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Nurse Stella's Grief Capsule

by Rev. Njambi Ngaruiya BCC

APC Forum, April 2022, Vol. 24 No. 2


“Nothing is working!”whispered Stella (pseudonym), an ICU nurse I met while walking from the parking lot to meet with a family whose patient was dying. As we got closer, I noticed she was crying and by her demeanor seemed as if she was still in a patient’s room. She turned her head backwards to gaze at the hospital buildings and with an aura of desperation again looked back at me. In a voice choked up with tears, Stella went ahead to describe a difficult night trying to save the life of a fifty-year old woman who had Covid-19. I was wrestling with how best to support her when she quickly uttered “I just need a break from all this.” I sensed her deep sadness and frustration as she continued “we are doing everything (pause) everything and nothing is working!” I watched as she looked back at the hospital buildings again and then back at me as if desperately searching for a way to escape the nightmare. But instead, Stella quickly ended our brief conversation saying, “I am coming back,” which I understood as her plan to be there when the family arrived. Still feeling at a loss of how to support Stella in our brief encounter, I quickly rushed towards the hospital buildings after letting her know I would be available to talk more. 
On reflecting on this encounter, I realize many caregivers were feeling like they were fighting an infinite and hopeless battle with Covid-19. As another nurse shared with me one night; before the pandemic, their work was treating patients with the hope of recovery. But, that had disappeared and what they were trying to do was keep patients alive for a few days. Hypothetically, I would call this, “trying to ward off death for a short while” knowing that once patients are in the ICU, it is just a matter of time before the angel of mortality beckons. In a Dutch-based nationwide study conducted primarily on the psychological impact of Covid-19 on ICU caregivers in 2020; Caillet et al. (2020) noted their results revealed a high incidence of anxiety (48%), depression (16%), and (27%) PTSD symptoms among the critical care nurses. This highlights what I observed while trying to support caregivers alongside patients and their families. As the months during the surge proved, caregiver support is a complex issue. Their needs go beyond the physical fatigue due to the surge, the lack of resources or the emotional trauma of their experiences with Covid-19 patients and their loved ones. Several caregivers told me what they experienced was beyond the normal burnout and in many cases, was exacerbated by the fear of contracting the illness or facing the stigma of what may happen if they talk about working in a hospital. On a personal note, I understood their experiences while recalling several visits with my mechanic a few months into the pandemic. He reminded me often that “I work in a hospital” and with a controlled gesture of kindness, would offer me a chair to sit outside the office while waiting for my car. 
Shen et al. (2020) in their Chinese-based study proposed several solutions of dealing with the psychological stress of ICU nurses during the time of Covid-19. These include measures such as using communication mechanisms to reduce anxiety related to new or unfamiliar working environments, allocating patients based on actual nursing ability and where necessary providing more training. Again, Shen et al. (2020) suggested enhancing education and training to reduce concerns about the spread of infection, adjusting work shift hours to ensure nurses have plenty of rest and the use of psychological interventions through in-house therapy. Finally, they contended that creating an environment that fosters connection with families such as the use of WeChat videos, support groups and a professional team to provide mental health training and guidance are appropriate measures for reducing Covid-19 related stress (Shen et al., 2020). However, as O’ Neil (2020) explained, the extent of mental health issues and psychosocial challenges is diverse and applicable to societies as a whole. In proposing the consequences will be felt for an extended time, O’ Neil et al. (2020) gave an example of the impact of Covid-19 on health issues such as cardiovascular disease and health management. 
As I reflect on my encounter with ICU nurses such as Stella and many other caregivers during the pandemic, I remain aware that the recovery process will take a while. She represents the struggles of those serving in the frontlines while caring for the patients and their loved ones. Covid-19 and the new strains will continue to challenge every aspect of healthcare and societies in the future. As I observed that night, Stella was trying to navigate the complexities of what her role as a nurse had become. She openly lamented with the family while explaining to the patient’s daughters who were grief-stricken how they tried everything possible to save their mom’s life. Her sense of hopelessness was evident to the family who later shared with us; “we all had Covid-19” and their grandmother was a patient at the same hospital. In an attempt to reassure the two daughters, Stella used a phrase that I commonly hear among nurses “she’s maxed out on everything,” meaning they had run out of medical options to save her life. In what I would say was an existential moment as I closed in prayer lifting up the patient’s soul into God’s hands. Stella’s deep grief was shared by the family who could only watch helplessly through the window, while waiting to hear their mom was gone!
References Cited
Caillet, A., Coste, C., Sanchez, R., & Allaouchiche, B. (2020). Psychological Impact of COVID-19 on ICU Caregivers. Anaesthesia Critical Care & Pain Medicine, 39(6), 717-722.
Shen, X., Zou, X., Zhong, X., Yan, J., & Li, L. (December 01, 2020). Psychological stress of ICU nurses in the time of COVID-19. Critical Care, 24, 1.
O'Neil, A., Nicholls, S. J., Redfern, J., Brown, A., & Hare, D. L. (2020). Mental health and psycho-social challenges in the COVID-19 pandemic: food for thought for cardiovascular health care professionals. Heart, Lung and Circulation, 29(7), 960-963. 


Rev Njambi Ngaruiya is a Board Certified Chaplain and APC member. Currently, They serve as a full-time chaplain with Providence St Joseph’s Hospital in Burbank. They enjoy dancing, taking long walks to think and pray, meeting new people, and having conversations about life.