Janelle (Pierson) Heisler '12, '15, graduated from Walla Walla University with degrees in health promotion and nursing.
I have been a nurse now for eight years with over half of that time working in the emergency department. My passion is for emergency nursing! I was drawn to this specialty for the anticipation of what might emerge shift to shift, potential for saving lives, fast pace, and ability to treat patients with a spectrum of ages with all levels of acuity. There is rarely a dull moment, and we often see tragedies with few victories. This 22nd of February, I expected no different.
I arrived at the unit with the plan to do administration work for the day which included chart audits, patient call backs, etc. I wasn’t dressed in my normal attire of scrubs because I didn’t think I would be needed out on the unit. As the day went on, I was able to get most of my administrative tasks completed and was about to go home, but I needed to deliver some updated quality forms to the charge nurse who was working that day. I walked out onto the unit and saw a large commotion in room 11. I asked the charge nurse what was going on and she responded, “peds code, drowning”.
My heart sank. It doesn’t matter how long you have been a nurse; pediatric codes are the absolute worst and stick with you forever. I asked the charge nurse where the parents were and she pointed me to the family room. I quickly walked over to room 11 to see if they needed any help on the clinical side, but the team looked well established. So I made my way over to the family room where the mom, dad, and older sister were. They were understandably distraught. The mom was sitting on the floor in shock, the dad sat in a chair, bawling his eyes out, and the sister (about five years old) was confused about what was going on. I suddenly found myself in the sacred role of taking care of the family.
While comforting the family I uncovered more of their story. They had a large family and lived in the country. The parents mentioned they had six kids and lived on a large plot of land which included a pool and below-ground jacuzzi. The dad stated he had taken a work call while the mom needed to do something in the house. The mom asked the older children to watch the baby while they played outside and she would be out to play with them in a few minutes. When the mom finished what she was doing she went outside to see what the kids were up to, but couldn’t find the baby anywhere. Finally, after calling her husband and doing a thorough search they found their 19-month-old baby girl, Natalie*, in the freezing cold jacuzzi, lifeless. Emergency Medical Services (EMS) was called and CPR initiated.
When Natalie arrived at our department, EMS had been doing CPR in the field for about 30 minutes. We hooked her up to all our monitors and continued life-saving measures such as maintaining CPR, warming her up, and giving Pediatric Advanced Life Support (PALS) medications. About 15 minutes after she arrived, I asked the mom and dad if they would like to see her; they said yes. On the way over to the room I was explaining what they might hear and see. As the code continued, the energy in the room started to get darker and darker. The team had given her around 15 rounds of epinephrine and other medications, yet she remained in pulseless electrical activity (PEA). We coded her for over an hour. We were trying to get her temperature up before calling it. The doctor reached out to another facility for their expert opinion. They stated that she likely drowned before going hypothermic versus the other way around. Therefore, considering how long we coded her, death was inevitable.
During this time it felt like an eternity. The world stopped. The medical team gave their best effort. I was intensely focused on the family and the mother in particular. I was by her side explaining what was going on and why they were doing certain things. If she had questions I was there. If she needed someone to hold on to, pray with or cry with, I was there. It was truly emotionally taxing. Many times I was at a loss for words. I wasn’t sure how to best support them, except just to be present for them.
Then the doctor called time of death.
The mom ran towards the bed screaming Natalie’s name and scooped her up in her arms. The dad fell to his knees in shock and disbelief. The sister didn’t understand why everyone was so sad. The medical team stopped the life saving measures, stepped out of the room, and everyone started to cry. I paused, heartbroken for everyone. Tears came down my cheeks and soaked my mask. My heart affirmed that I was needed, but I didn’t know how best to help. How could I help? There wasn’t anything I could do to fix this problem. I couldn’t bring her back to life. I felt helpless.
I believe I felt the Spirit urge me to just be present. Cry with them. Hug them. Pray for them. Make them feel as warm as possible in this cold, dark, and irreversible situation. I was there, in this devastating moment, with them.
