We recently got an email from a listener named Lindsay. She’s a nurse practitioner who lives in Philadelphia. And she’s currently working in an ICU in New Jersey, about an hour and a half away from home. She normally works in pediatric oncology, but because her husband has already had the coronavirus she volunteered to work with adult COVID patients for the time being.
Lindsay is 28, and she's been working as a nurse since she was in her early 20s. And we here on the team thought Lindsay’s email about her job right now…and struggling with what a “good death” means today…was really important. And beautiful. So we asked her to record her thoughts. Here’s Lindsay.
I've been surrounded by death in my job. I mean, as a oncology nurse, I've washed children before taking them to the morgue. I've comforted families as they leave the hospital without a child. And mourned and grieved with my coworkers for a life cut so short. In end of life care and oncology, we focus a lot on what constitutes a, a good death for a patient and their family. Um, obviously there are some unexpected deaths that are devastating, but the oncology community is a small one, and we really try to grieve together as a family against, you know, the insidious enemy that is cancer.
But COVID is really changing the way I'm seeing death. Like, I knew patients were sick and I knew healthcare workers were struggling. Uh, but what I didn't even have them is that like, the deaths that you see from COVID are the worst kind.
Right now I'm at a small community hospital without many resources. They have one iPad in the whole hospital for families to FaceTime their loved ones. But the iPad can't go in the room to bring them close because then it's considered contaminated. Families schedule a time but if the nurse can't get away from another patient or as an emergency, it just all goes out the window. So we're making do with what we have. Um, I'm FaceTiming families with my personal phone. I write down notes about patients on PostIts in hopes they'll be given to the family after they pass. Um, one I wrote the other day was that "I washed Mr. Johnson's hair today and I saw the scar behind his right ear. I'd love to know the story of how he got it."
There's no stopping the deaths though, in this time of COVID. You watch the numbers go down on the monitor and you try to call the family, but, uh, you can't be in the room with them as they pass. You can't hold a patient's hand as they pass away. You can't expose yourself that often. It has happened in our hospital that some of the families don't find out their loved one has passed until 24 hours, or even 48 hours later, when they call and they realize that there's a new patient in their loved one's room.
None of these deaths are what I consider a good death. There's no time to grieve. There's no time to know the people who slip through your fingers, whose hair you washed, whose bodies you bathed, and who you talked to during your shift to soothe yourself and them. It's simultaneously the most intimate and most anonymous relationship I've ever had.
I don't really have an answer for this question. I'm not sure if there's an expert who can tell me how to do a better job as a nurse in the time of COVID, but I just wanted to reach out because this is the question I ask myself every single shift. How do I as a nurse or how do we as a healthcare community give patients a good death during a global pandemic?
That’s Lindsay. If you’ve got a message for her, or thoughts about her question, send in a voice memo or an email to firstname.lastname@example.org.