I've been back to work in the NICU for a few weeks now and it's actually going quite well. My manager gave me 7 shifts 'buddied' which means I've been working with another nurse to cover one assignment so I have time to get my skills up to scratch without worrying about being totally 'in charge' of the babies. I'm kind of surprised how much I (so far) enjoy working and don't long to be home with Kaia (at least not TOO much). I realize how much I missed the NICU and how much I like 'high tech-ness' of it compared with the contract job I did in between pregnancies. The NICU is a much more difficult job and a more stressful place to work, but more interesting too. I'm only doing 2 shifts a week though, so I think it will be manageable.
Being with the babies does bring up a lot of feelings though. I've been missing Aidan and thinking about my pregnancies more than I have in awhile. Partly that is due to working with people I haven't seen in over 2 1/2 years who of course, want to know what I've been doing all this time. (Was on bed rest, had a dead kid, worked somewhere else, was on bed rest, had a live kid, then looked after her and pumped breast milk for a year. Thanks for asking!) A lot of people have sort of kept up with me via facebook and immediately ask "How's your daughter?!" It's a safe thing to ask. Every parent likes talking about their kid. It's nice to be able to respond about how well she is doing. How happy she is. How healthy.
No one mentions Aidan unless I do.
In between taking care of the babies, and when there are no parents in the room or while we're on break, I've shared with some of my colleagues what we've been through in the last few years. What it's like having a pregnancy that's in danger. What it's like having a child that died. What it's like having a baby in the NICU. As much as my colleagues 'get it', since they work with families in similar situations to mine every day, it's an impossible situation truly to understand until it's you. The fear. The anger. The hope. The disbelief. The sense of loss.
Seeing the babies isn't as hard as I expected. I haven't had any really strong reactions or flashbacks or feeling like I can't cope. That being said, I haven't had to look after a brand new extreme preemie yet (< 25 weeks). I'm kind of dreading having to admit a brand new 23 or 24 weeker, but I'll cross that bridge when I get to it. I know it will be difficult looking after a child who is closer to Aidan's gestational age.
There are a few babies on the unit who are former extreme preemies. One I looked after a couple of weeks ago is now many months old and still not doing well. May never do well. This baby may have spent months and months in the hospital, parents hovering, hoping, praying; enduring many, many painful and invasive procedures and surgery...and may still die. In situations like this, my colleagues have a hard time wholeheartedly agreeing with the parent's decision to continue care, and 'nurse me' gets this. It's awful to watch a child have to endure so much suffering day after day. As a medical professional you begin to feel more like you are hurting the child, than helping him or her. You begin to question what type of life a child is going to have after surviving so much. Will he or she grow to enjoy life, able to actively participate in society? Are you doing the family a service by saving their baby? Or will life be a constant battle from one medical crisis to the next? It's also a struggle to balance the wishes of the parents who may want to continue no matter what, while being afraid you are no longer 'doing good' for the child. How much is too much? There are no right answers.
However, coming back to work I find I am much more sensitive to the decision making processes that parents of these types of children might face. I have a much better appreciation of what it's like to have to make very hard choices when there is a lot of doubt surrounding the outcome. How hard it is to keep up hope day after day, in the face of so much adversity. How angry you feel at doctors, nurses, social workers, as they look at you with pity, as if you're not *quite* understanding how serious the situation is. As a parent you feel it's your job to have hope for your child. Hope that he or she will be okay, that your baby will end up on the good side of statistics. It's hard to do this when you never get any good news and never see much progress. I have a feeling, this will be another area I might have difficulty coping with. Identifying too strongly with the parents of 'hopeless' cases. We'll see how it goes.
One other thing that I have found really interesting is that I'm finally beginning to have that sense myself as a changed person. The one I was 'before Aidan' versus 'after Aidan'. I often read on others blogs how they feel they are a very different person person before and after their baby died. They don't recognize their 'before' self in photos. They don't identify with the same values or concerns they had prior. They feel like a changed person. I honestly never really felt that way after Aidan died. I definitely saw the timeline of my life as 'before' and 'after' but I couldn't say I really felt like a different person. I felt like me, only sadder.
Being back in the NICU, I'm really getting a sense of myself 'before' and 'after'. I realize that I never entirely assimilated back into who I use to be, because I never returned to all the same routines that comprised my life before him. Aidan died, and then I started a whole new 'work life'. I had new colleagues, I worked different hours and I worked on a different floor with an entirely different patient population. I didn't have to make myself 'fit' into my old life entirely, because I just never went back to it.
And now I have.
I will say, it's weird. I belong and yet...I've experienced so much. And I realize that changing jobs when I did, was entirely the right thing to do. I'm glad my career moved in a different direction after Aidan died. It helped me cope, and not just because it removed me from 'the babies'. It helped pull me out of myself by having to interact with new people and learn new things. It kept me feeling like I was moving forward rather than just that awful feeling your life 'circling' after your baby dies. I've realized that that would be my advice to anyone who has lost a child. Once you come to the point where you can get out of bed and walk out the door, try something new. Anything. It doesn't have to be as big a change as a new job. Just change your routine, even if it's something small. It helps to get you out of that mindset of what 'should' be and helps you to focus on what is. That, in my opinion, is an important step in moving forward.
Coming back to the NICU, I feel like I'm picking up where I left off. It's strange, but also kind of good. My life is different now. I'm mom to a living baby, and mom to a dead one. I've faced some of the situations that were my worst nightmares. I've grown and lost and gained and hurt and survived so much that I realize I'll
never be able to truly go back to the person I use to be. I'm not the same person that I was on my last 'before' shift in January 2010.
And now, that's finally okay.
Do you feel you are a different person 'before' and 'after'? Does that bother you? What do you think of my advice to change your routine after your baby dies? Would you agree or disagree?