Sunday

Driving down Greenbelt Road very early Sunday morning, it is hard to believe that during the week this road is a busy main thoroughfare. Now it is empty and desolate and reminds me so poignantly of the back country roads of my childhood.

I am started out of my reverie by a dark blue Jaguar whizzing by my chugging and wheezy Vega. Despite our disparate lifestyles, I feel a kinship with the man behind the wheel. We are the only two cars on the road and I wonder what drives him out of his Sunday morning sleep.

The reasons for my early rising and bravery are varied and complex and they deal with the mundane world of economics. My kids keep growing out of their clothes and the demands for the necessities, such as a chicken in every mouth and a car in every garage, have taken precedence in my life.

After 20 years of marriage and motherhood, I have shouldered yet another responsibility, a job. My skills, aborted in mid-career by the birth of my first child, lie in the field of nursing. A registered nurse, I dusted off my medical volumes, and my mind, and proceeded to get involved for pay.

Like all underpaid and overworked professions, and I include the finest in this category, like police and firemen, nurses have to work weekends, holidays and nights. It takes a special person to do a special job but I sometimes wish the renumerative benefits were as satisfying as the psychological ones.

As I turn down the side road leading to the nursing home, my thoughts shift. Dawn perceived with different eyes by the geriatric patients, awakening to a silent world of pain and hopelessness, can bring despair. A twinge of guilt assails me. I am relatively young and relatively health. Is it all a matter of relativity?

The night shift, wan and tired, welcomes me with relief and a hurried report. Working nights is a long and painful ordeal that requires a traumatic shift in a human's diurnal pattern. I know. I worked nights for a year. I watch them pass hurriedly through the front door, pocket a heavy assortment of keys and simultaneously down my first upper of the day, a hot cup of aromatic coffee. The night's eerie silence is broken by the first buzzer of the day.

A woman who works has three full-time jobs and the ache and tiredness from one runs into the other. As I sigh and dig into the morning medications, I make another futile vow to get to bed earlier tonight. Monday

Monday downs dismal and rainy. The roads, slick, are busy with indifferent, irritable drivers. There were so many school clothes to wash and iron, I didn't get to bed until almost 1 a.m. When the alarm went off at 6 a.m., I turned over on my side and angrily shut it off for 10 more minutes of blessed sleep. When I finally did jump out of bed, I realized I was very late and very depressed. The kids, reluctant to get up, were cranky and needed 10 more minutes of my precious time to get moving. The night shift was cranky at my tardiness. The patients, sleepless and irritable, demand more of me than I can give.

Three care nurses have called in sick and I am short on all floors. It is late morning before we are finished with the breakfast trays. I have no time for a coffee break today because the ambulance team is wheeling a tiny wizened figure, bundled in blankets, down the hall.

"Good morning," a tiny voice squeaks. "Are you my nurse?"

When I assure her that I am, she grins and whispers, "Well, I have to go you know where to do what you know what."

Mary L., my admission, is 83 years old and with all her faculties intact. Bright, alert and talkative, Mary lived alone and managed her own life very well. Until one morning, addicted to physical exercise, she snapped her lumbar vertebra. After a short and therapeutic stay in the hospital, she was sent to us for a few more weeks of rehabilitative therapy. Tuesday

Henry T., once a mighty big and generous man, had an illness three years ago which left him paralyzed on the left side. For awhile his wife was able to manage his care at home but when his condition began to deteriorate, she found it necessary to seek help.

It was a difficult decision for her to make, committing a loved one to others.

Mr. T., meanwhile, feels betrayed and bereft, and his distress, transferred to his wife, aggravates her anxiety. His complaints, physically oriented but deried from emotional uneasiness, are many and varied, and he leans on his call bell. I sigh and admonish my staff, and myself, to be patient. Within a few weeks this emotional upheaval will subside and Mr. and Mrs. T. will settle into a satisfactory routine, realizing that this was the only intelligent decision they could have made. Wednesday

A day off during the week is not an unpleasant phenomenon. Getting up early, I send the kids off to school with a little more loving patience and rush through my cleaning chores, although the appellation "clean" does not apply anymore. I straighten and vacuum and dust but never wash windows or empty out closets. I simply have run out of time and energy.

Today, I have to go shopping. I rush through the aisles picking up socks and shirts, a new uniform for myself. I stop at Woodies for their special Wednesday lunch.

After lunch I go grocery shopping, return home and spend an hour putting all my purchases away. Then I indulge in my hobby, cooking, and soon a large pot of spaghetti sauce is bubbling on the stove, and a fudge ribbon cake is baking in the oven. The smells emanating from the kitchen permeate the house as I work on my latest unsold story.

When the kids clamor in after school, we are glad to see one another and we talk a long time, one after the other interrupting with their special news. These are the precious times and there are so few of them to savor anymore that I try to make the most of it. Even though they are in their teens and pre-teens, and welcome independence, I still feel twinges of guilt leaving them alone so much. Thursday

A patient died at 10 a.m. this morning and although she was one of the most frustrating patients to deal with, both clinically and psychologically, I deeply regret her death. A severe diabetic, she cheated on her diet with impunity, begging unsuspecting visitors to bring her chocolate cookies or candy, which she hid from me with sly ingenuity.

A protester since admissions, she complained about the food, her room, her noisy roommate and, above all, that damn nurse, me, who was always snooping around. Salty with her verbs, she was not above liberally spicing her conversation with four-letter words, hurling wild imprecations at us whenever we attempted to give her a shower.

However, the last few weeks, she grew lethargic, her condition deteriorating to a semi-comatose state. Despite our efforts, she died. Friday

Emmie had been with us for a long time and was nearing her 96th birthday when she went into cardiac fibrillation. Because we did not have the sophiticated equipment necessary, we sent her via amulance to the nearest hospital, where they acted heroically and saved her life. She had clinically died but was revived. Three weeks later she was returned to the nursing home more profoundly disorientated than when she had left.

Her son, who is 60 years old, came to see me today with tears in his eyes.

"What's the sense of letting her live like this? She's been senile for 20 years now but at least she was able to walk around and feed herself. This is no way to live. She's 96 years old. I'm 60. What's the purpose? My poor old father died at 80. He lived a long and good life and when his heart stopped, it just stopped. He died with dignity. I wish they let me die when I die."

Although he was distraught at the moment, his ideas were not new. We had often talked about his problem. Saturday.

Mrs. N.'s family is irate, especially her grandson, who has taken a healthy but superficial interest in geriatric nursing. When they come to visit, she is quiet and sleeps most of the time, and they feel, especially the grandson, that we are oversedating her.

We are sedating Mrs. N. but very carefully and very cautiously, for her own sake primarily, and for our sake secondarily. Because she was so severely agitated, she walked about after she climbed out of a protected bed and rebroke her hip. She broke one of my care nurses' nose and gve another a severe hematoma on her left breast. She has inflicted many other minor injuries on my staff. Hence the need for sedation. Sunday

The weekend dawns once more, and I succumb to the pleasure, because I am off, of sleeping later this morning that I usually do. I straighten up the week's debris, change beds and dust floors, grocery shop and finally sit down for an hour or more to read. I read voraciously, greedily. It is my one of my passionate vices.

This afternoon the family makes a short trip down to the city. It is the best time of the year to play tourist. The kids love to ride the Metro, have lunch on the Mall and throw around a few Frisbees. We never get tired of touring the Smithsonian and this afternoon we start on the Museum of Natural History. The main point is that we are together and therein lies the importance of our life.