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Sarah Shin, Nu’18

“As an intensive care nurse, I spend many shifts face-to-face with suffering, pain, and death. My critically ill patients fight to live, day in and day out. With all the procedures, imaging, monitors, lights, beeping, and poking, patients have asked me if it is easier to die than to suffer.

Sitting in a family meeting for one of my patients with extensive multiple organ dysfunction, I listen as the family wonders if discontinuing ventilator or dialysis support means killing their mother. Frustration and guilt build up as they begin to realize that survival will not necessarily mean recovery. They sleep and sit bedside with their dying mother each day, rejoicing in miraculous steps up and other days, lamenting devastating falls down. My colleagues and I fear how they will cope. Over a period of a few weeks, the family slowly decides to stop medications, dialysis, and finally the ventilator. A social worker and I hang up colorful lights and pictures of her family in her room during Christmas.

And about a month later, hours after the patient has passed away on comfort care, I take the lights down from her room. In that moment, it becomes clear to me that although we cannot change the finality of death, we can find ways to provide compassion and dignity.

During my senior year at Penn, I took a class with Dr. Salimah Meghani, in which we not only discussed guidelines for palliative care management but also the critical involvement of nurses in palliative care communication and coordination. Our discussions highlighted the nuanced art of the nursing practice, in that, although we can do our best to treat physical symptoms, there is an inevitable importance of the emotional aspects of our care. How do we provide quality support during this time? How can we ensure patients can embrace what they love, what has meaning to them, at this point in their life? How do we, the healthcare providers, take care of ourselves?

Two years into my career, and I am continuously trying to find answers to these questions. All I can be certain of is the overwhelming gratitude I feel towards my colleagues, with their steadfast support during the difficult times, and towards my patients and families, for showing me that, as Haruki Murakami says, “death is not the opposite of life, but a part of it.”

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