Sadly and ironically, I have experienced loss in my own family to drowning. Not my own child, but three of my cousins. My aunt and uncle were traveling and stopped at a campsite beside a large, fast-moving river. It was late at night and my cousins were sleeping in the car, so my aunt and uncle decided to quickly run into the bathroom, which was right next to their campsite, before setting up camp. When they came out of the bathroom, the car was not where they had parked it. The car had rolled down the slight, barely noticeable slope into the river. The force of the river was so strong that my aunt and uncle could not open the door. It took several hours before EMS could retrieve my cousins. Devastatingly, none of them made it. After the incident, the police discovered a defect in their car which caused the car to shift out of park when the driver door was shut hard. This was one of my first experiences with tragedy, but lives with me to this day—and probably forever.
Eighteen minutes had now passed since pronouncing Natalie dead and as I stood there wondering what to do next, I realized that they may want to sit beside her and we didn’t have enough chairs in the room. I walked out of the room and came back with two chairs. I started getting them situated when the mom set the baby back on the bed and then sat in the chair. I almost walked out of the room to give them some space and time to grieve when I noticed something strange. I noticed Natalie’s chest moving up and down. I stood there watching her for a solid minute because I thought I was crazy and just seeing things. But no, I wasn’t just seeing things.
Miraculously, she was breathing on her own.
I ran out of the room to find the doctor. “You are going to think I am crazy,” I said, “but Natalie is breathing on her own and has a pulse!!” The medical team ran back into the room in shock and disbelief. We hooked her back up to the ventilator, monitors, and started stabilizing her. We then contacted a local hospital with pediatric intensive care unit capabilities and arranged transport. They also couldn’t believe this miraculous story!
By this point, I had stayed with the family way past the end of my shift, but I was committed to remain with them until Natalie left our department. While the air ambulance crew was getting the report and doing all their checks, the mother reached over to me and grabbed my hand. She looked at me with tears in her eyes and said, “I know God put you here today to be with me through this. I could not have gone through this day without you.” With tears rolling down my cheeks as well, I opened up to her a bit. I said, “I don’t know why I was placed here today, but I do know a little bit how it feels when a family member drowns.” Enveloping me in the biggest hug, she told me, “When Natalie recovers from this, I am bringing her back to see you. She will be walking!” I told her I hoped that would be the case and that I would love nothing more than to see her walk. Shortly after, the crew loaded her up and took off.
A few days later our doctor got a call from the hospital where she was sent. They informed him that Natalie was opening her eyes and able to be extubated mere days after the incident. The MRI also looked very promising! Then the following week the father called our doctor to update him that Natalie was moving all four extremities and said the word “dad”. She started physical therapy with the hope of discharge soon to another facility that would help enhance her rehabilitation.
I look forward to the day when I can see Natalie walking! I know she doesn’t know who I am, but her life has and always will have an impact on me. Emergency nurses look death in the face frequently, but it's rare when we see our efforts pay off or miracles happen. It is easy to become numb and jaded in this profession. But this was the first true medical miracle I have ever witnessed in my career and it gives me hope!
This experience reminded me of a piece of scripture, Psalm 77. The psalm starts with sadness and anguish towards God in times of trouble. The writer wonders if God will ever be present again or if He will continue to reject him. But about midway through, the writer changes his tone. He remembers how great our God is and all the miraculous things that He has done for him and God’s people. The writer is overwhelmed with God’s goodness!
I know in the world of health care, sad things happen all the time, and unfortunately we are not able to save everyone from the grips of death on this earth. I also believe that miraculous things can happen—though to understand why miracles happen to some but not others is beyond my understanding. But one thing I do know to be true is that our God is good and even through the tragedies in this life, His goodness will overwhelmingly shine brighter in the end.
This is what brings me hope in my career as a nurse, as well as in my life.
*For the sake of privacy, names have been changed.