Six feet of distance prevents hugs. Masks cover smiles. Gloves negate the warm touch of hands. Words uttered convert moments in times such as these into the worst of ones’ life, and our mechanisms of providing comfort are banned in an effort to maintain safety. When a mother’s son is taking his final breaths, how does one hold her up and comfort her if not with their arms?

The patients I worry about now are the same who have always plagued my dreams: the uninsured person who sits across from me, with smooth brown skin that mirrors my own. Their skin sinks into their temples, their tears move slowly down their cheeks, their lips suck the words ‘stage 4’ into their mouths, and they chew and chew until they swallow and choke.

We sit in these rooms alone now because the virus has restricted visitation. Family visits are limited to images on phone screens. I imagine the patients—their ears hanging closely to the speakers—listening to whispered words of support that are not as comforting after those soundwaves travel across a digital network. I furrow my brow and squint my eyes as I share in their heartache, whispering how I wish things were different.

Words uttered from six feet away.

Palliative care is a field that serves as an extra layer of support for patients and families. How do I provide this in a time when my body could unknowingly be carrying a disease that brings more suffering? Do my eyes convey the touch I wish to give—can they give a warm embrace?

I shift. They chew.

In our office, we strategize how to handle the surge of COVID patients that may come, and the death that may follow. How do we provide a dignified death to a homeless patient who has nowhere else to die but a hospital nearing capacity? How do we navigate this new normal, while continuing to serve the patients who have always needed us? Many non-COVID patients have stopped coming into hospitals, but our patients are the ones who remain—cancer is still here, and it does not fear a pandemic. As nurses, we cannot prioritize our own suffering, although I sometimes want to cover my ears and close my eyes to block it all out.

Still, I find the moments that have drawn me to palliative care and will forever keep me coming back. The movement of a body released from pain. The soft creases in the corner of eyes when a good meal is enjoyed without nausea. The stories of a life lived to its fullest. Laughter bursting from rooms where it’s so often absent. Facetimed loved ones communicating joy. These are the moments that keep me coming back, and make the chaos a bit more bearable.

– Mansara (Sara) Hassan, MSN, APRN, AGNP-C, Nu’14, GNu’18
University of Pennsylvania School of Nursing