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Nurse, mother of a 23-week micropreemie and a Prolacta employee

Emily Million provides a rare perspective on how to advocate and make informed health decisions both as a parent and as a nurse.

Article was originally published in the National Black Nurses Association News, Spring 2016.

Watching mothers with tired eyes full of grief and desperation wash and fold tiny clothes in the NICU parent room, I put my headphones in my ears and try to drown out the sound of monitors and alarms chiming constantly only footsteps away.

I watch my fellow nurses running from room to room with their hands full of medicine, stressing about their sick babies and trying to manage their unimaginable workload. I know they are tired for I am one of them.

But, today I am also the mother of a very sick 23 week micro preemie born at 610 grams. I feel the double burden of mother and nurse. My mind reflects on the practical state of nursing today, and the risks it may pose to my little Rosie.

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As a nurse in this situation, I may know too much. Hospitals are big business. I see that every year administration pushes for more cost effective budgets, causing a domino effect of higher nurse to patient ratios, higher nurse turnover rates due to stress, overworked staff, and a lessened ability to give quality one-on-one care to patients. As a result, some nurses talk about building unions, and demanding better standards. Yet, that effort alone may mean less time in front of patients – which is what matters most.

And some like me don’t want to be perceived as money hungry or selfish. Nursing is not glamorous. Nursing is grueling hours, holidays and weekends, and leaving your family to care for someone else’s. It’s holding dying hands, and helping people cross over to the other side. It means rushing from room to room, making critical decisions and praying you don’t make mistakes.

Nursing means hoping that our actions will help a critical patient make a turnaround before your shift is over. We are exposed to all sorts of diseases and sickness yet we do it willingly and sincerely -- only wanting to make a difference and to help someone in their time of need, with a servant’s heart.

Most days I go home wishing there were more hours in the day and asking myself if I did all I could. But, this is my calling and I wouldn’t have it any other way. My Rosie looks so pitiful and helpless. She is so premature and underdeveloped, my touch is perceived to her fragile body as pain. I want to cry and fall apart, but I’m a nurse so I know how to shove it all to the back of my mind and resolve to be strong.

I open her tiny isolette that looks like a rain forest inside trying to mature her gelatinous skin and I read her a story. It’s the only thing I can do, other than pray. Everything I know has been turned upside down, and I along with the other NICU parents are all wondering which will come first -- a birthday or a funeral.

My Rosie is still here. I’m really not sure how long her life will be. I don’t know if she will see or hear, (her eyes were fused at birth) but she’s here. I look at her drips hanging, and I see her dry, chapped lips and frail little body.

How did we get here? I was working 3 days before my water broke in this very NICU. I felt fine. How were we both so sick without me knowing? I review signs and symptoms I could’ve missed. Rosie’s oxygen levels start dropping.

I anxiously grab her nurse. I watch my colleagues swarm into Rosie’s room, her oxygen levels are critical…. again. They begin their protocol of sustaining her life medically. I ask myself silently if it’s selfish or ethically right to keep her here. At first I watch without fail from a nurse's standpoint.

Who washed hands? Who’s bagging her? Are her oxygen saturation levels improving? Is she septic again? Is she hurting?

Neonatologists and nurses are pouring in the room, and I hear orders being barked in shrill voices. Then, silence. I look up, “she’s recovered, Emily. Try to turn your nurse brain off. One day at a time, and sometimes, one minute at a time.”

My time to advocate for her as mother and professional would come out of desperation, striving for her to receive proper nutrition. That I alone would get the opportunity to give her exactly what she needed and only something I could give her, my breast milk.

But it went a step farther. She needed fortification. Just as they were preparing formula to add to my milk I held the line and said, “No, wait, let me get you the research.” And for the next 24 hours I pulled all the evidence-based data I could and brought it back to her physician and to the administration of the hospital proving that only human milk-based fortifiers were appropriate for a baby as small as my Rosie.

It was a struggle to get folks to change long-ingrained practice but advocating for our children and our patients is what we do best. Rosie’s health and growth took off as soon as we put her on an exclusive human milk diet and the rest, shall we say, “is history.”

Due to Rosie’s outcomes and my fight for her nutrition, the feeding protocol designed for Rosie became standard of care for all preemies in the unit less than 1,500 grams and to this day, it remains. For a very long time, I kept Rosie isolated due to her delicate immune system. I

still keep jars of hand sanitizer by the doors. Every night to this very day even 2 years later, I tiptoe to her bed, just to watch her breathe and look back in amazement at how far she has come in her short little life. What will she become and will she have any life-long impact?

Either way, she’s a miracle. This is the life of a registered nurse and a mother of a former micro preemie, a delicate dance between knowledge and nurture, skill and determination.

We nurses are the core of compassion and the “art and science” of critical care.