Monday, August 4, 2008
There but by the grace of God go I...
Ahhh...a Monday morning off, a huge thunderstorm rumbling in, a lime-green kitchen to sit in...what more could I want? I worked all weekend in the Special Care Nursery. It was a busy weekend in Labor and Delivery, which trickles down to the other areas (I work Special Care, postpartum, and newborn nursery, just a constant rotation). I actually ran up to the hospital on Friday evening to try to start an IV on a baby, and failed. Arghh.
Our Special Care Nursery is nothing like a NICU (sometimes much to my delight, and others much to my dismay), but we do admit babies who are as young as 32 weeks (2 months early) and can support them with antibiotics and oxygen (which isn't a lot of support), but if they need more support than that, then they have to be transferred to Spectrum in Grand Rapids. If a mom steps into the hospital ruptured and contracting and ready to deliver a 24-weeker, we can stabilize that baby and prepare it to be shipped to the "Big House" as well. I'm not gonna lie: I LOOOOOOVE stabilizing those tiny, sick, and fragile babies. I don't wish for that to happen to any family, but if it has to happen, please let me be there!
One of the (many) interesting sides to dealing with such an unpredictable population is that with every baby comes a set of parents (or at least one parent, as is frequently the case). You never know what you'll get from either side. Just because someone had a baby doesn't mean that they're prepared (mentally, emotionally, financially, physically, spiritually...the list goes on...). Just because someone had a baby doesn't mean they're happy. Just because someone is having a baby doesn't mean she's taking care of herself. And that's the rub...
I must speak in somewhat vague generalizations here, but some of the hardest babies to care for are those who are withdrawing from whatever mom was using during her pregnancy. It happens more than one cares to realize. Sometimes we deal with babies whose mother never sought prenatal care and abused street drugs thru her whole pregnancy, and in those cases the mother willingly gives the baby up for adoption, or Child Protective Services steps in and removes the baby from her (that is, if drug testing in the baby was positive). In other cases, the mother was abusing some pretty hard-core drugs (crack, meth, heroine), quit those drugs, and began using a prescribed drug that is "safer" to take during pregnancy, helps her wean from the illicit drugs, and prevents her from going thru the severe withdrawals. The drug of choice is usually methadone, and it's potent, highly addictive itself, and the effects on the baby are still ugly. But it's the lesser of the evils, and it's controlled. The sticky wicket is that CPS may be involved, and the mother's parenting might be highly questionable, but there's not enough reason for the child to be removed from her care.
A newborn going thru withdrawal is horrifying. They're usually (but not always) medically managed and have to continue taking methadone for weeks while they're in the hospital. The baby is frantic, beyond your typically fussy newborn, nearly impossible to console or control. The mother is usually pretty frenetic herself, a fast and drastic emotional cycler, demanding, and manipulative. Taking care of the baby itself is exhausting, and then you throw mom in the mix. If dad's involved, he may be in jail, he may be abusive, he may abuse the drugs himself. Usually her support system is shoddy at best, and she has absolutely no coping mechanisms.
We emerge from nursing school vowing to be non-judgmental with all of our patients, regardless of their illness, history, circumstances, the way they treat us, where their piercings are, etc. It's far easier said than done. Nurses can easily become a crass and jaded crowd. Nurses can be VERY judgmental without realizing it. I admit, it's terribly difficult to deal with a situation like this and keep myself from shaking the mother and screaming, "LOOK at this!! You DID this!! Look at your baby - he didn't ask for this and he didn't even have a chance!" Other families who are present in the nursery aren't getting the care they deserve simply because, well, they're 'normal' and they're not the squeaky wheels. The consequences of one person's actions are so far-reaching.
But if I grew up in an abusive household, how would I have turned out? If my mother were an alcoholic, a drug abuser, a prostitute, whatever, what decisions would I have made? People don't just make these decisions because it sounded fun, and they're dying for any form of love, numbing, whatever will help them block out of the fact that their life is a train wreck. They don't usually WANT to be in this position, but life and circumstances pushed them there, and there but by the grace of God go I save for the fact that I was born into a stable environment.
Galations 6:14: "May I never boast except in the cross of the Lord Jesus Christ..." I have no - NO - reason to be so haughty as to think that people in this position are below me, that I'm better than they are. It is only by God's grace that I woke up again with AIR in my lungs, let alone the fact that I woke up clean and forgiven in God's sight. Sin is sin to God: it separates us from Him and that's that. Whether I gossip or snort crack is irrelevant; I'm a sinner in need of His grace and we are ALL in need of Him. I can take credit for nothing in my life; the work that Jesus completed on the cross is what it all comes down to. That's all that matters, no matter who you are or how much you have. May I continually put my pride to death on a daily basis and consider the kindness I've been shown by Christ, and humbly extend that to everyone...not just the ones whose decisions I like.