1. Grogan, Kara Caparulo RN


An encounter dreaded by a new nurse becomes a cherished memory.


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In the fall of 2018, I was a new graduate nurse and had just finished my orientation on a medical-surgical unit. No matter how comprehensive an orientation is, it cannot prepare you for every situation. Near midnight on my fifth shift by myself, I was told to expect transfer of a hospice patient from the ICU. The nurse giving me report said that the patient, Ada Capatelli, was not a candidate for discharge to Hospice House or to home with hospice care because she would not survive transport. She had already been in the ICU for several days and defied the odds for how long she was expected to live and was only being transferred to me because the ICU needed the bed for a critical patient. The nurse told me her family was already at her bedside and refused to leave her side.

Figure. Illustration... - Click to enlarge in new windowFigure. Illustration by Eric Collins /

After receiving report, I felt in over my head and unwilling to deal with this sad situation. Though my nursing education covered hospice care, I had no real experience with it. I decided I'd just try to keep the patient as comfortable as I could and then leave the room as soon as possible to give the family privacy.


When I asked one of my coworkers for advice, she agreed that I needed to keep Mrs. Capatelli comfortable and try to help her die with dignity, but also said that I should do my best to take care of her family. She suggested offering them warm blankets and pillows and bringing them extra chairs, a simple idea that had never occurred to me.


A few minutes later, Mrs. Capatelli was being pushed down the hall in her hospital bed to room 813, her family surrounding the bed. I took a deep breath and followed. Once in the room, I offered the family pillows, blankets, and extra chairs and let them know I wanted them to be comfortable while they were with her. The son responded by telling me that she would never leave his side when he was sick, so he wasn't going to leave hers.


After I'd gathered the blankets and some extra chairs and brought them back to the room, Mrs. Capatelli's daughter told me that someone had suggested to her that her mom might not have died yet because she was still holding on to something. Beginning to cry, she asked me what it could be. I told her that I didn't know. I could only stand there as if frozen, trying not to cry with them. I felt strongly connected to the family in their dread of her death and wish to do what was best for her, but couldn't think of anything else but to just be there for them.


I remembered that my coworker had suggested doing whatever usually comforts me when I'm upset. I asked them when was the last time anyone had eaten something. No one could quite remember. Our cafeteria was closed, so I raided the snack machine and brought them back some food. A few of them nibbled at the sweeter items I'd brought. Then one of Mrs. Capatelli's sons spoke up about how much he was going to miss her cooking, and the room fell silent again. When I asked him what his favorite recipe of hers was, he brightened up a bit and told me. Then we started swapping recipes and, before I knew it, swapping stories about our similarly large, close-knit, passionate families. Their mom was definitely Italian, from the way she cooked to the way she disciplined. We laughed about how much trouble one of the sons got in when he was young and joked about how that was why the other son was her favorite. When I left the room to go check on my other patients, I was still smiling, thinking of Mrs. Capatelli making lasagna for her family.


I was giving one of my patients their 6 AM heparin shot when I got a call from a coworker saying 813's family had just called the desk and said she wasn't breathing anymore. I went to her room a few minutes later with my coworker and we pronounced the time of death. After my shift, I stayed on to share hugs and cry with the family. I thanked them for letting me take care of someone so special to them. We decided that their mom had been holding on so long just to make sure they would still be okay without her, and hearing them laugh over shared memories had given her that confirmation.


I cried the entire drive home and still cry at times when I'm thinking of her and her family. There was so much love in that room and I was blessed to be a part of it. An encounter that I was dreading and terrified of is now one of my favorite nursing memories. This family taught me the importance of caring for the entire patient-including the family. Thank you, Mrs. Ada Capatelli.