Dame for a Day: Cassie Alexander

Dame Kaz

Hello, lovely readers! I’m so happy to be bringing you a fabulous guest post – not to mention a great giveaway (see below) – courtesy of the super talented Cassie Alexander. It’s been a while since I was here with a Dame for a Day, so I hope you’ll help me make Cassie feel at home.

She’s the author of NIGHTSHIFTED (a debut UF that was published to great reviews back in May 2012), which I have read and enjoyed. I love it when we get a new spin on urban fantasy! And the next book in the Edie Spence series, MOONSHIFTED, has just been published:

Not only is Cassie a registered nurse and a talented writer, she also has one of the coolest author pics I’ve seen. *sigh* I really need a new one… :)

Full Moon Nights
by Cassie Alexander

So it’s fitting that I’m writing this on the night of a full moon, seeing as Moonshifted revolves around werewolves. Full moons at the hospital are legendary. Even though they don’t really matter…it sure feels like they do. It seems like everyone goes crazy at the same time.

While I don’t directly put experiences I’ve had with patients into my books, I do use moods and bits and bobs here and there, to make everything seem more real. Here’s one of the stories that kind of got massaged into Moonshifted, in a couple of different ways.

Once upon a time, I was working a ton extra to make money to pay for my wedding. When I called in for an extra shift this time, they needed me in medical ICU.

Now, I’d floated there some before. I liked their set up very much – big rooms, good windows – not windows to the outside, but windows to the main nursing station, so people can hear you if you need to call for help.

When you’re the float nurse – you’re either getting the most stable patient on the floor, because they don’t trust you with anyone else – or the worst, in some other fashion. Not the most critical, but the worst. The person with TB in the negative air pressure room, or the demented person who’s trying to get out of bed, or the detoxing alcoholic who is going to ask you to “sleep with him” twelve times before the night is through.

One of my patients was a prisoner, in from the jail. I knew he hadn’t killed anyone, because there was only one cop sitting outside his door. (If they have two cops then you know they’ve murdered someone before.)

He was there because he had a GI bleed – he’d spent the night before shitting blood. And his family was local, so they’d come in to see him. Now, the patient was nice enough. But his son…..looked like Tom Savini, who you might remember as the character Sex Machine in From Dusk Till Dawn. The guy with the machine gun in his crotch.

The doctors are planning on doing an endoscopy on Sex Machine’s dad, to look inside and see what ulcers he has, what’s going on in there. Could it be stomach cancer? Yeah. Or could it be that jail is stressful? Probably. The doctors have already come in and explained their plan, and so we – the patient, me, and Sex Machine, we’re just waiting until go time. The cop is sitting somewhere outside.

So it’s just the three of us in there together when Sex Machine loses his mind.

“What’s the worst that could happen?” he asks me.

Not in a nervous relative nice way, or a give me some comfort way. His eyes are steel, and I know his dad’s done something to get locked away for a long time in a not nice place.

“Tell me. What’s the worst that could happen!”

“Let’s leave the room, sir –” the cop is outside. And I don’t want to have a worst case scenario conversation inside the room.

“What’s the worst that could happen!!!”

“I’ll talk to you outside –” All I can think is that the doctors really should have fucking covered this. But who knows, maybe they did, maybe this guy doesn’t listen. Maybe he’s not ever going to listen.


Well, the worst thing that could happen…is that his dad could die. I don’t want to tell him that though. Not in front of my patient. Not…when its Father’s day? Because yeah. It is. Father’s Day. And this lunatic is yelling at me full force in front of his dad, asking me to tell him that his dad might die.

Luckily, the cop outside – who was flirting with the respiratory tech – comes in. And I tell him to call security – because our campus security and the county cop outside are from different teams – and to get this guy out of there. Which, thankfully, they do. He calms down, but I still have him taken away, for his father’s stress level, and my general health.

Fast forward an hour. My patient seems nonplussed by things. I suspect his son gets kicked out of lots of places.

We’re in there while the procedure is going on. The doctor’s roto-rootering my patient with the endoscope, and I’m pushing fentanyl and versed, doing the conscious sedation part of things. Her eyes are on the computer screen giving her a camera’s eyes view of my patient’s stomach, all red and inflamed – and my eyes are on the monitor over his head, watching his progress.

I don’t know if you guys have heard of vasovagal syncopy before. If you remember the episodes of Scrubs where JD faints when he’s having a bowel movement – or you remember all those stories about Elvis dying on the toilet, you have. Your vagus nerve runs from high to low – and when it’s stimulated by, say, the bearing down that people do to poop, it can slow your heart rate dangerously low.

You know what else disturbs it? Sticking long tubes into people’s stomachs and then looking around.

