Authors

  1. Fritz, Maddison Margaret McGee MSN, RN, FNP-BC, CCRN

Abstract

Finding a deeper space for empathy

 

Article Content

Today I volunteered at a community health fair. It was the same one I volunteered at exactly a year prior. Today I reviewed the same lab results with some of the same patients in the same rural high school gym. It felt like deja vu. Only last year I was just entering my third trimester of pregnancy and I was starting to get sick.

  
Figure. Illustration... - Click to enlarge in new windowFigure. Illustration by Janet Hamlin.

A lingering throat tickle that day soon turned into bouts of uncontrolled coughing. The next day a positive COVID test and oxygen levels in the 80s landed me in the hospital. On the drive there, I reassured my husband that he didn't need to come in with me, that our two-year-old needed him at home, and that this was just to confirm our baby was okay.

 

After the initial flurry of assessments and monitor hookups, I took my final exam for my FNP pediatric course-in case I got sicker, I wanted the semester wrapped up. Shortly afterward the resident came in and recommended monoclonal antibodies. I signed the consent and watched my nurse-a new grad-prepare the antibodies, something I'd done numerous times as a pediatric ICU nurse. When she forgot to prime the filter tubing, I apologetically pointed it out. She blushed while we joked about the joys of having a nurse as your patient.

 

It was around 3 AM when she started the infusion. Moments later she walked out of the room, leaving the call light nearby. I lay there recalling the steps in my hospital's monoclonal antibody procedure: "After beginning infusion, closely monitor patient for infusion reactions . . . " Suddenly my heart started racing, my face and chest got flaming hot, and I began coughing uncontrollably. All my extremities went numb and tingly and the coughing became gasping for air.

 

It's insane how many thoughts can run through your head in five seconds: Where'd my nurse go? Where is that call button? Why can't I get any air into my lungs? I'm going to die. My baby! I've seen this before-an anaphylactic reaction. So this is what it feels like. If my heart stops, they have five minutes to get my baby out safely. What are the mortality rates for this? I need my nurse!

 

I thought of my husband getting the call about my death from an anaphylactic reaction. I lunged over and hit the stop button on the medication pump. My hands frantically searched for the call light, and I mashed the button repeatedly, the room spinning, my vision static, my body racked with gasp-coughing.

 

My nurse stepped into the room, paused and assessed the situation, and then flew into action, calling on her walkie-talkie, shutting off the IV antibodies, getting help. The room flooded with lights and people as she started to give a detailed report. I heard someone say, "She's having an anaphylactic reaction. Grab the epi and the code cart." I don't know if it was the meds or the fact that the antibodies had been shut off, but I was able to suck air in again.

 

I began shaking uncontrollably, and I remember saying, "I think my blood pressure is dropping and I'm going to pass out. Can you lay me back on my left side so baby gets blood flow?" This whole time my baby was being monitored-piercing through the tunnel voices, I heard the beep-beep-beep of baby's heartbeat drop until it triggered an alarm. I could just make out the red light and big blinking heart rate of "60." If baby was outside of me, this is where we'd start CPR, I thought.

 

"Do you need to get her out of me?" I asked as I tried to recall the size of a 29-weeker from the times I'd floated to the NICU. There were more people, and I heard talk of a C-section in that "we're very worried but not going to show it" voice health care professionals, myself included, sometimes use.

 

All of a sudden, though it seemed like an eternity, the beep of baby's heart rate picked up and the alarm stopped. It was like everyone in the room started to breathe again. Baby was gonna be okay; I was gonna be okay. A nurse called my husband and put me on speaker. "Love, I need you to come in," was all I could muster.

 

The next weeks are a blur: constant contractions (apparently uteruses don't like anaphylactic reactions), COVID, bed rest, and several hospital visits. It's all pretty fuzzy.

 

But today, as I drove home to my luscious, healthy eight-month-old, I saw with clarity the ways that night shaped the nurse I am now. As I sat today with patients who shared how health scares, hospitalizations, and cancer treatments have shaped and scarred them in the last year, I noted within myself a deeper, wider space to empathize with the terrifying, out-of-control, vulnerable things our patients experience. And for that, I am grateful.