1. Brunner, Robin K. RN, CCRN

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A RECENT CHRISTMAS EVE started like any other workday. I arrived in the ICU to receive my assignment and begin my 12-hour shift. Little did I know that it would involve much more than meeting the physical needs of a critically ill patient.


Holiday tragedy

The previous day, a 42-year-old Amish man and his wife hired a driver to take them and their 4-year-old daughter K to a holiday event. Along the way, the vehicle was rear-ended and thrown into the path of an oncoming car. No one was wearing a seatbelt and no safety seat was available for K; she was ejected from the car and died at the scene. The driver died at the scene as well. The Amish couple, Mr. and Mrs. F, sustained multiple traumatic injuries and were medevaced to my hospital, a Level I trauma center.


After receiving report on Mr. F, I gathered my thoughts in regard to death-specifically the death of a child-and uttered the first of many prayers for both my patient and myself. My goal was to keep Mr. F hemodynamically stable and as comfortable as possible. Mrs. F, who was under the care of a colleague, had pelvic fractures and required mechanical ventilation. They both had to deal with the sudden loss of their child as well as the driver's death.


Mr. F, who had a lacerated spleen, asked often about his wife, who was close by in another ICU bed. "Do you know that our little girl died in the accident?" he asked. I took a deep breath as I held back tears. I took his hand and said, "Yes, I know." We sat quietly, and he softly said, "She was too good for this world.


"We have six other children, but we often watched K and commented that she was too nice, too kind, and too selfless. This world would have beaten her down, and now it can't." Now I was crying. I asked Mr. F to tell me more about K. He beamed as he told me about a curious, loving 4-year-old with knowledge far beyond her years.


When I asked what I could do for him, his wife, or his family, he said, "Can you get the autopsy done so we can have the viewing in our home tonight? Can K's body be brought here, today, to the hospital for my wife to see her before she's buried?"


Bringing K home

The facility completing the autopsy and the medical examiner from a bordering county were in charge of K's body. I still had to be Mr. F's nurse and stay focused on his care, so I asked our trauma nurse practitioner and trauma case manager to make the necessary phone calls. Unfortunately, because of the Christmas holiday we couldn't get through to anyone to speed things up. We persisted with calls and finally got through to someone in pathology, who told us that the autopsy was completed and the body had been picked up by a funeral home. They didn't know which one, but Mr. F gave us the name of one used by the Amish families in the area.


I found their phone number and spoke to a lovely woman who understood the Amish tradition and knew this family. I requested that K's body be brought to the hospital, and she agreed.


The arrival

I spoke with a colleague who was caring for Mrs. F. We discussed the possibility of weaning her off the sedation just before K's arrival. I spoke with family members and kept them updated. I also made arrangements to transport Mr. F into his wife's room. My colleague and I would be in the room to monitor our patients.


I called security to assist in escorting K's body discreetly to the trauma-surgical ICU. They agreed to fully cooperate with this sensitive issue.


When the small body of a child arrived, a respectful hush fell over the unit.


Saying goodbye

Being a nurse for nearly 34 years has been more of a calling than a job. On that Christmas Eve, all the training I received as a nurse and a human being came together as I watched a mother cradle her dead little girl. I watched a husband hold his wife's hand while stroking the angelic face of his beautiful child. This made me recognize that something far bigger than me makes this world happen. It was truly a privilege that I was in that place, at that time, helping those parents say goodbye.


As healthcare providers, sometimes we get to participate in something that's too good for this world.