Many people across the world have been directly impacted by the COVID-19 pandemic, but there are also those who are affected indirectly-while being "on the other side" of the virus. I have been an RN for over 37 years, during which I have helped families who lost their loved ones. I recognize that ethical dilemmas are something that nurses encounter, but I never thought I would be in the middle of one involving my own family during a global pandemic.
I was raised in a small community by two loving parents who worked hard all their lives. Unfortunately, they were both diagnosed with Parkinson disease and eventually required placement in a long-term care facility and hospice care.
Then along came the COVID-19 pandemic. Life would change forever as my family and I knew it.
Nursing facilities were ordered by the state to lock down as a pandemic-related precaution. Suddenly, I was unable to visit my parents, make sure they had everything they needed, and provide some level of daily contact to the outside world that helped them survive. They were suddenly isolated in a facility where they knew no one. We were able to call them on the phone, but it was not the same as being in their room with them. Through the videocam in their room which we had installed, we saw mom and dad deal with confusion several times. It appeared that dad struggled to try to help keep mom oriented to their situation.
One afternoon, I received a phone call that my father had been found on the floor. The staff at the facility assured me that he was not seriously injured. I expressed my concerns for their safety and well-being, and requested the staff to check on my parents more frequently. I realized that the facility has been stressed due to the pandemic, but I was also stressed about my parents' safety.
Later that day, I received another phone call from the facility staff who informed me that my dad had fallen again, and this time he could not get up. When I arrived at the facility, I was greeted by the receptionist who said that I could not go to my parents' room. I asked her to obtain permission from the administration, but a nurse came out and told me that an ambulance had been called to take my dad to a local hospital. I knew that my dad's wishes had always been to die under the care of hospice and not be taken to a hospital, so I immediately expressed my concerns. She said that my dad had agreed to go to the hospital, and if I'm amenable to the plan, I could go and see him after a temperature check. I agreed to his wishes, had my temperature taken, and finally got to see my dad and mom for the first time in weeks. Dad was on the floor wedged in the doorway of the bathroom. After he was taken to the hospital, I gave mom a big hug and left for the hospital, where I waited in the ED. Upon examination, my dad did not appear to have any fractures but was in a lot of pain. A chest X-ray demonstrated pneumonia, so my dad was admitted.
During my dad's hospitalization, we lived on the other side of the COVID-19 pandemic. He did not have COVID-19, but the hospital had to protect patients and restricted visitors. Only one family member was allowed to enter the hospital after a screening process at the door each day; other family members had to remain outside of the building. We took turns going to the hospital and sitting with dad as his health continued to decline. After his COVID-19 culture came back negative, he was moved to an inpatient hospice unit. He was considered end of life so we were allowed to continue to visit one at a time. At some point, hospitals in our state adopted a no-visitor policy. As a nurse, I understand the importance of having no visitors during this trying time, but as a family member on the other side of the virus, it was very stressful.
Fortunately, I had support systems that helped me adapt to this challenging situation. My faith in God and daily prayers provided me with spiritual support. My family, including my husband, daughters, sisters, brother-in-laws, and many cousins, reached out and consistently shared comforting words. My manager and coworkers also helped relieve the stress of such an emotional situation. Despite their stressful work in a hospital setting amid the pandemic, they offered words of support and assistance.
On the ninth day of my dad's hospitalization, I received a phone call that dad was not expected to make it through the day. The hospice unit turned their heads and let my sisters and me sit with him as he passed peacefully. Being on the other side of the virus, we faced unexpected challenges beyond what we considered normal. Nevertheless, it helped me successfully adapt to adversity through my support systems.