Being a nurse is a very rewarding but challenging profession. We have the privilege of floating into and out of people’s lives on an as needed basis. In many circumstances we gain instant trust, bonding with people in their most troublesome times. I’ve been with people in pain, short of breath, taking their last breath, and taking their first. Life is so incredibly short and can change in an instant…
Our day started just like any other. Arriving to our shift at 0700, ready to work. We get a shift change report, check our rooms for safety and supplies, and update the white boards (very important task). Patients come and go with varying chief complaints, needs, treatments, and follow up. Each patient is unique, even though they might have the same “chief complaint” as the patient in the next room. Some patients enter the department as a walk-in through triage and others come by ambulance. Whichever the route of arrival, patients are triage based on needs and attended to in the order of priority, hence, just because you arrive by ambulance with your stubbed toe, you may not get seen before someone who walked in with chest pain. Anyways, as the day progresses, ED nurses are aware that at any time any tragedy can enter the department. I don’t recall the day, or even the time of day, when an infant (under 1 year old) arrived at the ambulance bay doors. The paramedic was running, carrying the baby, and performing CPR (cardio-pulmonary resuscitation). Time both sped up and froze in the same instant.
These are moments in a nurse’s career that instinct, training, and critical decision-making all converge. The team embraced their roles, with one person taking the story, another setting up the monitors, someone else getting IV’s and bloodwork. We all worked together towards the goal of doing everything humanly possible working towards a positive outcome for this child and the family.
We soon learned that this child was born with a birth defect, was recently discharged from the hospital, had seen the family doctor that morning, and was found in the crib unresponsive. It was later described by the paramedic, that in cases such as this, they often don’t make the trip to the hospital as the evidence suggests, we are not successful in resuscitating infants found down in these circumstances; however, in this case, for reasons I won’t elaborate on, they made the trip to the ED. We provided respiratory support and continued CPR until the parents arrived. Research indicates that when families witness the lifesaving efforts of healthcare staff, they are more accepting of the outcomes, and they are less likely to pursue legal action. I agree with the importance of having family at the bedside; however, at times this is the hardest part of what we do. In the moments of resuscitation, it is easy to suppress emotion and focus on the tasks as an effort to cope; however, when you are doing chest compressions and make eye contact with the family member, it is difficult to hide the tears. As in this case, I was responsible for CPR, I usually try to keep my eyes down, focus on the rhythm and count but this day, I looked up and made eye contact with the father, who in that moment began to wail…
It wasn’t long after the parents arrived that the team felt we had done everything possible. We stopped resuscitation efforts, wrapped the baby in a blanket, and gave her to her father to hold. The room was silent except for the sobs of the parents. We all stood in respect, holding hands and supporting each other.
After a traumatic event, such as a child’s death, it is important for healthcare teams to debrief. That day, our team gathered together and said a prayer (even those not religious participated). We cried and praised each other’s knowledge, teamwork, and skills. And as always, I walked away knowing we did the best we could, with the skills, resources, and knowledge we had at the time. We are only as good, as we are in the moment…but there is always room to learn more!
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Trudi
The Nomad Nightingale 