Why I Stay In Nursing

The climb is part of everyone’s journey

It was the spring of 1996. I had recently fulfilled my one-year requirement of adult-cardiac nursing and had just started pediatric cardiovascular ICU training. That was all I had wanted to do when I started working as a nurse in 1994 — take care of cardiac kids. Finally, my journey into cardiovascular pediatric nursing had taken its first step.

But journeys don’t always unfold as you had planned them during the calm, midnight hours of sleepless excitement.

It was the first day of spring outside and I was alone in room 4116 with one of the most beautiful babies I had ever seen.

Hannah appeared to be the perfect newborn. Her dark skin, flawless; her black hair, thick. Her rolls of baby fat were precisely placed — cheeks, chins, arms, and legs overflowing in all the right places. She was perfect — on the outside.

Hannah had been born with persistent pulmonary hypertension and a coarctation in her aorta. That meant her lungs had trouble taking in and exchanging oxygen and the large vessel coming off the top of her heart was kinked like a garden hose. Shortly after her birth, she was in respiratory distress and had to be placed on a ventilator to help her breathe.

The only cure for pulmonary hypertension in a newborn is time. But time wasn’t resolving Hannah’s life-threatening problem. So her doctors tried to buy her more time. If the coarctation of her heart could be surgically repaired, it might help resolve pulmonary hypertension.

After the coarctation repair surgery, she was admitted to the Cardiovascular Pediatric ICU in room 4116, where I first met Hannah and her family.

Hannah spent those first few days in the Cardiovascular Pediatric ICU with me — a fledgling nurse who couldn’t reconcile the outward, perfect baby with the inward, sick baby.

How could this happen? How could life and death be placed in this mother’s hands at the same moment?

I couldn’t wrap my mind around the contrast of life and death so distinctly placed— her beauty parallel to her defect.

I cried nearly every night after Hannah’s mother left the room.

It wasn’t like this when I was taking care of cardiac adults. You expect things to happen to them. They’ve lived their lives, their bodies are dying anyway, right? How could I have been a nurse for two years and not have faced any of these quandaries before?

And yet, here I was, watching Hannah’s family lessen their grip on their baby’s life one finger at a time. What was I doing here? Why don’t I leave?

On her second day in the Cardiovascular Pediatric ICU, Hannah’s condition worsened. She was placed on ECMO (extracorporeal membrane oxygenation), a machine that oxygenates and pumps blood through the body. ECMO is reserved for the sickest patients, functioning as the heart and lungs of the person, keeping the patient alive while their own heart and lungs rest.

Hannah’s pulmonary hypertension refused to bend. She died when she was five weeks old.

Her mother and father got to hold her near the end. I remember gently placing little Hannah in her mother’s arms once two days before she died, guarding the numerous tubes attached to her. But for those five weeks of her life, she was untouchable — too sick to kiss, too sick to touch, too sick to hold.

Working nights in an ICU allows for plenty of heart-to-heart time that is often deeper and darker than the night itself. Hannah’s mother told me how she believed there was a reason she had carried Hannah for nine months and given birth to her.

“There’s a reason that her life is lingering, even now. There’s a reason she is climbing this mountain,” she said, peering out the 4th story ICU window at the frigid night air.

I realized then that this young mother might never know the reason for Hannah’s life journey. There in the weight of her voice, it was clear: she knew there was a reason, somewhere, and that’s all that mattered. She didn’t have to know what the reason was.

I don’t know if Hannah’s mother ever found her answer.

I know I never found the answers to my questions.

But taking care of Hannah, even for those few weeks, helped me to see the improbability of some journeys — life obliging death and death regretfully accepting.

Hannah lived her life graciously and with dignity. Her parents lived her brief life with her as they were expected to — with support, love, and respect. They never scowled, were never inconsiderate of those around them. They believed there was a reason behind this torturous climb.

Looking back, I think they knew. They knew that it doesn’t matter which route across the mountain any of us take.

If you take the short road up and over the mountain, facing the struggle of the steep climb, it doesn’t matter.

If you travel around the west side, which is not too long but has rough terrain, it doesn’t matter.

If you go around the east side, which has the longest path but easiest on the feet, it doesn’t matter.

Whichever way you go, what matters is what you take with you.

I guess that’s why I stayed in nursing, even with no answers to my questions. I figured if Hannah could tough out that steep climb over the top of the mountain, then I could get through the brutal terrain around the west side.

Perhaps the reason her parents will never know was right in front of me the whole time…

Babies like Hannah need a place to journey across the top of the mountain, and nursing provides that place.

That’s why I’m a nurse. And that’s why I stay.

If you enjoyed this little mess of words, I accept hugs in the form of

— Generous highlighting and applause

— Copious comments spilling with gratitude and deep-thoughts

— Scads of followers Julie Nyhus MSN, FNP-BC

— Positive thoughts directed my way

In peace and hope,

Joolz