The critical care nurse is trained to assess, treat, and monitor severely ill patients to facilitate their recovery. Knowledge and technical skills are learned to achieve one specific goal, preventing death. 

Once care is no longer focused on curing but supporting death and dying, the care of the patient continues, but the goals have been reprioritized. Peace, comfort, and dignity in death become the highest priorities. Many nurses feel ill-prepared for this, it’s a very powerful position to be in when you can relieve the suffering of another human being. Palliative and comfort care is not something taught in the ICU but is learned through experience at the bedside. For many nurses, this can be overwhelming. Not only is the bedside nurse charged with relieving pain for their patient, but for the family members at the bedside as well. 

Preparing for death in the ICU, particularly at night, lacks manpower, ancillary services, and specialty services. The process can exhaust all caregivers involved. I would like to relay a night when Jenny McDonald, charge nurse of the ICU, embodied the mission and values of Providence Alaska Medical Center. The patient came into the emergency department for respiratory distress. Her increasing oxygen need required Bi-PAP, and despite our support, she was quickly approaching the limit of care we could provide. Despite being young, the patient was presented with the news that she would likely die if they attempted to insert a breathing tube. Knowing she would likely die, she made her wishes known. Her wedding was supposed to be that weekend; she requested that she be married before the procedure.

Once Jenny became aware of this desire, she spearheaded making this happen in the late hours of the night. She contacted the unit secretary, who agreed to come in early with decorations. Other entities were enlisted within the hospital to get refreshments and cake; she organized the chaplain to officiate the marriage. The decorations brought in were combined with ones from the Serenity room to decorate the patient’s room. Jenny tasked a nurse to make a bouquet for the bride-to-be. Throughout the entirety of this event, Jenny made sure that all caregivers who took part were okay; she made the staff feel seen and heard. She extended this caring to the patient’s family, ensuring that every step was met with honor and dignity, along with as much joy as the situation would allow. All the caregivers involved stayed into the next shift to ensure the patient got her wish. Once she was married, the patient proceeded with the procedure and ultimately passed shortly after.

Organization, communication, respect, and empathy were embodied by Jenny that night. She advocated for the highest quality of care that this patient could have received in the last phase of her life.