This is the second time I have had the family of a patient in critical condition make the decisions to stay away from the ED and not to be with their loved one during their end of life. Although it's a tough decision to let your loved one die alone, they have comorbid conditions and do not want to turn one family tragedy into multiple illnesses.
My 91-year-old DNR patient with bilateral infiltrates, respiratory distress, and hypoxia would have spent her final hours alone. But, her nurse Jenna, put on full PPE and stayed in her room holding the phone with the voice of her daughter, silenced alarms, and gave this patient the dignity of somebody being with her as her HR went down from 103.... to 80... to 60.. to asystole. The process is unpredictable and can linger, but Jenna was there at her patient's side in the suffocating PPE attire. Jenna had asked me earlier when I told her the family was not coming due to health concerns if I expected her to be in the room watching the monitor or if she could watch from the desk. I replied, just check on her but I don't expect you to be 1:1 as I know you have other patients. As long as she is comfortable, we confirmed the DNR comfort measures with the family. She had other nurses care for her patients and decided on her own that this woman would not die alone.
I am so very impressed with Jenna and our other nurses who put aside fear, fatigue, and their own needs to be anything our patients need.