Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Grieving the end of life experience from an ICU nurse

Alexandria Frangedak, RN
Conditions
March 28, 2020
903 Shares
Share
Tweet
Share

The image of patients dying in the intensive care unit is changing. Over the phone, family members cry on the other end as I tell them that we are not allowing visitors due to “the coronavirus” at this time. They tell me, “but I help make his decisions for him.” These decisions now have to be made over the phone.

This is just what we have to do to keep society safe.

I am an RN working on the frontlines in a thirteen bed ICU with an attached four-bed surgical ICU. These beds are rarely full. Today, they remain full of individuals on ventilator support, all testing positive for COVID-19. Our unit is now the designated COVID-19 ICU.

They are not improving.

Family members call the nurses’ phones, and they ask how their loved one is doing today. They are unable to be at the bedside due to visitor restrictions. So, when I tell them “he or she is not doing well today,” they don’t know that I mean that they are not improving, that they will probably not make it off of that ventilator, that the next time they will see their loved one, will be when they pass away in this unit.

Difficult decisions will have to be made by family members and advocates. Decisions that are inevitable, like removing ventilator support and making the patient comfortable.  Decisions like changing their code status to NO CPR, decisions to place their family member in hospice care.

These were tough and morally distressing judgment calls to make when visiting hours were not restricted. I can not imagine the difficulty and moral distress felt by these individuals now.

The last image many of these families will have of their loved one is that of the patient lying in bed, being assisted by a ventilator and other machines.

When one woman had tested positive for COVID-19, her family had made the decision to withdraw ventilator support. For these extreme end of life circumstances, for now, two visitors were allowed at the bedside. Her family members were placed in yellow isolation gowns, a mask, and a face shield. They held her hand with their own gloved hands. The patient wore a mask. After administering comfort care medications, knowing that it would only be a matter of hours that this loved individual had left on this earth, I stepped to the corner and cried through my N95 mask, as I reminisced about how beautiful and sobering this scene used to be, not even a few months ago.

I loved the families that would be at the bedside daily. I loved seeing a dying patient covered in warm blankets, sometimes with their own robes or homemade blankets on top of them, in a room full of their loved ones. I loved seeing these families tend to their dying mother, brother, sister, or child- washing their faces, lotioning their hands, singing to them, playing music. I loved seeing families, sometimes up to thirty people at the bedside, sharing memories, and laughing.

I loved sneaking boxes of tissues in the room and letting patients enjoy their final days or hours with those who mattered most, doing what they loved most- being together, while I silently snuck around the room doing what needed to be done. I am grieving for those who will not be able to have a beautiful end of life experience. People are dying from COVID-19, and many will be dying alone. Without a solution to this crippling isolation created in the wake of this virus, I fear that it will leave families scarred and with complicated grief patterns. I can’t hold their hands. I can’t cry with them. I don’t know how to help them.

Alexandria Frangedak is a critical care nurse.

Image credit: Shutterstock.com

Prev

Medicine is a team sport, and we will only beat this pandemic if we work together

March 28, 2020 Kevin 0
…
Next

What is the role of medical students during the COVID-19 surge?

March 28, 2020 Kevin 0
…

Tagged as: COVID, Critical Care, Infectious Disease, Palliative Care

Post navigation

< Previous Post
Medicine is a team sport, and we will only beat this pandemic if we work together
Next Post >
What is the role of medical students during the COVID-19 surge?

Related Posts

  • Understanding critical care in the ICU: then and now [PODCAST]

    The Podcast by KevinMD
  • Nurse practitioners will save primary care

    Leah Hellerstein, LCSW
  • A real-life example of irrational health care spending

    Taylor J. Christensen, MD
  • Ethical humanism: life after #medbikini and an approach to reimagining professionalism

    Jay Wong
  • End-of-life care talks begin at home: even for doctors

    Abdel Albakri
  • Can the dwindling numbers of primary care physicians explain decreased life expectancy?

    Niran S. Al-Agba, MD

More in Conditions

  • Urgent innovation needed to address growing mental health crisis among children and families

    Monika Roots, MD
  • The importance of listening in health care: a mother’s journey advocating for children with chronic Lyme disease

    Cheryl Lazarus
  • The unjust reality of racial disparities in pediatric kidney transplants

    Lien Morcate
  • The surprising medical mystery of a “good” Hitler: How a rescued kitten revealed a rare movement disorder

    Teresella Gondolo, MD
  • The power of coaching for physicians: transforming thoughts, changing lives

    Kim Downey, PT
  • Unlocking the secrets of cancer conferences: an end-of-life counselor’s journey among pharmaceutical giants

    Althea Halchuck, EJD
  • Most Popular

  • Past Week

    • Why affirmative action is crucial for health equity and social justice in medicine

      Katrina Gipson, MD, MPH | Policy
    • The hidden factor in physician burnout: How the climate crisis is contributing to the erosion of well-being

