we lost a baby today

mother/babyRN, RN · Mar 4, 2002

What if? Such a question for answers that never come...Still, it helps me to remember the people God put me in the path to assist...Each patient has a story and teaches a lesson....

Angel Baby · Mar 21, 2002

If you ever get to the point where a demise or neonatal loss doesn't touch you--it's time to get out of OB nursing.

Patients intuitively feel and know more than we say and the greatest gift you can give to a family enduring this kind of loss is your compassion.

This may be hard to believe, but your care can be a positive influence for this family during their most difficult time. They will remember that you were there, that you cared, and even if you cried with them. This doesn't make you weak--it makes you a caring human being--not someone insensitive to their needs and feelings.

I understand what you're going through. I had an elective induction on Christmas Eve. The family had a 3 year old son (normal lady partsl delivery) and a doula. It was a struggle to keep the baby on the monitor, but the kid was healthy and looked great. The Dad wanted the Mom to be allowed to walk, bounce on the birthing ball and generally hang from the ceiling at will. He and I were not getting along very well--I tried to give as much freedom as I could and had regular lapses in monitoring (I would sit next to the Mom as she bounced on the birthing ball and try to keep the baby on the monitor--didn't work).

Several hours into her induction she got on the ball again and I couldn't track heart tones. She complained of this contraction that just wouldn't stop and her fundus was soft. I convinced her to get back into the bed--couldn't find heart tones. Uterine rupture, stat C/S and a brain dead neonate taken off life support 2 days after Christmas. We almost lost the Mom. The rupture was fundal and spanned the physician's whole hand--pinkie to thumb. Placenta was fundal so we had a complete abruption, as well.

I will carry that baby in my heart as long as I live--I had never had a perfectly healthy baby die in front of me. The husband blamed me--hospital settled. Who knows if the 5 minutes we searched for FHT's and attempted to place FSE with the doc en route would have made a difference--maybe seeing the deceleration would have gotten us to the OR quicker--I'll never know. I failed that innocent child. I thought I was doing my best in trying to give the family some of what they wanted--the doula accused me of trying to rob the patient of her birth memory by insisting on doing things my way.

I almost left nursing all together, but trust me, you can come back. I still love laboring patients, enjoy the challenge and the privilege of being part of their experience. It took me a year to let a patient back on a birthing ball, though. I decided that I would not let this experience ruin all that is good about what I do. Nurses who stay in OB are committed (or need to be committed--hehe) to the cause and have a passion for the game.

I'll never forget that experience and it aged me about 10 years but it's not what I have to do EVERY SINGLE DAY--I don't even know if I learned anything valuable from that experience. I do know that I never take a healthy newborn for granted anymore.

CATHYW · Mar 21, 2002

Such sad news! No matter the age, or day of the year, there is never a good time for death, especially the sudden ones. The folks who have terminal illnesses are finally at rest, but the loss still tears at the families.

One of my most tragic deaths occurred before the infant got to the ER. Her parents were retarded, and when she cried, put the baby in bed with them. She was 2-3 mos old, and in the night, one of them rolled over onto the child and suffocated her. In this state, all deceased persons (except hospice) must go to an ER to be pronounced. She came to my ER, and was my "patient." The parents and grandparents were stunned, almost zombie-like. While they were visiting the baby in the main trauma room, we received a call that a code was enroute. We had no time to take the baby to the morgue, so we put hre in our "Moses basket" that was used specifically for that purpose, for babies, and put her in the cast room. The code on the older lady was unsuccessful, and as we were winding that up, we got a call that ANOTHER code was enroute, and would need the same room. I took the lady, on her stretcher, to the cast room, and put the baby in the basket next to her, on her stretcher. Somehow, I felt that the baby was safer with the older lady. Call me crazy, but that is the way I felt. We lost the next code too, but things finally settled down some, and a transporter became available. He took the baby to the morgue with the "grandma lady", on the stretcher. He thought it was somehow appropriate, too.

shay · Mar 21, 2002

Wow, Cathy...that's really sweet. I like that.

nograd · Mar 22, 2002

Cathy,

You brought tears to my eyes, it's both beautiful and tragic.

Sable's mom · Mar 22, 2002

Cindy,

You and all involved will remain in my thoughts and prayers. I still remember my first fetal demise - 1978 - and carry that child with me forever.

If your hospital is not part of the RTS (Resolve thru sharing) network, now would be a great time to start it. I'll private message you with the name of our RTS coordinator(I'm in the UP, too.)

Hope this helps.

Linda

mother/babyRN, RN · Mar 23, 2002

I haven't visited this post for awhile, but it still moves me greatly...I wasn't on recently when this happened, but within the last few weeks, someone with no prenatal care (no money, she said), arrived in labor. Initial fh was in the 60s. They had the iv, o2 and positioning going on within 5 minutes of her arrival...The hr recovered ( who knows how long it had been down) and she was found to be nearly fully ,was ruptured for thick mec and everything happened so quickly she even had a cold amnioinfusion....Within an hour of her arrival she was in the or but the outcome was not successful.....Hurts every single time, doesn't it? Whether you are there or not..When I was in cardiac nursing, more than once I would be talking to a patient with a septal rupture, when both of us knew there was no hope and STILL with a regular NSR on the monitor, knowing the only outcome was terminal, just glad to be able to be there..As a new grad, I had a patient who dehiced and was found to have a pancreatic tumor..The thing was to attempt to keep him as calm as possible as I continued, to no avail, to try and control the bleeding with pack after pack of kling...He also knew he was going to die, and held my hand while we both silently cried throughout...He took my hand and told me if I never learned anything else, the patient would let me know, either by telling me or via silent communication, whether he or she desired small talk, large talk ( the real deal, as he put it), or no talk....I think that is so very true.....I wonder if I ever had an opportunity to talk either with Sylvia Browne or John Edwards, if any of my thousands of patients would be somewhere up there looking after me....:) I hope so....

Charisse · Apr 17, 2002

A little more than a year ago, I lost my first baby--after working as a nurse since 1985. This is the first time I have ever put it into words. Mom was a tiny, anorexic woman--less than 5' and pre-pregnant weight of 80 lbs! She seemed ok, but I was warned at report that her mother was asking strange questions about our lab work and if one of them was for hepatitis. I thought little of it at the time. Mom was being induced and was proceeding ok during the morning hours. She was AROM'd at 0700 that day--clr fluid. Mid morning, lab tells me I need to redraw her HIV. This means only one thing--prelim labs found her to be HIV+. Her mother started asking more unusual questions about the lab I was drawing--like "Is that another hepatitis that you are taking? or HIV?" Her baby kept me on my toes from the moment mom started to push. Her baby became tachycardic with variable/late decels. Baby continued like this till we went to the OR. On the way to the OR, mom tells her husband, "You know if there is anything wrong with my baby, that it is my fault." Fetal HR was tachy but regular, without decels in the OR. When the baby delivered, it was like a dishrag.....Resus efforts did no good. It was the first time I had ever lost a baby. The pts husband was at the head of the OR table, along with her mother, but no one had told them a thing. 20 minutes after the code was called, the doc came to talk to them. Meanwhile, I am standing there, knowing the outcome, but cannot do or say anything. I just want to hug them..hold them...talk to them... We had bonded so strongly during the labor and I cannot tell them a thing yet. For another 45 minutes, the pt and I are alone in the COLD OR....no one relieving me (change of shift was 40 mins earlier)...no one checking to see how we were doing (she was still asleep). I tried to talk to the doc and he just turned away from me. When the father and g'mother finally were told, I talked to them, held them, cried with them. I promised to stay till my pt woke up from anesthesia, which was 2 hours or so later (which I did..I sat on the floor next to her bed, held her and cried with her, said a prayer with her). She started saying she killed her baby.....

As the days continued after the delivery, it turns out that mom was not only definitely HIV+, but she has full-blown AIDS! The baby died from chorio..the pathologist said it was the worst case of chorio he had ever seen and that the baby could never have lived through it!

I didn't know what the "protocol" was for this kind of situation. This was new for me. I needed to ask my manager questions, like.....will I need to take off a few days to get myself together? and other such questions. My manager, even though she was told repeatedly that I needed to talk to her afterwards, never came to see how I was doing. I even called the next day and left messages to no avail. Now, I have been in the midst of other crises over my career and ALWAYS the docs sat down with all of us affected nurses and discussed with us what happened...how it could have been prevented, are you all ok, etc....The docs were never ok until we nurses were ok. Nothing at all like this happened to me after this delivery.I was treated like a pariah. Till this moment, I was one of the favored nurses. All the docs loved me. I had nothing at all in my records that was negative. When I came back to work right after this happened on my next scheduled day, I thought I felt a change in the docs, but my co-workers told me that all was ok. Sure.......Needless to say, 2 week's later, I was called into my manager's office (this is the first time she has talked to me about this incident) and basically was told that the same docs who loved me and praised me didn't want me around any more. They wanted me gone right after the incident. The conversation got worse from here, but I was told to seek a job near where I live since none of the same docs worked here...that I would have trouble from them if I worked where they did. I was told that I would always get a good recommendation from her, that she had no complaints but that I was basically a persona non grata there now. I could take a hint, for sure. During subsequent phone calls, before my resignation, my manager told me I was the docs' scape goat. They needed someone to be their scape goat for this situation and it was me! I have never seen this before, but I have had older nurses tell me over the years that it does happen. I just never thought it would be me. Never in all of my years.

