NursingLink

Pediatric Nurse Takes Home Small Patient

Pediatric nurse Camille Echols knew better. She was well aware of the rules against getting emotionally attached to patients — both the written and unwritten ones. And she understood the logic behind them.

But the head and the heart often don’t agree.

And how do you explain these rules to an infant?

Last summer, then 14-month-old Ashley was admitted to Children’s Healthcare of Atlanta at Egleston suffering from malnourishment, physical abuse and neglect, hospital officials said.

On top of that, she needed a kidney transplant, but hospital authorities decided they couldn’t put the child on the waiting list because it was questionable whether she’d get proper follow-up care.

Developmentally delayed, Ashley spent the majority of her time alone in her hospital crib, gagging herself with her fingers, in hopes that vomiting would get her attention.

It did.

Echols was assigned as Ashley’s primary nurse. She would soon decide to make a much bigger commitment.

She started visiting the baby on her off days because she couldn’t bear the thought that no one else would.

She told her partner, Julie Dobbs, about Ashley. Soon, Dobbs started visiting the child as well.

They started to bring her toys and clothes.

When Ashley got well enough to leave the hospital, there was one condition: The child’s biological mother had to be at the hospital four consecutive days before the girl would be released to her, the hospital care team decided.

That never happened, Echols said, so the state claimed custody of Ashley.

For Echols, that’s when the traditional boundaries between professionalism and compassion got really blurry. She said Ashley’s biological mom approached Echols with a request. She said she wanted to turn her life around. Could Echols become Ashley’s foster mom in the interim?

Echols said yes. Children’s Healthcare was initially a little nervous.

“They were a little concerned at first,” Echols said, “I got fussed at a little, but they had to cover themselves. I didn’t talk about it at work.

“We kind of walked into it blindly,” Echols said. “I think the mom knew she wouldn’t ever take Ashley back. We hoped that too, but we didn’t know how it was going to play out.

“We tried to keep in mind that this could be only temporary, but how can you do this and then give her up?”

They never had to.

Echols and Dobbs hired an attorney and, in May, they adopted Ashley.

“When Camille first asked me about [adopting], I was hesitant at first,” Dobbs said. “When I met [Ashley], though, I couldn’t say no. Camille knew that would be the case. She says, ‘Oh, you have to come see this patient’ to me a lot. This one was different.”

Echols indeed did know Dobbs would say yes.

“It was impossible not to get attached,” Echols said. “She was so needy, she’d eat up every bit of attention you gave her. Now, her personality is totally different than it was last year.

“She was very withdrawn and cried all the time. Now, look at her.”

What you’d see is a happy, fully nourished jumping jack of a kid. Her legs are stronger and can support her, though she still is not walking. Ashley’s health has improved greatly since Echols and Dobbs began caring for her.

Now, even the most bureaucratic of officials at Children’s can’t help but be thrilled.

“As a pediatric nurse, it is always challenging because you do not want your emotions to overshadow the professional care you provide your patients, but we are all human, and sometimes you cannot help it,” said Amy Hauser, the director of transplant services.

“I think the outcome is fantastic, and Ashley has flourished and is doing wonderful because of the love and care she has received from Camille and Julie. Everyone in the children’s transplant department was absolutely thrilled for all involved when the adoption was finalized.”

The Echols-Dobbs home is as hectic as can be. On top of adjusting to having a 2-year-old, Ashley needs medicine intravenously twice a day and receives dialysis for three hours every Monday, Wednesday and Friday.

Ashley is on the transplant list. Camille’s mother, Lisa Fort, is a possible donor but must await medical clearance.

“I instantly knew it was meant to be,” Fort said. “I thought that’s why God brought us to her, so I could give her a kidney.

“I just made my sisters promise to give me a kidney if I ever needed one.”

(c) YellowBrix 2008

---