There’s No Crying in Nursing

When I was a new graduate nurse in labor and delivery, I distinctly remember thinking that I never wanted to be one of the nurses that cried on the job. As a brand new nurse, I thought it was a little strange that a nurse would cry because a provider upset her, or because a patient’s delivery didn’t go as planned, or because a baby didn’t behave at birth. I thought if I always did the best I could, that I would think that was enough, and that alone would ease my mind. I would be content, resigned to the fact that I couldn’t control everything, and all that mattered was that I was providing the best care I possibly could.

And for a while, every time a provider upset me by doing something I didn’t agree with, I’d shrug it off.  And every time I raced a woman to the OR, I’d pray the entire way there that everything just ended up alright, that we’d just end up with a healthy mom and baby. And every time a baby behaved badly at delivery, I would let the nursery nurses work their magic, pitching in to quickly give them any meds they asked for or to check a heart rate.  Every time something bad happened, I could feel the adrenaline in my throat, I could taste it on my tongue.  And for a while, as a new nurse, even with the adrenaline bubbling up inside of me, I wouldn’t cry. I felt so strong, as if the good care I provided was enough, as if the good care I was providing made something better.  It was a slow progression, but suddenly, one day, I began to choke on that adrenaline. It pounded so hard in my throat, robbing me of my voice and shaking every part of me inside. I still remember the first day I cried in labor and delivery.

On a labor and delivery unit, there are fetal monitors everywhere you look. Everyone is always watching every strip. My favorite nurse was working triage that day. Years and years of experience kept her demeanor calm and collected. She was the one person everyone was always thankful to see during an emergency. Every single nurse on every single unit can name this nurse for them, and she was it for me. As I passed by the nurse’s station, I saw this nurse take a patient back to triage. And a few minutes later, right on schedule, I saw her fetal monitoring strip.

The baby’s heart rate was half of what it should have been, and with each passing moment the baby’s heart rate declined, so fast and steady we didn’t even have one second to spare. Nurses and techs flooded triage. I watched as my favorite nurse, with steady hands and a quiet voice, direct everyone quickly and calmly. Oxygen was placed on the patient and before I could even find out what was wrong, the patient was wheeled to the OR in a triage bed, on her hands and knees, and the only physician on the unit was scrubbed in and ready to cut. We couldn’t have moved faster. Nothing we did was going to make that baby’s heart rate suddenly 120.

Even though it was probably less than five minutes from the time the patient walked onto our unit to the time we all raced her back to the OR, by the time the doctor pulled her baby from her belly, it was too late. No matter how experienced the hands that touched her were, no matter how quick our actions had been or how fast we had reacted when we knew her baby was in trouble, nothing we could do could change the fact that her baby was dead.

JME Portraits-20

I remember looking down at the patient, sleeping soundly in her intubated slumber. As I left the OR, her family was waiting right outside the door. Although I didn’t say anything, they knew the moment they saw me that no one would be bringing out a baby.  Her husband stood there, shock silencing any words and paralyzing his body. Her mother started crying, vocalizing the pain we were all suddenly presented with. I didn’t know what to do or say, so I just hugged them all and let them sob into my neck.  Tears soaked through my scrubs. They hugged me so hard, not wanting to let me go. Over their shoulders, I could see a little girl sitting in the corner, playing with a stuffed teddy bear that was meant for her new baby brother. And as I walked away, my shoulders wet from the first set of tears from so many people, I bit my lip so hard and tried to focus on the floor to keep from crying. They had gripped me so hard, my body still hurt from all their grief. I couldn’t make it to the breakroom. I couldn’t make it to the bathroom. The first empty patient room I saw, I scurried into, closing the door quickly behind me. I collapsed in a chair and I cried. Trying to cry quietly, the sobs shook my entire body. I cried for the patient, I cried for her family, I cried for the baby. I cried for the nurse and every other person who had touched that patient and ultimately failed to alter the outcome.  And in between sobs I had to wipe away tears that ran down my face so fast and furious, so I could still see my own patient’s fetal monitor strip from the computer at the empty bedside.

That wasn’t the first or last time I witnessed a bad outcome. But for some reason, that day, that delivery, the wall I had created finally softened and I allowed myself to cry at work. I think it was because it was that nurse, the nurse that I looked up to, the nurse that could do no wrong in my eyes, even she had failed to save that baby.  Even she had failed to spare that woman that grief. It was that day, that delivery, that I realized sometimes it doesn’t matter just how great you are, or how well everyone works together, or how quickly you all do the right thing—sometimes there is no saving someone.

