We are delighted to share this essay written a few years ago by our newest Advisory Board Member, Barbara E. Britt, RN, MSN.
~Michael and Frida Donner
Nursing takes some strange paths, there’s just no doubt about it. This career, the very one that so filled me with anxieties in the early days of my learning that I often wondered if I would ever find my way, this very career has perfused every aspect of my life and every part of my being. What I have come to realize is that there isn’t a part of me that responds to any situation or person without that ever present nurse tagging along and being part of the response. It’s just part of who I am, of what you get when you talk with me. As obvious as that statement might seem to be, it took me some years of maturing before I had a more full understanding of what that really meant and how it played out in my everyday life. I also know that I’m not alone among nurses in my relationship to my profession in my day to day life.
So it was that one summer day at a camp for kids with cancer, I was setting up meds for the next meal time when we’d hand them out to the campers and the Med Shed was buzzing with midday activities and the laughter of campers and counselors engaged in all manner of fun things. It was a session when we had the luxury of having 3 nurses and one doc to handle the mostly routine needs of all these campers with cancer and their sibs. But even that staffing carried with it a craziness of trying to juggle the demands of medication administration safety with the request from the MD for a better pair of tweezers for splinter extraction and the calls of the next crowd of kids coming in to use the bathroom who also were sure that we could have no finer goal for the day than to allow them access to the treasured red vine canister on the desk. Such is the nature of camp: total childhood normalcy standing right next to 14 pills and capsules going into a med cup for one child at one meal, only to be repeated again at dinner , with IV antibiotics tucked in a drawer in case one of those same happy kids suddenly developed a fever along with low blood counts, with the IV pole standing by in the utility closet.
I was absorbed in my med set up in the dispensary and so largely ignored the next buzz of excitement when someone unexpected came in the main Med Shed door. With that particular ability to lock out the noise extraneous to my main activity, I maintained my focus until someone came into my immediate space and called my name. I looked up and found Sara standing in front of me, waiting for me to give her the hug that she clearly was waiting for and needing. We shared one very long, very tight hug before we broke apart and stood looking at each other and then started both to talk at the same time. Sara was one of our counselors, one who had accepted in prior summers the paid summertime leadership role at camp of unit director while she was on breaks from her teaching job. I’d known her for years, had tended her hurts and illnesses over many summers, shared laughter with her and her counselor buddies and mourned with her over the absence of well-loved campers who had lost their private battles with cancer before they could return to camp one more time.
Many times she and I had tramped through the bitter cold of a mountain night to dispense nighttime meds in order to keep kids warm in their cabins and we’d laughed our way through the cold as her flashlight guided us and my mittened hands tried not to drop that cold muffin tin of meds. I had taught her lots of things about her own health, helped her figure out what kind of doctor she needed to find for her own needs, explained to her the full scope of what our campers experienced when in the treatment world. Through those times we’d become good friends at Camp, always able to pick up where we left off at the prior session. Here in front of me was Sara who had “grown up” at camp from a young woman just out of college and embarking on her career to an engaged and then married Sara, and then finally to Sara who was expecting a baby. That baby had been born a few months before this particular session of camp and one of our saddest camp community times was when we had to share the phone call that told us that Sara’s baby had died within hours of his birth. Yet here she was, not scheduled for camp but somehow inexplicably standing next to me as I poured meds. I expressed to her my sorrow at her loss, and wondered aloud to her what had brought her up to this particular session, and told her how much I missed her being with us.
Sara explained that one of the outdoor challenge course counselors had needed her to bring up some special equipment and that she’d volunteered to be the one to bring it because she was hoping, since it was the first session of the summer which I generally staffed, that she would find me. Then she said it, the words that made me feel the catch to my heart which was both a touch of terror but also a glow of specialness that she could trust to me an issue so important to her. Sara said “I brought my baby’s autopsy results, medical chart and his baby pictures we were able to get just when he was born and after he’d died, and I was hoping you’ d go over them with me so I could understand why my baby died.”
In a world of need where it seems on some days there are just too many problems to solve in too little time with too little resources, one learns to treasure those moments when you are allowed to experience with blinding clarity the reality that you as a nurse, as a person, have made a difference in someone’s life. To have Sara ask me to walk with her on this very personal and painful journey of pouring over her baby’s medical record and autopsy results was one of those moments and I took it as a mark of trust and her belief in my caring. Sara and I went out onto the Med Shed porch to sit in the sun and let it bake our tears dry as I looked at her precious pictures, one of a living child, two taken after he had passed, and then read all the words that described his short, chaotic few hours of life. She hadn’t yet gone over these records with anyone. I explained terminology. She told me what she knew. We talked about how his birth had gone well, that he had had a good Apgar score, that all seemed well , that she got to hold him. She went to her room, he went to the nursery. Within 4 hours he had died after desperate attempts to save his life. Mom thought it was due to massive bleeding but she wasn’t sure. She talked, I listened. I talked, she listened. We spoke of DIC and what it was, and why it was discussed in his reports. She talked of her great need to be pregnant again, and her fear that the same thing might happen a second time. I talked to her about the importance of her going back to her OB/GYN doctor to ask questions of him, something she had not done because she had sensed that she made him uncomfortable. I am hoping that indeed I helped her know that she was entitled to call the newborn intensive care unit MD to speak with him about those autopsy results so that she had a clear picture from him of what It meant from his point of view . Then I helped her set up a consult with one of the experts in pediatric clotting disorders so that this person could walk her through what she needed to know before getting pregnant again. We cried a lot.
By the end of our two hour session during which the camp flowed around us and my nursing colleagues handled everyone and everything that came up in the interim so that I could have this conversation, we reached the place where only hugs were needed. She thanked me for all my time and information and understanding. Sara promised to go after the information she still needed and to call me if she had need to do so. She decided to pass on having dinner with the campers in the dining hall, she said it was just a little too raw still to be in midst of such happiness, said her good bye to me and her other buddies, and off she went with records tucked under her arm.
Sara called me several months later. She was pregnant again and nearing her due date. She had indeed consulted with the pediatric clotting expert I’d recommended to her and he had reviewed all her records and done a lab work-up on her. She was excited to tell me that he found nothing wrong but as a precaution she was going to deliver at a place where they could care for high risk infants. Two months later I learned that she successfully delivered a healthy baby girl.
Sara is busy with family life now. 5 years after the birthday of that first boy she now has two children who are thriving. Thus, camp counseling is no longer her priority but I stay in touch through the other counselors who come each summer to camp. They describe to me a mom loving motherhood. I will be forever grateful that she chose me to help her find her path through this time of unbelievable tragedy, and then move onto to joy again. My personal self fully merged with my professional life had brought my best to her that day on the Med Shed porch and I have no doubt that I made a difference in her life that day, and in all the days she enjoys as a mother.