      Elizabeth Cerceo, MD | Physician
    • The power of coaching for physicians: transforming thoughts, changing lives

      Kim Downey, PT | Conditions
    • Why doctors aren’t to blame for the U.S. opioid crisis [PODCAST]

      The Podcast by KevinMD | Podcast
    • Unlocking the secrets of cancer conferences: an end-of-life counselor’s journey among pharmaceutical giants

      Althea Halchuck, EJD | Conditions
    • Physician entrepreneurs offer hope for burned out doctors

      Cindy Rubin, MD | Physician
  • Past 6 Months

    • Breaking point: the 5 reasons American doctors are dreaming of walking away from medicine

      Amol Shrikhande, MD | Physician
    • “Is your surgeon really skilled? The hidden threat to public safety in medicine.

      Gene Uzawa Dorio, MD | Physician
    • It’s time to replace the 0 to 10 pain intensity scale with a better measure

      Mark Sullivan, MD and Jane Ballantyne, MD | Conditions
    • Revolutionize your practice: the value-based care model that reduces physician burnout

      Chandravadan Patel, MD | Physician
    • Unveiling the hidden damage: the secretive world of medical boards

      Alan Lindemann, MD | Physician
    • Breaking the cycle of racism in health care: a call for anti-racist action

      Tomi Mitchell, MD | Policy
  • Recent Posts

    • A pediatrician’s journey into integrative medicine [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why allowing yourself to embrace discomfort is necessary for personal growth

      Jillian Rigert, MD, DMD | Physician
    • Unconventional health care, flawed studies, and biases: Navigating the complexities for optimal well-being

      Kara Wada, MD | Physician
    • Urgent innovation needed to address growing mental health crisis among children and families

      Monika Roots, MD | Conditions
    • The importance of listening in health care: a mother’s journey advocating for children with chronic Lyme disease

      Cheryl Lazarus | Conditions
    • Medical errors and the power of apologies [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

Leave a Comment

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • UnitedHealthcare in the Hot Seat Over GI Procedure 'Advance Notification' Policy
  • Genetic Risk Score Predicts Hypertensive Disorders of Pregnancy
  • FDA Warns on Certain Forms of Compounded Semaglutide
  • Fired COVID Whistleblower Doesn't Want to Settle His Case
  • Video of ACOG Presenter Being Slapped Goes Viral

Meeting Coverage

  • TAR-200 Led to High Complete Response Rates in BCG-Unresponsive Bladder Cancer
  • More Success for CAR T-Cell Therapy in Rheumatic Disease
  • Trial Shows RA Can Be Stopped at Preclinical Stage
  • Tenapanor Improves Abdominal Symptoms in Patients With IBS-C
  • Benefits Found for Hand OA Drug Treatments
  • Most Popular

  • Past Week

    • Why affirmative action is crucial for health equity and social justice in medicine

      Katrina Gipson, MD, MPH | Policy
    • The hidden factor in physician burnout: How the climate crisis is contributing to the erosion of well-being

      Elizabeth Cerceo, MD | Physician
    • The power of coaching for physicians: transforming thoughts, changing lives

      Kim Downey, PT | Conditions
    • Why doctors aren’t to blame for the U.S. opioid crisis [PODCAST]

      The Podcast by KevinMD | Podcast
    • Unlocking the secrets of cancer conferences: an end-of-life counselor’s journey among pharmaceutical giants

      Althea Halchuck, EJD | Conditions
    • Physician entrepreneurs offer hope for burned out doctors

      Cindy Rubin, MD | Physician
  • Past 6 Months

    • Breaking point: the 5 reasons American doctors are dreaming of walking away from medicine

      Amol Shrikhande, MD | Physician
    • “Is your surgeon really skilled? The hidden threat to public safety in medicine.

      Gene Uzawa Dorio, MD | Physician
    • It’s time to replace the 0 to 10 pain intensity scale with a better measure

      Mark Sullivan, MD and Jane Ballantyne, MD | Conditions
    • Revolutionize your practice: the value-based care model that reduces physician burnout

      Chandravadan Patel, MD | Physician
    • Unveiling the hidden damage: the secretive world of medical boards

      Alan Lindemann, MD | Physician
    • Breaking the cycle of racism in health care: a call for anti-racist action

      Tomi Mitchell, MD | Policy
  • Recent Posts

    • A pediatrician’s journey into integrative medicine [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why allowing yourself to embrace discomfort is necessary for personal growth

      Jillian Rigert, MD, DMD | Physician
    • Unconventional health care, flawed studies, and biases: Navigating the complexities for optimal well-being

      Kara Wada, MD | Physician
    • Urgent innovation needed to address growing mental health crisis among children and families

      Monika Roots, MD | Conditions
    • The importance of listening in health care: a mother’s journey advocating for children with chronic Lyme disease

      Cheryl Lazarus | Conditions
    • Medical errors and the power of apologies [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Leave a Comment

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...