A Nurse’s Wish

Being an obstetrical nurse, I am surrounded by beauty every single day I come to work. What people who don’t work in obstetrics don’t know is that labor and delivery can also be incredibly sad. As maternal-child nurses, we’re not just holding babies and taking pictures of new parents. Some days we leave work so emotionally shattered, we feel crippled by the weight. I cannot count how many bad or unfortunate things I have seen in my short career as a nurse. But without hesitation, the absolute worst thing I have ever experienced is the unexpected death of a baby.

When I admit someone for labor, I can’t help but get so excited. Even if I’m tired, even if we’re short-staffed, even if the mother is screaming in a lot of pain, I love it. Part of the magic of labor and delivery is that the same process unfolds at each delivery. Sometimes something unexpected comes up, but nurses are trained to deal with these things. We know how to handle a shoulder dystocia. We know how to handle a seizure. But when a baby is delivered and dies right before our eyes without any notice or warning, it can shock us to our core and leave us questioning if labor and delivery is where we should really be.

I once admitted a young mother in labor. She was pregnant with her first baby and she kept telling me how excited she was to finally meet her baby girl. Both sets of grandparents were with the young couple. They were all eagerly awaiting the birth of their very first grandchild. The mother was the most perfect patient any nurse could have asked for. A petal-pink lace dress delicately hung on a baby hanger inside the patient’s room. Throughout the entire day, we laughed and took bets on when her baby would be delivered. I offered my best guess—the baby would be born right at shift change. They wrote my name on a piece of paper next to 7:08, and I jokingly told them I had an unfair advantage, as her labor nurse. When she finally felt the urge to push, she delivered the most beautiful, perfect baby with a sweet button nose and the longest lashes I had ever seen. But we could immediately see what was wrong. And I still remember it all, as if in slow motion. With the absence of a baby cry, and the frantic moves of every nurse in the room, I still remember that mother hysterically asking what was happening. I still remember her husband crying with his head in his hands. Nurses and physicians flooded into the room, crowding around the baby in the warmer. I remember watching the chest compressions, watching the intubation, watching the placement of the umbilical lines. But the absolute best physicians and the greatest nurses I have ever worked with, all working quickly and steadily together, were unable to save that baby. I still remember that mother trying to climb out of her bed, clawing at the rails, her legs still numb from her epidural. And when the room, full of physicians and nurses and a code team went silent, she fell back into her bed paralyzed in disbelief and in shock. The time of death was called at 7:08.

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Thinking about that day, tears still blind my vision and it’s still a little hard to breathe. Thinking about that day, I still choke on all the sadness. That day, in that delivery, I felt suffocated by every event in the room. I didn’t know what to do or what to say. I didn’t know how I was supposed to help her. Long after everyone had left, I didn’t want to leave her alone in a room empty of a warmer or a crib. The room felt so burstingly bare and missing. When I finally left her hours after my shift, it all hit me. My heart pounded out of my ears and the realization of what had just happened made me sink in so much sadness. I walked into the break room, full of nurses with red faces and tear-stained cheeks, and we hugged each other and I sobbed into their shoulders. And then I got my things and went home, because I had to work the next day and because that’s what we do as nurses.

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I couldn’t talk about what had happened that day at work with my family. That night, tears flowed effortlessly down my face and into my bath water. I texted my patient’s nurse to check on her before I went to bed. And when I finally fell asleep, I dreamt of that perfect baby, her incredibly sweet parents, and the little lace dress hanging on the closet door in her room.

When I went back to work the next day, my heart started racing as I approached L&D. I ducked into the nurse’s lounge as quickly as I could. I was so afraid that I would see her family. I didn’t know what I would say to them, what I could possibly say to people who came to the hospital thinking they were going to leave with a healthy baby. I couldn’t tell them that I had no sign, that there was no warning, and that I too was blindsided, just as they were. I was so frightened that they would hate me for not being able to just know. I sat in the break room, waiting for my shift to start with my head down. I bit my lip so hard to keep from crying I noticed the metallic taste of blood in my mouth. I only raised my head when I felt someone’s hand on my shoulder. I looked up to see the charge nurse standing over me. With a soft voice and sympathetic eyes, she asked me if I would be willing to take care of the patient. She told me that the family had requested that I take care of them again. And beneath her comforting hand and her reassuring fingers, I crumbled right there in my chair. I took care of that patient for the next three days until she went home, coming in even on my days off.

As I sit here typing this, I have to blink away tears. Thinking about everything that could go wrong in labor and delivery, thinking about everything that does go wrong in labor and delivery, I have to close my eyes and wish with everything I have for only one thing. This holiday season, my one wish is that every nurse knows their worth and that every patient knows theirs. If you are a nurse or if you are a patient, do not ever be afraid to voice your concerns. Do not ever be afraid to ask questions. Sometimes no amount of planning can alter a bad outcome. Sometimes nothing we do can prepare us for what we’ll be presented with. But we all have to work together to prevent the negative outcomes we can. And it’s not just about bad outcomes, it’s about the best outcomes. We can no longer solely focus on improving communication between the physician and the nurse. We have to engage our patients, because they know more than we think they do and they know more than they’re telling us.

If you have ever been the patient in a situation where you were devastated by the unexpected, if you’ve ever been the family that didn’t take your baby home, please know—please really know— that there’s still a nurse out there thinking of you. I hope that one day we will all meet again and that we’ll all have something to celebrate. But until then, know that your nurse remembers you and the life of your baby, however short their little life may have been. Somewhere out there, there is a nurse with a heavy heart in their chest and eyes blinded by tears. Your story is not forgotten. We remember.

