Foster Care Emergency Removal

"Can you meet KC at penn station at 8:45am? The plan would be to head to LI, move the child to FR. Lmk thanks!!"

It was a little after 10 PM last Thursday when I received the text above in an e-mail from my supervisor.

My supervisor provided no other information surrounding the case. (I knew this was a true emergency because my supervisor usually does not e-mail me work assignments late in the night!)

All I knew was that I had to help KC (the Foster Care Social Worker supervisor at my agency, NAC) remove a foster child from her current foster home and place her in a new one. I also knew that this emergency removal was tied to the foster child's medical needs. That night I went to bed trying to put two and two together.

What were this foster child's medical needs and why was the current foster home unable to meet them? The LIRR train cut through the crisp fall morning air as KC and I sat wrapped in our scarves and fall coats. "So did your supervisor tell you what's going on yet?" I looked at KC blankly and shook my head. "I bet you must have felt like you were on a covert operation, like you were a CIA agent!"

We both laughed and the train zoomed onwards into the morning. During the train ride, I learned that the medical staff and supervisors in Foster Care had studied this case closely and decided that moving this foster child was the best choice for her health.

When KC and I arrived, Shayla (name changed for confidentiality) sat at the bottom of her foster home's stairs with her head down next to her foster mom. Surrounded by trash bags full of clothes, I had a feeling she knew quite well why we were there. When Shayla burst into tears before KC or I said a word, my suspicion was confirmed. Shayla knew. And I also knew that this was just the beginning of a tough day.

My interest in learning about Shayla's medical needs faded upon seeing Shayla so sad. Foster Mom comforted Shayla, assuring her that this was not their last time together. In the meanwhile, I moved Shayla's trash bags into the agency van, eyes cast downward, moved by Shayla's sadness.

The van ride to Shayla's temporary foster home placement was long, cold, sad, and bumpy. Shayla, a 16-year-old immigrant, came to the United States on a medical visa to treat what doctors initially diagnosed as Cystic Fibrosis (CF). Over time, doctors ruled out Cystic Fibrosis. Shayla instead has Non-TB Mycobacterium and Bronchiecstasis.

These two conditions make oxygen uptake into Shayla's blood much harder than for a person whose lungs are functioning normally. Shayla has to breathe more often to get the same amount of oxygen that somone with healthy lungs gets in one breathe.

(Interesting fact, especially for pre-meds out there: If a person with healthy lungs breathes 20 breathes per minute on average, Shayla breathes about 32 breathes per minute. If a person with healthy lungs breathed at Shayla's rate, he or she would be classified as hyperventilating.)

Now the question still remains, why was Shayla removed from her foster home on an emergency basis? Earlier in the week, Shayla went to the ER for severe respiratory distress. The ER doctors were not sure what triggered the distress but thought something in the home (e.g. air freshener, lit candles) could have been the cause.

The NAC medical team met together after learning about Shayla's ER visit. At the NAC medical staff meeting, the doctor, nurses, and some foster care staff decided that Shayla would be better off in a new foster home that was more sensitive to Shayla's medical needs.

Shayla smiled and laughed upon seeing her replacement foster mom because she had previously met with her and gotten to know her in another context unknown to me. I helped Shayla move her clothes into her new room and helped her throw out old school work papers, or artwork she didn't like.

Out of a trashbag, Shayla pulled out two half folded images of bunnies she colored. She gave one to me and one with googly eyes to KC. I felt a sense of joy that I had been able to make Shayla's emergency transition slightly more bearable. I helped her move her things and let her vent to me during the van ride!

Ever since that day, Shayla's bunny hangs on my office wall. Despite how dramatic and sad the experience initially appeared to be, Shayla was upbeat in her new foster home. Her optimism was illuminating. And whenever I look at the picture of Shayla's bunny, I will remember Shayla's optimism during her difficult times.