Senior Nurse Mentor

Girls in Sunny Italy

On Hem-Onc, my First Fear had been that pain would cause little children to withdraw and be afraid of me. On the teen unit, my First Fear was linked to embarrassment. I’ve already given the boy’s side. This chapter is about the girls.

I did have one stroke of good fortune. Unlike teen boys, I wasn’t new to caring for teen girls. When I’d worked on Hem-Onc, we had occasional overflows from the teen unit. All were girls, probably the result of a rule that sent girls to the medical unit and boys to the surgical unit one floor up. Usually, it’d be a girl who’d be with us for but one night. Only Christy, who was dying of a brain tumor, was an exception. You can read about her in both My Nights with Leukemia and Hospital Gowns and Other Embarrassments.

Newly employed and working on Hem-Onc, at first I treated these teen girls like children, since that was all I knew. But then a situation arose—the Maria I write about in Hospital Gowns—when it penetrated my thick skull that I shouldn’t treat a fourteen-year-old girl like a four-year-old boy. From that point on, I wrestled with what to do. On nights—unlike days—I had time to think. I learned with each new girl, and was surprised at how different they could be. 

As time went on, I began to realize that embarrassment didn’t just involve teens. The older kids I cared for also had issues. Chemotherapy means fast IVs and constant potty calls. For younger ones my work was an endless series of diaper changes, bedpans and urinals to spare tired parents a middle-of-the-night wakeup. If I hadn’t known how important fluid monitoring was for our critically ill children, I would have hated it as mere busy work. I wanted my work to matter.

But from about seven years and up, my patients began to show modesty. When I went into a child’s room, I’d often find a filled bedpan or urinal waiting for me. These kids were awaking their parents for that. My hunch is that it wasn’t sexual—it happened with both boys and girls—but was a part of growing up. They were acting more like adults.

On the teen unit, calling for mommy or daddy wasn’t usually an option. Most patients were in four-patient rooms that had little space for more than brief visits by parents. Fortunately, most of our patients could get to the room’s tiny toilet for themselves. They didn’t need me.

Now we turn to the third group of patients on the teen unit—those girls. On a typical day, I cared for four boys and four girls, each in multi-bed rooms, along with two or three patients in private rooms. I’d usually stay with that group until my two-day break came and then return to a different cluster.

One part of that work made my head spin. Leaving boys’ room for the girls’ was like traveling between two different countries. If you think of the boys as living in a glum northern country where the sun never shines, then the girls lived in sunny Italy.

When it came to dress, the girls were as relaxed as the boys were uptight. Going into their room was like visiting a slumber party. Sheets were kicked down and gowns were never tucked in. Climate control at the hospital wasn’t perfect. Hem-Onc, extending out in a long wing by itself, tended to get cold on winter nights. I often had to get an extra blanket for sleeping children. In summer, the teen unit tended to get too hot during the day. Even a sheet could be too much in the afternoon.

The casualness of the girls created issues. Often, the nurse or I had to catch a girl about to go into the hall and pin up the back of her gown, lest she flash her undies as she walked about. That never happened with boys—never.

In short, most of these girls were as casual about their dress as the boys were uptight. To understand why, simply flip what had the boys upset. Having all female caretakers soothed the girls for much the same reason it alarmed the boys.

Now you know what my primary First Fear was. Those girls, I told myself, were casual because their caregivers had all been women. Now that wasn’t true. I had arrived, manly beard and all. Would my guyish presence change their mood? Would they become as glum and withdrawn as the boys? I hated day shift’s busy work, but felt it was compensated for by more opportunities to know my patients. Unfortunately, I wasn’t getting to know many of the boys. Would embarrassment mean the girls became distant too?