The Nurse Dilemma and Parenthood

At the family Thanksgiving (last weekend, thanks to the many family members in jobs that don't shut down for holidays), one of my nieces, a NICU nurse on track to become a Nurse-Practitioner, was talking about health care and other topics. (NICU, neonatal intensive care, "preemie" babies, babies born with other severe problems, heartbreak kids, all; hospital stays are long and survival rates are not high -- but most of those those babies had slim chances to none at all thirty years ago)

"We need universal health care," she said, "Like all the other civilized countries."
I made polite noises and lifted an eyebrow quizzically; I don't enjoy arguments. I did point out that government health care doesn't work so very well, to which she responded, "They pay a set amount per procedure, no matter the outcome! And they keep reducing the things they do cover."

She noticed the implied contradiction; she's no fool.

In further conversation, it came out that it tears her up to not be able to help; to send kids back to homes without power, without proper care, without parents who can or will do what it takes to care for them.

The easy, bumper-sticker libertarian question is, how much of my tax money do you want to mitigate your angst? Yeah, simple, neat, isn't it. I'm not asking it.

Here's a more difficult question: neo-natal nursing is high-stress work. The pay's decent money but they're not getting rich. What they are doing is working through tears, working with gut-churning emotional conflict, keeping little vegetables alive while Mums and Daddy dither, putting in endless hours with babies who will make it but whose parents never show up until the day the baby is sent home. They try to save the baby the rich teen-ager gave birth to on the toilet and left there, the baby whose new grandmother, on calling 911 and being told what to do, replied, "I'm not reaching in there after that." They work with utter-jerk surgeons, nasty cold men people hate, unfeeling guys who, on hearing the baby they worked on for eight hours has died after a struggle, drive in from an hour away, walk right to the NICU, tenderly lift the tiny corpse from the nurse's arms, look down and say softly, "We tried, buddy, we tried," hand the baby back and stride savagely out of the hospital, never making eye contact with another human being.

So the question is: what's it worth to keep these people from burning out?

I don't have an answer.

Maybe we're better off leaving the decision to bean-counters -- just as long as we don't run out of nurses who'll take on the job.


One thing we'd better do is get better at prevention. A significant proportion of the babies that end up in NICUs are born to drug-addicted mothers, to mothers who were malnourished, to teenagers who denied and hid their pregnancy. There's no law that'll stop that, no government program that can fix it but it can be slowed, one mother at a time. To the extent any of us can personally lend a hand to help on an individual basis, we should. And for pity's sake, we've got to try to change the trend of people seeing children, their own children, as an inconvenience.

Margaret Sanger, a figure both admired and loathed (and with good reason for both opinions), often stated her goal as trying to "ensure every child was a wanted child." So put, it's a good goal and one that can be just as easily done by helping (even glorifying) parents as by preventing pregnancies or worse yet, terminating them; and since all three are options available in a free society, there's probably at least one of them you can lend a hand to. (Not to pile yet another soapbox on the heap but it usually does more good and more directly affects individuals in a positive way to work for a positive goal. It's a lot easier to get people to try a new thing than to stop them doing something they're already doing).

Politics can be fun but bumper-sticker politics is full of pitfalls. There's no digging out of most of them from an ivory tower or even a blog; if we want a better, more free society, if we hope to roll back the growth of Mommy/Daddy Government, it's up to us to roll up our sleeves, pick up a shovel and use it to dig a path out rather than slinging mud. Sure, you're just one person; maybe you'll only ever be able to help one other person. But you'll have made that much change.

Wave signs, get on the evening news -- or help a scared and lonely girl? Which one will you look back on with the most pride?

Which one will help keep nurses -- nurses whose help we may someday need for our own families -- from burning out?

Which one will do the most to slow the demand for socialized medical care?

[It seems I have been a bit unclear. I'm not talking about "charity," I'm talking about doing what you can, within your own ethical framework, to push the younger critters within your easy reach a bit closer towards civilized behavior anent reproduction. This is rife with self-interest: if we end up with a huge bunch of barbarians and their preventably-hard-started offspring, it's going to make our "golden years" a lot less nice than they'd otherwise be and in a huge number of ways. Among other considerations, I'd as soon not be having to shoot the worst of them on a weekly basis when I'm greyhaired and rocking on the porch. Hollowpoints are expensive! YMMV.]