Diane's story

I was due to have my baby in the hospital where I had worked as an Intensive Care Nurse for fourteen years. Having worked in critical care for such a long time I suppose I had become complacent as in thinking myself immune to ever becoming a patient in an intensive care unit.

My husband and I had rung the hospital and we were advised to go there for assessment. The midwifery staff were unable to locate a foetal heartbeat and requested a doctor to attend.

This was the dreadful moment when he told me the baby had died. I felt numb and unable to express any emotion. An unbelievable calm overcame me, my husband sat with a look of disbelief. The child we had both so hoped for was not to be the cause of this was a placental abruption.

I was transferred to the labour ward and the process of delivery began. This in itself was a form of psychological torture lying there I could hear newborn babies cry. Eventually the term “labour” came into its own as the hard work of pushing began. My epidural only provided adequate pain relief down one side and I ended up using entonox.

I was in the most excruciating pain and could remember being told "you can’t have anything else as you have no blood pressure". I managed to deliver our daughter, Catherine Anne. All I can recall at this point was seeing a pink bundle as I blurted out "I am going to...". I had passed out due to a huge blood loss of about 1500ml. I was told later that I had had a post partum haemorrhage.

The next recollections I had were blurred as I presume I was slipping in and out of consciousness. In between experiencing the most dreadful pain I remembered being wheeled along a hospital corridor on a trolley and all I could see were ceiling tiles and lights.

Apparently I was on my way to theatre. It felt like I was having a never-ending dream as I had began to awaken. Again pain was evident and I felt so hot everyone told me to leave my warming blanket on as I was peripherally shut down. The nearest I could equate to this is when you are in bed in the summer and you keep removing your bedclothes due to the heat.

The pain had spread to my fingers they were so sore I kept asking my husband to rub them hard, this was due to them becoming swollen and the rubbing provided some relief. Things got worse as I was being repositioned when it was discovered that I was still bleeding, so I was back to theatre.

My journey now became surreal like an out of body experience. Somehow I could not separate my being an intensive care nurse from my being a patient. In my head I was assisting with looking after someone who was critically ill and yet detaching myself from the fact that it was me. Whether this is a coping mechanism provided by my body I don’t know but it was a bizarre experience.

I was lying on an anaesthetic table, looking around watching nurses and doctors squeezing blood into me. Then I realised that I was in the process of having a central line inserted into my neck. Suddenly I struggled to breathe. It felt as though my lungs were sticking together I sat up bolt upright gasping for air.

The central line insertion had to be restarted and days later people would comment on the bruising around my neck. This had been made worse due to the fact I had developed disseminated intravascular coagulopathy (DIC). In total approximately 32 units of blood products were transfused.

I was then told I was going to be put back to sleep. I refused to allow this until I had seen my husband as I genuinely felt that this time I would not wake up and I was going to die. I did wake up only to find my journey was not at an end but the whole nightmare was to continue.

At this point in time (I was informed sometime later) I was too ill to go back to theatre and lay for 45 minutes while blood was transfused. Then amongst the madness was a face I recognised; one of the intensive care consultants that I had worked with. He inserted a femoral arterial line and took an arterial blood gas my ph was 7.1. I overheard the mention of a swann ganz catheter and told them I they were not putting one of those in me.

This next memory was vivid. I was given 3mls of Fentanyl into my right hand. The doctor who gave this came to see me a week later when I was on the gynaecology ward and introduced themselves stating that they had given me an anaesthetic and that I had been too ill to probably remember. The expression on their face was interesting when I recalled them administering the Fentanyl.

Throughout all this, drowsiness was in constant attendance so everything I observed has a hazy edge to it. I remember screaming out loud and then a pressure was felt around my throat. This was cricoid pressure as I was going back to theatre.

Eventually a hysterectomy was performed to control the bleeding and I woke up in bed in the intensive care unit where I worked. This was an interesting scenario, as I had never woken up in bed at work before!

As well as the central venous catheter and the arterial line there were a few extras, a vas cath (there was the possibility of needing dialysis) and three abdominal drains.

I have no actual recollection of being ventilated and sedated but I experienced being in sheer darkness and moving my arms not because of wishing to extubate myself but of wanting to pull air in. Out of the darkness a voice shouted "Do you want this tube to stay in?". Obviously this was directed at the medical staff, as they needed to prescribe further sedation.

Next there was light and a friend asking me to take deep breaths. My husband was at my side and I had an overwhelming desire to write, as my voice was still weak following three days of intubation.

Frustration kicked in when I couldn’t hold the pen. It was as if I had never held a pen. My fine movements were compromised after just a few days as an intensive care patient.

Frustration occurred many times especially when I couldn’t move in bed not even bend to pull up the blanket at the bottom or even lift my hand-bag. I used the catheter stand to drag my bag across the floor. Where was my strength? I thought it was the day after my "bad dream" and was shocked to discover that it was days after the event. What had happened to me?

I went into overdrive not wanting to sleep but needing to know every single detail of this horrific experience. I still felt a little hazy even when a midwife appeared at the side room door with my daughter at last I could see and hold her. There was no preparation for this; I began to bond with her as I had done with my sons. A few days after this two friends came to see me. I had Catherine in my arms. Today was the time to say goodbye. My friends followed my instructions to the letter when I told them to take her away, they did. I had lost my daughter again.

The morphine patient controlled analgesia (PCA) resolved my pain but then the hallucinations began. I could see a large black rat running along the skirting board. This was scary I knew it wasn’t real but couldn’t stop seeing it.

The day the PCA was stopped meant that I no longer had a means of numbing my sensations / emotions, it was the equivalent of walking into a brick wall. I now had to cope with the reality of the situation and commence a rollercoaster ride of emotions. I had to deal with body image following surgery, the grieving process, guilt, post traumatic stress disorder, failure as a women because I could no longer bear children the emotional list is endless.

Once discharged from the intensive care unit gradually I began to lose the drains and the catheter and then I had to face going home. It was soul destroying to walk out of hospital holding onto my husband for us both to see a new baby going home with its parents. That should have been us.

As I entered the house I began to touch the television, the table, the chairs and other objects. it was as if I was making sure this was not an extension of the bad dream. Speaking of bad dreams, the nightmares soon began. They all took place around an anaesthetic table and there was always a person leading me around by the hand who I never saw. In one dream I was led into an anaesthetic room and my mother was on the table. Standing around her were doctors and nurses who suddenly began to pull off her limbs like in a horror movie. I woke up with my hair stuck to my head by perspiration.

In another, someone was saying that all the dead babies were in the wrong place. In my sleep I was panicking to find Catherine and I didn’t want to wake up until I had found her. These nightmares continued and always got worse around the anniversary of the event. Over the years they have gradually reduced, as have the flashbacks.

Hair loss was a problem my clothes were constantly covered by my hair. The counseling I had was extremely useful. As my recovery continued I came to terms with the fact I would need to return to work which I successfully did and developed an interest in Critical Care Outreach.

I could now empathise with critically ill patients and I feel this has improved the care I provide. I had been guilty, as I presume many critical care nurses have, of thinking how well we have done to have a patient well enough to be discharged to a ward but not once did I have any conception of what they may find themselves having to experience as part of their recovery.

I now work as a critical care outreach nurse yet I still feel that as far as my journey is concerned I may never find an end.