National Nurses United

" I will never forget her hazel eyes," said LA Sio, an intensive care unit (ICU) registered nurse at the James J. Peters VA Medical Center in the Bronx, New York City. "She was so scared." Sio was there when the Covid-19 patient was admitted, early in the pandemic, and she tried to comfort her as hos- pitals across the country banned visitors. When the woman awoke from heavy sedation and asked if she would be able to go home, Sio tried to be encouraging, saying, "Don't worry, you got this!" A month went by, and while Sio and her team worked the most intense shifts of their careers, her patient was dying. There were no iPads in those early days, and when she called the woman's husband on the phone, he didn't understand how to use Facetime anyway. The woman died without ever seeing a loved one again. "If I close my eyes right now, I can see her face," said Sio, her voice cracking with emotion. She knows her dedicated team, with their Bronx work ethic, gave their all for their patients. But the ones she lost still sit with her—the man whose last request was to be moved closer to the sunlight, the patient with cracked lips who des- perately called out for water—and she thinks about visiting the hazel-eyed woman's husband when the pandemic ends. Although nurses have spent their careers caring for dying patients, Sio is not the only one feeling the weight of a new kind of death. Covid-19 patients stay in the ICU for weeks or months, and die scared and alone, only able to access loved ones through a screen. Studies have shown that various factors about Covid-19, including the unprecedented number of critically ill patients, can lead to post- traumatic stress disorder (PSTD) for nurses and other health care workers, according to an October 2020 Psychiatry Research article. "I tear up just thinking about it because you are their only lifeline," said Amber Ugarte, an ICU registered nurse at Sutter Solano in Vallejo, Calif. It has been disturbing, Ugarte said, to see patients her age or younger die. Once, a patient who reminded her of her mother declined more serious treatment until it was too late, given that Covid-19 patients can often feel better than they are actually doing. That still haunts Ugarte. "The hard part for me is I literally take it home with me," said Ugarte. "I love bedside nursing, I love the ICU. The last six months have changed things." RN Celia Nieto, an ICU nurse at St. Rose Dominican Siena Cam- pus in Henderson, Nev., said that months and months into the pandemic, going through the process of guiding a Covid-19 patient out of the world has "not gotten easier," although she and her col- leagues have gotten better at it. She once wheeled an iPad into a room and dialed eight differ- ent numbers, one after the other, so family members could see their dying loved one. As she stood there, in her new role as a fly on the wall during virtual goodbyes, the final words of the patient's grandson really struck a chord. "My grandfather was like a father to me, and it was basically all the things I said to my grandfather," said Nieto. "It was heart wrenching." Melissa Macasieb-Paat, RN, a charge nurse in the ICU at Kaiser Permanente in South San Francisco, Calif. said it can be especially hard to facilitate the very first video chat with family members who haven't yet seen their loved one hooked up to a lot of equipment. "It's shocking to them when they see it for the first time," said Macasieb-Paat. Wrangling with the technology behind virtual family visits can also be stressful. "I've called IT, and said the speaker doesn't work, the camera went out. Sometimes, it's frustrating, espe- cially when you have some real life-and-death decisions." 22 N A T I O N A L N U R S E W W W . N A T I O N A L N U R S E S U N I T E D . O R G J U LY | A U G U S T | S E P T E M B E R 2 0 2 0 Dearly Departed Patient death is different with Covid-19, and it's taking a heavy toll on nurses. By Kari Jones THIS PAGE: Celia Nieto, RN feels the emotional burden of Covid-19 deaths. OPPOSITE: LA Sio, RN thinks often of Covid patients they have lost.

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