My most defining professional moment in my career came about not when I was with a patient, but when we were home with our newborn daughter.
The call came at 4:47pm on a Wednesday. We had brought our daughter home after an extremely uneventful birth. Our second child, she had come out the exact opposite of our son. Eyes open, awake, staring at us as if to say, "Yeah, I am here."
After three days we went home and began our second trip through exhaustion, night feedings, diaper changes, and everything else that goes into raising a baby. At 4:47 pm it all came to a halt, and despite over a decade of critical care experience, I was for the first time paralyzed with fear.
"Your baby failed the heel stick, and may have Galactosemia. You'll receive a call from the Geneticist later today, but until then stop feeding your baby any milk products."
That was it.
As we waited for the geneticist to call, my professional brain kicked in. I remember the oddly humorous thought I had that why would the pediatrician call to say my daughter has a disease named after a video game?
I began researching Galactosemia. Liver failure. Sepsis. Death. Symptoms in the first few days of life (I missed the importance of this one, as it was week 8). Death. My child suddenly was dying, and I couldn't stop it.
It brought me back to so many conversations I have had with patient's families regarding death and dying. I used to almost brag about how much I liked, and how good I was at end of life discussions and care with families. At 4:47 pm that changed.
The funny thing was, I completely missed that symptoms begin a few days after birth when the baby drinks milk, and yet my child had drunk milk for 8 weeks with no issues. How easy it is to miss cues, clues, and even blatant slaps in the face from information when we as nurses have been trained to sniff out these clues better than smoky the bear smells fire.
My child, after a year of doctor visits, blood work, and monitoring turned out to have a variant of Galactosemia that would not affect her life in anyway other than her husband would need to be tested before they have children. For a year, I assessed her sleeping, eating habits, drinking habits. I snuck into her room to watch her breathe. I coddled her, hugged her more than I had my son, and told her I loved her a million times. I paid more attention to her than I do my own patients.
And it changed me, and my professional practice as a nurse. No longer do I gloat about my end of life care. No longer do I complain when it's busy, complain when I am burdened, or have to stay late, or write an extra note, or bail out someone else's patient who needs ICU care. As a nurse practitioner, I save lives. I used to take it for granted. Now, it defines and fulfills me.