Nurse, Mother, Patient

I’m a mother of two girls, ages eight and ten. When I attend birthday parties, soccer practices, and all the usual social events, people often ask what I do for work.

When I tell them I’m a pediatric ICU nurse and have been doing this for 13 years, I can feel the conversation shift from casual to something much heavier.

I understand the awkward pause that often follows. We have suddenly touched on something tender: the idea of children becoming critically ill and dying in an ICU.

Because children are just getting started.

And yet, as amazing and almost magical as children can seem, they are just as human as any of us. They are just as vulnerable to serious illness and death.

You may be thinking what many people say to me: “I don’t know how you do your job.”

I want to share how I have learned to do it.

It hasn’t been through compartmentalization, which is what healthcare professionals are traditionally taught. I have learned another way, and I want to share that journey through three patient stories.

The first two patients are children. The final patient is me.

When I was in nursing school, I was certain I would work with adults. I had spent years researching care for frail older adults, including exercise, toileting, and feeding interventions.

I did not have children of my own yet, and I was, quite frankly, awkward around other people’s kids.

So I was pleasantly surprised to discover that I fit more naturally than expected into the prescribed role of a pediatric nurse. I liked the idea of being a healer and a kind of superhero to my patients and their caregivers.

I entered the work rather starry-eyed.

At the beginning, there was so much to learn about the skills, science, and technology of ICU nursing. Two years into my nursing career, I had my first child. Two years later, I had my second.

As frightening as it was to be a new nurse, becoming a new mother was terrifying.

There is no prescribed role for parenthood. I had to discover who I was becoming as a mother, who my children were becoming, and what our relationships and values would look like as we faced life’s struggles together.

For those first four years of nursing and parenthood, I was in the weeds, trying to absorb everything.

Around the four-year mark, the dust began to settle. A new space opened inside me where I could process my patients’ stories in a way I had not been able to before.

I wasn’t ready for that space to open.

I came onto a shift and found that my patient was about the same age as my younger child. She was dying from a serious infection.

Her parents had decided to withdraw life support. My job was to walk them through what would happen when we removed the breathing tube and stopped the medications keeping their child alive.

Her parents could not bear to remain in the room while we did this, but her mother wanted to return afterward and help bathe her.

As they stepped outside, her mother looked at me and said, “Please be gentle with my child.”

I looked her in the eye and promised that I would.

We disconnected the equipment, and her child died within about five minutes.

We cleaned the room and invited her mother back inside. We stood on opposite sides of the bed and bathed her daughter together.

The mother began to sing.

The song was not in English, so I could not understand the words. It was a lilting, haunting melody. She would sing until her voice caught, then begin again.

I knew it must have been a song she had sung to her daughter on countless nights at bedtime.

When the bath was over, she dressed her child in pajamas from home and kissed her goodnight one final time.

I went home after that shift, kissed my own children goodnight, and felt absolutely wrecked.

Until then, I had been taught that doing my job required compartmentalization. Leave work at work. Think of the hospital as the place where all the abnormal, tragic, and sick cases are contained. Clock out, leave your patients behind, and return to your normal, healthy life.

But that shift taught me that the stories I witness in the hospital are too human, and I am too human, to simply leave them at work.

Who I am and what I do inside the hospital are just as real and true as who I am outside of it.

I realized I did not need to learn how to compartmentalize. I needed to learn how to integrate everything I experienced into the whole of who I am.

As I began to do that, I found an unexpected sense of relief and freedom.

I no longer had to pretend that I did not grieve for my patients. I could simply grieve.

That allowed me to move closer, learn more about who my patients and their families were, and provide the kind of care I had always wanted to offer but had perhaps been too afraid to get close enough to understand.

Seven years later, I cared for a child whose chronic illness had progressed to the point that she was no longer responsive to or engaged with the world around her, including her parents.

Her family had reached a crossroads. Should they pursue more aggressive measures to prolong her life, or begin withdrawing treatments with the understanding that she would likely die?

By then, I had learned to move beyond explaining the clinical differences between one path and another. I could ask different questions, move closer, and understand who this family truly was and what mattered most to them.

I learned that they wanted their child to be free from unnecessary suffering and to have quality of life above all else.

Together with the medical team, we developed a highly individualized end-of-life care plan. It helped her parents feel that they were still caring for their child rather than giving up on her, even as they prepared to say goodbye.

I spent the final days of her life with her and her parents.

On the day she died, amid very real grief, her mother said, “I am so lucky to have experienced what it is to be a mom. I’m so lucky.”

The death of a child will never feel right.

Bringing our full humanity to children and the people who love them will always feel right. It helps all of us remain true to who we are until the very end.

Still, there was one barrier between my patients and me. I remained the healthy one. I could clock out, go home, and return to my healthy life.

That remained true until this past year.

In January, I received a phone call telling me that a biopsy of a lump in my right breast was positive for cancer.

For the first time, I understood what it feels like to have your entire world overturned by serious illness in a single moment.

I went through treatment during the first half of the year and was declared in remission in June. I then began long-term preventive hormone therapy, and our family started settling into its summer plans.

At the end of July, my husband developed a random infection that reached his spinal column. The swelling became so severe that he suffered a serious spinal cord injury.

He was rushed into emergency surgery, barely able to move his arms or legs. We did not know how much function he would regain, if any.

He spent a month in an acute rehabilitation facility, then returned home to continue his recovery with me as his primary caregiver.

I am incredibly grateful to say that, although some deficits remain, he returned to work last week.

Many things about this past year shocked me. One of the greatest surprises was the pressure I felt, both from our culture and within myself, to perform.

I felt expected to project endless stability, optimism, and clear-mindedness. I wanted to be a superhero patient and a superhero caregiver.

A voice in my head kept saying, “Don’t be too sad. Don’t be too angry. Don’t be too needy.”

The people who brought me the most comfort were those who did not arrive with performances of their own.

They gave me room to bring my real questions, fears, and sorrows to the surface. They helped me understand who I was and where I truly stood amid the chaos.

It may surprise you to know that I continued working through most of the year. That was my choice, although I had no idea how it would go.

What I have discovered is that when I enter a patient’s room now, I am no longer as intimidated by the emotional complexity of the experience, whether it belongs to the patient, the caregiver, or me.

I am more open to letting people show me where they are within the whole messy mix. I can also recognize where I am within it.

Then we can meet each other and find the next step together.

My hope is that all of us can begin moving beyond compartmentalization, especially when it is driven by fear of other people’s experiences.

We can open ourselves to the full range of human experience and discover a different way to carry one another and allow ourselves to be carried.

There is freedom in releasing the pressure to perform. There is freedom from the loneliness and isolation that performance creates.

I can tell you, as someone who has been deep inside all of it, that this is how I have learned to do my job.

I have also learned that it is the most freeing and beautiful way for us to be.

Thank you so much.