I Wasn't Always This Strong - part 3
My first job out of college was as registered nurse in a neonatal intensive care unit (NICU). It was my night with Michael Hagerdorn that initiated me to the world of hit and run drivers. Michael Hagerdorn was a preemie who had grown up in our unit. He was around 9 months old and still breathed through a tracheotomy or tube in his throat. He was hooked up to a ventilator which did his breathing for him, thus the reason he could not be discharged home. You must remember this was 1979 and we simply did not have the technology we have today for these little preemies. We all knew and loved Michael Hagerdorn and the docs were trying everything they could to get him weaned from the ventilator so he could go home. But alas, his lungs were too damaged so his future was bleak. In every other way, Michael was a normal 9 month old. Although small for his age he was active and loving and had a wonderful personality. We had been his family for his entire life and we all loved Michael.
I had only been working in the unit for about 6 months and one night I was given Michael as my patient. I was feeling confident in my skills by that time and never questioned that I could handle his needs. When a baby has a tracheotomy you need to suction the tracheotomy tube out every couple of hours to make sure it stays clear of mucous, otherwise the baby will start having difficulty breathing. This entails taking a small tubing that is attached to a suction machine and passing it down the tracheotomy tube and then pulling it out as you suck. It’s a relatively simple procedure and I had done it hundreds of times since I had started the job. I was working nights at the time. I went to do one of Michael’s routine suctioning and as I pulled out something went wrong and I knew it almost instantly. Michael started struggling to breathe. The tracheotomy tube looked like it was still in place but he was quickly turning blue. I grabbed the Ambu bag which is a bag that you can attach to a tracheotomy tube and blow air into the lungs. But when I tried to blow air into his lungs I couldn’t. I just couldn’t. The lungs would not expand and I could feel extreme resistance. Within moments Michael was the color of a blueberry. I yelled for help and then I panicked. The respiratory therapist came running in as did the charge nurse. Me? I was useless. I dropped everything and stood to the side with my hands over my mouth saying “Oh my God, oh my God, oh my God”. The respiratory therapist was yelling to me for some equipment but all I could do was stand there frozen watching this tragedy unfold. I thought I had killed him. I remember one of the nurses pulling me away and sitting me down in a chair and then moving in to help. I will be forever grateful for the skill of that respiratory therapist as he stepped in, immediately recognized the problem, took out the old tracheotomy and replaced it with a new one. Michael quickly pinkened up and the emergency was over.
But not for me. I was traumatized. Seeing my distress, my charge nurse told me to take a break. I left the unit and never went back that night. I walked the halls crying with the realization that I could kill someone. A mistake on my part could change the course of someone’s life if not end it. I quite literally held the lives of these babies in my hands while I was caring for them. Unless you think me a total idiot, I believe before this night intellectually I understood this. That’s what medicine is all about but until I was actually, truly faced with it I hadn’t totally internalized this fact. As I walked the halls I heard over the pager my charge nurse paging me to return to the unit. But I just couldn’t. I couldn’t go back to a place where I had almost killed a baby. I couldn’t face the parents who would be in that morning to see Michael. And this for me was a moment of clarity - when I understood for the first time hit and run drivers. Before that night I could not understand how anyone could injure or kill a person by accident and then leave the scene of the accident. But now I did. My first reaction was to do just that. Run. As far as I could. To say I was disappointed in myself was an understatement. I eventually returned to the unit and had a long talk with my charge nurse. The next night for my shift I was assigned to Michael Hagerdorn.