Christmas: A Change of Plans

InterVarsity’s Nurses Christian Fellowship helps nursing students, nursing faculty, and nursing professionals lay a foundation for their life and nursing practice that is centered in the love and truth of Jesus Christ. Author Darlene Sredl teaches at the University of Missouri, St. Louis. The following story, like the original Christmas story, is about a baby, inconvenience, a change of plans, and God’s miraculous response. This account is a condensed version of a story which appeared in the April/June 2015 issue of the Journal of Christian Nursing.

Pulling into the hospital parking garage, I turned off the radio while hunting for a vacant spot. Reminded by the Christmas carols I had been listening to that this was the season of hope, I sent up a prayer, “Lord, put me where you need me, but give me your grace to do what needs to be done.” Help never more needed than tonight, I thought, rushing through the heavy doors marked “Neonatal Intensive Care Unit” (NICU).

Although I was what many considered a veteran pediatric nurse, transferring to the NICU meant learning an entirely new body of information on premature infant maladies, and assimilating it quickly. After an intense and grueling nine-week orientation, little did I realize, on this my first night working autonomously in the NICU, just how quickly I would apply my newly acquired information.

The assignment sheet revealed I had three patients but there were no acute life-threatening problems, just infants slowly gaining weight waiting for discharge. What a joy to have a chance to nourish these little ones while cuddling and loving them.

I looked up to see the charge nurse walking toward me. “There's been a change in your assignment,” she said, pointing to the name penciled over a scratched-out entry on the assignment sheet.

“Uh, okay, but just one patient?”

“This one patient will be plenty...but I know you're up to it.” She smiled reassuringly.

I donned the isolation gear then carefully slid past the curtains of the private isolation room. There, in the dim light, lay a huge baby. Unlike most NICU premature infants who were housed in clear Plexiglass isolettes, Marilee* lay on an Ohio table, which is used for larger babies attached to larger and more complex equipment. Marilee looked to be about six months old, bloated from steroids, no doubt, and sedated so that she would not inadvertently turn or pull out her tubes. A clear plastic extension connected her endotracheal tube to an angrily hissing and puffing oscillator positioned next to her bed.

I counted the drips, 11 intravenous pumps in one infant girl. Stroking her forehead gently I said, “I am going to take care of you, Marilee. It's going to be okay.” I begged then, “Lord, please, let that not be a lie!” In times like this I find comfort and strength in believing God's promise, “God is our refuge and strength, an ever-present help in trouble” (Psalm 46:1, NIV).

As if on cue, Robin, Marilee's off-going nurse, entered the room. “Do you know this baby?” she asked, hoping for an easy report with someone who at least had a working knowledge of this infant's care.

“No, this is my first shift off orientation,” I explained.

“Your first shift off orientation and they gave you this assignment?” she asked incredulously, sighing. “Well then, we'd better get started.”

In a nutshell, Robin told me how Marilee had a problem called surfactant B deficiency and had been a patient since the transport team had airlifted her shortly after birth. “Pulmonary surfactant coats the alveoli with a Teflon-like covering that reduces the surface tension of moisture, thereby preventing lung collapse,” Robin began. “The only effective therapy in cases like this is lung transplantation. But this family has a strong faith in God. They are constantly at her bedside praying. Except for tonight.”

She continued, “Tonight is the annual lung transplant Christmas party, and every patient who ever received a lung transplant at this hospital, as well as all those waiting and their families, are invited. Even the cardio-thoracic surgical team is there! The staff felt it was important for Marilee's family to go to the party, partly for stress relief, and partly to engender new hope by seeing all the kids with new lungs acting and looking like normal children.”

“Don't worry,” Robin concluded, “New lungs will probably not be available tonight because of the party.”

Two hours into my shift, I was starting to get comfortable with Marilee's care requirements when her mother called. Yuletide carols blared in the phone's background, making it hard to hear. Marilee's family was at the party, but they were miserable. The past six month's routine of living near or at the hospital, taking vigil turns at her bedside, was not easily changed.

Although I was totally new to the case, Marilee's mom seemed to trust me, and we spoke with easy familiarity. She shared her frustration over the long wait and depletion of the family's financial resources, but spoke of her continuing faith and strength, believing in God's provision. I reminded her that Christmas meant renewed hope. Almost as an afterthought, I asked for her beeper number before we hung up. “You never know,” I said, trying to offer hope again. 

Just 30 minutes later beepers started going off. A transplant was available. Debbie, the lung transplant coordinator told me to call Marilee's mom and get her in ASAP (as soon as possible)!

To me, ASAP means, “Always Say A Prayer.” I said a fast one as I dialed the beeper number. The promise of 2 Timothy 1:7 (NIV) states, “For God did not give us a spirit of timidity, but a spirit of power, and of love, and of self-discipline.” Gradually, a steady calm replaced my anxious trepidation, and I knew with certainty that with God's help, I would be able to do what was required to give Marilee the best possible chance at life.

Marilee's family arrived a short time later. Julie, Marilee's primary nurse, also arrived. She lobbied the charge nurse, asking that I change assignments again so she could care for her primary patient. But the charge nurse gave the choice to me.

Although I was new to the NICU, I was not new to transplant nursing and had, in fact, just transferred from the cardiothoracic transplant floor. I knew I was probably the most comfortable with pretransplant requirements of any nurse there. Although Julie protested, the charge nurse backed me up.

I caught up with Julie a short while later and asked her why she didn't come in at 7 p.m. as she had been scheduled. Julie informed me that she'd been Christmas shopping and showed me two bags of colorfully wrapped Christmas gifts for Marilee and her family.

I reminded Julie that Marilee's family needed a friend as well as a nurse. “Why don't you be that friend tonight?” So, whenever her own assignment allowed a little slack time, Julie donned the isolation garb, came in and talked quietly with Marilee's family, pulling one Christmas present after another out of the bags to “oohs” and “aahs” of delight.  

We got word that the transplant was a “go” and the moment came to transfer Marilee to the operating room. Before leaving the room, Marilee's mom asked for a moment of prayer with anyone who wanted to participate. She reminded us of God's promise in Matthew 18:20, “Jesus said whenever two or more of you gather together in prayer, I am with you also.”

Thus, fortified with faith, we sent Marilee off. Many hours, and much nursing care later, Julie and I met at the time clock, both of us exhausted. “Julie,” I stammered, “I'm sorry I didn't want to change assignments with you.”

“No, no, don't apologize,” she said, “You were right not to. I probably shouldn't have even asked. I was late, and I'd probably have been a basket case. I haven't worked up a transplant patient in years!” Her words reminded me of Proverbs 12:25 (NIV), “An anxious heart weighs a man down, but a kind word cheers him up.”

Marilee progressed well after the transplant. Although she would need to be on immunosuppressant medications for the remainder of her life, her parents were thankful to God, the transplant host, and all who had aided in her continuing quest for life. As for me, I regularly settled into one of the unit's comfy loungers, snuggling and loving Marilee up to her discharge. I contemplated the miracle of Christ's birth and the miracle of Marilee's transplant.

Posttransplant patients need a biopsy every three months, checking for organ rejection. Marilee and her family periodically came to the NICU to visit after the procedure. Seeing her thriving, I recognize that I was but an instrument of God's provision to use as he saw fit. I participated in one of the best Christmas gifts possible—utilizing my nursing skills in a procedure that helped to save a life! I thanked God and asked him to please bless the family whose own loss led to this miracle for Marilee.

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* Patient name has been changed.