Loss and Grief (Memoirs of a Mother and Nurse)

Nurses have good days, bad days, stressful days, heartbreaking days, and hopefully a few uneventful days sprinkled in between (we like the uneventful days!).  There are a few funny and good days that I remember, but the days that stick out to me the most are, unfortunately, the hard ones.......probably because the hard days are the ones that teach me the greatest lessons.  I'll never forget one of the greatest life lessons one of my patients taught me on one of my hardest days as a nurse......

........I got to work extra early that morning at about 6:30ish.  I had worked the day before and knew this day would be really busy after the patient load I had the day before (nurses are usually given the same patient assignment they had the day before).  The prior evening--right before the end of my shift--I had sent one of my patients to the OR to receive an emergent surgery on her small intestines. They had completely twisted on themselves causing a slew of problems and immediate surgery was required to repair this.  Oh yes, and she was about 15-16 weeks pregnant.  Though this surgery could put a lot of stress and danger to her unborn baby, it was absolutely necessary to save her life.  So I sent this sweet, nervous mom down to surgery, went home, slept, and came right back to work.  I was anxious to know how she'd done since coming back from surgery.  The report I received from the night shift nurse was promising: the surgery went well, my patient was doing well, her husband had stayed by her bed all night, and 2-3 ultrasounds throughout the night confirmed that baby was doing well, had a strong heartbeat, and was happily sucking his thumb and kicking away inside his mommy.  The ultrasound did confirm a partial placenta previa (the placenta was partially covering the cervix), which was causing my patient to slightly bleed, so she would probably be on bed rest until that resolved and we would continue doing daily ultrasounds on the baby until my patient was discharged from the hospital.

I was so relieved.  Thank heavens for the surgeon who saved her life and thank heavens the baby was still doing great!  Knowing that I would want to spend extra time with this patient that morning, I quickly did morning rounds on my other patients before heading into her room.  My patient was awake, sitting up in bed and talking to her husband when I came in.  We chit-chatted about how surgery went, how excited she was to get home to see her 18 month old son, how she would need to contact friends from her church to help her out while she was on bed rest.  She then mentioned that her pain medicine was wearing off and her abdomen was hurting.  Could she have more pain medicine?  She also wondered if I could bring her some more chux pads since she felt like she was spotting a little more "down there".  I did a quick check to see just how much she was spotting and my heart dropped.  I didn't see very much spotting, but her chux was soaked.....and that's when I saw her baby's head crowning; her baby, who was still a good 7-9 weeks away from the possibility of surviving outside the womb, was not going to make it.  Her increased abdominal pain, the feeling that she was spotting more.......her water had broken and she had gone into labor without realizing it because she had just had abdominal surgery and was on pain medication.......she had no idea.......

As my fingers and hands went numb I knew that I could not deliver this news to my patient alone.  I felt like falling into a heap on the floor and letting out an ugly cry, but I was her nurse.  I had to keep it together and I had a lot to do in the next 30 minutes.....call the OB doctor, call the surgeon, get this mom pain medicine, grab extra chux, help this mom deliver her baby, deliver the placenta, monitor her bleeding post-delivery, call the in-house social workers for grief counseling, grab packets of paperwork I'd need to fill out, and most importantly help this mother grieve......

"Let me just step outside and get more chux pads, some pain medicine, and I'll be right back," I said.  (I have no idea how she did not see the horror or panic on my face).  I quickly grabbed my charge nurse, made a phone call to my patient's OB doctor to inform him about what was happening, grabbed some pain medicine for my patient, took some deep breaths to try to compose myself, and went back into my patient's room with two other nurses to inform her what was happening, and then to help deliver her baby.

It was such a whirlwind of emotions and activity in the room, but all noise and activity seemed to stop when my patient's tiny baby boy was wrapped in a towel and placed in my arms.  I stared at his tiny hands clasped together across his chest, his ten little toes, his little lips that still seemed to be pursed from when he had been sucking his thumb a few hours before.  He was a perfect baby boy with a soul.  Perfect but just born too soon.  The trauma of surgery was just too much for his mother's body to hold onto the pregnancy......Though I did manage to suppress the "ugly cry", I turned away from my patient while I held her baby and let my body silently shake with sobs.  These are the heartbreaking moments of being a nurse that are so hard and yet very sacred and special at the same time.

