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Life Is Not Fair

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Erin Wells, RN, BSN, CPN
Cincinnati Children's Hospital
Cincinnati, OH, USA

Life is not fair. The sooner you learn that, the better off you will be.

This was my mom's favorite response to all of her three girls' many "that's not fair" comments over the years. Long gone are the days when life's list of injustices included who got to ride shotgun, who used the last of the hot water or who drank the last of the milk. As a transplant coordinator, watching patients and families who wait for a transplant that never comes is what comes to mind when I think about the word "unfair". While losing a patient is never easy, there is an added sharp edge for me when it is a loss of someone who didn't get their shot at a second chance. It would be so easy to blame the system, the lack of organ donors, or our own inability to get our patients to transplant. The reality is much more difficult to swallow - there is no good answer, no blame to place. The reality is simply that life is not always fair.

When people ask about how I deal with the death of a patient as a pediatric nurse, my answer is always the same. It never gets any easier and the day that it does is the day I know it is time to hang up my scrubs. We all deal with the loss of a patient in different ways. Some people use their natural outlets to work through the grief process - their teams, their family and friends, their pastimes and hobbies. Some people want to talk through their feelings, while others are more private and stoic. There is no right way to move through the process as long as you are dealing with your feelings and moving forward.

Growing up, decorating the Christmas tree was a really, big deal in our house. The day after Thanksgiving, we would pull out all of our decorations, including our family Christmas ornaments consisting of homemade ones we created at school for our parents, those my mom had purchased for us to remember family vacations or milestone events in our lives, and those given by grandparents or other relatives over the years. Each one was special in its own way and held a story or memory. Every patient is like a treasured, precious ornament on my tree. When one of them passes away, it is like watching one of those beautiful, unique ornaments fall off the tree and shatter before my eyes. I mourn the loss of something so special and fragile that can never be replaced, but eventually have to sweep up the pieces and move on. At the same time, I tuck the memories away in a corner of my heart to be cherished and never forgotten. This is the best analogy that I have been able to come up with in trying to put my own process into words.

The great equalizer for the grief is the joy we experience as care team members. There are so many small victories, so many happy endings, so many stories of those who get their second chance and thrive and so - cherish them. George Bernard Shaw had the best advice, "write your sad times in sand, write your good times in stone". There is still much work to be done. ■

Disclosure Statement: The author has no conflicts of interest to disclose.

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