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https://www.infirmiere-canadienne.com/blogs/ic-contenu/2016/09/01/la-vie-avant-tout

A pioneer in pediatric palliative care, Marion Rattray has helped make the time dying children have left the best it can be

Sep 01, 2016, By: Laura Eggertson

Even before Marion Rattray was born, her life was shaped by the terrible grief of parents who had lost a child. After delivering a stillborn daughter, Rattray’s mother was not able to see or hold her first child, or grieve the baby’s death. Seeing the lifelong effect that loss had on her mother led to Rattray becoming a pediatric nurse and one of Canada’s pioneering nurse specialists in pediatric palliative care.

Rattray was adopted in 1947 when she was three days old. She grew up knowing the story of Baby Joan, that first child. “My mother suffered the loss her entire life because it wasn’t managed properly,” says Rattray. “From watching her and living with her in her pain…I had empathy and compassion towards parents that were losing a child.”

She graduated from the Sherbrooke Hospital’s school of nursing in 1968. After five years at Sherbrooke Hospital, Rattray was hired as a general staff nurse at the Children’s Hospital of Eastern Ontario (CHEO) in Ottawa.

Rattray spent the first 19 of her 41 years at CHEO working on the adolescent ward. At the time, young people with life-limiting illnesses such as cystic fibrosis were treated on the same ward as other patients their age, whose conditions might range from broken legs to anorexia nervosa. There were no pediatric palliative care specialists; nurses were expected to take on a mix of patients.

Initially, Rattray was nervous about being assigned to dying children. “Parents watch every move you make when they are around a dying child’s bedside — so there’s a nervousness that comes with being watched and with their thousands of questions,” she says.

There was little published research on pediatric pain management or palliative care. At first Rattray was unsure of how best to advocate for her patients or their families. Then she decided to acknowledge the terminal nature of the children’s illnesses, focus on managing their symptoms and make the time they had left the best it could be.

“I was always drawn to those families,” she says. “I seem to be able to instil comfort somehow, even if only for a minute.”

Rattray saw a need for special practice and training in palliative care. From the family of a 14-year-old girl diagnosed with leukemia, for example, Rattray learned the importance of making what she thought was a small gesture: staying with them past her shift’s end until the girl finished her first induction of chemotherapy.

“I saw what a difference that support made to them,” she says of the family. “They mentioned it so often. Doing it on my own time meant that I really cared.”

From the family of a young boy who was on a ventilator until his death, Rattray learned how hard parents want to hang on to their dying children. She wishes she had had the words then to say what she would say now — that parents and care providers have to consider whether they are doing something for the children, rather than for themselves.

Rattray also discovered the work of Dr. Balfour Mount, one of Canada’s first palliative care physicians, and the palliative care program he established at the Royal Victoria Hospital in Montreal. Even as she rose through various positions at CHEO, from clinical leader of the pediatric inpatient unit to acting operations director of hematology/oncology and then of the pediatric patient service unit, Rattray continued learning about palliative and hospice care.

From 2000 to 2005, she studied via distance education at the University of Dundee in Scotland, where she graduated with her bachelor of nursing, with a concentration in palliative care, at the age of 60. (She also earned her certification in hospice palliative care nursing from CNA.)

She put her knowledge into practice when she was formally seconded to create a palliative care program for CHEO. In 2004, when former Ottawa Senators assistant coach Roger Neilson died and the Ottawa Senators Foundation approached CHEO to build a children’s hospice in his name, Rattray led the effort. She spent the next two years establishing and fundraising for Roger’s House. By the time it opened in 2006, Rattray was the manager of palliative care at CHEO and of the hospice. She retired in February 2016.

Despite the emotional toll of continual goodbyes to children Rattray cared deeply about, she loved her work. She dealt with the children’s deaths by not bringing those stories home to her husband, David, and by being continually grateful for the good health of her two sons, Scott and Kevin; her daughters-in-law, Michelle and Shannon; and her six grandchildren. She also replenished herself through golf, walks, time at her cottage near Eganville, Ont., reading, and following the lives of the British monarchy — a pleasantly distracting pastime.

Rattray continues to run bereavement groups for parents and is establishing one for grandparents. She also speaks publicly and helps fundraise for pediatric palliative care and Roger’s House.

“It’s incredibly rewarding,” Rattray says of her work. She will never forget the parents who would speak to her even as they were following a gurney out of Roger’s House for the last time. “When those parents turn around and say ‘I don’t know how I’ll ever thank you’ — and their child has just died, I find it astonishing,” Rattray says. “The fact that I’ve made a difference to this family and this child — there’s no monetary value on that. I’ve gotten back so much more than what I’ve given.”

10 questions with Marion Rattray

If you could change anything about yourself, what would it be?
I would like to be starting my career all over again with the knowledge, wisdom and experience I have today

What is one thing about you that people would be surprised to learn?
I am actually quite shy, even though I come across as very outgoing

If I had more free time, I would...
Take a gourmet cooking course

Where did you go on your last vacation?
Bowen Island (near Vancouver). I visited a childhood friend who is also a nurse

Name one place in the world you’d most like to visit.
Africa, to observe primates in their natural environment

What was the last good book you read?
Matrons and Madams by Sharon Johnston

Who inspired you to become a nurse?
I was admitted to hospital at age five and cared for by wonderful nurses

What was the best piece of career advice you’ve received?
Never say no to a project or a temporary position that will take you outside your comfort zone

What do you like least about being a nurse?
The lack of true teamwork in interprofessional teams

Name one change you would like to make to the health system.
I’d allow nurses to work to their full scope of practice and play a more expanded role in the health system

Laura Eggertson is a freelance journalist in Ottawa.