I’m watching the monitor with the patient’s information on it, and suddenly his heart rate and oxygenation start to drop. The doctor’s watching the other screen, and she’s clipping ulcers as fast as she can find them, like she’s in a Japanese hospital video game from the 90’s.

“Doctor – he’s tanking.”

She glances over at the other screen.

Everything drops. His heart rate, his oxygenation, his blood pressure, everything goes.

Now – I was a new nurse then. At the time, I’d never been in a code. Chances are it wasn’t as dramatic as it felt – but it felt pretty effing dramatic at the time. His oxygen’s in the 70s and dropping. Nineties is normal. I’m grabbing the bag mask off the wall, so I can give the man straight O2 as soon as the doctor’s done – and telling her to hurry up. Now – now – now!

The doctor’s hauling the scope out of him like a magic trick and yelling for Narcan. Another nurse runs out to get it and comes back and hands it over to me.

I’d never given anyone Narcan before that night. I didn’t even know how to give it at the time. You don’t know how to give everything ever when you start off – you learn along the way, which is scary as hell.

“How fast, how strong?” I ask the people in the room, because his numbers aren’t coming back up – and by now we’ve got a growing just-in-case-this-goes-to-shit crowd. Any time you holler out for Narcan, people gather around.

“All of it, stat!” someone says.

So I do. I draw it up and slam it into his vein. And then start breathing for him with the mask, watching his numbers climb back up to normal levels – and pretty soon he revives.



Sex Machine isn’t going to wait in the parking lot to tear me limb from limb for killing his dad.

At that moment – it’s kind of hard to describe how I felt. Elated? I’d seen something bad happening, and I’d done what I was supposed to do to stop it, and now my patient was fine. He didn’t even remember what had happened to him – when I coyly asked him later in a way that made sure that it didn’t seem like I was actually asking, “Hey, do you remember that time that you almost died?”

At the end of it, I felt like I’d done some real nursing. That situation – and others like it – made me realize that I love my job, even all the crazy parts of it. And if you read Moonshifted, you can see how that experience (and forty others) inspired situations in the book, although they’ve been changed around to protect the innocent along the way. 😉

How would you like to win a copy of either NIGHTSHIFTED or MOONSHIFTED?

Cassie is offering TWO winners the chance to win the signed book of their choice – either the brand new release, or the first in the series to get yourself up to speed. Just leave a comment on this entry letting us know which book you’d prefer to win by 12pm EST on Monday, December 3rd. Kaz will randomly draw two winners from the virtual hat and announce the winners later that day. PLEASE NOTE: The giveaway is only open to US residents.

Get commenting… stat! 😉

More on Cassie:

Cassie Alexander is a registered nurse. Her debut novel, Nightshifted, came out from St. Martin’s Press in May, and its sequel Moonshifted is out this week. Book 3 in the Edie Spence series, SHAPESHIFTED, will be out in June 2013. Follow Cassie on Twitter.


  1. Michelle C. says

    I’ve got Nightshifted but haven’t read it yet, I think I need to start reading it soon. I’d love to win a copy of Moonshifted.

  2. Rebe says

    I’ve read Nightshifted as well and would love to read Moonshifted. I always wondered how nurses would deal with treating patients with unruly relatives. Sounds pretty scary!

  3. Sam Dailey says

    They sound amazing and I would love to jump into this series, so it makes the most sense to start at the beginning. I can’t wait to read Nightshifted.

  4. Sally Younger says

    I have not yet read any of your books writing come with praises from one of my most loved author Devon Monk.
    After reading reviews as well I now am looking for word to reading Nightshift.

  5. Lilly Savage says

    I would thoroughly love to start this series, and Nightshifted would be great!
    I adore Devon Monk, and am quite sure I will love your books too.


  6. Barbara Elness says

    I recently read Nightshifted and I thought it was a wonderful story with really great characters. I can’t wait to read Moonshifted, so that’s the book I’d love to win.

  7. Aleta Goin says

    I’m always on the lookout to discover new authors in a genre that I enjoy so much. I would love to try Nightshifted!

  8. Nikki Wyatt says

    I would love to get Nightshifted. I am always looking for new books and series to read! They sound awesome and can’t wait to read them!!!!!!

  9. says

    Please forgive me, BUT THAT WAS HILARIOUS!!! Hahahaha I’m a vet tech so I know animals are slightly different but boy can I relate! And the reference to Sex Machine has me laughing so hard I’m crying! Fantastic post today!! I’d love to win Nightshifted! I’ve been dying to read it! :)

  10. Cas says

    This series looks great! Thanks for the good slice-of-nursing-life, Mz. Alexander. I’d love to be entered for Nightshifted, please! Thanks for the giveaway!

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