Janine Galeski, MSN, MA, FNP, RN, is an instructor and preceptor coordinator at the Frances Payne Bolton School of Nursing at Case Western Reserve University. She also maintains her clinical practice on a palliative care team in a community hospital. Janine shares the realities of palliative nursing during the COVID-19 pandemic.
My name is Janine Galeski, and after six years of being a labor and delivery registered nurse, I transitioned into a Family Nurse Practitioner role with a focus on inpatient palliative care for the last several years.
Along with the other certified nurse practitioners on our Lake Health palliative care team, I accompany our patients and their families during serious disease and the end-of-life, trying to ease physical and emotional suffering.
COVID-19 has presented additional challenges and increased the suffering of most of our patients by adding stress, fear, and taking away the usual sources of comfort, such as an empathetic touch of a nurse or the joy of visitors.
There is no drug to replace this. We can fix physical pain, but the emotional pain of the patients and families (and the medical team) is the real challenge.
We help the family understand that COVID-19 does not stop at the lungs, but also destroys the kidneys and the heart in some cases. We help them make the difficult decision to establish a DNR or even to withdraw care. We order the medications that help make the dying process as comfortable as possible.
We help the ONE family member who is allowed to be at the bedside at end of life, to gown into full PPE and stop them from taking their mask off when they are sobbing and need to blow their nose. We check on the family members in the parking lot and keep them informed. We call the brother who is out of state. We hold the phone when the kids are saying good-bye. I have even translated by videoconference to a sister in Germany. We are often the ones telling them their loved one is dying. There are rarely happy endings in our job.
Yet, I feel palliative care is at the heart of nursing and needed now more than ever. I am always amazed to hear families thank me after their loved one has passed. It was a great the privilege to help bring life into the world as a labor and delivery nurse, and it is an even greater privilege to help our patients when they leave this life.