Thursday, April 19, 2012

Grace.

I copied this post off of Ali Chandra's blog.  She's a nurse on the ship and her job is so way different from mine.  Take a moment and spend some time with Ali and see what she faces down on the ward:

"Most days, being the Ward Nurse Maxillo-Facial Team Leader doesn't mean a whole lot out of the ordinary. I lead rounds, write orders, cover lunch breaks. I do all the same things the evening charge nurse does, just with a fancy title tacked onto my badge. Things can fall into an easy routine and I forget that I'm really in charge of anything.

Until someone comes asking for my input, because I'm one of the ones who can say yes or no.

Today, as I was getting ready to leave, one of our hospital physicians came into D Ward looking for me. There was a little baby with a cleft lip and palate waiting in C Ward. She was being seen by the feeding program and just wasn't gaining weight. 

When I introduced myself to the baby's parents, they smiled up at me, eyes full of hope. I placed the oxygen sensor on her little foot, and as I bent to assess her, I asked her name. Her mama answered simply. Grace.

Grace. An undeserved blessing. At ten weeks old, she weighs just a hair over six pounds (if that), despite her parents feeding her as much as she can handle, a few drops every half hour. Too much of that formula seems to be going into her lungs rather than her stomach, and the telltale signs of a baby in distress were easy to see when I unwrapped her to check her oxygen levels. Add to all this a congenital condition that caused little Grace to be born with an underdeveloped lower jaw, further increasing the work she has to do to breathe, and it's no wonder that she's very sick.

The problem is, we're not a medical hospital. That may sound strange, but it's really more accurate to call the ship a floating specialized surgical centre. We're set up to do surgeries, lots of them, and our patients are, for the most part, perfectly healthy apart from whatever body part we're operating on. Grace is far too small for surgery right now, and this close to the end of the outreach we're not even sure we can get her fat enough to withstand the operation to close her cleft lip before the ship pulls up anchor and sails away.

It's wrenching being caught like that between a rock and the very hardest of places. Yes, we could admit her to the wards, put in a feeding tube and help her gain weight. But every day she spends in a bed is another day that someone else might not get to have surgery. New patients show up on the dock every single day with tumors and cleft lips and a myriad other conditions; we could stay here for years and not come to the end.

In the face of such overwhelming need, how do you triage? How do you decide who gets to come on board and who gets sent home? How do you choose one life over another? And, once you've made the decision, how do you sleep at night?

Sometimes it's all I can do to stop my mind from racing through the day's decisions, replaying every conversation, questioning every move. Tonight is not one of those nights.

This evening, Grace is under the watchful eye of a pediatric ICU nurse in D Ward. There's another PICU nurse working tonight who will take over her care, and one of the nurses working tomorrow morning is the one who used to run the feeding program before the current dietician took over. God knew Grace was coming to us today; it seems He set up the schedule long in advance to make sure the right nurses were working at just the right time, just like He's done so many times before. Grace's papa saw me at the gangway as he left for the night. Thank you, he said. Grace is in the room now. They are caring for her. Thank you.

Tonight I sleep easy, knowing that we made the right choice. Whatever happens with small Grace in the future, she is ours to care for now. The need in West Africa is no less overwhelming because we've admitted this one tiny baby, but I know in the deepest part of me that we are not called to fix all of West Africa. We are called simply to be faithful to the ones placed in our way.

Today, that was Grace. Tomorrow, it will be someone else. And the next day, and the next, and the one after that. Every day we will reach out to the hopeless and speak to them of God's love. Every day we will be called on to extend to them the same grace we were once shown.

Grace. An undeserved blessing."

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