A few hours later after the initial shock and commotion had died down, it was just myself, my patient, and her husband in the room.  At one point she turned to me and took my hand.
"Thank you for everything today.  You have been so sweet and compassionate.  I know that nurses often suppress their emotions because they have to carry on and keep working caring for everyone, but I really appreciate your tears today, they have helped me feel supported."

"I am just so sorry for your loss," I  told her.  "I'm a mom, too, and I can't imagine losing one of my babies.  I am so, so sorry."

"You just seem touched by this in a way different than anyone else who's been in my room today......Have you ever lost a baby?"

"No, not like this."

"What do you mean?"

"Well, I've had a miscarriage, but I was only about 12 weeks along."

"That is still a loss."

"Yes, but the circumstances were very different."

"Holly.......did you ever mourn your loss?"

(I thought about it for a moment.....my miscarriage.....it happened at my husband's family reunion when we had only been married a year.  I barely knew the 100+ members of his family and in the awkwardness of going into labor to deliver a tiny fetus, I think many people did not know how to respond other than to ignore that it was happening.  The few who acknowledged what was happening offered sympathy with an, "at least you know you can get pregnant!!" encouragement and upbeat smile tacked onto the end.  With the encouraging or vacant responses I received, I was resolved that what I was going through was not tragic or even a big deal.  It was just a miscarriage.  I could always get pregnant again.  So I loaded up on ibuprofen for the pain and didn't shed a single tear, not even when I passed the baby in a restaurant toilet the next day........)

"Oh sweetie......you are mourning your loss," she concluded when I didn't answer.

I was a little offended at her suggesting this.  My miscarriage from 4 years prior had not crossed my mind all day (or even for the past several months) until she mentioned it.  I reassured my patient, "Oh no, no!  I am mourning your loss.  My own miscarriage never even crossed my mind until you mentioned it.  The circumstances surrounding my miscarriage were different....not as big of a deal."

"Just because you were a few weeks behind me in gestation and just because the circumstances were different doesn't make it any 'better' or 'worse'.......loss is all relative......someone's loss may seem trivial compared to someone else's, but it is all loss still the same.....we should grieve our own and grieve with others who have lost, too........I will shed a few tears for your loss today, because this is really hard and I feel for you!"  She squeezed my hand again.  "I'm grateful that you were my nurse these past few days.  You know, because of your miscarriage you can understand in some way what I'm going through and I think that is why you have been the most compassionate and relatable person I've had through all of this.  It's been a gift, really, so thank you."

I went home and cried a lot that night.
I cried for that beautiful baby boy who's life was precious despite being so brief.
I cried for my patient who would go home empty-handed, no longer planning for the birth and life of her baby boy.
I cried because my patient was right......

We do ourselves a disservice when we don't allow ourselves to mourn a loss because others don't recognize it or because it pales in comparison to another's loss.  Grief is a natural and even healthy part of life.
We do ourselves and others a disservice when we withhold compassion unless the loss seems harder than our own or "worthy" of our compassion.  Grieving with others brings us a little closer to the Divine.

I think of the example of our Savior, one who--despite His eternal perspective--still wept and grieved over the loss of Lazarus, and one who extends his compassion and succor to even our smallest trials despite his suffering being greater than them all combined.  I am grateful for my patient following His example: allowing herself to mourn her loss and still setting aside a few tears for my loss, no matter where it stood in comparison to hers.  I saw her in the grocery store a few months later.  She looked the picture of perfect health.  She had gotten the "okay" from her doctor to get pregnant again and was very excited to expand their family.  We gave each other a hug and chit-chatted for a few moments before we parted ways with her saying, "I've been thinking about you a lot.  Thank you for being there during such a profound moment of my life and for mourning with me.  It has taught me a lot."  Funny how patients think it's the nurses who are the ones giving and teaching.  I have found it to be quite the opposite. :)