Jordan Alec-Cruise Armstrong died February 9, 1999 at the age of 17 months. He was a vibrant baby boy with a bright future, even if his beginnings were incredibly difficult.
Jordan was born September 4th, 1997 with a rare condition called gastroschisis. In this, his liver and intestines were on the outside of his body and doctors presumed he would not make it. They also presumed that he would not be able to eat by mouth for several years. To be clear, I didn’t blame the doctors for thinking these things, nor was I angry at them for putting a short shelf-life on his life expectancy. After all, they are in a lose-lose situation from an ethics perspective. Some parents want to hear the likely scenario and others want to hear the best case scenario. I just happen to be in the former category. But I “digest”…
Jordan had 13 surgeries and spent 5 months in the hospital before coming home under two conditions. One, he had 24-hour home nursing. Two, we went to the University of Pittsburgh Children’s Hospital on a recurring basis, this given the very high likelihood that he would need a liver transplant.
By February 8th, 1999, Jordan had been eating by mouth every day for 7 months.
By February 8th, 1999, Jordan had been 4 months removed from a liver transplant list.
By February 8th, 1999, Jordan’s required home nursing care was reduced to 12-hours a day (9 p.m. to 9 a.m.) — specifically because he needed his fluids at night.
On February 8th, 1999, we were ecstatic and thankful to the doctors and nurses who took care of him.
About those fluids. When you are born with gastroschisis, it becomes very difficult to absorb food and liquids, even when you begin to eat by mouth. These things can pass right through you because your kidney, liver, and intestines do not function properly. Intravenous lines are absolutely critical for a multitude of reasons, not the least of which is the prevention of dehydration.
On February 9th, 1999, I woke up at 6:30 a.m. to the sound of an alarm but it was not from my clock. The vibrations in my head and my heart were palpable, and all I could do was run into the living room and pick up my son. He was dying. As I looked to my left, I noticed my home nurse was sleeping. Was I angry at him? You betcha. Then was not the time to show anger however. It was not the time to think about anything except the health of my son who, at 2:13 a.m., rolled over his central line and was receiving zero fluids from that point forward. As I sit here today, I often wonder why I heard the alarm over Jordan’s wheezing, his voice. Regardless, I heard it. Jordan’s nurse was on a couch three feet away from him and heard none of it. In looking at the nurses chart, which was supposed to be updated every hour on the hour; there had not been an update since 9:30 p.m.
My wife and I drove our little baby boy to the hospital at 6:45 a.m., my mother-in-law in tow, and we fought for his life. We were literally weaving in and out of traffic and looking back every 15 seconds to ensure he was still okay. At one point, our mother-in-law, who was holding his hand, screamed. She could feel his pulse dying. My wife had to remove him from his car seat and give him mouth to mouth because we had already lost him. She was doing her best, I was frantically driving, and in the end, we lost him.
Jordan died because our home nurse fell asleep on him at 10:00 p.m. or so the night before. As TLC would say, this is actual and factual.
Within a matter of days, the agency who provided the nurse was calling us to talk settlements and apologize profusely. We had not heard directly from the nurse who fell asleep, but we were assured that he was fired. My unsettledness began at that very point.
Twenty years later, I spend the majority of my days facilitating difficult discussions wherein people bring in different sides, different emotions, and a high degree of incivility. None of this helps move a culture forward. What they bring in most frequently, however, is generalization.
- Blacks are criminals
- Women are emotional
- Cops are racist
- Leaders don’t care
- White men are angry
- Millennials are spoiled brats
I have done a lot of facilitation work in hospitals and health service organizations. I distinctly remember a female supervisory nurse telling me in confidence that she would never recommend a male nurse for home nursing because of the need for compassion. I’ve been in rooms where male doctors complained about how Black orderlies were more negligent than white orderlies. As one of them put it, “They’re on their phones or flirting with the nurses more often than not”.
Are these true? No. They are sexist and racist. But generalization goes all ways.
When we were in the early stages of the lawsuit, one of our lawyers suggested that we “ride the bandwagon of concern of male nurses” to a high settlement. I declined. After this, they asked if I was at least willing to give “emotional testimony about my concern with the nurses lackadaisical response to their error”. Again, I declined.
We woke the nurse up right before we left the house and he was anything but lackadaisical. He was contrite, emotional, apologetic, and self-critical. And no, he never mentioned a fear of losing his job or being sued. We never got the impression that he cared about anything but what had happened to Jordan.
Six months later, we were awarded $250,000, a very low amount considering the loss of life. Our lawyers reminded us that we “took the high road” and thus they were unable to convince the insurance companies and mediator to award a higher amount.
For the next several months after Jordan’s death, I was reminded of how understandable it would be to hate the nurse, to want to kill him. I had so-called friends questioning my level of care because, from their lens, I was just too calm about what he did.
I didn’t hate him then and I don’t hate him now.
People make mistakes. We teach leaders to create environments where people can make mistakes without worrying about their livelihood and well-being.
He was hurting. Some of Jordan’s other home nurses spoke of his inability to shake what occurred, years after the incident. One of the nurses called him suicidal.
He has a family. He knows what occurred and he has children of his own. As such, he knows the stakes. I don’t need to remind him through hate and discontent.
I have had people say that, if they were me, they would never trust another doctor or nurse again. And why?
There are 3.8 million nurses in the country today. Are they all going to fall asleep on a patient?
There are 950,000 doctors. Same question.
Losing my son was excruciating. So is losing the individuality of every person in this country; in this world. But that is exactly what is happening with every stereotype, every generalization.
Have some teachers slept with their students? Yes. Does that mean that the below statement is true? No!
Statement: Teachers are pedophiles.
Nurses are not negligent, there are some negligent nurses.
Again, my home nurse had a family, to include his own children. What additional pain would he have felt if I had gone on a crusade to bury him and his reputation; his name? How would that have affected his children and how they regarded their father? What would have happened if I had crusaded against the home healthcare system as a whole, all the while shoving my sons picture in everyone’s face as a stark reminder of just how bad and irresponsible it all is? How might it have affected the collective regard that people have towards home nurses?
Here’s the thing, and there’s really no way around it. My home health nurse was, and likely still is, a good person. I only use the word “likely” because we haven’t communicated in 20 years. He made a mistake but to extrapolate that mistake and paint pictures of a terrible person that works in a terrible system in a terrible world with terrible people is to perpetuate the generalization that is already eating our social lunch every day.
Losing a son truly sucks and is one of the worst moments in my life to date. There are no if’s, and’s, or but’s about it. It was a nightmare that came true. Still, I can’t lose myself, my spirit, and my love for humanity as a result. More importantly, I can’t contribute to the home nurse losing anymore in life than what he lost as a result of his unintentional act.
Who would I be as a diversity and culture champion preaching perspective and emotional intelligence if I railed against him and everyone else in the nursing world?
Who are we if we cannot see people for who they are and what they are outside of a single incident, no matter how tragic?