On October 8, 2003, my dad had a massive heart attack at home. My mother called the paramedics, who did everything they could to save him, but he was pronounced dead upon arrival at the ED. Twenty minutes later, when I got to the ED with my mother, husband, and 15-year-old son, a social worker (who is a colleague of my mother's) told us the news. He also introduced my mother and me to the staff as "a social worker and a nurse" and announced, with a nod toward the ED staff, "These are the nurses who will be taking care of you today." The nurse assigned to us looked at me, then turned and walked away.
When we went to see my dad's body, there was vomit on his gown and tubes hanging from his mouth. Cremation had been planned, so I set about the task of cleaning him up. Two nurses stood in the doorway, watching silently. They left the room as I struggled to find supplies. When my mother asked for a lock of my dad's hair, I asked a group of nurses for a pair of scissors. They were perusing a scrubs catalog. One said she would find a pair "somewhere" and then went back to flipping through the catalog. Eventually a different nurse entered, handed me the scissors, and left the room, muttering instructions for me to leave them at the desk when I was done.
Just as my 12- and 17-year-old daughters arrived to say good-bye to their grandfather, the doors on the opposite side of the room flew open and a nurse appeared holding two Ziploc bags full of ice. I asked if the ice could wait for five or 10 minutes. "There are time limits on organ donor eyes," she replied, "and I must put the ice on now!!" She placed the bags of ice over my dad's eyes, holding them in place by leaning on my dad's face with her lower arm and elbow, and then roughly secured them with an Ace bandage. When she was done, his hair stuck out in all directions. His right upper lip had been pulled up into the bandage, making it look like he was snarling. The bags weren't fully closed and ice water trickled down his chin and onto his chest and gown. I closed the bags, but not before his gown was soaked. I was too stunned and numb to fix anything else. This was my children's last vision of their grandpa.
A few months later, I contacted the hospital administrators and arranged to speak to the ED personnel during a staff meeting, hoping that by discussing my observations I might clarify for them what a family needs when a loved one dies.
When the ED director introduced me, postures stiffened and all movement came to an abrupt halt. With so many hostile faces turned my way, I paused, wondering if I had the courage to continue. I thought of my dad, my family, and my belief that every nurse sitting in that room wanted to do the right thing. I forged ahead.
As I described the ice-bag incident, a nurse sitting in the front row grimaced, her eyes wide. A nurse who was standing rolled her eyes and whispered to those near her. When another nurse said she would try to be more attentive to the families of dead patients, mumbling rippled through the meeting.
Although I made it a point to express my respect for their work, I heard many discouraging remarks at that meeting. One nurse commented, "Since you are a nursing professor, you probably don't know that ED nurses have no time for this kind of thing." Another said, "You obviously don't understand how hard it is for ED nurses to comfort the families of patients who have been dropped on our doorstep already dead." Still another said, "I don't understand what more could have been done for you. Did you need hugs or what? Warm, fuzzy behavior is not my style!!"
My response to these nurses was this: "Hugging was not the point. I wanted the nurses in this department to pay attention to my family and me. I wanted the nurses to verbally acknowledge our grief. I wanted eye contact. I wanted help caring for my father's body. I wanted sensitivity when my children came to say their last good-byes. And I wanted basic respect and loyalty from my nurse colleagues. I do not think this is too much to ask."
When I was finished, the ED director thanked me for coming. Then he turned to the audience and said, "I know we all do a great job. Remember that this is just one family member who had a problem."
About three weeks later, I received a card in the mail. It was from one of the ED nurses, and it read: "Your willingness to help us, and teach us, despite the personal cost of reliving that experience, is most appreciated. Many nurses have approached me in the last few days, all resolving to change their nursing practice."