1. Collins, Amy M.


Updated several times a week with posts by a wide variety of authors, AJN's blog Off the Charts allows us to provide more timely-and often more personal-perspectives on professional, policy, and clinical issues. Best of the Blog will be a regular column to draw the attention of AJN readers to posts we think deserve a wider audience. To read more, please visit:


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There was only a tiny drop of blood. I was worried, of course, but I went to my OB-GYN for reassurance more than anything else. Maybe she would tell me I was doing too much and needed to rest. Maybe it was just normal. But as soon as she looked at the ultrasound screen, I knew.


Usually when I went for a scan, she turned the screen toward me. Until now, every scan had been great. I had just entered my second trimester. The barrage of tests given to women of "advanced maternal age" had all come back normal. The baby's heartbeat was strong at every visit, and I was riddled with nausea, something I'd been told was a "good sign."


This time she stared at the screen for what seemed like forever. Then, quietly, she told me that my baby of 16 weeks' gestation no longer had a heartbeat. Moments later, the high-risk doctor came in to confirm this. I turned away as he talked to my doctor about the "degradation" he could see, suggesting the death had happened over a week before. Somehow this terrible word-and image-is what stuck with me, even weeks after the event.


Later I entered the ambulatory center where I would have a D and C. I'd never felt so out of touch with my body. I was floating somewhere above, watching myself make zombie-like motions with a blank stare. A nurse met me at the elevator. She took me by the arm and gently steered me aboard. "I'm so sorry," she said.


Lots of people submit articles toAJNwanting to thank nurses for the care they provide. When a nurse makes all the difference in a difficult situation, it's obvious why so many people feel compelled to document it. The care doesn't even have to be earth shattering. Some nurses might say they were just doing their job. But the simplest things-a touch, a gesture, kind words, a connection-can provide comfort in an otherwise comfortless situation.


The nurse who took care of me during my brief stay was just the right mix of gentle, informative, understanding, and humorous. She had a big presence, and I could tell she was seasoned. Despite the fact that she worked in a busy ambulatory center, I felt like I was her only patient.


She placed a warm blanket over me while I waited to go into surgery. Something about this maternal gesture, from a complete stranger, made my tears begin to fall. "This isn't going to be easy. Especially this weekend being Mother's Day. It's going to mess with your head," she said. "But it will get easier." I appreciated her honesty.


"I have a beautiful son at home," I said. "I'll try to focus on him."


She comforted me when my emotions ramped up as I was being wheeled into surgery. "It's going to be okay," she said.


Later, when I woke, the nurse told me, somewhat to my embarrassment, that just before I fell asleep I'd blurted out that I worked for AJN, and how much I respected nurses, that they were the ones who really connected with patients. I have no recollection of this, but it does echo how I feel. Especially about nurses like this one, who was helping me get through perhaps the hardest day of my life thus far.


When my husband arrived, she told him to pull the car up, that she would bring me down in a wheelchair. My teeth were chattering, a side effect, she explained, of the anesthesia. "Let me get you a warm blanket," she said. As we wheeled past the nurse's station, another nurse said, "You're not allowed to take the blankets out of here." "Really?" my nurse replied. "Hmm, I didn't know that." She winked at me conspiratorially, and we kept going.


Outside in the dazzling sun, it seemed impossible to digest that I was no longer pregnant. That this had happened to me. That I was one of the "less than 1%" of people who miscarry in their second trimester. That the future I'd imagined, with two little boys playing together, was not going to happen. The nurse squeezed my hand, snapping me out of my thoughts. She helped me into the car and said goodbye, leaving me with the confiscated blanket.