Tuesday, May 5, 2020

Forever on the Frontlines


These past few months have shone a spotlight on our health workers and their level of dedication and commitment to caring for others. I have been fortunate that neither me nor any family members have needed that care during this devastating time, but I did need it once before, and my nurses were the unsung heroes long before this pandemic took the world by storm. They really always have been.

When I lost Jace, I had a few incredible nurses on hand to walk me through the darkest day of my life, and while there was little they could do to ease my pain or reduce the trauma, they made my time at the hospital bearable, survivable.

I went in to deliver Jace on a Sunday, which meant the L&D of Kaiser Permanente was on skeleton crew with a shortage of most staff. There was only one doctor on duty, and I only saw her four times throughout the 15 hour stay at the hospital. She was a bit cold given the circumstances, and wasted little bedside manner on me. She rattled off the plan to bring my dead child forth and went about her daily routine. I tried to give her the benefit of the doubt, as it had sounded like she had already worked a lengthy shift before I sulked into her delivery room. My mom argued that doctors just tend to be distant like this because it’s an emotional defense mechanism. “They have a hard job to do, if they get emotionally involved it can become too much for them.” While I certainly understood this argument, I couldn’t bring myself to agree with it. As a therapist who has worked with extremely difficult cases, I know how bad I would be at my job if I turned off my heart completely and worked only with my head in spite of the emotional effect. My clients would see the disconnect in me as much as I saw it in my doctor. But luckily for me, nurses have gone to a different school of care.

A small group of nurses came and went as their shifts changed, a few I only saw once or twice, others may have been there for the delivery I couldn’t really recall, but one was stationed with me for the majority of the day, and showed such immense care for me I had to wonder if she were a therapist in another lifetime. Amanda tag-teamed it with another nurse whose shift was up at the beginning of my visit and she was truly a blessing throughout the day. She performed her standard duties, taking vitals, helping me go to the bathroom, administering the meds, fetching ice chips, but the extra duties made the difference. She always took a moment to sit with me after the blood pressure and temps were taken, and asked how I was doing. She offered to listen if I needed someone to talk to; she often held my hand, tried to reassure me, and appeared genuinely stricken by my tragedy. During one of her many visits, she sat with me for several minutes and gently encouraged me to allow a photographer to come take pictures of my son once he was born. She provided grief booklets to me and my family and explained to me the resources available. She provided absolutely no pressure in the decision to see or hold my baby after he was born. She took the time to ask his name and she wrote it on the dry erase board to be sure any staff member who came in knew who they were delivering.

When the delivery came, I hardly recall how the nurses and doctor came into the room so quickly, and in the panic, pain, and grief and don’t remember any of the faces of the medical staff that surrounded me. I don’t know who cleaned him, who handed him to me, and I don’t remember anyone leaving the room. I just remember the sudden silence, the tiny baby in my arms, and Amanda sitting next to me, typing some key information into my chart.

I cried quietly as I cradled Jace and whispered all my love to him, followed by an abundance of tearful apologies for not being able to keep him safe, for not being enough to keep him alive. Amanda suddenly reached out and touched my arm. “This was not your fault. You don’t need to apologize for anything. You didn’t do anything wrong.” I sobbed harder, nodding in agreement, but deep inside still believing that I could have done something, anything else while he was alive and it could have made all the difference.

Eventually Amanda stepped out to allow me time with Jace, and then I called my family back in. It was late when she returned and I asked her to contact the photographer. A slight look of concern passed over her face, and she said she would try to call the agency because their office closed in less than an hour. She assured me if they couldn’t get the agency, they would take photos for me, and rushed off to get them on the phone. She returned to share she left a message and hoped they would call back soon. I imagine she frequently checked for calls and messages, and while she was sitting with me, the call came through and she returned once more to happily share that the photographer was on her way. Amanda and the other nurses rushed to gather a blanket for him and went off in search of a knit cap that would fit his tiny head for his photos.

Throughout the night she returned trying to encourage me to eat, offering to get me a variety of snacks or juices. I hadn’t been able to eat anything that day, but I had no appetite, and she seemed concerned every time I turned it down.  She sat again with me for several minutes to explain the details of the mortuaries available to me for stillborn services and arrangements, and guided me toward the most affordable one as I knew these arrangements would be costly in addition to a significant hospital bill.

Other nurses came to take Jace’s weight and height as well as his footprints. They returned with a beautiful shadow box they had made with his name and footprints, as well as a hand-made bead bracelet with his name. They gave me a beautiful book for grieving mothers.

Amanda assured me I could spend as much time with my baby as I wanted; I could stay the night at the hospital if needed, but as hard as I knew it would be to leave my son, I didn’t want to remain with the death that hovered in that room any longer. I had said my goodbyes to Jace in the several hours I opted to stay with him, and I knew it was time to go. Amanda gathered Jace from my arms and gently set him in his delivery bassinet as I settled into the wheelchair, and she painstakingly removed his knit cap and blanket so I could carry them home with me. As she wheeled me down the empty hallways taking me further and further away from my son, I sobbed, and she rubbed my shoulder.

My mom’s car sat waiting for me at the hospital entrance, and as I lifted myself from the chair, I turned to thank her. Though she had been a solid rock for the last 11 hours with me, tears started to fill her eyes. I hugged her, and we broke down together in each others’ arms. “This was the worst day of my life,” I told her, “but I couldn’t have gotten through it without you.” I hugged her just a moment longer, then my mom said her thank yous and goodbyes, and we left the hospital in silence. I found myself wondering many times if Amanada was okay, knowing the experience must’ve been truly unpleasant and possibly traumatic for everyone involved, especially for those who refuse to disconnect and be present with their patients. But it made all the difference for me. The photo above was a picture of a nurse posted to the internet months ago who had worked an extremely long shift and ended it with a stillbirth before returning home to her sister's for a quick dinner and emotional moment. When I saw it for the first time and many times after I became emotional myself and I thought of Amanda. 

I have heard from some women in my support groups that they were not as fortunate as I was with the medical staff that accompanied them through their losses. I’ve heard from others they had experiences similar to mine. Whatever the case, I am grateful for the staff that carried me through this. Their care and support of me will never be forgotten, and a part of me hopes that if I get pregnant again, they may still be there so we can close this circle of grief together. One woman in the group reported that she had read an article that some nurses believe that most of us don’t even remember their names. I admit I struggle to remember the name of the nurse who came in once to take my temperature, or the nurse who came to take Jace’s footprints, but I remember when Lori cleaned me up after my water broke, and when she gave me my medication. I remember Penny taking charge when Amanda went on break. And I will never forget Amanda.

Whenever you’ve needed a nurse or will need one, remember it’s often a thankless job with long hours, tough tasks, difficult patients, and trauma, and they still come back to work the next day to do it all over again.
Thank you.