Unusual things occur in the Ronald Reagan Medical Center at UCLA.
Patients rise from bed with new hearts and lungs. The machines are valorful of the kidney stumbling, the heart valves, and the bronchial tubes. All patients are entered with dangerous health concerns, leaving the vast majority, or at least on the road to healing.
The unit contains 150 nurses, at least twenty of them on the ground at any time. They exist for all of this: every seizure of stubbornness and needle, every setback, every recovery challenges the possibilities. They are associated with their patients and defend their best interests.
“Our actions live, survive and get everything the patient needs to get there,” said MojCA Nemanic, a nurse registered in the unit.
But sometimes, despite the best efforts of everyone, the most common thing in the world happens here too. The heartbeat is slow and then stops forever. The diaphragm makes a final breath and not less again. People die.
“None of it is left to repair,” said CCRN Lindsay Brant said, “Honoring the patient’s death can be an effect on life.”
This is the spirit behind society, and it is an initiative proposed by Brant two years ago to support patients and their families and unity employees during the death process.
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1. Lindsey Brank ring a bell during her meeting with his colleagues, before they tend to patients. 2. Brant supports the patient’s hands. 3. Brank, left, and unit manager Catherine Murray Candle Preparing. (Al Sib / Times)
Under the leadership of a nurse of 12 nurses, the initiative gives the nurses tools necessary to care for the patient until the moment of death, and even after that. Society allows these sponsorships to defend the patient’s preferences at the end of life as they do during their treatment, and to address their grief after loss.
“The presence of a person alive and recovery is a beautiful story,” said Brant, an old veterans for 12 years in the unit. “Why should death and transition also not be very important?”
The idea of society with Marbelt, one of the first Brant patients in its early years in the intensive care unit.
Unit nurses talk about patients in the outlines to maintain their privacy, but even the naked features of a painful Marble story: a somewhat severe wound cut her body in two parts; Daily arduous treatments that caused suffering as much as I was amazed.
Marble was enough. Her surgeons wanted to move forward. In frustration, Bantot planted herself in front of the door to the hospital room, except for entry until the doctors acknowledged what the patient wanted, which was tasting care and peaceful death.
Brant said that the experiment raised awareness: The system that was created with a noble goal is to save people sometimes that can sometimes ignore their humanity.
Brant took a course Death care At the Upaya Zen Center at Santa Fe, NM has become an approved Doula, the person who helps others prepare for the end of life and supports them during the operation.
By 2023, she decided to deal with its president, the director of the unit, and the CCRN KATRINE MURRAY, with an idea of an initiative called society.
Molly Mayville, Alison Kirkgard and Tony Estrada, from the left, is preparing from the threshold choir to enter the patient’s room to sing next to their bed in the intensive care unit of heart disease at the Ronald Reagan Medical Center.
(Juliana Yamada / Los Angeles Times)
Murray was immediately interested. The intensive care unit was still suffering from the shock of the Covid-19 crisis, as the employees appeared to be an endless wave of epidemic patients.
studies I found that critical care nurses are at a great risk of anxiety, depression, and post -shock and exhaustion disorder since the epidemic, thanks to the poisonous mixture of unforgettable work and moral distress to watch patients who suffer, often die, without their loved ones.
Murray said: “People die alone – that was one of the things that we will never finish.”
Even before the epidemic, intensive care nurses About dissatisfaction and frustration With hospital procedures that failed to honor patient preferences at the end of life.
A 2018 study Among the intensive care nurses did not find any physical procedure or diagnosis of the patient related to the nurse’s tightness. The respondents said that watching the death of the patient was not in itself annoying.
The left, the left, and the maro, to the right, discuss the patients who will visit the threshold choir.
(Juliana Yamada / Los Angeles Times)
But they were more likely three times the reporting of severe emotional distress if they felt that their patient died of what they considered a “bad” death: he was afraid, no one heard of them, their desires and dignity.
“The death process is part of humanity, and therefore the process itself must be respected, just as the patients themselves need to respect them,” said Brant.
Starting in June 2023, Brant began to wipe out colleagues about their comfort and experience with the care of patients who die. Small group exercises started and “cheating leaves” circulated from advice to support patients and their families.
Society was officially launched in the summer of 2024. It includes a group of programs aimed at distinguishing patients and making the meaning of death.
In the goals of the care component, nurses talk with patients about their hopes of treatment and comfort with severe measures, and conversations that are documented and used to communicate patients’ desires to their medical team.
Unity has become early adopting at the University of California, Los Angeles 3 desires programWhich helps caregivers to implement the final requests for patients and their families: a wedding ceremony in the hospital room, and a plaster template from the interlocking hands of the patient and his wife, a final in the open air (there is no small work, taking into account Armada from the medical equipment that must come).
Brant cares for the patient in the unit.
(Al Sib / Times)
Brant connected ThresholdA national network of volunteers who sing on the aspects of poor birth and death. Members of the Western Chapter of the choir visit the unit every Thursday to sing the calming consensus of patients who need rest, regardless of their diagnosis.
There is a moment of silence, rituals after the patient’s death, in which nurses and doctors join their loved ones in the hospital room to honor their death.
For employees, there is an appearance and participation, a quarterly session on zooming and personal to extract information about the challenges in the unit. Some people are vent. Some people cry. Some participants do not say anything, but I write in the chat how it means hearing colleagues who express similar feelings.
Murray said that the hospital, which had previously allowed social workers and advisers to unity nurses, but absorbing their services was low. On the contrary, they appear and share “just work, because we do it for each other instead of someone else.”
In late 2024, CCRN Quentin Wetherholt was interested in a patient with a long -term disease when he felt a precise change in her behavior. He started targets for care conversation with the patient, her family and her doctors who reviewed the possible options for treatment, which I have already tried. After hearing her choices, the patient spoke: You no longer want vital measures.
From this point, the patient’s position was “nothing but joy, and it is irony that it was paradoxes.
“It was a very difficult way it was: a lot of pain, a lot of surgery. Thus, she has gone immediately, and she can enjoy her time the way she wanted to enjoy her – her sense of self has restored her.”
“The death process is part of humanity, and therefore the process itself must be respected, just as the patients themselves need to respect them,” said Brant.
(Al Sib / Times)
The patient’s relative asked to fly from the outside. I asked for milk. She died in peace after about a week, with a family around her bed.
After the patient’s death, the unit kept the attendance session and sharing sadness on it and for others who recently passed in the unit.
“Before, it was almost similar to a pride point – as you know,” death does not affect me, this is what I do for a living. “But now it is good to go with your co -workers, and be able to get this forum to heal really and not to have to his bottle.”
Early data promising: In a survey of nursing staff five months after the moment of silence started, 92 % felt more related to their patients and their families, and felt 80 % near their teammates. Brant applied for a grant for the participation of the community program with other six -intensive care units in the hospital.
“We are a family here, and we are treating patients as if they were an extension of our family,” said Brant. “Nursing is the best excuse in the world that loves strangers, and treats all humanity as if it was your closest friend and loved ones. It is a gift to be able to do so.”