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Imagine the anxiety you would feel if your mother told you that she didn’t want you anymore.

Seriously. Stop and think about that for a minute.

Oh, and by the way, you’re only nine-years-old.

So, nine years old. Your mother is a drug addict. She comes to your weekly visit and she looks you in the eyes and says that she cannot stay clean. That she would rather do drugs and go to jail than to take you home.

No apology. No sympathy.

Very matter-of-fact in her words.

I love the drugs, not you.

One thing I hated about working in residential was not being able to just take all of these poor babies home! How in the hell do you look at your nine-year-old daughter and tell her that you can’t stay clean for her?!

I wanted to take this sweet girl home with me at the end of every shift. I even talked to my husband about it. She was not a bad kid. She was dealt a shitty hand and needed to know what it was like to be loved and to have a normal life.

Her mother was hooked on drugs the entire time she was pregnant with her. The hospital sent her home with a bullshit safety plan. Those usually consist of social worker check-ins, having the mom go to therapy, NA meetings, drug screenings. I mean, why not send a newborn home with someone who has been doing drugs during the whole pregnancy, right? And then we wonder why these kids struggle!

Let’s call her Katelyn. She was full of anxiety. Her poor little brain was doomed from the start. The brain cannot develop appropriately when drugs are being abused by the mother. The effects are long-lasting and impact the child for their entire life, whether you want to believe it or not.

Katelyn was removed from her mother’s care and placed into multiple foster homes. Her anxiety was so high that she was unable to function in these foster homes and was struggling to stay in school. She attempted to run away from her foster homes. Her anxiety ultimately led her to residential.

The day she was admitted to the facility was an eventful one. She was brought in by her caseworker and the poor little girl with long brown hair and terrified eyes took off running down the hallway and into a small room. She crouched down and hid behind the table. She curled up into a ball and started rocking back and forth with her eyes closed as tears ran down her pale, freckled cheeks. She wouldn’t speak to anyone. She wouldn’t even open her eyes. It broke my heart as I walked back to the nursing station to let her clinician try to break ground with her and at least get her to the unit.

This wasn’t the first time that we had kids behave this way during admission. Kids often are brought to the facility without warning, to avoid them trying to run away. I always had mixed emotions about this. I get that we do not want the kids to run away, but surprising them with a residential stay never seemed very fair to me. If someone brought me to a random locked down facility without telling me, I’d freak out too.

We couldn’t let the kids onto their unit without at least completing a lice check. We always liked to do a full assessment first, but there were situations like this where you learn to compromise and do what is going to best benefit the child.

It took almost two hours before they were able to get Katelyn to calm down enough to walk to her unit. She did let us do a lice check first, but then started closing her eyes and shaking again so we knew that we would not be able to do everything we needed to. We needed to give her time to get her bearings and catch her breath before we started asking her questions and unfortunately poking her with a needle for a TB test.

There was always only one nurse working on the weekends and the next day, which happened to be Saturday, I was scheduled. I told the other nurses not to worry about trying to finish the admission and to give her the night to calm down and I would try in the morning.

I read through her chart to get as much information on her as I could that would maybe help me build a rapport with her. When I went to the unit that morning to pass medications, I saved hers for last. When staff called her up to the door to get her meds, she walked with her head down, staring at the floor. Her long brown hair was in front of her face. I was glad to see that she walked out of the room on her own and was no longer crying.

She had the slightest of freckles across the bridge of her nose and her crooked teeth were surprisingly white. She was very small for her age and her voice was quiet and raspy. She instantly stole my heart.

“I have your medicine for you this morning. I like your Frozen pajamas!” I told her as I placed the pills into her hand.

“You like Frozen?” She asked as she put the pills in her mouth and gulped them down with the nasty fountain water.

“Do you wanna build a snowman!?” I asked her and she laughed. I then told her that I would have to take her to the nursing station to finish her admission sometime this morning. Her eyes got big and she shook her head no. I told her that we could watch Frozen on my phone if she wanted to while I asked her questions and she agreed.

After I finished passing medicine to the rest of the units, I called Katelyn to come up to the nursing station. She walked with her feet shuffling, hardly coming off of the ground, as she slid into the chair at the table. I proceeded to grab my phone and put on Frozen, but she stopped me.

