment I could manage. "Just point me at the right boy." I stood up and held out my hand for the thermometer.

  "Not so quick," Sharon said as she unscrewed the lid on a jar of Vaseline and dipped the thermometer.

  "Do I put it in his mouth with that all over it?"

  Sharon laughed. "My dear, you aren't going near anyone's mouth."

  Chapter 5

  Taped inside the door of every medicine cabinet at Byerley State Hospital and School:

  Temperatures should be taken and recorded:

  If the resident feels overly warm to the touch

  If a distinct change in eating, behavior or sleeping pattern is noticed

  If coughing, vomiting, or respiratory changes are noticed

  If frequent urination is noticed

  If resident is obviously ill

  General Instructions

  Take and record temperatures of ill residents every three-four hours, or as often as ordered or needed. If resident shows an elevated temperature (100 degrees or more) for six straight hours, call dr. for instructions. If resident shows an elevated temperature of 101 or more, contact the doctor on call. If resident shows elevated temperature of more than 102 degrees(regardless of symptoms or previous history), make arrangements to transport to on-campus hospital immediately. Clean thermometer with alcohol or soapy water after each use and store in alcohol.

  Taking Oral Temperatures

  Oral temperature readings are not recommended at Byerley State Hospital and School unless the resident is very high- functional and proven to be non-epileptic.

  Taking Axillary Temperatures

  Shake glass thermometer down by snapping wrist sharply. Make sure mercury level is below 96 degrees. Raise resident's arm, place the tip of the thermometer squarely in the armpit, lower arm. Hold thermometer in place by firmly keeping arm to chest for three or four minutes. Read thermometer. If thermometer reads more than 99 degrees, a fever is present. Axillary temperature readings are not as reliable as rectal temperature readings and should only be used when rectal temperature readings are not available.

  Taking Rectal Temperatures

  Shake glass thermometer down by snapping wrist sharply. Make sure mercury level is below 96 degrees. Dip silver thermometer
end in petroleum jelly. Have resident lie on side with knees drawn up. Insert thermometer into rectum no deeper than 1". Hold thermometer in place for two-three minutes. Remove thermometer and wipe on a tissue. If rectal temperature is higher than 100.5, a fever is present.

  "Got something to write with?" Sharon asked.

  I held up a brand new Parker pen, another gift from mom, and waved it with a marked lack of enthusiasm.

  "Good," she said, handing me the goopy thermometer and a sheet of paper, as well as a wad of tissues. She cuffed me lightly on the shoulder. "Buck up. You'll see a lot worse than Ben Johnson's rear end before this shift is over."

  I decided not to mention that I had never seen a naked male over the age of three, and followed her into the maze.

  She stopped by a bed where a large boy lay curled under the covers, breathing heavily through his mouth. Thick snot bubbled at his nose, and his eyes were red and runny. Sharon dug a tissue out of her pocket and gently wiped his nose. "Sick boys can't go to the dining room, so we have their meals sent up. John feeds them and eats his supper here while we take the rest to the dining room."

  She looked up and said, "He doesn't like to go to the dining room anyway, so it works out nice for us."

  "Ben doesn't like to go to the dining room?" I asked.

  "Not Ben. John. John doesn't like to go to the employee dining room.” Sharon stood up and looked at me expectantly. I knew we were done with chitchat.

  "So this is Ben?" I thought I’d better make sure. "What's wrong with him?"

  I spoke quietly. It felt odd to talk about Ben when he was right in front of us.

  "Just a garden variety cold. But colds can turn into pneumonia, and mongoloids are particularly susceptible. So we keep an eye on them."

  Until that moment, I hadn't noticed the boy’s slanted eyes and short neck, characteristics that marked easily a third of the residents I’d seen. She patted Ben’s cheek and smoothed his hair out of his eyes. He smiled weakly in return.

  "Okay," Sharon said, stepping aside. "He's all yours. Ben, this is Becky, the new mom."

  "Dew Bob," Ben said groggily without lifting his head from his pillow.

  "Becky's going to take your temp, Ben," Sharon said to him slowly.

  Ben smiled gamely, rolled to his side, and pulled his knees up without being told.

  I sat on his bed and looked at the thermometer in my hand. I looked at Ben, who was facing away from me, unconcerned. He knew the drill. Without being told, he pulled his pajama bottoms down.

  I sat on the bed contemplating Ben's rear end. It wasn't as bad as I'd expected it to be. "Okay," I said, trying to sound soothing, and not scared out of my wits.

  I held my breath and gingerly moved to insert the thermometer, but at the last second, I chickened out and closed my eyes.

  "Ungh," Ben said.

  "Oops," I said, blushing.

  "You gotta look," Sharon said. "Otherwise you won't know where to aim."

  So I tried again and bravely kept my eyes open.

  "I'm supposed to hold on to it?" I asked Sharon. "The whole time?"

  "If you don't hold on to it, they'll suck it up inside with their incredibly strong rectal muscles," Sharon said gravely.

  "Really?" I tightened my grip on the thermometer. Holding it seemed easier than fishing it back out.

  "No, of course not," Sharon laughed. "You need to hang on to it so you can pull it out if they roll over or have a seizure. You don't want broken glass in there."

  Sharon looked at her watch again. I checked mine. Three minutes had passed. I removed the thermometer and wiped it on a tissue.

  "101.8," I said to Sharon, writing the temp and the time down on the sheet she'd given me earlier. "It's gone up. Should we notify someone?"

