"Renee and Ned, we need
to have a talk with you." Snuggled close together on the hospital bed, while
they wait for the nurse to bring newborn Cassie back, the couple look surprised
to see you enter their room together with their obstetrician, Dr. Wu. As he gently
hands the blanket-swaddled infant to Renee, Dr. Wu takes a deep breath and speaks
quickly, "This is Karen Wilson, a nurse who works with kids who have disabilities.
I’m sorry, but we’re pretty sure that Cassie has Down syndrome. Karen
can help you get connected with the right agencies, and tell you what to expect
as Cassie grows up."
Watching the family closely,
you see that Renee seems dazed as she clutches Cassie tightly to her breast.
When Dr. Wu finishes, Renee smiles brightly and demurs, "There’s nothing
wrong with Cassie. Look how alert she is! I know she didn’t nurse very
well yesterday, but she’ll do better once she’s home." Ned, on
the other hand, stands abruptly and brusquely asserts, "Well, both of you
made a pretty big mistake. Our daughter is just fine, and we’re ready to
go home right now." He turns his back and starts gathering up the flowers
and congratulatory cards from around the room.
As a nurse case manager
for the Developmental Disabilities Clinic, you know that Cassie and her parents
have a long road ahead of them. While their initial denial is a normal, protective
mechanism, you know that Renee and Ned will soon be coping with the other stages
of grieving that follow the diagnosis of disability in a child. Over the next
two days in the hospital, you spend time getting to know the family and provide
them with basic information about Cassie’s issues. After discharge, you
make a home visit to begin dealing with the most immediate issues: