By Hasti Taghi
Texas Children’s nurses were the backbone of the twins’ care team and they played an integral role in the girls’ growth, development and healing, from inside the womb to post-separation.
When operating room nurse Audra Rushing finally sat down after a 30-hour shift, tears flowed unexpectedly. Overcome with emotion, she couldn’t help but flash back to the moment just a few hours earlier when she stood between the two beds of twin sisters Knatalye and Adeline Mata as they finally lay separately for the first time.
“It was like seeing a baby being born for the first time,” Rushing said of the twins’ separation. “Throughout the surgery, there was no time to stop and think about how monumental this was. Once it was all over, there was just that feeling in my heart like, ‘this is why I do what I do.’”
Rushing was chosen as the lead operating room (OR) nurse for the Mata twins’ separation surgery, which took more than 24 hours to complete. Months before the girls’ separation surgery, Rushing’s job was to ensure all of the logistics were ironed out — a significant challenge, since she had never been involved in a case where two patients were in the same OR, requiring two of every monitor and every piece of equipment. With more than seven medical specialties represented, the needs and preparations were great.
“The attention to detail in this case doesn’t compare to anything I’ve experienced in my career,” Rushing said. “This was the culmination of all 13 years of experience I’ve had in the operating room.”
Nurses from the antepartum unit, neonatal intensive care unit (NICU) and pediatric intensive care unit (PICU) helped plan the details of every procedure and developed solutions and therapies to keep the girls comfortable as they grew into new milestones, playing crucial roles in Knatalye and Adeline Mata’s successful separation and recovery.
PREPARING FOR DELIVERY
Before the twins were even born, specialized nursing care began for their mother, Elysse Mata, who was monitored around the clock for several weeks in the Texas Children’s Pavilion for Women antepartum unit — a dedicated care area designed for expectant mothers who are on bed rest or require monitoring for complex pregnancies. Nurses there, like Stephanie Pruitt, help ensure the safety of the mothers and their unborn babies and also comfort the mothers during their extended hospitalizations until delivery.
As the conjoined twins’ arrival came nearer, the family’s story began to receive international attention, and the hospital staff felt the eyes of the world on them.
“It was definitely an exciting case because it’s something few people experience during their nursing careers,” Pruitt said. “But I treat all of my patients like they are high profile, so Elysse was just another patient who needed my absolute best care and attention.”
Pruitt was part of the team that ensured Mata was able to reach a safe gestational age before her twins were delivered and transferred to Texas Children’s NICU, the largest in the country.
THE FIRST 10 MONTHS
The first days in the NICU can be a complex, emotionally charged time for any family, and the Matas were no different. Thankfully, NICU nurses are specially trained to handle these cases with care and compassion.
“I walked into their rooms for the first time when Knatalye and Addie were just 6 days old,” nurse Jennifer Pitlik, one of the girls’ primary NICU nurses, said. “The Matas really made us feel like an extension of their family, and we encouraged them to parent their hospitalized babies.”
For 10 months, NICU nurses cared for the girls as they grew into healthy toddlers, strong enough to endure their difficult separation surgery. For Alex Luton, a clinical nurse specialist in the NICU, overseeing the team that managed the girls’ care was inspiring.
“There was a clear multidisciplinary partnership on every aspect of care,” Luton said. “Nurses, therapists and physicians worked together constantly to make decisions about the girls’ care, whether it was the logistics of how we would keep the girls comfortable on one bed, or what we could do to give the girls some mobility at an age when most babies would begin to roll or crawl.”
Before the girls’ surgery to place tissue expanders on their chest and abdomen in preparation for their separation, Chief of Plastic Surgery Larry Hollier, MD, said nurses asked crucial questions about the twins’ comfort and development.
“In one of the planning meetings, we were mired in all the technical details of the expander surgery, and two of the nurses who care for these children every day asked us, ‘Just out of curiosity, how are they going to relax? How are they going to sleep? How do we position them?’” Hollier said. “These were important questions to ask. It’s all those details that make an integrated system like ours so effective in complex cases.”
During the surgery preparation process, nurses coordinated with physical therapists to design a special bed and a positioning swing for increased mobility as the girls grew. And at 10 months after their birth, it was finally time for Knatalye’s and Adeline’s big day. More than a dozen nurses who’d cared for them during that time came from various units to stand with the family, lining the halls as the twins were wheeled off to surgery.
“It was my day off, but I came in to be with the family and other staff as we went through the emotions of this historic day for all of us,” NICU nurse Hawa Samson-Metzger said.
SEPARATION AND RECOVERY
Once in the operating room, the girls were under the care of a nine-person nursing team. Accompanied by one of the lead surgeons, Rushing was there to give the family the good news after approximately 20 hours: The girls were finally separated.
“It was really emotional for me to deliver the news,” Rushing said. “When we started the surgery, we knew the chance of loss was very real, and each time we hit a big milestone, we felt relief.”
About 26 hours after the first incision was made, the team wheeled the girls into the PICU, where their NICU nurses waited to greet the family and ease the transition of care.
For Elysse Mata, whose little girls are now home, the bond with the nurses is something she hopes to someday share with the twins.
“Our nurses are like my friends — they’re really family,” she said. “They’re the girls’ aunts. I hope one day the girls will be back to meet every single one of them.”
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