Natalie

I step into the hallway, heading toward the nursing station, and spot Renee. Great! Exactly what I needed to start the shift, as if Lauren’s little dig earlier wasn’t already enough. Ignoring her, I walk straight ahead.

In the med room, Jaime sits stiffly, her brows pulled together and jaw tight. It’s obvious she’s had enough of Gerald’s lecture. I manage a smile, the kind that sneaks in after I’ve gone against someone, with a touch of guilt, even if they earned it. “Good evening.”

She goes straight to the report without even looking up. “Not much happened today. Marcy’s on antibiotics for cellulitis in her left leg. Owen and Brian are both on post-fall. Dorothy was hitting staff during care, so I’ve initiated behaviour tracking.”

“Alright,” I say, diving into the narcotic count. When I’m done, I let out a quiet breath. “No mistakes tonight. Must be a record.” I meant it as a jab, hoping she’d fire back so I could bring up her old slip-ups. But she doesn’t respond. She grabs her bag and heads out without a word.

With a sigh, I sink into the chair and check the roster. Ashley and Trey are working tonight. No call-ins. A few weeks ago, that would have been a big relief, but not now. Things run way better when the two full-timers are here, no doubt. However, ever since I complained to Gerald about their low work ethic, and he spoke to them, there has been some tension. It’s not how things used to be. Luckily, the PSWs work eight-hour shifts while the nurses work twelve, so they won’t be here until ten.

By seven-thirty, I start my rounds with the night medications. The shift moves quickly as I handle complaints, check on residents, and distribute medications. And before I know it, it’s ten o’clock, and Ashley and Trey appear.

We chat for a bit before going over the report. In between, Ashley gives me a once-over and says I’m not looking my best. I brush it off, blaming period pain for how rough I look, but I can still catch the doubt in her eyes as she leaves to start tasks with Trey. I then settle into my usual night routine. I make my rounds, checking that all the doors are locked, the air and water temperatures are within the normal range, the kitchen appliances are working correctly, and the laundry machines are turned off.

Next, I begin to check on the residents. I give Agnes in Room 5 her scheduled pain medication. I check in on Owen in Room 23 and Brian in Room 7, both of whom are on post-fall monitoring. I also check on Jane in Room 2 and monitor her oxygen levels since she’s on oxygen.

Once that’s done, I sit down to get some charting out of the way. With no nurse practitioner or doctor in today, there are no new orders to handle. It’s a quiet night, which doesn’t happen all that often. As long as no one falls, gets sick, or worse, passes away suddenly, things usually stay calm.

By midnight, most of my work is done. I’ve still got a couple of assessments and two RAI-MDS left to do. RAI-MDS is the quarterly assessment we complete for all our residents. It’s long, repetitive, and completely draining. It typically takes one to two hours to finish just one, and honestly, I’ve yet to meet a nurse who enjoys it. It requires full focus, and tonight, I’m not there. I decide to leave it for another shift and take a bit of downtime.

I pull out my phone, and almost as if she’d been waiting for it, Ashley walks by and gives me a look. “Oh wow,” she says, eyes on my phone. Since I’ve been nagging them about phone use at work, this feels a bit ironic. I feel a little embarrassed but play it cool. “All good?”

“Looks like someone finished their work early,” she says, glancing back and forth between my phone and my face like she’s letting me know she noticed. She seems surprised, which makes sense – it’s not something I usually do outside of break. “Having a quiet night?” As soon as the words leave her mouth, she covers her mouth with her hand, as if they slipped out by accident.

There’s an unspoken rule in health care. You never say it’s a quiet night. The moment you do, something shifts, and the whole night can go sideways fast.

I shoot Ashley a look that says What have you done now? Then I ask, “Don’t you have something to do?”

She grins. “I do. I’m heading to Iris’s room. She needs a bedpan.” With that, she turns and walks away.

The night crawls by, slow and unbearable, like time is mocking me. My eyes are getting heavy, so I decide to focus on my assessments. I log in and start typing, but I’m not really paying attention. My mind keeps wandering to the stalker, to Bethany and Mason, and to Lauren’s unexpected remark.

I never thought Lauren would speak to me like that. She was upset when she first found out about Mason and me, which is understandable, and then she ignored me for a few days. But eventually, she came to me and confessed that she realized they were never right for each other. She even said she felt relieved that he was no longer her boyfriend, that she didn’t have to worry anymore about what people thought.

Now, I’m starting to doubt how honest she was. It seems like she’s holding something back or still carrying some resentment.

My thoughts spiral, and restlessness builds in my chest. I shift in my chair, folding and unfolding my legs. I can’t focus, and without that focus, nothing’s getting done. Unlike Jaime, I can’t afford to mess up.

I sign out and glance at the clock. It’s twelve-thirty.

I need a coffee to shake off this fog. In the staff room, I make a strong cup and sink into a chair, cupping the mug in both hands. The heat settles into my fingers. I lift it to my lips and take a small sip. Before it even reaches my throat, the door swings open.

Ashley stands in the doorway, pale and breathless. Usually, I’d assume it’s another pointless interruption to mess with my break like every other day, but something about today feels different. Even before she speaks, I know something bad has happened.

“Brian’s on the floor. Looks like he fractured his hip,” she says.

I glare at her. “What else did you expect?” I ask, thinking back to her earlier comment about having a quiet night. She really had to say it, didn’t she?

“I am sorry,” she says, and her face shows she means it.

“Of all the residents… why did it have to be Brian?” I mutter under my breath.

