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The end, through the eyes of a critical care nurse

Lauren Bever, RN
Conditions
September 13, 2021
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On the day you die from COVID, many things will happen.

A colleague and I will enter the room to carefully prepare and clean your body.

We will shut off all the IV pumps.

We will turn off the ventilator.

We will silence and turn off the monitor that is screaming at us that something is emergently wrong.

We will remove the breathing tube from your throat.

We will pull out the intravenous lines.

We will remove the arterial line that monitored your dangerously low blood pressure.

We will remove the catheter that drained your bladder and measured as your urine output gradually decreased to nil.

In the end, they will leave the room, and it will be just you and I.

The machines will be turned off.

The beeping will have stopped.

The alarms will be discontinued.

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The room will be silent for the first time in days.

I might have music on, if your family told me what you like to listen to. I’ve listened to all kinds of music at the end.

Classic Rock. Big Band. South American flutes. Chinese ballads. Country and Western.

Today it was the Beatles.

“Yesterday … all my troubles seemed so far away … Now it looks as though they’re here to stay … Oh, I believe in yesterday …”

I’ll cover your body with a sheet and try to position you so that you look as natural as possible.

I’ll dial the phone number or open the video chat, and your family will pop up.

They will see you and begin sobbing uncontrollably.

They will tell you that they love you.

They will question their God.

They will tell you that they don’t know how they will go on without you.

They will thank you for being a great partner, great spouse, great child, great friend, great person…

They’ll put the dog up to the camera so you can “see” them one more time.

Old grudges will be forgiven or put aside.

I will be privy to family secrets and skeletons that nobody else knows about.

I’ll never breathe a whisper; your secrets are safe with me.

I will listen silently as they beg and weep and plead and grieve.

I will close my eyes tightly at the scream that signifies pain so raw and deep that it stings even my numb and burned-out heart.

I will try to hold back the tears that gather in my own eyes as I empathize with the pain your family is feeling.

I will fail.

I will cry silently too.

I will wait patiently until their tears have slowed and they have told me that they are ready.

I will hang up the phone or shut off the video.

I’ll sigh to myself as I start to clean up.

The bag that your battered body lies in won’t be zipped up yet.

I know it sounds crazy, but I don’t believe in zipping up the bag until I’m ready to leave the room.

I can’t bring myself to clean your room while you lie there inside a dark zipped-up bag, ignored because you no longer breathe.

So, I’ll take down the drips.

It will take me a while.

You’ll have been on a lot of drips.

Sedation.

Pain medication.

Fluids.

Pressors.

Anti-anxiety medications.

A blood thinner.

I’ll take them all down and puddle the lines on the floor while I dispose of the excess contents.

I’ll gather the unopened supplies in the room and begin throwing them in the trash.

The new cardiac electrodes that don’t need to be placed on a chest that no longer has a beating heart.

The pulse oximeter that would read “zero” if I were to attach it.

The oral care kit that we used to try to prevent you from getting a secondary infection in your lungs.

The bags of dialysate that were used in a valiant attempt to preserve your kidneys.

The tubing that was attached to the ventilator to breathe for you.

The numerous pictures and cards that your family dropped off at the front desk of the hospital for us to hang in your room for encouragement and support.

All of it will go in the trash.

Nothing can be salvaged from a COVID room.

I’ll tidy up the many caps that have found their way onto the floor.

Caps from IV flushes. Caps from medications. Caps from IV tubing. Caps from respiratory equipment.

Caps that were opened and discarded so quickly as we worked so feverishly that they’ve long since been forgotten and relegated to the floor.

Finally, I will be done cleaning.

I will stroke your hair. I will hold your hand. I will position you, so you look comfortable.

I will wonder why you didn’t get vaccinated.

Fear? Conspiracy? Misinformation? Just never got around to it?

It doesn’t matter now.

I will look into your face one more time.

I will zip the bag.

I will leave you in the room to be transported to the morgue.

You, however, will never leave me.

Memories like this are not ever forgotten.

Because in the end, on the day you die from COVID, it will be just you and I.

Lauren Bever is a critical care nurse.

Image credit: Lauren Bever

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