“Can we just listen to music instead?” She asked and I in turn asked what she wanted to listen to. “Stitches, by Shawn Mendes.”

We probably listened to that song ten times while I completed her admission before she started to sing it. Her little raspy voice was so sweet and innocent and surprisingly pleasant to listen to. She told me that she loved to sing and that was her favorite song because she knew all of the words. She said that she would always sing when she was sad or mad or scared. She said that she was sad a lot because of her mother’s “choices.”

I asked her what choices her mother was making that made her sad and when she replied, a piece of my heart broke.

“She is supposed to be not doing drugs for six months before she can be my mom again.” Katelyn then went on to share with me the stories of the foster care homes she had been in and how she watched her mom put needles in her arms instead of tucking her into bed. She said that there were some days when she wouldn’t get to eat dinner because her mom would be “sleeping” on the couch. “She never even braided my hair or anything,” she was crying now.

I did my best to comfort her without saying anything mean about her mom. I wanted to tell her that I’m sorry her mom had her priorities screwed up and that she deserved someone better than that. But instead, I encouraged her to stay positive. And that I was willing to braid her hair.

This quickly became an every weekend thing. Every Saturday when I was working, she would eat lunch with me in the nursing office or I would eat lunch with her unit and then we would listen to Shawn Mendes and I would braid her hair. It was a little piece of happiness that she looked forward to every Saturday and I was happy to be able to do something so small that seemed so big to her. Even on the Saturdays when she would get upset, she would instantly calm down when she would see me walk onto the unit. She knew that, at least for a little while, she would feel okay.

This was probably one of the more difficult cases for me. This poor girl was quiet and scared and full of anxiety due to the trauma of her mother being addicted to heroin. She was a good, sweet kid who just needed to feel loved and cared for. It makes me sick to my stomach thinking about how her own mother couldn’t give her that.

One of my favorite things about Katelyn was watching her come out of her shell. She was conquering her anxiety one day at a time, in an environment where she felt safe and cared for. She was just a child. Her room was full of stuffed animals she had earned. She had gotten a pink rainbow unicorn comforter from her caseworker and had her tiny little room looking exactly like a little girl’s room should look. She loved to craft and was always making the coolest things out of duct tape. She once made me a purse and a ring out of colorful duct tape and I still have them to this day.

Like I said previously, working in residential is hard. You get so attached to these kids. I cried the day she came knocking on the office door and told me the horrible conversation she had had with her mom.

She had been in the residential facility for almost a year and they were looking to discharge her back home to mom. However, her mom, her caseworker, and her clinician all had a meeting that morning to talk about discharge plans. Katelyn had told me that her mom was not able to stay clean. She had failed her last four drug tests and quit going to her NA meetings. She was about to do time in jail. Katelyn would not be going home to her mother. She would be going back into foster care.

“She looked right at me, nurse Brandy, and said she was sorry that she couldn’t try harder. She could have tried harder! She didn’t try at all!” Katelyn was screaming and her clinician was standing behind her shaking her head in shame. We were all heartbroken for this sweet little girl who so desperately needed not to feel alone. There were no words to say that could mend her heart from the damage her mom had done. And now she had to wait around for a foster placement. Another place where she didn’t want to go.

The days after this, I could see her anxiety slowly creeping back in. She started arguing more, hiding in her room, and avoiding going to groups. We would now be heading back to square one. She could have lived a normal life had she only had the proper environment to do so.

Not all of her days were bad. In comparison to the way she was when she first was admitted into residential, she was much improved. She smiled more and was better able to cope during moments of stress, but we missed our window. We had her stabilized and happy and hopeful. Her mother ruined that for her and this poor child will never live a normal life because of it. She will always have that pain. However, I’m hopeful that she has been able to continue to push forward and overcome every obstacle that is thrown her way. I pray that she becomes a successful adult who stops blaming herself for her mother’s choices.

The day of her discharge, I braided her hair one last time. She sang me Stitches by Shawn Mendes one last time. She hugged me one last time. She whispered thank you to me as she walked out of the door of the nursing station with her caseworker and new foster mom. I couldn’t work up the courage to say you’re welcome.

Instead I went into the bathroom and cried.

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