Gave my heart away again. (long)

Hellllllo Nurse, BSN, RN · Dec 5, 2006

((((((((Km5v6r)))))))

Makes me think of this poem-

Nothing Gold Can Stay

Nature's first green is gold,

Her hardest hue to hold.

Her early leaf's a flower;

But only so an hour.

Then leaf subsides to leaf.

So Eden sank to grief,

So dawn goes down to day.

Nothing gold can stay.

-- Robert Frost

2curlygirls · Dec 11, 2006

I'm so sorry. I have often wondered if I should switch from NICU to PICU. Your post makes it pretty clear to me I wouldn't have it in me. It's hard to lose a baby you've been taking care of, but when they can interact and smile (not many of our babies can), oy! You were truly an angel for this wee one. He was lucky to have a nurse like you.

DDRN4me · Dec 11, 2006

I did special needs pedi for 20 yrs..sorry to say that it doesnt get easier but you console yourself that you did your best to make the little guys time on earth better. I love to picture my kids in heaven running and laughing and playing...things they were unable to do here on this earth. Peace to you my friend you have learned what it is like to truly care . Mary

AliRae · Dec 18, 2006

We have a little man on our unit right now ... He spent the first 5 and a half months with us (new policy- cardiac newborns come to PICU instead of NICU), and we nursed him through 5 or so codes and near-misses. He's a twin, whose perfectly healthy brother is at home enjoying the full attention of his parents. The parents are virtually uninvolved with him, so we're his family. In September, he went to a rehab hospital to get ready to go home, and has spent the last couple months bouncing back and forth between there and our unit. When he's at the rehab hospital, I go and visit him and spend time with him, holding him and playing with him. When he's with us, I get assigned to him virtually every day I'm there. He's getting ready to go home sometime this week (home home!) and I'm stuck feeling like I'm sending him home with someone who's not really his mother. Attached? You could say so! I think, as long as you're not getting attached to all your kids that way, its okay. There are certain ones (like the little guy in your story, definitely!) who need extra love. If we, as nurses aren't going to provide it, who will? I take flak sometimes for being so involved in this little guy's life ... one of the nurses is threatening to buy the "Are You My Mommy?" book for the two of us. But, at the end of the day, that's why we do what we do. Because, in the little ways, every day, we're here to make things better for our patients.

mslinzyann · Jan 11, 2007

Wow, this story really tore me up and made me decide to do general peds and NOT PICU. That is really tough stuff. You did all you could and cared so deeply for this child...the fact that he had no family.

I am sitting here crying. I wonder if I can do nursing at all! Hang in there- I understand your grieving. (hugs)

AliRae · Jan 20, 2007

Oh dear. My little man, the one I wrote about up there, just passed away this morning. I think God had things planned out pretty well, because I had switched with someone and wasn't coming in until 11. So I didn't have to code him, but I still got to spend time with him afterwards. I'm just not sure what to do with myself. I haven't been home yet, working until 11P, but I just don't think my family is going to get it. I need some love here. =/

Pediatric Critical Care Columnist · Jan 20, 2007

Here's some comin' atcha AliRae. I had the same experience a couple of years ago; I came on for a 12 hour night and they had just extubated a patient I had been very involved with. He was only 29 days old and his family had never really bonded with him because of his heart defect and how sick it made him. They had already left, so I held him in my arms while he died. It was one of the most profound experiences of my life and I'm grateful that I was able to do it. What you take away for this will be something very special that your family isn't going to understand, but I surely do. I know that you gave him loving care to the very last moment he was in your sight and his time here was blessed for your involvement in it. I really believe that 'our' kids feel the love we give them and know that they're special. If you let it, today will be a character-shaper that most people will never know. :icon_hug: Talk to the others who cared for him and share your grief with those who share it. You are each the other's best supports. And don't be afraid to give your heart again and again and again.

km5v6r, EdD, RN · Jan 20, 2007

AliRae you are right God did have this planned out for both of you. Your little man knew love. That is the most important thing. Very few other people are going to understand. We do. I do. You will grieve. Allow yourself that time. Remember, you did everything you could for him including giving him the love he needed. As nurses we step in and do for patients what they or their families can't do. Most of the time that relates to physical care. Occasionally that means we also step in and provided the emotional care or support and at times; love needed. The cost can be tremendous. In time the pay back is also tremendous. Your little man knew very little about life as a normal child. He went throuh more pain then most do in a life time. He never knew what it was to play in a sand box, eat a popsicle or run through the sprinkler on a hot day. He did know what it was to be loved, to have a familiar face make him more comfortable, a familiar hand touch and play with him. You made a difference in his life. Medicine couldn't heal his body but you did nuture his soul. In the end, personally, I find that to be most important. Protect yourself for a while. Allow your heart to heal. In time it will. You are a good nurse. And we do understand

AliRae · Jan 21, 2007

jan and km5 - thank you. i think what the 2 of you said was pretty much exactly what I needed to hear. It's actually been amazing to feel the love and support from those around me right now. I think 6 different nurses called me at work yesterday to see how I was doing.

I guess, when you come from the perspective that I do, namely that it's not my love I'm throwing around, but rather God's love through me, it makes it possible to keep doing this. Jan, you said "give your heart again and again and again." Frankly, I can't conceive of it right now. But I'm hoping I'll get there. I was able to switch with another nurse, so I'll be able to attend his funeral. That's been a tough one for me to wrap my head around- it's the first one I'll have gone to in my time as a nurse. It's okay, right, to go? I think in this case, especially so. I was one of the 3 people in the whole place that the baby's dad would listen to and be rational with. I spent more time with that little guy than both his parents put together and squared. I think it's right that I'm there. 9 and a half months is long enough to form one heck of a bond... But I hope I'm not just trying to justify this to myself...

km5v6r, EdD, RN · Jan 21, 2007

Go to the funeral. For yourself it will help complete the cycle. There is no true "closure" with something like this. For the parents it will show respect and caring.

prmenrs, RN · Jan 21, 2007

I want to share some memories I have of a little boy named Arturo. "Artie" was a premie who was born somewhere around 1977 and died 13 months later. Artie had a family, Mom, Dad, older sister. They lived in a rural area of the county on the farm where dad worked. They had housing, but no phone. Anytime we wanted to call them, we had to call his boss! They could only come to see him once every week or 2. So, we were his family. Of course, it didn't help that they didn't speak English.

Artie turned into a "chronic", the kind you never see these days, Thank God. We didn't know anything about developmental care, and the unit didn't have full time RRT support.

I remember Halloween. I made paper nurse's hat, put my stethoscope around his neck, along w/a label for a name tag, and here's Artie, RN. The picture shows a bug eyed premie looking alarmed, but in my eyes, so adorable.

I remember sitting on one of our bar stool chairs holding him in my lap giving him a racemic epi nebulizer treatment. Not the greatest idea I ever had. "Could someone come and take Artie before I fall off this chair and drop him?" Yep, I was getting the racemic epi, too. It was a wierd feeling, let me tell you!

And I remember New Year's Eve @ midnight when the Head Nurse managed to get him to drink a little, a really little bit of champagne out of a medicine cup!

We had a birthday party for Artie complete w/a cake and presents. His family was there and it was very nice. He wasn't anywhere near being well enough to go home, and we had no idea when he would be.

About 2+ wks later, there was a very well known Neonatologist in town lecturing, and she was invited to come to the nursery to see Artie. She examined him briefly, lifted him up, and in front of maybe a dozen people, including Artie, announced that he would never do well, look @ how his legs are scissored, and a few other things. I remembered being horrified.

He died ~ a week later. Coincidence? I think not.

NICU was not my main job @ that time, when I took care of Artie, I was "moonlighting", but on my rounds as Infection Control Nurse, I made sure to stop by. Regular staff knew how attached I was to Artie, so they called me @ home to tell me that he had just passed--very suddenly.

I did go to his funeral; another nurse was there, too. In the middle of the service, this Volkswagon bug drives up, and out come 2 of Artie's docs, and another couple of nurses--all wearing those yellow isolation gowns!! I didn't know whether to laugh or cry.

So that's Artie's story, or @ least my part of it. I've never written it all down. I'm glad I shared it you.

Pediatric Critical Care Columnist · Jan 21, 2007

Of course you should go. As prmenrs's story shows, these kids get into a lot of hearts and deserve to have the people who cared for them present as they're given back to God.

Two years ago we had a little boy, the only boy in a family of four girls, in our unit who was born with a hypoplastic right heart. He had been through all three stages of remodelling at our hospital and had done well. One day he just didn't look right so his dad called one of our cardiologists, who told Dad to take him to hospital. The family lived in a rural area and had a distrust of their local hospital, so they packed the little boy into the truck and drove 8 hours to our hospital. They arrived unannounced, since the cardiologist had expected them to go to the university hospital in their own province, not drive all night to us. When they came into the ER, the doc took one look at the child and reached for a death bundle. However, they were able to stabilize him long enough to get him to us, where within hours he was on ECMO. He stayed on ECMO for more than a month then successfully decannulated, had a heart transplant and seemed to get a bit better. Very suddenly one night in April he crumped. This time his parents had seen so much and knew far more than they ever wanted to that they recognized that his time had come. He passed away just before midinght on April 5. There were many people in our unit who were devastated. Our management pulled out all the stops to enable as many people who wished to make the 8 hour dirve to attend the funeral. Two of our docs flew into the nearest airport, attended and flew back to be on duty that night. I looked after this boy every shift for a solid month while he was on ECMO and then many more times later, and I think about him every so often and smile. His mom is expecting a little brother for him in a few weeks and they've kept themselves together. They come to visit every once in awhile and keep in touch so we all know they're okay. It's nice.

alirae, I know you'll find the strength someday to give your heart again and again and again. It will keep you humble and grateful for small favours. And so human.