The ultimate compliment for a nurse is a family requesting you as their nurse on their child's last day on earth.
J was a 2 year old patient the PICU knew well from his last 24 neurosurgeries. This admission was different. He was found unresponsive at home, intubated in Odessa, and transferred to us a few days before Thanksgiving. J's mother was a single mom who poured her heart and soul into caring for her children. She never gave up and always wanted us to do everything we could to save her son's life.
When J arrived to the PICU, he was all of our focus. He required a ventilator, fluid, resuscitation, central line placement, continuous blood pressure medication, and then a shunt tap into his head at the bedside. The shunt tap indicated a very high intracranial pressure and infected cerebral spinal fluid. Since J would not respond to any of the bedside procedures and we did not know how long he was down at home, we obtained a CT scan and EEG for brain activity. The results were devastating. J had suffered a severe anoxic brain injury and another infected shunt. The EEG showed very slow brain waves and activity.
Throughout the studies, the mother stayed by his side and was involved in all the care discussions and decisions. She knew this admission was different. She called in her family from Odessa to come to the Children's Hospital. She knew the following day would be J's last day on earth and first day in heaven. The mother requested Brittny Ayola to take care of them, the ultimate compliment. I understand why she would make this request. Brittny has a confident, compassionate, Christian soul that brings peace to all around her.
Brittny started the day by taking the time to ensure the mother understood J's condition and his inability to recover this time. She supported the mother's decision to withdrawal care by crying with her, explaining each step of the process, and letting the mother decide when J would fly to heaven. I remember walking by Brittny with a tear streaked face and explaining to the team how to support the mother, family and her.
Brittny spent the morning making priceless, sacred treasures for the family so they would not have to leave the hospital empty handed. She coordinated with child life to make clay hand print molds and hand and foot print canvas paintings. She coordinated with music therapy to record his heart beat, which would later be incorporated into the song "Jesus Loves Me" using a violin and guitar.
Brittny coordinated with our charge nurse and Intensivist to transfer J to our palliative care room. To create a more sacred environment, she took the extra time and thought into bringing a diffuser with lavender oil to bring a calming sense to the room. She dressed the bed with little boy blankets. Families remember the small acts of kindness, the smell, the tone of the room, the love.
The mother held J as Brittny played the "Christopher Robin" song in the background. When the mother was ready, Brittny withdrew all of the medical support from J in the most compassionate way possible. J took his last peaceful breath in his mother's arms. Brittny allowed time for the family to hold and lay with J, as long as they needed. Brittny respected the entire family and allowed everyone to share their thoughts and memories.
At the end Brittny coordinated alone time for the Brittny, mom and J, so they could spend sacred time giving him his last bath. They shared lots of memories during that time to help the mom cope with the loss of her son.
Over the holiday and the following days, Brittny called the mother to check on her. She helped ensure all her wishes for his burial and funeral were coordinated as she wished. Brittny made the mother a photo slide show to music to give her yet another priceless memory. Brittny is making a plaque for the PICU in memory of our sweet J. Our team and J's family will never forget her compassionate way of honoring our J.
Brittny's care gives honor to God in the most dignified way.