It was a slow Thanksgiving day shift.  The nursery was quiet, and I was counting the hours until I could be home celebrating with my family.  Half way through the shift a call comes in from the Mother/Baby unit.  A nurse is concerned about one of her babies, who is not eating well and is breathing fast.  The pediatrician would like him admitted to the NICU for monitoring.

I received report from the Mother/Baby nurse.  She informs me that mom is a 40 year old gravida 10, para 9–now 10 (she has been pregnant 10 times, and has 10 living children).    She has custody of none of her children due to issues with drug addiction.  She is living in a local community shelter.  She had no prenatal care with this pregnancy.  Her drug screen is negative, and she states she has been clean and sober for over two years now.  She denies knowing who the father is.  She was brought in by ambulance, and had an uneventful, but precipitous delivery about 18 hours ago.  The infant’s drug screen is negative.  Social Work has been notified, and the Department of Children and Family Services is investigating.

The mom accompanies the baby to the NICU.  The mom looks as if she is 60 years old.  She is haggard, and weary, and scared. Her hair is unkempt, and her nails are caked with dirt.   I introduce myself and she gives me a worried smile.  She has not one tooth left in her mouth.  She sits quietly as I proceed to admit her baby to the NICU.

The baby is full term and his size is appropriate for gestational age.  He is markedly tachycapnic with respirations of 80-100 breaths per minute.  He is active to irritable.   He has a soft heart murmur.   I do the routine care of monitors, starting an IV, drawing an arterial blood gas, etc.  The infant’s oxygen saturations are 60% on room air. I place an oxygen cannula on the infant and paged the neonatologist.  I proceed to measure the baby’s oxygen  sats from his upper extremities and obtain a four extremity blood pressure.  His upper extremity saturations are 85%, and there is a positive difference between the upper and lower extremity blood pressures.  His overall oxygen saturations do not improve while on 100% inspired oxygen.

The neonatologist gives the mom the bad news that her baby most likely has a cyanotic heart defect.  He needs to be transported to a Childrens Hospital immediately for surgery.

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This mom, who has more than a lifetime of hurt and pain, this mom who has lost 9 children because of her own drug use and inability to care for her babies, this mom who has been abused and beaten and who has sold her own body to survive, this mom who was homeless, this mom who has turned her life around and is clean and sober and struggling to survive, this mom…….

This mom turns to me, a white, well-educated, upper middle class woman, a nurse…..this mom turns to me……..

This  haggard , tired , no teeth in her head, mom turns to me and kisses me full on the mouth.  This mom cries with tears of pain and joy.  This mom repeats over and over again about how thankful she is that we were there to take care of her son.  How we helped her and how God sent her to us.  I am so very thankful for this day. The day my son’s life was saved.

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This nurse is so very thankful that this mom was sent to me.  This mom who showed me what being thankful really means.  Her and he son was sent to us…..we were not sent to her.  And for this…. I am so very thankful.

RR