all we've got

Sometimes being a nurse feels like belonging to a strange, secret club. We have our own language (where things like tracheomalacia or amp and gent or positive pressure ventilation actually mean something), and our own set of weird customs (such as hanging out in hospital wards on our days off). Most days, it feels good. It's incredibly satisfying to scrounge around the cupboards of an ICU, make a call back home to your old unit who, six months down the road, still seem excited to hear from you, and manage to MacGuyver a bubble CPAP setup that actually works. It's the biggest rush ever to realize that your being the one to care for a particular baby during a particular shift has actually made a difference in the baby's condition. And it just makes you happy to have a mother's face light up when you walk through the door, knowing that she trusts you with her child's life for the next however-many hours you'll be on duty.

Unfortunately, while the past couple of days have been something like that, they've also been laced with a very real sense of frustration. Sometimes being on Team Nurse isn't all it's cracked up to be. Sometimes, despite all the paper clip and duct tape creations you rig up and all the moments of getting the baby settled and sleeping for the first time in forever, it just isn't enough. Sometimes they get worse instead of better, and you can't stop questioning your every decision. Sometimes you just can't stop worrying.

Baby Greg isn't doing so well. He's slipping backwards, his jaw starting to swell again as his small body burns with fevers. He's struggling to breathe but fighting all our efforts to help him. And we're at a loss. We talk about him constantly. We sit at dinner, and instead of socializing with friends, we huddle there, heads bent together as we try to come with a new plan. We talk about him in the halls as we pass nurses who are on shift. We visit on our off hours, just to see how he's doing.

I know I'm taking this too personally. I know I'm not the only one who cares about Baby Greg and I know I'm not the only one who can care for him. But these days, this whole nurses' club seems terribly exclusive. There are only a handful of us here who are experienced and comfortable with caring for such a sick baby, and we're being looked to as 'experts.' It's scary, really. I came from a health system with a ton of oversight. It sometimes felt like I couldn't make the slightest move back home without going through a complex hierarchy of charge nurses, residents, fellows and attendings. If I didn't know an answer, there were always about twenty people within reach who could help me out. Here, the doctor (an orthopedic surgeon) asks the nurse (who, thankfully, was Jenn, an incredibly skilled NICU nurse) which antibiotics he should give. Here, the few of us who are comfortable caring for Baby Greg can't get sick, because there just isn't anyone else to call to cover for us.

It's such a strange paradox. I love working here because I love the challenge of making something out of nothing. I hate working here because, all too often, I'm expected to make something out of nothing. With Baby Greg, right now it feels like we have nothing. We don't have the right doctors. We don't have the right supplies. We don't have enough nurses. We don't have the answers. But I can't look his mama in the eye and tell her that. I can't bear the thought of explaining to her that she might lose yet another child.

So we'll keep fighting. We'll keep coming up with new plans and inventing new equipment and praying for miracles. Because, right now, that's all we've got. And I hope it's enough.