1. Appel, Yehudis BSN, RN


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Before I became a nurse, I heard that nurses have special moments with their patients and families that they never forget, but I never truly understood what that meant.


My first neonatal code occurred about six months after I completed my orientation in the pediatric ED. I remember that shift being a particularly busy one. In the midst of the hustling and bustling of assessing and medicating patients and reevaluating and discharging them, I heard banging on the triage door and saw a mother and father wheeling in their baby carriage, frantically crying out that their baby, Skye, was blue in color.


I remember quickly removing her clothing and seeing how cyanotic she was, all while an electrocardiogram was being obtained and she was placed on the cardiac monitor. I recall hearing the doctors paging overhead for pediatric respiratory and anesthesiology to assist with resuscitation. Other team members included a certified nursing assistant and a medical student who tried to relax the parents but were understandably not successful.


There were multiple unsuccessful attempts to obtain peripheral vascular access in Skye. I can still see the look of terror on Skye's parents' faces as the drill gun used to insert the intraosseous access whirled into baby Skye's bone, then was somehow also unsuccessful. A neonatal intensive care unit (NICU) nurse came and was able to obtain peripheral vascular access, which ended up becoming infiltrated shortly thereafter. Intubation was not successful either.


Gradually and miraculously, things improved slightly for Skye and she was transported to the NICU. Even though she'd improved very slightly, Skye was not doing well when she left us and I was not certain that she would survive the night. I never knew what ended up happening with Skye after reaching the NICU, but I also never forgot about her.


Some impressions are lasting. Almost two years later, I was working as the pediatric triage nurse. When I read the next patient's name on the triage card, I thought it looked familiar but couldn't remember why. When I called for the patient to come inside so I could triage her, in came a very familiar looking woman with a two-year-old daughter.


It took a moment for the fact to sink in that the patient waiting to be triaged was none other than Skye. This time, she was two years older and was smiling, spunky, playful, cheerful, and of course acting like she was the boss of her mother.


Because I never learned what happened to this baby girl after we'd rushed her upstairs to the NICU, I found myself saying to the mother in astonishment, "Is that my baby Skye?"


Her mother responded with a beaming smile on her face. "Yes, and I remember you and thank you and everyone who saved my baby."


I was shocked that the mother remembered me. After all, there were so many things that happened during that code, and emotions were running very high.


Usually, we do not know what happens to our patients when we leave after our shifts or once they are transferred to another unit. We go home thinking about our patients and what more we could have done for them.


I used to think that patients and their families don't understand or realize how hard we try to help them and that we actually do remember them. While we were trying to save baby Skye, her mother seemed to be in a world of her own, uncertain whether her child would survive and live to see the next morning. Skye was the focus, not me, and I never thought her mother would remember me. What I did not realize is that the patients and their families remember us too. They remember how we tried our best for them and advocated in the best ways we knew how.