Six Degrees of Separation: How Close Is Too Close?

1st practical transfusion method/otis archives3, via flickr

I stand in the fluorescent-lit hallway, waiting my turn at the window to pick up two units of blood from the blood bank. Ahead of me, a woman whose hair is swallowed up by a paper bouffant cap wears blue scrubs and hot pink Crocs on her feet. I assume she’s from OR, because of her garb. The blood bank is located in a staff only access area, and the hallway is narrow. Loitering, I feel the same awkwardness I feel standing on a sidewalk while waiting my turn at an ATM. What’s the socially acceptable separation between the person I’m waiting behind and myself? Too much, I block the hallway or the sidewalk for others. Not enough space, and I intrude on the interaction. How close is too close?

On my way back to the clinic, I carry the units of blood in a Playmate cooler marked “Biohazard.” I stand in another hallway waiting for an elevator. It’s flu season, so I hit the “up” button with my elbow to avoid getting virus on my hands. I look around first so visitors won’t see me do it. I don’t care if hospital staff watches. They understand. The elevator door opens, and I get in. After the doors close, the person standing next to me coughs as if expectorating a lung. This is too close.

Back in the clinic, I double-check the first unit of blood with another nurse. I am about to put the blood of a human being into the veins of another. If the match is wrong, it is not close enough, and the blood will harm its recipient. Too close is an abstraction, a meaningless idea in blood transfusion.

I remember placing my hand deep into the chest of a patient once, so close I could feel the heart beating against it. “This is life,” I thought to myself, “and I am as close as can be.”

Julianna Paradisi blogs at JParadisi RN; her artwork appeared on the cover of the October 2009 issue of AJN, and her essay, “The Wisdom of Nursery Rhymes,” was published in the February issue.