Thursday, July 28, 2011

A Duty Of Nursing I Never Expected

A few years ago, a baby died in my care.

I did everything I could.  We fought hard for her life, but she died anyway.

And the parents blamed me...and sued me.

This post is hard for me to write because to this day I mourn for little "Emma."  I mourn for her parents and how much they wanted her; and for the relentless, sickening, violent pain forced upon them.  There is nothing like the cry of a mother who has lost her baby.  Nothing in this world.

As nurses we endure endless hours of training and retraining to know what to do when a life is at stake.  So many times we use that knowledge and save lives...and it all pays off.  But to come to a time when everything we know is useless; to try and fight and fight and...lose.  And a baby dies.  And we couldn't save it.  What an unsurpassable defeat.  It's indescribable.

And then to learn that the mother blamed me for the death of her child.  I was completely broken. 

In respect for Emma and her parents, I'm not going to tell the nitty gritty details of this story.  My fellow medical readers will understand when I say that it involved a velementous insertion, ruptured membranes, and blood.  To those of you who don't understand:  it was a rare, disastrous, often undetectable situation that went as bad as it could go, and there was not a lot that we could do.

On a side note, Emma's mother came in for an induction having had a very normal, healthy pregnancy; expecting a natural, uneventful labor; and this situation is an example of why I cringe when I hear of women claiming that home deliveries are perfectly safe.  They are not.  If something goes wrong in labor, often it goes very wrong, extremely quickly, and although we couldn't save Emma, most of the time we can save these babies and/or their mothers if we move quickly.  If you're at home, and you have to take the time to travel to the hospital when something is wrong, most of the time it's too late.  Just have your baby in a hospital and quit arguing about it.

Back to my story, the parents named me personally in their case, and accused me of atrocities...and I do mean atrocities.  Not only did they think I was negligent, they accused me of killing their baby.  I was dumbfounded when I read the complaint.  It's amazing how a traumatic experience can skew a person's memory.  They not only named me in court, but they went after my nursing license, my very means of livelihood. 

I went through months of interviews with the Risk Management department of my hospital.  They were extremely supportive of me, which a lot of hospitals wouldn't do.  They protected me when the mother demanded a meeting with me.  They provided a lawyer for me who, I must say, was the smartest lady I've ever met.  I had to write pages and pages of response to the parents' "Discovery" documents to answer everything from why I asked her about pain management at admission and "terrified her," to describing my hospital's policies and my understanding of them, to why I thought I had sufficient training to do my job. 

Then, once that was over, I had to appear at a deposition.  8 hours of questioning by a large panel of lawyers with a video camera 1 1/2 feet away from my face.  8 hours.  They questioned me on everything from each nook and cranny of the tracing, to discussing the personality of the patient.  8 hours.  It was the longest, most demeaning day of my life.

But none of this was as hard as knowing that Emma died in my care...and that her mother blamed me.

The case was dropped because neither I, nor the doctor, did anything wrong.  The Board of Nursing dropped the complaint against me, finding that I upheld all that my license holds me responsible for...including trying every reasonable attempt to develop a therapeutic relationship with this patient.  Even though everything was dropped, and my nursing "name" was cleared of all charges so to speak, it still doesn't heal the pain and feeling of failure I felt.  And it certainly didn't heal any of the parents' pain.  But perhaps it filled a purpose.

For many months I desperately asked the questions:  Why in the world couldn't they see that I tried so hard?  Why did they think I was so unbelievably at fault and accused me of doing things I would never dream of doing?

Since then, I've come to an understanding.  It's not about me.  It's about Emma.  It's about the parents' unbearable challenge of dealing with their grief and very deep anger over losing their baby girl.  I can understand that.  If I was deemed the object of their anger and they felt they were finding release and closure by their accusations toward me, then I guess I have filled my purpose...a nursing duty that I never thought about before. 

Perhaps you are a health care professional facing a legal battle, and like me, you feel overwhelmed and even unsure of how you handled the situation.  Remember that hindsight is always 20/20.  Don't beat yourself up looking back over your actions, knowing the outcome, and thinking, "If only I..."  Did you do everything you could?  Did you follow policy?  Did you follow your heart?  Then keep your chin up and go in there and show what you know with dignity, and be proud of your plight.  Perhaps you are filling a purpose too.