The truth is, the idea of dealing with Renee stresses me out more than Brian’s injury. That probably makes me sound heartless, but I’ve been in this field long enough to know it’s not uncommon to feel this way. Over time, your patience thins. You get tired. Sometimes, when a resident falls and gets hurt, instead of feeling compassionate, you feel frustrated. You wonder why they couldn’t stay in bed and sleep like they were supposed to.

I dump my coffee in the sink and toss the cup in the trash. “I’ll be there in a minute.”

Ashley nods and hurries off. I grab the blood pressure cuff from the nursing station and follow her to Room 7. Inside, Brian is lying on the floor a few feet away from his bed, groaning. Trey is trying to slide a pillow under his head while Ashley does her best to support his leg. I glance down, lifting his gown. His right hip is turned outward and swollen. One look is all it takes – it’s fractured.

“Do not touch him,” I say, stepping in.

I crouch beside him. “What happened, Brian? How did you fall?”

He glares at me like I’m the one who pushed him off the bed. Then, all of a sudden, he starts shouting, “Ouch! Ouch! Ouch!”

“Was the bed alarm ringing?” I ask Ashley.

“It was. That’s how we found him.”

“How did he fall all the way over here?” I ask, eyeing the foam mat beside the bed on the floor. Usually, when someone falls, they land on the mat – it’s meant to prevent injury. I’m not sure how he ended up this far from the bed. “Did you guys move him?”

“No,” Trey replies. “He was found right here.”

“Were the wedges in place?” I glance at the foam positioning wedges still tucked under the bedsheet. They’re supposed to keep him from rolling out.

“They were. Seems like he fell right over them.”

“Seriously?” I narrow my eyes. “When did you see him last?”

“A few minutes ago,” she says. “When I went to give Iris the bedpan, I peeked in. He was sleeping then.”

I don’t believe half the things they say. They always tell me exactly what I need to hear, as if to prove they did everything right. God only knows how much of it is true.

“I’ll call an ambulance. Stay with him,” I say as I hurry out.

First, I dial 911. Then I call Renee to let her know Brian is being sent to the hospital. Thankfully, it goes to voicemail, and I leave a short message. It feels like my prayer has been answered. I did not have the patience to deal with her tonight.

The ambulance arrives within twenty minutes. And Brian is taken out.

By 1.15, I finally sit down to start charting. There is always so much to write after a fall. It is strange how little time we spend with the resident in the moment, compared to how long we spend documenting the incident afterward. I once timed it. I spent seven minutes with the resident, who had a fall without an injury, and twenty minutes writing everything down. If there had been an injury, the time would’ve easily doubled. That is how it works. We need to document every little thing to protect ourselves.

Ashley and Trey are talking loudly beside me. I shush them. “I’m trying to concentrate.”

It is already past time for rounds, but they are taking a short break. The last half hour has been chaos. Brian was screaming with pain and woke up a few residents. The ambulance took longer to arrive than I expected. I tried calling the on-call doctor for an injection order, but he didn’t pick up. I ended up giving him Tylenol, the only option I had, but it didn’t help. He could speak at first, but then it got worse. He could only mumble through the pain, panicked, pointing at nothing. We are all drained after trying to calm him down and manage the small group of residents who gathered outside his room, confused and worried.

Ashley brings over some tea. They keep chatting while I type, mostly listening but tossing in a comment here and there. The conversation keeps circling back to Renee and how she will react. She is already mad at the night staff, especially since most of Brian’s falls happen during our shift. We’re surprisingly united when it comes to Renee.

Then my phone rings. I glance at the screen and groan. “Oh… it is Renee.”

I answer.

“I got your message. What happened to Brian?” she demands, nearly yelling.

I explain, already knowing she will not get it. And, of course, I am right. She does not. Instead, she lectures me on how to do my job. I put her on speaker so Trey and Ashley can hear.

Then she drops the threat. “This is the kind of thing the ministry should be called about. You guys failed to keep a resident safe.”

That is when I lose my patience.

“This is a critical incident, so I will give the ministry a call. Feel free to do that as well. I’ve got to get going. I have other things to do.” I hang up before she can say another word.

Trey grins and shakes my hand. “Good for you. You do not need to listen to her.”

“She was not always like that,” I say. “Brian could still walk when he first came in. He had some dementia and was not safe at home. He ended up making a bunch of girlfriends here. Bit of a pervert, honestly. That is what changed her.”

“He still is,” Ashley says. “The flirting when we clean him is so uncomfortable. That is why I let Trey handle him.”

“Oh, he’s good with me,” Trey says.

“That’s because you’re a man,” Ashley teases. “He’s such a jerk around the women. He even made advances on a few residents.”

“Really?” Trey raises his eyebrows. “Would you allow it here?”

“As long as it’s consensual and both parties are cognitively sound, all we can do is provide them privacy,” I explain. “He started approaching non-cognitive residents, and that’s how he ended up on all those meds and eventually in a wheelchair. Of course, the increase in falls contributed to his slow decline in overall functioning.”

“Renee has changed a lot since then. She knew exactly what was going on here. She has messengers inside the building reporting everything that’s going on,” says Ashley.

I glance at the clock. “It’s around 2,” I remind them. “You guys better start your rounds. It’s getting late.”

“Oh well, let’s start,” Trey says, reluctantly standing up.

Ashley stretches her arms. “I wish it was 6.”

“Four more hours to go,” says Trey, as they walk away.

As they enter the first room, I refocus my attention entirely on the charting. But almost instantly, Ashley comes running back.

“Frances isn’t breathing!” she yells.

“What?” I jump up, startled.

“She’s dead,” Ashley says, hands on her head.

“Are you out of your mind?” I ask, already running toward Room 1.

I knew it. I knew it. The moment someone says, 'It’s a quiet night,' you know everything’s about to change.