I have decided, for the time being, not to return to my love...delivering babies...I cannot deal with these politics, this BS...I cannot deal with docs telling me to my face that they love me and trust me, and then run to my manager and tell her something else...I know you never can trust some people all the time, but there is an essential, basic trust that has to occur between colleagues for a team to work well together. I was found blameless in this situation and yet......I was their scape goat.

SmilingBluEyes · Apr 17, 2002

Wow, I am touched, horrified and angered by your post. I am so sorry for the treatment you received from your coworkers, managers and doctors. Did they ever give you CONCRETE reasons WHY this happened to you? From your account, it sure seems to me you did EVERYthing right and I would love to have a nurse like you at my side during a loss. There are no words....except I am sorry. :-(

Charisse · Apr 17, 2002

Debbie,

Thank you for the kind words. I do appreciate them a lot. Let's just say that I am, more so than ever, a proponent for unionizing nurses. Unfortunately, there is no union for nurses in Texas. Of course, this incident went to peer review and I was found to be without blame in the death of this infant. Someone on the committee asked me why I resigned. I asked her if she wanted the truth (my manager was there). I was told yes and I told them that I was told it would be in my best interest to leave and not seek work in that immediate area. There was a gasp you could hear across the room from almost everyone there. Of course, my manager lied and said she never said that (we had 2 witnesses who heard what she said--and they said similar things to me, such as "Money speaks, Char..."--so if I wanted to go to court and they didn't want to perjure themselves, they would have to agree with me) and that she was sorry that that was what I "thought" I had heard. At that point, I wanted to run out of the room. I was flabbergasted. Here the woman who touted herself as a nurse advocate (she used to be in the beginning, but I don't know what happened along the way) was lying about what she said. I paused for a bit to collect myself, lowered and controlled my voice and looked directly at her eyes and said, "And I am so very sorry you cannot find it in yourself to tell the truth right now. You and I both knew what was said." For a while I considered going to the Ethics Committee and turning in a case of retaliation...I didn't because I didn't know if I really had a case (the hospital has a "no retaliatory" clause in its ethics statement).

Personally, I was told by the people who assisted and scrubbed in on this delivery that there was something that occurred to the baby at the moment the doctor was delivering it that might have caused or added to its demise. I didn't see it, but everyone else who attended all came to me separately to tell me what they experienced. A few minutes before I was called into my supervisor's office, the chief OB took me into a room and asked me if I thought the attending doc, his partner!, took too long and was there anything outstanding about the delivery that he ought to know. THINKING that I had this wonderful relationship with this doc, I told him the truth. He then went to my manager's office...and then I was called into her office after he left. Personally, I think the they were scared that someone would talk and implicate the attending. Like I said, I was told that they needed a scape goat and it was me!

I pray on a daily basis that I can get my love for my profession back. This isn't burnout. To me, this is more like a death of a loved one or a divorce. I wish I could deliver babies again. This hurt me to the core of who and what I am. Like I said, I have been a nurse since 1985 in perinatal care, but I have been in the "field" even longer. I was a childbirth instructor since 1979, too. Assisting women in birth is..or was...what I was all about.

And now it is gone......

Again, Debbie, thanks for the sweet words. They made me smile amongst the tears...

Char.....

Angel Baby · Apr 18, 2002

I am so very sorry that your heart is hurting--I wish I could say I didn't believe what you are saying, but I've seen physicians blatantly lie and cause the nurse to take the liability (and fall) in situations.

There's no reasonable explanation of why things have to be this way............fact is you've had a double whammy. It's hard enough to watch a baby die in front of you, but to be shut out when you needed their support and encouragement, is a travesty.

I hope you can heal to the point of returning to your passion. There are so many people that you have touched and left your unique impression on. You may never know how much of a positive effect you have had on so many women, but the true loss would be to deny so many more this same caring, competent touch.

OB nurses are sisters--and we need you in the sisterhood. We need to keep competent, empathetic patient advocates who have a passion for what they do--I'll be a shoulder for you anytime you need it!!!!!

Charisse · Apr 18, 2002

Renee,

Thanks for your kind words, too. I guess part of the reason I wrote this here is for a reality check. I sit here sometimes thinking....ok..something just wasn't kosher back then. I try to make sense of it all and it doesn't make sense. I appreciate

your input here and helping me by listening to me.

As I wrote elsewhere, I just wish this situation was the only thing now that was keeping me from the field I love so much. Given I am much healthier now than when I was working, I now also know for sure that I have a latex allergy. Kinda of seals my fate, doesn't it? And to think that I had planned on becoming a nurse-midwife, too. My sweet hubby, after I left the hospital, offered to put me through midwifery school and I sadly had to tell him that the allergy would still be there.

Char.......