9 comments:

  1. You are amazing, Jani! What a terribly sad story on so many levels! I am so sorry you had to endure all that! You are a strong person and a wonderful nurse! It's my privilege to know you! Blessings!

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  2. "Perhaps you are filling a purpose too."

    Perhaps. Life and death is inevitable in the hands of every medical practitioners and we can't deny the fact that every life is not within our control. Everything happens for a reason, hope you find the reason beyond the death of Emma, eh.

    Thanks for the share,
    Peny@baby phat scrubs

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  3. Thank you for sharing your ordeal. I am amazed at how kind and compassionate you are towards the parents who put you through so much unfair and unnecessary grief. I am so glad that your hospital was supportive of you, though. Your integrity and compassion speaks volumes about your character. I do hope and pray that over time you will heal from this experience and that Emma's parents will, too. Again, as an aspiring L & D nurse, your story is very helpful.

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  4. I lost a baby early in my career. We had the spontaneous death of a healthy baby seconds after birth with no rhyme or reason. The parents sought an autopsy. We held a review weeks later at which time the autopsy reports were announced. I went weeks barely keeping myself together to find out his death was caused by a rare and unpredictable/unpreventable complication of an OP baby. We were all shocked and again devastated. I ran into the Mom a few weeks after that(postpartum complications, poor lady ) and we both sobbed. A loss is horrid and I can't imagine how you felt with them suing afterwards as well. :( people think L&D is the unit filled with rainbows and butterflies... and sometimes it is but sometimes it's horror and devastation. I remember every dead baby I have seen, every delivery that ended in mama cries not baby, every baby I held as it passed cause it's parents couldn't bare to...those sweet angels...it's not all rainbows

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  5. What the general public does not understand is that despite the best that medicine and nursing has to offer, sometimes people die. That includes babies. The medical profession did such a good job to get laboring women into the hospitals at out of the hands of home birthing midwives almost 100 years ago that many parents now believe that a hospital birth is a guarantee for mother and baby's good health and of course, survival. Add to that the growing numbers of mothers who are high-risk to start with due to obesity, diabetes (gestational and Type II), with high blood pressure and other preexisting medical complications, and you decrease your chances for an uncomplicated healthy delivery. Please get as healthy as possible before you get pregnant and then you and your MD, CNM and RN will know we did everything we could to prevent an intrauterine or neonatal loss!

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  6. Oh, Jani, how awful for you and everyone concerned. I, too, have assisted in the delivery of death or watched a baby die so soon after birth that the shock and pain never quite leave you...
    That having been said, perhaps you (and the new L&D nurses who may read this) will get some comfort from a bit of wisdom I learned in my years as a Legal Nurse Consultant. We (nurses) are NOT expected to be all knowing, prescient or perfect--except maybe by ourselves. I am well past childbearing age myself, but I hope and pray that when my daughters give birth that they are blessed with nurses as compassionate and caring as you are.

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  7. I to remember every loss down to the last detail. I am at this point thinking that I just need to walk away from working as a Labor and Delivery nurse in the near future.
    I have had a couple of deliveries recently where there were not enough staff available to watch laboring women in an LDRP rooms to far a part for the stage of labor and both needed one on one care which they only got for a few hours. Fortunately, we were on the way to the OR when the strip went to Cat 3 and the baby only needed 3 minutes of PPV, but it was to close for me.

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  8. I just found your blog. I am in tears. I am a labor and delivery nurse and I know the indescribable pain of an unexpected death of a newborn. I wasn't sued for that case. You are right to focus on the loss of the parents, and their effort to somehow "make it right". Lay people have no idea, no idea at all how stressful this job can be. I love it. I love it with all my heart, but I think that it is killing me a bit too. If one more person walks up to me and says "oh, you have the best job, rocking babies all day, seeing new life everyday", well some day I just might lose it. We work with maximum loads every day. If there is a abruption, a uterine rupture, a crash Cesarean, there are no extra hands to help.

    Be very, very kind to yourself. You sound like a wonderful nurse.

    Michelle

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  9. I too, had a patient early in my career who lost her baby (after my shift) and who tried to sue, but due to very clear documentation could not secure a lawyer since the fault was clearly not ours. I waited those three years after in dread, though, hoping to never face her again or have to go to court. We hold lives in our hands every day - it's a miracle we have as many good outcomes as we do.

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