Working as a neonatal nurse means that my colleagues and I can’t escape from the stark reality that some babies are born sick and, despite our best efforts to save them some of them tragically die.
In order to carry on working in the job that we do without burning out or making ourselves completely miserable we have to accept that sometimes there is nothing we can do to save a baby. As heartbreaking as it is to admit it, it’s a horrible fact of life and there’s no escaping from it, much as we wish it wasn’t true.
When we lose a baby we allow ourselves to grieve and we acknowledge that our grief does not make us weak but shows that we’re not made of stone. We all know that the day that we no longer grieve is the day that we no longer truly care.
So we shed our tears and we hold the parents and tell them how sorry we are. We go to funerals where there are tiny white coffins and we remember the babies that have died in our own private ways.
But ultimately we have to pick ourselves up and carry on or risk becoming completely bogged down and losing our way and we all know this.
But even with all our coping mechanisms, methods to relieve stress and off-loading to understanding partners and friends there will always be some cases that hit us hard and that we find difficult to deal with.
For me, the babies that I find the most upsetting to care for are the ones that we have no answers for. Not only do we not know how to save them but we don’t even understand why they became sick in the first place.
These are the babies who are born to mothers who had easy, straight forward pregnancies with no indication that anything was wrong with either mum or baby. They’re not born prematurely or show any other warning signs; in most cases we have no idea that anything is amiss until the baby is delivered and it quickly becomes apparent that something is dreadfully wrong.
These are the babies who break my heart.
I sit beside her, stroking her head and rubbing her little hand with my thumb.
I’m waiting for the doctor to set up the necessary equipment so that he can scan the little girls heart.
Her little face is grey and she’s clammy with sweat. The bedside monitor starts alarming and when I look over I can see her heart rate rising even though nothing has happened to upset her.
She’s so distressed that nothing seems to calm her and the only time that she settles is when she’s asleep.
I talk to her softly; telling her that I’m here and that I won’t let anything bad happen to her. I know that she doesn’t understand what I’m saying but I try to soothe her with the sound and tone of my voice.
I know that we’ve got some difficult decisions to make for this little girl and we need this scan to help us make the one that is best for her. The scan will show us how effectively her heart is functioning but we’re not expecting good news.
I also know that because she’s so distressed we’re going to need to try and finish the scan as quickly as possible but at the same time it’s going to be difficult to get an accurate scan of her heart.
I’ve wrapped her firmly in her blanket, partly to try and comfort her but also to stop her from waving her arms around and bashing the ultrasound probe, meaning that the scan would take even longer that it’s doing already.
Her little face is so swollen that her features are distorted and her eyes are almost permanently closed, such is the effort of trying to open them. On the rare occasion that she does open them she doesn’t seem to be able to focus and they dart about wildly, displaying her obvious distress.
She hardly resembles the newborn baby who arrived on the unit in the middle of the night a few weeks ago. If it hadn’t been for the lines and wires attached to her she would have been no different to any of the other full term babies born in the hospital that night; each beautiful and perfect in their own individual ways.
The doctor doing the scan is trying to be as quick and as gentle as possible but it’s not enough.
She struggles against me and I start singing to her softly; the same song over and over, not caring that the doctor is looking at me strangely if it helps to calm her down and willing to do anything to take away her pain.
The breathing tube in her airway prevents her from making any sort of sound but it’s obvious that she’s crying in fear and distress. I can feel the lump rising in my throat and the feeling I get of my nose threatening to start running just before I cry.
I don’t know how to help her.
I don’t know what to do.
I have to grit my teeth and bite my tongue to keep the illusion that I’m calm and in control when in reality I want to burst into tears at the downright injustice of it all. I know that life isn’t fair but this.
I can’t think of anything less fair than being lead to expect that you’ll have a healthy baby to hold in your arms, only to have them snatched away from you for reasons that no one can explain.
A few days later, despite trying everything that we could, the little girl died.
We never found out why she became so unwell and, as a unit we were heartbroken that we lost her.
Accepting the limitations of medicine and of our own knowledge is one of the most difficult things about about being a neonatal nurse and something that hasn’t really become any easier the longer I’ve been a nurse.
It’s never felt fair.
I don’t think it ever will.