Then one morning I came to work and she wasn't there. The neonatologist on during the night said that he was called to her bedside in the wee hours of the morning because she was doing poorly and that by the time he arrived from the call room the baby was already dead. They tried resuscitating her, but to no avail.
What happened to her isn't clear. One of our NICU nurses had called in sick that night. A "pool" nurse, one from a nursing agency, was called in to take her place. Normally we wouldn't assign a pool nurse to a patient like Mary, a sick patient on a ventilator, because the pool nurses don't know the patients and might not be as confident in their NICU skills. It's hard to find good pool nurses. But staffing was short, we had other sick babies, and she had to do her part. About all we heard was that she was working with the baby, the baby went bad, and then couldn't be resuscitated. The baby also had some air filled blebs on her skin called subcutaneous emphysema.
Piecing things together, I suspect what happened is that the baby may have been "bagged" - given breaths with a ventilating bag - too hard, that is, given too big a breath for her lungs. I think she had a collapsed lung from that and it was too much for her to handle. If one of our own nurses had been taking care of her, one who knew her and knew how to bag properly, that baby might still be here. If a nurse hadn't called in sick, the baby might still be alive. I can't prove it and can't do much about it, except urge our nursing managers to keep us well staffed, but I'm not the only one who thinks that baby would be living if one our own nurses had been taking care of her that night.
Life is fragile, especially in an NICU. But it shouldn't be dependent on whether someone calls in sick or not.
P.S. I'm going to a conference in San Francisco for the next three days. I hope to have some internet access there and post a post in 2 days, but if I can't, I'll post when I get back.