Looking back, I realized that Baby K’s death served as a catalyst for everything I had not processed in the CVICU: the codes, compressions, and other children who had passed away in recent months. I had taken care of these dear patients or been familiar with their journey but when I learned of their passing I’d simply feel sad for a second and then get back to work. I never quite processed their deaths. I didn’t where to begin.
I needed to learn how to face the emotional impact of working in this high intensity environment, how to swim in this thick sometimes murky water and come up for air. And I needed to learn now, after less that a year in the ICU or I would continue to flounder and possibly drown.
Sometimes a few deaths occur in a short time span and I can feel the sadness on the unit. But I know now how to take care of my emotional well-being. I allow myself the time to process their passing and my connection with the family. I pause after work and look up at the night sky or have a coworker pick up a shift so I can sit at the kitchen table and write about the patient’s journey and draw pictures and honor their life. Everyone has a different way to process. My coworkers love to do yoga and play with their children and pets and get together and drink wine. This is simply my way. Maybe over time it will change. Perhaps I’ll no longer need full days to let the sadness go. Or it’ll just take a few minutes to say a blessing for the patient and their family as they pass on. Only time will tell. As of now I am grateful to have and take the time to honor their life and these important lessons I’ve learned.
I have not taken care of every child who passed away on our unit. Some deaths slide by without me needing to do the personal work, but I find myself checking in with the nurse who took care of the child on their last day on earth, asking How are you? I am here if you need to talk. What are ways you are taking care of yourself? Do you know about the resources the hospital provides? Don’t go to the cold room by yourself. The family was so fortunate to have you as their nurse.
Baby K gave me a new path, one I wandered down blindly in the initial thick of my grief but got clearer with time. I begin seeking other outlets in nursing–attending the Schwartz Center’s inaugural Compassion in Action Healthcare conference, being a panelist on our own Schwartz Center rounds and falling in love with palliative care. I’ll write about these experiences later.
About a year later, I took care of the second baby who passed away during my shift.
The situation felt completely different. This patient had two nurses: one to take care of him, the other for the ECMO machine. This little baby had suffered a brain bleed and his mother and father did not want him to suffer anymore, we planned to withdraw care later that evening. In anticipation of this, we dressed him up in a little hat with his stuffed animals and took photos, got clay prints of his tiny hands and then painted his feet green and blue and pressed them onto paper in the shape of a butterfly. The ECMO nurse, who had taken care of him the last three shifts, connected with his parents and coordinated their request to switch him to a bigger bed so they could all lay in it together, as a family. When it came time to withdraw care, she was the one who decannulated the ecmo circuit and wrapped him up and placed him in his mother’s arms. Then she stayed in the room after he passed and cried with the parents.
In some ways I got the better end of the deal: I only took care of him on his last day of life and I did not know the family. He passed at 7pm, and expecting the family to stay a few hours holding their baby, I left when my shift ended at 7:30. Later I learned that his parents departed shortly after, leaving it up to the night shift nurses to do his post mortem care, take him down to the cold room, and then continue on their work.
Knowing this, I could have stayed. I should have stayed. But I slid by without any more of the traumatic parts, this baby’s already cold body in his mother’s arms, hearing her wails, and concocting my own vision of his journey down to the cold room.
Was this way better or worse? I still lived through it– felt the sadness rise from my gut and tighten in my throat, eyes watering as I looked at this little baby in his mother’s arms for the first and last time. I carried this home.
But that night I took a few minutes to sit outside looking up at the stars, clouds parting.
I breathed in, whispered his name, honored his few months on earth, and sent a prayer to his parents.
I breathed out, trying to let it all go.