A death in the work family

By: Debbie Moore-Black, RN

At an early age, Tasha remembered looking up to her mama dressed in a crisp white uniform and a nursing cap placed perfectly upon her head — one bobby pin at a time. Tasha learned what sacrifice, responsibility, and dedication were all about.

She also knew her mama’s love for the nursing profession.

When Tasha was four years old, she used to say: “One day, I will be a nurse just like you, mama!”

Tasha excelled in academics. She loved chemistry, biology, microbiology, anatomy, physiology and psychology. By the time Tasha finished all of her academic requirements in college, she proudly held up the letter that came in the mail. The letter of acceptance into nursing school.

Her dream came true.

Tasha proudly displayed her BSN diploma. Her true love was behavioral health. She wanted to help people in a time of distress and dysfunction — a time when patients felt their life and desire to live started to unravel.

Tasha knew how to deescalate the one in a rage. She knew how to calm the sobbing tears of a lost soul. She could comfort and listen with a calming spirit. If she wasn’t holding their hand, her eyes told them that she cared. And sometimes, that’s all these patients needed — someone to listen, someone to care.

Tasha and her mama were a team. Joined at the hip, and as Tasha’s mom grew older, Tasha was there to take care of her.

Tasha also took care of her behavioral health unit. She considered the staff her “other” family … her second family. The staff grew to love her. Her endless generosity often meant providing the entire staff with a full course meal. Sometimes it was on a random day, sometimes an Easter dinner, Christmas or New Years’ Day. Tasha was full of love. And her staff loved her dearly.

Tasha put her scrubs on. Day three of 12-hour shifts.

She felt a little “off” on this day. Lots of “indigestion.” She felt weak with some shortness of breath. But she knew her ongoing indigestion well. Her weakness and shortness of breath had to be attributed to her third day at work.

Tasha clocked in. Ready to go, looking forward to a nice long weekend off.

She told a fellow RN, though, that she wasn’t quite up to par on this day. But she knew she could make it through these next 12 hours.

At 17:30 (5:30 p.m.) Tasha was outside of the behavioral health unit talking to a patient’s family member and giving them an update. As Tasha was talking, she stopped, slumped over and fell to the floor.

The family member frantically screamed for help. The staff arrived, a code blue was called, and CPR was initiated immediately.

The code blue team hooked her up to the EKG monitor. Ventricular fibrillation.

A nurse yelled out: “Shocking … all clear … shocking again!”

And after almost two hours of coding Tasha, they couldn’t bring her back.

The physician on the code team pronounced her death.

Our Tasha: Our vibrant, spectacular Tasha was not coming back.

The staff felt lost and broken.

EAP and chaplains set up counseling sessions by Zoom. A poster was placed in the unit by a fellow nurse with pictures of Tasha at restaurants with her staff “family.” Pictures of Tasha at the full-course meals she’d bring into work and of her laughing till her belly hurt. Of Tasha and her mama.

But our behavioral health unit felt as if Tasha’s death had sucked all of the energy out of everyone.

Many people attended her funeral. Nurses, psychiatrists, technicians — her second family. Sullen. Sad. Lost. Broken.

And on this crisp, clear blue sky day, tears flowed from all.

The mahogany casket stood still, shining in the sun with brilliant purple flowers on top. Her favorite color.

And her mama in her wheelchair watched as they lowered her only child, her only daughter, into the ground.

One friend strummed slowly on his guitar.

“How great thou art…”

42 years old.

It won’t happen to me.

It’s just indigestion.

Denial.

Cardiac arrest. 100 percent LAD.

We bowed our heads as the preacher stretched his arms out, looking up to the heavens:

“Thy Kingdom come.

Thy Will be done.”

Originally published on KevinMD.com

A beloved COVID ICU patient turns to comfort care

By: Debbie Moore-Black, RN

Everyone loved Mrs. Maria. She was everyone’s mom, grandma, teacher.

Maria grew up in poverty. Though her family was poor, she knew her parents and siblings loved her and loved each other. But the one thing she knew her passion was at was school. Every morning she couldn’t wait to go to school and learn more. And she knew one day she would be a teacher.

Throughout the years, Maria excelled in school and became the valedictorian of her high school. Her grades and civic participation landed her a scholarship to college. She became that loving teacher. The one we all remember. The one that challenges you to do your best. The one that charged you with energy that you didn’t think you had.

Through the years, she married, had three children, and eventually became a grandmother. Her children and grandchildren loved her. She was their comfort, their love, their wrap-around teddy bear. The neighborhood loved her. The community loved her. And she progressed to a master’s degree and then a doctorate in education.

She led her community as the supervisor of the county schools. COVID hit this community hard. This city. This state. And though Maria wore her masks and encouraged all to wear masks and social distance, the country’s school systems became difficult. Virtual/Zoom courses were created and soon the established school system became riddled with gaps and unsureness on how to continue keeping school open.

Maria came down with a cough. A persistent cough. And then a temperature. And when she became short of breath, she knew. Her family drove her to the hospital. Her oxygen saturation was dropping progressively.

As she entered ICU, the intensivist had a careful talk with one family member and with Maria. They would choose to intubate her. Ventilator, central line, arterial line, then came the Levophed and vasopressin drips for her blood pressure that kept dropping. Every day, every hour was a new evaluation of her oxygenation. Her O2 would vary. One day was good; we’re gonna make it. The next day was horrid. FiO2 increased, Ativan and morphine added. Wrist restraints to avoid potential extubation.

And the nurses came in, gowned, gloved, face masks and face shields. Turning and repositioning Maria … and all of the other COVID patients.

The nurses knew. They knew it was a matter of time.

When they had to prone Maria, they knew it was a last-ditch effort. Her kidneys were failing. Dialysis was started. And Covid ravaged her body. Her organs, one by one, shutting down. Lungs, kidneys, brain bleeds …. gasping, asynchronous with the ventilator … and Maria could not be helped, no matter what we did.

We also loved Maria. We have loved them all. They are not a number. They are a person, a mom, a dad, a sister, a brother, a grandmother, or a grandfather.

The neighborhood showed up at Maria’s house. Candles lit. Showing their love and respect for a great leader. A great mother and grandmother to all. A great teacher. A great doctor of education.

The nurses gathered around Maria as the ventilator was pulled. The family via video said their goodbyes.

“We love you, grandma.”

“We love you, momma.”

Comfort care. Occasional morphine for pain. And we held Dr. Maria’s hand with our latex gloves on. Masked and faceless … but our hearts were there. Melting. Tears.

Fly high, our angel.

Fly high.

Originally published at KevinMD.com