Another piece of my heart

After circling the hospital parking structure, I found an open space and parked my car. As I walked towards the hospital, I looked down at the ground, watching my Converse-covered feet move mechanically just past the hem of my jeans. This is wrong, I thought. I've made this trek three nights a week for the past three years, but always wearing my "work shoes" and scrubs. And usually at dusk or after dark. But it wasn't only my attire that was unusual, there was no reason to the bright noonday sun. And again I thought of why this felt so wrong. It was a familiar journey, but today was different. I was not a nurse today. I wasn't going in to the hospital to work. I was going in to grieve.

Just two days before, I had made this same journey, but it felt like a lifetime ago. Two days ago, I had walked in to work, anticipating a nice, peaceful night taking care of my primary, Layla*. I had been taking care of her for the past three weeks, almost from the night she was born, and she was making so much progress. She was tiny for her age, 35 weeks and still under a kilogram (approximately 2 pounds). But she was feisty. The last time I had taken care of her, I had turned off her IV fluids because she was tolerating all her feedings, even bottle feeding, despite her tiny size. As I walked in that night, I wondered how much progress she'd made during the weekend while I was off.

I felt my stomach drop down to my toes when I saw her that night. She didn't even look like the same baby. She was not only intubated, but on the ventilator saved for only the sickest of babies. I had left her with only one IV access, just for emergencies, but she now had several lines inserted, and the bedside was crowded with all the pumps administering medication just to keep her alive. All night my coworkers helped me, as I moved mechanically, doing my best to separate myself from the tasks I had to do. But no matter how hard I tried, I couldn't help the fact that several times I was frozen in place, looking at this swollen, pitiful infant and thinking, That's not Layla. Surely this can't possibly be my Layla.

Those two nights were among the top if not the hardest nights I've ever had at work. Not only because of how much work there was to do, but because of the emotional and mental burden I had to carry while fighting to save this child's life. For two nights, I watched Layla get worse and worse, despite my futile efforts. But the hardest part of the whole ordeal was facing her parents. I knew, because of my clinical knowledge and experience, that we were just postponing the inevitable, but how could I tell that to Layla's parents? How could I take away their hope? I knew better than to encourage false hope, but neither could I bring myself to tell them outright that the outcome would not be good. It was my job to look at things objectively, it was their job to hope and pray for the best for their daughter.

As I reported off to the day shift nurse at the end of that second night, I asked her to call me in case (in my heart, I said when) anything happened. Exhausted as I was, I knew sleep would not come to me that day. Sure enough, around noon, my phone rang. I almost didn't answer. I already knew what the nurse had to say.

So I went to the hospital. not caring about my appearance. I still hadn't showered from the night before and I looked a wreck, but even though I was going to be amongst my peers, I knew I was going there not because my job required it of me, but because I needed to be there for her. For Layla and her parents. As a nurse, I was finding it difficult to maintain my professional distance. So in a way, I was glad that today I wasn't their nurse. I was their friend, joining them in their grief.

When I walked onto the unit, I washed up in the scrub room like any other visiting family member. As I walked into the room, I took several deep breaths before going behind the curtain that gave very little privacy to this family that had become so dear to my heart. Behind the curtain, I found Layla's mom in tears on the phone, likely calling all family members. Layla's dad was hunched over the warmer, stroking her cheek. When he saw me, he hugged me, or rather clung to me, and cried into my shoulder, saying, "Thank you for being such a good nurse." I instantly felt all my resolve to put on a brave face melt away as i broke down into sobs. I didn't know what to say, I had no words.

After her mom got off the phone, she gave me a similar greeting. It was just the two of them for now, but several extended family members were on their way. I told myself I would stay only until they arrived, so they could grieve in private. I ended up staying for three and a half hours. I couldn't bring myself to leave, even after all the family arrived. I stayed against the wall of the room, out of the way, feeling a little like an intruder. But when the chaplain came around to pray with the family and they welcomed me by taking my hands and drawing me into their circle I knew that right then, though we were practically strangers, we were united in our grief and sadness.

Every life is precious, no matter how long it is lived. Layla was not my child, but I cared for her deeply, and her family has touched my heart. I tried to go in to work last night, not 24 hours after she passed away, and I couldn't do it. As I walked onto the unit I saw the nurse practitioner who was on call that last night, then the fellow who wrote the order to take her off life support. When I saw the respiratory therapist who had worked with me and encouraged me those two horrific nights, I turned around and ran out of the unit sobbing. I have a few days off. I'm hoping these few days will be time enough. Time enough to ease the pain, to soften the memory. But never time enough to forget. Forgetting is ceasing to care. And in my life, both professional and personal, I simply can't afford to stop caring.

*Not her real name.