I haven’t shared too much about my job here on the blog, but this is a story about my patients.
I can tell you that very often my patients are grumpy, or down right angry. They even cry uncontrollably and unexpected. Most of the time they sleep, right through my prodding them and talking to them. They don’t seem to find it especially important to thank me when I call them beautiful or compliment their long, dark hair and chubby cheeks. They do make interesting faces and most of them have the ability to go from a grimace to an angelic and peaceful repose within seconds.
I know that they wouldn’t want me to share that they burp quite often, or even have a tendency to gag and spit readily. Some just can’t help themselves and fart or poop while I’m with them. Sometimes stuff like that just happens, especially when you aren’t really adjusted to so many changes and hospital rules.
Even though they don’t have much to say I can always tell who is going to be totally bored with my visit, or just as easily the ones who are already wide-eyed and following my every move. I always think that those are the ones I have to watch out for, that those patients will be the ones to purposefully and obstinately refuse to listen. Then they surprise me and I find myself wishing I could spend more time with them as they dismiss me and settle in for sleep.
Some of them try to be helpful. They want so badly to help me detach sensors or ear hugs and it often takes a lot of explaining to them that no, I really do have to tuck their hands back inside their swaddle blankets, but I so very much appreciate all their efforts.
I really can’t tell, even anonymously, any funny or whimsical stories that I hear from my patients. Most of them are just trying to comprehend how their world has turned upside down and why they can’t go back where they came from just hours ago. They’ll have stories for sure, but I won’t be privileged to hear them. I would like to assume that they will be happy and bright and optimistic stories.
Those are the patients that I visit in a quiet room with their loved ones close by.
Some of my patients are alone. I meet them in a large, sometimes noisy, space. Their freedom is tested because they are attached to machines. Many of these patients rarely notice when I stop at their bedside. Of course they hear me remark on their beauty and strength just like all the others. Some will show their displeasure for me with the occasional frown or soft high-pitched cry, but I move forward with my work.
These patients are almost always asleep. If they aren’t they twitch, and appear jittery. I move them about, touch them only as much as is absolutely necessary and watch them startle over and over again. There are some that I come to visit and I have to stop. They tell me that it is too much, too soon and they begin to scream in pain. These are the patients that are telling me their stories over and over and I see at least one every day that I am at work. These are the patients that don’t get to go home wrapped in loving arms at 24 or 36 hours.
These are NAS patients. Rather in severe withdrawal, or on a monitoring hold, these patients were born to mothers who used opiates during pregnancy. Those in withdrawal are given morphine. I work in a small facility. Our NICU can house six patients routinely with overflow for 1-2 more. Very sick babies are transferred to a Level IV facility. Most NAS babies stay with us until they are well enough to go into foster care. Since I began work on September 1st, there has only been one of my shifts without an NAS patient.
The work that I do with most babies is rather routine, and predictable in many ways. However, it will never be routine for me to stand in the doorway of the NICU and see a baby, only hours old, being given another dose of morphine. I could never predict how much an infant can tremble, and twitch and startle, never seeming to find peace and quiet.
I can only wonder what these babies stories will be, what their future will hold. I will not be privileged to hear them. I would like to assume that they will be happy and bright and optimistic stories, because to assume otherwise is too painful.