Labor and delivery is a secret world, a world where no one really knows what’s going on, unless you’re looking at it from the inside. If you were the family that had a bad outcome in labor and delivery— I can’t even find the words to describe what I want to say. I guess I want to say we’re sorry, even if there really wasn’t anything we could have done. We work to provide the very best care, the very best results, and we just wanted different for you. I hope that you find some small level of comfort knowing that sometimes even the very best nurses and physicians couldn’t have changed your outcome. Every single birth changes us. Your birth changed me. I can close my eyes and still feel your grief all around me, and I still remember you.

 

 

Until my next delivery ❤


10 thoughts on “There’s No Crying in Nursing

  • April 2, 2016 at 12:25 am
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    Wow…..I cry with you as I read this. I retired after 41 years of L&D nursing. I still remember some of my patients and sharing their grief. Those are the patients that I remember the most. As a clinical instructor for nursing students, I was asked “what if I cry?” My response is that sometimes we do cry. It’s OK as long as we are still caring for our patient. They know how sorry we are, just never let our tears interfere with our ability to care for the family.

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  • April 2, 2016 at 1:08 am
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    Your words touch my soul. Every time you put words to paper it is like you live in my head, putting my feelings into eloquent prose. Thank you for sharing our world.

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  • April 2, 2016 at 3:28 am
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    20 years ago this September our baby died in the delivery room, under very similar conditions. Though the doctors and nurses did everything they could our little boy still died… and we felt loved and cared for by the medical team. Two of the nurses even attended the funeral and one of those nurses and her husband and children became life-long friends. Thank you for being human. Thank you for your tears. You have no idea how much it means to patients to see that you care, that you too grieve the loss of a child and that we are more than just patients but grieving parents.

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  • April 2, 2016 at 11:55 pm
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    That made me cry. I hate that you had that experience. I only pray that it wasn’t the last experience you had in labor and delivery. Thank you so much for your kind words!

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  • April 3, 2016 at 9:06 am
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    This is beautifully written. I still remember the first time I have cried during a shift, and have done so many times since. Usually I try to keep it in until in my car on the way home. Our profession isn’t a simple one. It involves loss and anger and overwhelming stress. Nursing is messy, and nurses are only human. Thanks for sharing your story and thanks Trevis for sharing yours as well. So heartbreaking.
    Tori
    http://www.themamanurse.com

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  • June 1, 2016 at 3:04 pm
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    I’m a big cryer in real life but rarely cry at work. There is a handful of times I can remember crying and Labour and Delivery after the birth of a still born is one of them. It’s so heartbreaking. I think sometimes it’s totally appropriate for the wall to come down a little and share in our common humanity. I think our tears in cases of loss are also a gift to the family that that little life mattered. Well written.

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  • June 3, 2016 at 5:40 pm
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    I remember when I was in 7th grade we had a career week in school. I was asked what I wanted to do for a living and I said I wanted to be a social worker. I was told that I couldn’t do that because I cried too much. It was true, because I was very emotional and sensitive. Since then I have done many things, and about 22 years ago I decided to go back to school to become a medical assistant and subsequently an RN. I have worked in outpatient medicine, urgent care, inpatient medicine, ED, telemetry, hospice, and for the past 6 months I have been working in L&D. I didn’t want to cry as a nurse or a medical assistant but I found there were times when it just showed that I was human. I sat and cried with a friend after the doctor that I worked for just told her she had lung cancer. I cried when my first patient died. There were a few families that I became close to over the years whose family members lost one medical battle or another, and we shed some tears together. I cried much less than one would have expected as a hospice nurse, but there were some tears spilled during that portion of my career. Since starting in L&D I had one pt that experienced IUFD at 18 weeks, and I helped support her through that. It was not as difficult as I thought it would be due to my hospice background, but the agony of a woman who has miscarried 3 previous times and now has this experience is difficult to console. Sometimes you just have to release the sadness so you can move on.

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  • August 22, 2016 at 3:43 am
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    Sometimes no matter how much we are trained to do a certain job, things happen beyond our dreams, control and there is nothing that anyone can do to solve the situation. It happens in ALL walks of life and we just have to accept it, as “meant to be”. Crying is a God giving right and if we need to use it, then use it. To be taught you can’t cry is not good. I personally believe it goes a long way in helping your brain, nerves and your whole body relax and face reality. I have seen many nurses crying after losing a patient and I believe it tells the family members that the nurses really care and they aren’t the only one that are suffering. NEVER, NEVER blame yourself. Hang in there and thanks to all nurses for the hard work and hard hours worked.

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  • May 14, 2017 at 11:50 pm
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    As a Now I Lay Me Down To Sleep photographer I feel your pain. I look into the nurses eyes when I do a session and wonder how they can be so strong, shed no tears. I go to my car and cry the entire way home. I’m there to do a job, to get through the session with a clear head so that I don’t forget anything. I imagine that’s how you nurses get through the tough parts. You’re amazing and I love each and every one of you. Thank you for what you do and how you help these families.

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