There have been many difficult nights in my 12 years as a registered nurse. Deaths happen in medicine. Sometimes they are anticipated, sometimes they come unexpectedly.
As I think back over the years, I remember the woman, in her 80s, who was suffering from congestive heart failure. Her family sat by her bedside, holding her hand as she gasped her last few breaths. I also remember the man, only in his 30s, who was hit by a drunk driver while on the way home from work. I arrived at the scene of the accident and saw the blank stare of someone in severe shock. On the way to the hospital, despite all our attempts to resuscitate him, this young man died in the back of the ambulance. It would have been hard for me to believe that night, but my most difficult night was yet to come.
One night last August the intensive care nursery was especially busy. As I began my shift that evening, I noticed right away that there was an extra amount of tension in the room. There have been emergency calls from other hospitals that day, and our transport team had been busy bringing in three infants requiring special care which our nursery could provide. Two of the babies were very critical. I could see that it would be difficult night.
What I was not prepared for was our next admission, which I was to be responsible for, since I was the least busy at the time. The nurse from Labor and Delivery walked into our unit carrying a blanket and stating “This is a prostaglandin abortion. He has a heartbeat so we brought him over.” The baby was placed under a radiant warmer and I was told the rest of the facts. The gestational age of the baby was given to be 23 weeks by ultrasound. The mother had cancer and had received chemotherapy treatments before discovering that she was pregnant. The parents had been told that their baby would be horribly deformed because of the chemotherapy.
I looked at the baby boy lying before me, and saw that from all appearances he was perfect. He had a good strong heartbeat. I could tell this without using a stethoscope because I could see his chest moving in sync with his heart rate. With a stethoscope I heard a heart pumping strongly. I look at his size and his skin — he definitely looked more mature than 23 weeks. He was weighed and I discovered that he was 900 grams, almost two pounds. This was almost twice the weight of some babies we have been able to save. A doctor was summoned. When she arrived the baby started moving his tiny arms and legs flailing. He started trying to gasp, but was unable to get air into his lungs. His whole body shuddered with his efforts to breathe. We were joined by a neonatalist and I pleaded with both doctors saying, “The baby is viable — look at his size, look at his skin — he looks much older than 23 weeks.”
it was a horrible moment as each of us wrestled with our own ethical standards. I argued that we should make an attempt to resuscitate him, to get him breathing. The resident doctor told me, “This is an abortion. We have no right to interfere.” The specialist, who had the responsibility for the decision, was wringing his hands and quietly saying, “This is so hard. Oh, God, it’s so hard when it’s this close.” In the end, I lost. We were not going to try to resuscitate this baby. So, I did the only thing I could do. Dipping my index finger into sterile water and placing it on his head, I baptize the child. Then I wrapped him in blankets to keep him warm, and held him. These were the only measures I could take comfort the baby under the circumstances, no matter how much I wanted to do more. I held this little boy, who was still gasping for breath, trying to stay alive on his own. As the tears flowed down my face, I pray to God that he would take this child into his care, and that he would forgive me for my own part in his death. After a while, he stopped gasping. His heart continued to be, but the beating became slower and weaker until it finally stopped. He was gone.
It seems so ironic. No more than 5 feet from where I was watching this baby die, a team of doctors and nurses were gathered around a severely ill infant. They were trying every treatment they could to save this baby, while I stood alone with an infant who had a good chance to survive. But we did nothing for him. As it turned out, we lost both of them.
By Barbara. From Vital Signs: the Journal of the Friendship Pregnancy Center fall 1991
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