Until my next delivery ❤

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10 thoughts on “A Nurse’s Wish

  • December 18, 2015 at 6:05 pm
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    I have tears reading this. I know unfortunate things happen and never wish that on anyone to experience that pain and grief.

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  • December 18, 2015 at 6:51 pm
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    Thanks again for being the voice of every nurse. Hugs to you and everyone that has had to deal with these emotions.

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  • December 18, 2015 at 8:54 pm
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    As always, you write with your heart on your sleeve. I, too, have encountered the unexpected, and my work as a perinatal grief nurse brings me much sadness and yet, my presence is there. To witness who these tiny people were. No one else on this planet can do what we do. Thank you for spreading that word. Blessings.

    Reply
  • December 18, 2015 at 9:38 pm
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    What a beautiful, heartbreaking perspective you offer! I am so thankful for the wonderful nurses I’ve had in each of my deliveries. I’m convinced my labor nurse saved my son (my 7th child) with my last delivery. He was born with a knot in his cord, and the cord around his neck twice. She monitored his heartbeat with each contraction like a hawk and helped keep me calm. He is two weeks old now and I’m so thankful. Thank you for all you do!

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  • December 19, 2015 at 12:07 am
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    Beautifully written, I still remember the nurses taking care of us through all 3 kids and let me tell you the ones like you stay with us forever! Thank you for what you do!

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  • December 19, 2015 at 3:13 pm
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    I have been a L&D RN for 24 yrs now. Once I did my first OB rotation as a student I knew it was my place to be, that I had to work in that dept. Four years ago I even dabbled in the ER for 6 months after our unit closed unexpectedly (I’d been there 15 yrs). I both loved and hated going to work then, and when a job in OB, on days, FT no less, fell into my lap I jumped at the opportunity. But then to my surprise, I started to doubt my decision, because you’re supposed to give a new job a year to adapt, learn and settle in. With dread I told the manager, and then the staff about leaving, and where I was going. I wasn’t sure what to expect, after all a lot to money, effort and time had been spent training me. Most were very supportive, but some resented me because I hadn’t done my time on medical and ICU units before getting an ER spot. But when one resentful RN actually voiced those words to me, (long before I ever thought of leaving) I calmly answered, can you deliver a baby safety? Can you anticipate when there is going to be a problem? Can you act when a problem occurs that wasn’t expected, even when everything was going great? She answered I’ve taken NRP, of course I can. I smiled, and said thanks for all her hard work helping me learn the ER, that I appreciate her experience and and time she put in on those units. That it wasn’t my choice to have my unit closed, and I was happy to be working there. She let it go at that point, because everyone around us was listening, but I always knew she was watching me with resentment, and a cynical eye. My last shift I had 2 OB pt, one early that we shipped to another hospital, and another who preciped. But, not before I could set up and use the EFM, warmer, and the table, talk the MD through the delivery, (who hadn’t done a delivery since residency), clamp and cut the very tight nucal cord, and lead the resuscitation of a very stunned infant. Fortunately it all went like clockwork, despite not delivering a baby for 6 months, and baby responded within a short time. The Mum was doing well and wasn’t bleeding too much despite being a redhead ( what, really, why did she have to be a redhead?) who only laboured for a few hrs, and preciped…. in the ER. I mean, that could only be the next thing to happen, right? All turned out great though. I couldn’t stop smiling for the rest of my shift, and I had 6 hrs to go. I got lots of hugs, pats on the back, and complements on a job well done, smoothest easiest ER delivery ever. That one RN, who resented me was a part of all that, and was very sincere in her thanks of my being there. I was so grateful it all went well. That delivery helped me know I was making the right decision in leaving the ER. Like you, I have had deliveries like the one you describe in your story. The heartbreaking stories we all have as nurses, but ones like yours always seem to be the worst. Sometimes it’s hard to go back to work after it all. Fighting tears and a heavy heart, putting one foot in front of another, but doing it because we know that we do make a difference. I love to read your blog, it’s so well written, and funny, and so often spot on!!! Don’t stop writing. Nursing maybe your calling, but writing about it should be your second one. Thank-you for the time you put into your blog, you often voice what we are feeling, or doing. You help us realize we’re not alone. Sincerely Kimberly

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  • January 27, 2016 at 4:33 am
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    Wow! Being a nurse of 11 months in L&D I have had my share of patients who come in to L&D knowing that their sweet baby has passed inside their womb and it is always hard for me. With each patient it breaks my heart. (Not to mention when you get off work and have to let go of work to spend time with family on top of the heart ache of supporting a mother through the process of delivering her deceased infant.)

    So far I have not had an infant to pass outside of the womb. I know one day that that situation may happen, but I cannot even imagine.. At all.

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  • January 30, 2016 at 11:21 pm
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    I’ll never forget the day a mom came in for her routine, scheduled, section. Showed up to post-partum as normal, they were doing the admit stuff, checked for tones. Couldn’t find them so they called us to go check figuring baby was just in a weird position. Nope, no tones. Dr. estimated that the baby had been gone only a few hours. Had they scheduled her section one day sooner things would have been very different.

    I think the worst part is that most of the time we get no indication of why it happened. So many babies come to mind when thinking about this, it’s heartbreaking.

    Thanksgiving day will never be the same after a patient I had 10 years ago. I still think of that baby, and mom/dad, every year.

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