  "You can call the doctor when we finish," Sharon said. "Okay, Ben, pull your jammies back up."

  "Okay," he mumbled.

  "Well," I said with a note of pride, "that wasn't so bad."

  "I'm glad you feel that way," Sharon said with a smile. "Because you can do it again in a few hours."

  The rest of the ward was quiet. Or at least what passed for quiet. The residents laughed and talked and rocked and babbled just like before, but it was a calmer, less agitated noise than had greeted me at shift change. Some of the boys watched TV, some looked out windows, some rocked back and forth. This was just another afternoon in a long line of ordinary afternoons.

  We went back to the desk to log Ben’s temp in the day book.

  “I'll scrub the thermometers while you call the hospital and report Ben,” Sharon said when we finished. “It's just about med and shower time and we need to get moving," She slid the day book into the upper left hand desk drawer.

  I picked up the phone.

  "Switchboard," the voice said.

  "This is Rebecca Decker on Foster Second. I need to talk to someone at the hospital."

  I figured if that wasn’t the right way to go about contacting the medical authorities at Byerley, Miss Nasal Voice would let me know.

  "Just a minute," she said. "I'll connect you."

  Before I had time to congratulate myself, an impatient male barked, “Holbrook. Hospital."

  "This is Rebecca Decker on Foster Second. We’re supposed to notify the doctor if a resident’s temp goes over 101 degrees.”

  "Who?"

  “Ben Johnson,” I said.

  “Not the resident. You,” the voice said, sighing. “To whom am I speaking?”

  "Rebecca Decker on Foster Second."

  "Ah," he said, "the new girl.”

  The new girl? I looked at my watch. It was only 4:00 p.m., and news of my arrival had already spread to the hospital.

  "We have a resident here named Ben Johnson," I scanned his temp sheet for vital stats. "He’s male, mongoloid, twenty-five years old…"

  Twenty-five years old? I’d had intimate contact with a guy who was seven years older than me?

  I shook my head and continued. "…twenty-five years old. His temp has been rising steadily all day. It’s now 101.8. Rectally."

  "Okay," Holbrook said.

  I waited for him to continue.

  He didn’t.

  "Well," I said, finally. "Should we do anything for him? We’re supposed to call the hospital if a resident’s temperature goes over 101 degrees."

  "Yes, indeed," Holbrook said. "Just keep an eye on the kid. Give him plenty of fluids. I'll let them know that you called."

  "You mean the doctor isn't going to come over and look at him?" I asked, amazed.

  "You think the doctor is going to troop all the way over to Foster just to check a kid with a cold?" Holbrook said, annoyed. "You are new.”

  Chapter 6

  A hand-written note pinned to a pile of new clothes on a shelf in the office of Foster 2:

  Attention, afternoon shift:

  These are Clyde and Byron Jorgenson's new birthday outfits. Their parents specifically requested that the boys wear these clothes to the dance tonight. Please sew name tags in before shower time.

  Thank you, G. Petersen

  I sat at the desk, idly flipping through the day book, reading random entries, trying to get a feeling for what was and wasn’t normal on Foster Second.

  All I'd been able to glean was that a certain R. Moore specialized in misbehavior and was frequently put in the side room, whatever that was.

  I glanced around the day room, trying to spot the troublemaker. I discounted the rocking boy and the one with his hand in his pants because both seemed too self-involved to cause a ruckus. Everyone else was quiet and calm. Mumbled mentions of New Mom had faded in favor of afternoon cartoons, which most of the boys watched as if hypnotized.

  I sat alone at the desk and allowed myself a moment of totally unearned self -congratulation. I felt adult and in-charge for the first time that day.

  "Damn," Sharon said from inside the office.

  I peeked in carefully.

  She held out two identical piles of clothes. “Ca
n you believe this?”

  "Clothes?" I asked, not sure how to react.

  "New clothes," she said, disgusted. “New clothes for the Jorgensen brothers, that just happen to need tags sewn on before supper.”

  "You have kids from the same family here together?" I tried to imagine having not one, but two institutionalized, retarded children.

  "Worse than that, they're identical twins."

  “Good lord, how do you tell them apart?"

  "Their parents made sure that wouldn't be a problem," Sharon said, still irritated.

  "I can sew," I said, hoping that would help her mood. There was a length of cotton twill tape pinned to each pile. One was stamped B. Jorgenson Foster 2 several times in black ink. The other tape said C. Jorgenson Foster 2 over and over.

  "Would you?" Sharon asked. Her relief was obvious. "It's almost time to hand out meds, and John’ll start showers pretty soon. I'll never get these done by myself."

  I was happy to have an assignment that did not involve thermometers and Vaseline. Sharon busied herself with small tasks. Sighing softly, she sat a metal pitcher filled with water and a stack of small white paper cups on the desk and returned to the office, though she still managed to keep an eagle eye on the day room.

  She warned Bobby, the one who’d stuck his head in the office earlier, not to hang around the desk. He smiled and retreated a few feet, pretending to look in any direction but ours.

  "Keep an eye on the scissors," she said to me from the office. "He's a pack rat."

  I slid them into the top desk drawer for safety.

  Sharon reemerged carrying the medicine tray. "Can you take a minute and pour water for me?" she asked.

  I nodded, and put the pin cushion and thread into the drawer with the scissors.

  "Meds!" Sharon shouted. Her voice carried amazingly well in the large, open room.