1. Beiermann, Mary E. BSN, RN, CCRN-CSC

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The greatest gift is a portion of thyself.


Ralph Waldo Emerson


To highlight this year's nurse and hospital week theme, "The Healing Heart of Health Care," employees were asked to share, in 1 word, how we strive to be Simply Better. Based on social media responses, employees not only impacted the lives of our patients, families, and community but also played an important role in the lives of our fellow colleagues. This was the message from our hospital chief executive officer, John Bishop, after a successful employer appeal for this yearly celebration. I submitted my thoughts and was delighted to find I would be highlighted for this campaign.


It was the experience of losing 5 family members in 3 years that brought me to be grateful for every smile, commentary, and visceral reaction to the keepsake named the ECG Memento(C). Death, like life, is a universal human experience. We always have a need to feel attached and connected to our loved ones. Bowlby's1 definition of attachment is defined as a lasting psychological connectedness between human beings. It was the theoretical framework for the creation of the ECG Memento(C).


I would like to share my story. While I was sitting at my dying mothers' bedside, I asked the critical care nurse for an ECG (electrocardiogram) strip, just to have something tangible of her. As critical care nurses, we see the ECG as "proof of life." Two years later, I asked for and received my father's heartbeat tracing. I kept these two rhythm strips protected in a Ziploc(R) bag for many years, as a treasured memento of their last days of a lived life.


In 2012, my Aunt Rosemary died and I had been named successor trustee of her estate. While my husband and I were flying up the California coast to Mount Angel, Oregon, to begin the settlement process, I was reading a continuing education unit course on death, dying, and bereavement. I came across some key words I had not heard before, "object linking," "continuing bonds," and "attachment theory." These concepts started to make sense. It was a scientific theory that supported why I filed the strips away. I knew that, if having the treasured heartbeat tracing of my parents brought me comfort, maybe it could help other families going through the transition of losing a loved one.


Traditionally, the intensive care unit nurses give family members a bereavement folder when their loved one dies. I felt that there was more we could offer, at this time of life change. There was a gap in our end-of-life care. I felt that it was my "professional obligation" as a nurse to initiate a change in that care, to close that gap.


When Aunt Rosemary died, she was very religious and had many prayer cards that were laminated. Seeing these gave me the idea to look into using laminating products to create a laminated card with an ECG strip memorializing the image of the patient's "life-force." I found self-sealing wallet size laminates. Thus, the ECG Memento(C) was born. This new idea created a warm and exciting feeling!


I discussed my idea with Dr Peggy Kalowes, our hospital's director of nursing research and innovation at our Annual Skills Fair, and she said, "This is novel. I think we need to test this among our dying patients." In November of 2013, I began the Nursing Research and Evidence-Based Practice program. During the 15-month program, we developed the research proposal and carried out a trial to examine the impact of this novel intervention offered to families during the bereavement period. The opportunity of making a difference gives meaning and purpose to our lives. Moreover, finding people who are hurting and helping them through their troubled times adds value to the institutional organization.


When I showed a sample of the card, I received positive staff feedback. Comments included "groundbreaking" and "I wish I would have had one when my parent died" to "Everyone gets happy." It was the feeling that someone "cared" for the grieving families and that their deceased loved one was important and had mattered.


There was also a change of heart from my assistant unit manager, Carolyn Freitas, BSN, RN. When I showed it to her, she said, "Oh, I don't know if I'd want this," meaning "if" her husband had died. A week or so later, her husband had to euthanize their beloved boxer dog. She was unable to be there with her husband because of work scheduling. Two weeks after her dog's death, she showed me a card with "Maya's paw print," which the veterinarian personnel had individually signed it. She looked at me and said, "Now, I understand."


Since inception of the ECG Memento(C) in November of 2015, with support from leadership, nurses have created thousands of laminated heartbeat tracings and sentiment cards, for more than 250 grieving families, who have expressed appreciation and gratitude. A tangible and touchable remembrance had been created.


As we start this holiday season, it is with a feeling of being connected as we remember our loved ones. Even though they may not be physically present, their views, feelings, good or bad times, and mementos carry us on as we continue with our own life journey. We are grateful to have known that person and thankful for the lifelong learning experience they have given us. It reminds us that we are only alive for short time. With the healing heart of health care, nurses can make their interventions provide meaning in the face of death, creating positive memories to aid healing in the grieving process2 The heartbeat goes on for 2018 and beyond!




1. Bowlby J. Attachment and Loss. New York: Basic Books; 1969. [Context Link]


2. Capitulo KL. Evidence for healing interventions with perinatal bereavement. MCN: Am J Matern Child Nurs. 2005;30(6):389-396. [Context Link]