Jennifer Shay cradling four-pound, two-ounce Caden against her chest has to fight her instincts and avoid reacting when an alarm goes off in the neonatal intensive care unit at CHOC Children's at Mission Hospital.
Shay has to believe that the NICU nurses her friends and co-workers know what to do and do it fast, even if six-week-old Caden or his two siblings, Michaela and Austin, forget to breathe.
It's hard for the 30-year-old to force aside her maternal instincts. She says she has to force herself to do that, when as a nurse she knows the protocol is right but as a mother she frets over her triplets' every breath.
On Oct. 11 Shay, a pediatric and NICU nurse at CHOC Children's at Mission Hospital, gave birth to triplets in an emergency C-section after a nurse noticed that one baby's cardiac monitoring strip showed changes that signaled a problem. Dr. Marvin Posner did a bio-physical profile and found that Michaela and Austin were moving and that Caden had a heartbeat and hiccups but wasn't moving.
"I focused on his face to see what was happening," she said. "He looked up at me and said 'It's time,'" she said.
Shay had been hospitalized for seven weeks at Mission after starting to bleed and going into labor at week 24 of her pregnancy.
She had sworn she'd do everything to keep the babies inside her, including avoiding showering for two weeks straight because of constant contractions, staying indoors and living with the constant threat of losing them.
"I don't think you truly separate yourself," she said of balancing her medical know-how as a nurse and her maternal feelings. "My husband learned really quick to read my face. He asked me when I was on bed rest, 'What would happen if they came now?' I told him we'd have to kiss them and let them go. But at the same time I knew nurses in the NICU were scrambling to get beds ready. Every week I could picture my babies up here (NICU) at that stage."
And even though she works at CHOC Children's at Mission Hospital, she doesn't expect any special treatment, she said.
"CHOC Children's at Mission Hospital strives to deliver excellent, quality care to all of our patients, regardless of their family situation," said Linda Starn, director of the NICU. "Being a nurse here provides Jennifer with a unique perspective and an opportunity to experience CHOC as a recipient of the care we provide versus being the care provider."
BECOMING A MOTHER
Shay and her husband, Casey, 34, had tried for almost a year to get pregnant after having their first son, Riley, now three. But secondary infertility - defined as inability to get pregnant after a successful pregnancy seemed to prevent plans of more children.
Shay had a miscarriage. She worked in the NICU and took care of triplets born to a woman with infertility issues. Through her assistance, Shay and her husband sought an Irvine fertility specialist and on their third try became pregnant.
"By taking care of other people's babies, you find a lot of hope through your patients," she said. "This woman didn't give up, she kept on trying and God gave her three more. She gave me the information I needed."
Shay and her husband both told Dr. Lane Wong that triplets wasn't what they had in mind.
"I told him I have two arms and two legs," said Shay, smiling. "He told us, 'Triplets aren't common in my practice,' and we believed him."
For the couple everything has come in threes, it seems. On the third go-round Shay's egg follicles looked good and it was time to proceed. A few weeks later an ultrasound revealed three eggs and three sacks.
Shay took a picture of the ultrasound and texted her husband.
'ULTIMATE ASSIGNMENT'
Shay is still trying to shake the post-partum depression she got after giving birth to the babies. She came home empty-handed, something she said was hard to grasp. She has dropped the 30 pounds she gained plus another 10 pounds. Her mother, Carol Sampson, 50, unit supervisor of the pediatric unit at CHOC Children's at Mission Hospital, will move into the Shays' Dana Point home to help when the triplets come home. All three have apnea, a condition that causes them to stop breathing.
"We usually tell parents to expect the babies to come home by their due date," Shay says quietly, reverting to her medical side. "We hope they will be home by Christmas."
For now Shay makes daily visits to her babies. She doesn't focus on the usual things parents think about like weight and length. She worried about head ultra sounds and eyes exams things she knows will play out in the babies' future development.
She's gotten hand-spankings from the nurses for weighing diapers and cleaning equipment. She calls staying out of the nurses' way "the ultimate assignment."
"I see my colleagues trying to keep everything on schedule," said Shay. "The hardest thing is when the heart rate drops because I know what that means. I've jumped in a few times."
Sampson goes to the NICU every morning before starting her shift in the pediatric unit. At first she also couldn't leave her know-how out of the equation.
"You panic having worked in the NICU," she said. "You've seen orders come through. But when you see your own, you panic and it's like, 'Why are you doing this test?' You have to stop yourself and you have to maintain professionalism. You have to be strong as a grandma so you can protect your daughter and the rest of the family and reassure everyone."
For Shay, leaving at night is one of the hardest things she can do because rationally she knows the triplets have the best care possible, but emotionally she can't let go.
"When I call at night and one of my friends picks up it's a huge relief," Shay said. It's not just a name; I know exactly who they are. Then I can be mom. I'm so thankful to everyone. Just the fact that our three kids are here is a testament to what they did for us. I can never repay them for that."
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(c) 2009, The Orange County Register (Santa Ana, Calif.). Distributed by Mclatchy-Tribune News Service.