I wrote this article for my unit’s newsletter about seven years ago, just a few months out of orientation as a new graduate nurse. I have found myself thinking again about courage because a few days ago, my colleague held a little one in her arms after life support was withdrawn, until his heart finally gave out. His family was too overwhelmed to be there for his actual death, but returned with those piercing sobs that echo down the hallway and into every nurse, doctor, and respiratory therapist’s heart. After becoming a mom, there are certain cases I already know I’d have a much harder time with, and this was one of them. I wondered if I would’ve had the courage to hold this little one with such tenderness as my coworker did, knowing it would impact both my nurse and my mother’s heart on a whole new level compared to when I first started out in my career.

Thank you to all of you who do this indescribable work, and who show me indescribable courage every day.

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I find myself thinking a lot nowadays about courage. Perhaps much of this is due to the fact that there are probably few people who feel fear more acutely than new grad nurses working in a pediatric intensive care unit. While the intensity of the fear has downgraded a bit over the past few months from “terrified” to “uncomfortably uneasy,” it is still undeniably present. And so it pushes me in new ways to look for the face of courage.

C.S. Lewis once said, “Courage is not simply one of the virtues, but the form of every virtue at the testing point.” I think we know a little about testing points here in the pediatric intensive care unit (PICU). Our knowledge and sharpness of mind are tested with every unique case and every unexpected complication. And here I have seen courage in every person who comes back to work despite never having full assurance that we know all that we will need to know for that day. Our emotional limits are tested by the most unbelievable, heartbreaking stories staring us in the face through the eyes of a 5-month old baby. And here I have seen courage in every person who opens their heart to care for these children, even if it means we must feel what most people outside of the PICU will never fully understand. Our patience is tested by challenges to communication, cultural differences, and what may feel at times like excessive demands. And here I have seen courage in every person who chooses to persevere, assert healthy boundaries, and persevere some more, even when they do not receive the gratitude they deserve for their efforts. Finally, our core limits as human beings are tested as we find ourselves literally standing in the middle of this mysterious, sacred tension between life and death, hope and despair, love and loss. And here I have seen courage in every person who is simply willing to stay and offer the gift of him or herself to another human being in the midst of such tensions.

One of my outlets for processing all that goes on in our unit has been photography. I love the way this particular picture turned out because it feels wonderfully hopeful to me. There are so many things around us that can feel unclear, and at times, quite dark. And yet there are sources of beauty and light that push through, and this is what helps me to go on when I feel overwhelmed. Thank you to each of our managers, unit assistants, respiratory therapists, doctors, social workers, chaplains, and of course my fellow nurses, for showing me what it means to be so incredibly courageous in these early months of my nursing career.