Sunday, January 29, 2012

Losing My First Patient

*Disclaimer: this may be a sensitive subject for many readers*

So as many of you know, I've been a Neonatal Intensive Care Unit (NICU) nurse for a little over a year now.
And recently I lost my first patient.
Which is hard.
Because it's a little baby.
Only a few short hours in this world.
And it was hard for me.

I knew before the baby arrived that it was not going to make it.
So I had a little time to prepare myself.
But no amount of time REALLY prepares you.

When the baby arrived in the NICU, I buried myself in my work.
I took vital signs, helped start an IV, did everything the doctor and nurse practitioner told me.
I was doing ok, I was doing my job.
But then I looked up.
I looked into the eyes of the nurse practitioner and they were filled with tears.
"I just want to hold her, to rock her," she told me.
It was that moment that the severity of the situation hit me.
And it hit me like a train going 200 mph.
This baby wasn't going to make it.
And I felt myself fighting back tears from that moment on.

As the family began arriving, it got harder to deal.
Seeing their faces, watching tears slide down their cheeks.
Some of the family began praying, praying for a miracle.
My faith side of me wanted to hope with them, hope for a miracle.
But my medical side of me knew the severity, knew that we probably would not see a miracle.

Other nurses, the nurse practitioner, the doctor, they all kept asking me if I was ok.
Did I need a break, do I need some water, do I just need to get away for a minute?
I declined at first, I just needed to do what I could for this little baby.
I slipped my finger into the baby's hand and gently stroked her hand with my thumb.
She gave my finger a little squeeze, as if telling me, "Thank you".
Then, I knew I could no longer hold back the tears.
I asked another nurse to stand by as I slipped to the break room for a drink.
I fell back into some of the lockers as I chocked out a few tears.
I was doing everything I could, but I wasn't going to save this baby.

I came back, with tear stained cheeks, avoiding the eyes of the family.
Things were getting bad.
The baby's mom was still in recovery.
It was at that moment that I really started praying.
"God, please just let mom make it up here in time, let her see her baby, let her hold her little girl."

My prayers were answered as mom was wheeled up.
I carefully wrapped up her little girl and handed her to mom.
The respiratory therapist held the ventilator (breathing tube) tubing for so long.

After a while, it became inevitable that there was nothing more we could do.
Those parents had to make the hardest decision any parent would have to make.
They had to make the decision to remove life support from their little baby.
I stopped the IV fluids, gave the last dose of pain medication, and the respiratory therapist removed the breathing tube.

Mom was able to hold her little baby girl until she slipped into Heaven.
The doctor listened for a heart beat a little while later.
I saw him look at the nurse practitioner and then the clock and I knew.
Tears poured from so many eyes at that moment.

I stood to the side until mom was finished holding her baby.
As the family began slipping out, one lady looked me in the eyes with her hand on my shoulder.
"Thank you," she said. "I know you did everything you could. Thank you."
My voice caught and I was at a loss for words.
What does one say in this instant?
I'm sorry?
I wish I could have done more?
No words will ever be enough to express the pain I felt for this family.

I took the baby back from mom so she could get settled into her own room and we could do the things we needed to.
I cleaned the baby up, combed her hair, lathered her in lotion, and put a sweet dress and booties on her.
This part was so difficult for me.
I kept waiting for a sound, a movement, anything.
There were several moments were I would just stop and look intently, sure that I had seen breathing, but there was none.

Even though I knew the life had left this little baby, I still handled her as delicately as I could, probably more carefully than I would a still living baby.
I carefully swaddled her, placed her in a crib, and then delicately covered the crib with a blanket.
I slowly pushed the baby to the mom's room, as the doctor explained everything to her.
I left the family alone for as long as they wanted, to spend time holding their baby.

As I made my way back to the NICU and glanced into the room, I felt tears begin to resurface.
Blankets were strewn across the room.
IV and medication packaging was crumpled on the floor.
The half empty cups of water from the family were scattered around the room, the ice long ago melted.
It was so quiet.

I began grabbing things to place in the memory box for the family.
The blankets she had been wrapped in.
The baby wash and lotion and comb we had cleaned her with.
A clean diaper.
A lock of hair we had obtained.
The footprints and hand prints.
The disposable camera we had taken pictures with.

The family called me a while later, ready to let go now.
I brought the memory box to them.
I reached to take the little girl from mom and place her in the crib.
"Come see," I said to the baby, the words catching in my throat.
That's what I say when I pick up all of the babies I take care of.

I gently placed her in the crib and left to bring her back to the NICU.
A family member stopped me.
"Thank you. Thank you for everything you've done tonight."
I couldn't form any words so I simply nodded and slipped out of the room.

With the help of my wonderful coworkers, we finished our necessary things.
I just kept thinking, "She's so cold."
I wanted to hold her close, warm her body, though I knew I could not.

After everything was over, I was drained.
My job was technically finished, but that night will be in my memory forever.
I will never forget that sweet little angel's face.

15 comments:

Cori said...

