Meredith Bailey CWA 2011

Meredith A. Bailey graduated Magna Cum Laude in 2007 with a BSN from St. John Fisher College, where she received awards for her writing. She works full time as a Registered Nurse at Connecticut Children’s Medical Center in Hartford while attending YSN. Meredith entered YSN’s adult psychiatric program in 2009, and is expected to graduate in 2012.

Transcript of the reading:

Anonymous Heroes

“Okay but she’s having pauses,” I point at the tiny infant, struggling to breathe under the warming lights on a seemingly immense stretcher. The resident looks away, ignoring me for the second time, “I’m not concerned, her color is better now, I think we can just watch her,” with that I am dismissed and the doctor walks out of the resuscitation room. A dad sits immobile staring heavily at his daughter, barely aware of me or the resident. The respiratory therapist remains at the head of the bed and we share a knowing look. The baby lies on her back, her ten day old paper thin skin is being sucked in viciously against her tiny ribcage with each labored breath. Her perfect skinny fingers are curled into tiny balls. Her feet are scrunched in, and a large dressing covers one completely. It holds secure the IV I placed minutes earlier when she was rushed to me from triage. Her father carried her into triage gray and unresponsive. The resident is correct in that she does look better. Anything looks better than gray and not breathing. Oxygen, nasal suctioning, and IV placement proved stimulation enough to wake her momentarily.

With the resident gone I do all I can do- a thorough assessment. I sit at the side of the bed and I count, for two full minutes, I listen with my stethoscope, and even as the RT sees what I see we both know the baby needs a tube. I count five pauses per minute each lasting five-eight seconds. Not true apnea, but certainly not a good respiratory rhythm. The RT tries CPAP with an anesthesia bag, the baby sleeps through it.

The dad starts talking to no one in particular “My wife, she’s in the ICU across the street. She was diagnosed with a stage IV lymphoma eleven days ago. So we had the C-section as soon as we could…I…she’s a month early, did we? I can’t…” he cannot continue. I take his chunky hand. He’s so large, at least six feet next to my five and six inches. His barrel chest could hold seven little babies on it, but his poor heart underneath I can feel, shattering. “You didn’t do this to her,” I say quietly. We both sit and watch his daughter struggle for her life. I squeeze his hand, and I look at him, willing him to make eye contact, “Does your wife know?” He shakes his head; his large square brown eyes hold only pain. “We are going to take care of her now, okay? It’s not up to you any more, we know what to do,” he squeezes my hand back, and his voice cracks when he says, “You better.” I nod firmly and walk from the room in search of my attending.

I hear Dr. Steele before I see her; she’s a ball of energy, short and stocky. Her blonde hair sits in a bull cut framing her pixie like face. Her voice can be quite whimsical but she’s smart and she will dress down anyone who does not do her job well. She’s a nurse’s fiercest advocate and biggest challenge. She pushes the nurses to do one better, and defends us to the death when we do. She sees me come toward her and I ask her what she knows about the baby in room 1, “Well Lana says we are going to watch her, I’ll be in there in just a minute,” she starts to turn dismissively, but I stay hitched to her elbow, “Shannon, she’s having pauses, four to five per minute.”

She turns with renewed interest. Concern tinges her brow, “Well that’s not good, how long do they last?”

“Five to eight seconds each, they resolve spontaneously, but…” she cuts me off and continues, “That’s a lot, how’d she look when she came in?”

“Gray, not breathing” I reply hastily searching her eyes- already knowing what she’s going to say,

“That baby is buying herself a tube, I think,” she says quietly. I nod solemnly, and turn into the room with Shannon on my heels.

Dr. Steele auscultates the baby while respiratory continues to hold the anesthesia mask on her. Shannon assesses and then looks up at the dad. “Sir, your baby is very sick, she doesn’t want to breathe for herself, and eventually she’s going to stop. So we are going to help her breathe. Do you understand me sir?”

He says “yes” quietly and shoves his hands into his battered jeans. I see a stray tear, and can do nothing, say nothing. Shannon calls out the medications for the intubation expecting me to write them down, double check her, and draw them up. An influx of people enter our room and we are all united by a tiny baby ripped from the womb too early, a baby who may never meet her mom or may meet her too soon in heaven.

Lana appears at some point and coached by Dr. Steele she intubates the baby. There follows the usual flurry after an intubation of documenting, report to PICU, bedside xrays, and vent preparation. My only job now is to push more medications if she starts to wake up and to make sure we do not lose that tube.

The calm always settles in the elevator. It takes thirty-one seconds to go from the ED to the fifth floor in the PICU. Those thirty-one seconds are our last moments of peace with the patient and family. It is the only time they can process what just happened and what will happen. A lot can happen in thirty-one seconds. The only sounds now are the bag being pumped by the RT, the hum of electricity running the elevator, and the soft sob of a man. He looks at me through his reddened eyes, “Twelve days ago, I had a wife, and we were going to have a baby. You know what? I got mad because we couldn’t agree on a middle name. Emily Rose. That’s what she wanted, and I wanted to name her Emily Ann. That’s my mom’s middle name. That was the only thing I was worried about.” He chokes on a hollow laugh. “Emily Rose, well baby your mama wins again.” He sobs again, and I feel tears run down my face, “What’s your name?” I ask him. “Mike,” he replies as he takes a deep calming breath.

I put my hand out and shake his, “My name is Meredith I forgot to introduce myself before, but I’m your nurse,” we both smile at the absurdity of it; I do not know what else to say, “I think Emily Rose is a beautiful name.” I smile at him through my tears, and the elevator doors beep open. We hit the ground running toward the PICU and are immediately embraced and spit out by the PICU staff. There are nurses, doctors, and respiratory therapists all griping about the tape job we did in the ED around the tube and the IV. I shrug in acceptance. The PICU and the ED notoriously can do no right by one another- different priorities different personalities. I personally do not care how we tape the IV or the tube as long as they are in and functioning. I see Mike disappear into the crowd and I turn with a tech to take the now empty stretcher back down to finish the last six hours of my shift.

When I reach the elevator and the doors close the tech and I embrace thirty one seconds of blissful silence.

Before the end of my shift I walk by a room and hear Dr. Steele “…If you had just listened to your nurses we wouldn’t be having this conversation, you should be kissing her feet because she saved you tonight and more importantly she saved that baby…” I keep walking embarrassed.

Lana, Dr. Steele, they do not matter. Mike matters, and Emily Rose, and a woman in an ICU who will never know the name of the nurse who helped save her daughter. I do not know what happened to Emily Rose, nor to Mike. I do know I will not forget them as they most likely, have already forgotten me.

We are nameless and faceless. We buy groceries at the store, work out at the gym, and sit next to you at the movies. We are nurses and we are anonymous heroes willing and proud to save lives and to remember the names and faces of all those who will forget ours.