Oh my goodness I am so sorry this happened. I can't imagine being on either side of this, parent or doctor. It has to be the hardest thing. My thoughts and prayers to you and that sweet baby girls family.

Shruti said...

I was stunned for a few moments after I read this, Courtney... It must have been so difficult for you... Sending hugs all the way from India! I will keep the little girls family and you in my prayers today...

Laura at Ms. Smartie Pants said...

Courtney, that family was blessed to have you. I thank your for what you do, you were an important part of her life!

Pedey @ Do You Smell That!!? said...

Such a beautiful recounting, Courtney. I could feel the love & reverence you felt for this little life & the family that had to let go. It breaks my heart to know that lives are lost so young. The family was blessed to share this sorrowful moment with you. (((HUGS)))

Gretchen said...

As a mom that has walked on both sides of this, I MUST tell you that it is those little things and the resepect and kindness of staff during these terrible times that means so much to us parents.

I lost my first daughter 13+ years ago, and I still remember the kindness of the nurses and staff. I still have her memory box, and I STILL have her blanket right next to my bed. I KNOW she is safe in heaven, but I still miss her!

Not 3 years latter I was right back in the NICU with my son who has Spina Bifida and was born 8 weeks early. He was good sized (a big ole 3 pounds!) and strong, but I COULD NOT leave that hospital without him! My daughter never came home from there, and I was TERRIFIED that if I left my son wouldn't either. The staff was SO understanding, creating a place for me to stay near him, even after I was discharged. He thankfully only hung out there for 14 days, but I still fell in love with the staff. So much so, when 3 years latter my second daughter was born, many of those nurses were the ones I hand picked to take care of my daughter (and yes, they let me do that!).

Your compassion and kindness means so much to the family in their time of unbelievable pain. Thank you for what you do! (oh nad if you want to see my "little guy" swing on by our blog sometime...)

Amanda said...

Oh poppit, as a parent who has had to leave 2 babies in the care of PICU nurses and doctors, I can't express enough what it means to read this. Whilst undoubtedly a horrendously sad occasion, knowing that there people like you who can step in and care for our babies when we are unable to do so is such a comfort.

At the time I was too wrapped up in my own grief and sadness to even consider how the nurses and doctors felt, if it wasn't for them I honestly don't know what we would have done.

From the nurse who took photos of my new born son to bring to me whilst I was in recovery, to those who taught me how to feed and administer meds, to the 'crazy nurse' who found a spare buggy to zoom around the corridors with my other son to lighten the mood, your all amazing and such a blessing to the lives you touch.

I'm so sorry you've had to deal with this, but thank you for choosing this most difficult of vocations.

Life, Crafts and Whatever said...

I have such a huge respect for NICU nurses. My Ava Grace was in the NICU for 66 days, she was born with gastroschisis. Our primary nurse was amazing, and I still keep in contact with her.

What makes you a great NICU nurse is because that precious little girl DID touch your heart. As a NICU mom, I want a NICU nurse who has emotion, and feelings, not a robot.

Thinking of that family today.

<3

Jesika said...

Aww Courtney, sorry for a tough day. There is a plan for her and her family and you did all you could even more by saying a prayer.

OrangeHeroMama said...

oh my gosh, this brought tears to my eyes. As a mom of a preemie(11 yrs ago!) i remember how intense it is in there.
You did an amazing thing! (((hugs)))

Christina said...

oh Courtney - my heart breaks over this story!! SO sad :(

Gayle said...

When you first chose to work in the NICU, I told you that I didn't want to know when you lost a baby because I didn't think I could handle it. Then you called your dad last week and I immediately knew from his tone of voice what happened and I HAD to talk to you, MY BABY. You didn't go into allot of details with me and I thought I handled the call really well. But today, I read this post and your words conveyed how deeply this affected you, and I just started bawling for my baby girl who has a pure, loving & selfless heart and I just want to pull you into my arms and rock away your pain (not that you'd ever let me - haha). My heart aches for you and at the same time swells with pride at what a wonderful, caring daughter you turned out to be. You are a blessing to us and to every family you meet. I am proud of you, my Baebug...
I love you,
Momma

Robinatter said...

='( u r an amazingly strong woman for being able to do what u do! all i could keep thinking was how very blessed i am for my healthly lil man. thank u for sharing this.

Mindy said...

Bless you for your tender heart and your love for families and babies. May it never cease to affect you because it means more celebration for those you can help.

Penny D said...

Courtney,

Thank you so much for what you do as a NICU nurse. On April 4, 2012, my baby boy - Baby Nate - went to be with Jesus. Baby Nate spent 4 weeks in the NICU. He was born at 32 weeks. I had great NICU nurses. What you do doesn't go unnoticed!

Grace, Peace, and Joy,

Penny

Penny D said...

Courtney,

Thank you so much for what you do as a NICU nurse. I had nurses in the NICU that cared as genuinely as you do. On April 4, 2012, I lost my baby boy - Baby Nate. He was 4 weeks old and born at 32 weeks. What you do does not go unnoticed!

Choosing Joy,

Penny D

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