bereavement, critical care, death, grieving, high-tech, ICU



  1. Whitmer, Mary RN, FNP, BC-PC
  2. Hurst, Sue RN, MSN
  3. Stadler, Krista RN, BSN
  4. Ide, Robert


Banner Good Samaritan Medical Center is a 650-bed quaternary care facility located in the southwestern United States. The critical care service at Banner Good Samaritan Medical Center consists of 12 ICUs with nurses who care for medical-surgical, trauma, neurological, cardiovascular, cardiology, and transplant patients. Comparable with national standards, 70% to 80% of the institution's deaths occur in these units. Meeting the emotional, spiritual, and psychosocial needs of families experiencing the death of a loved one can be challenging for a nurse working in this high-tech, clinical environment. Novel interventions to address these challenges are welcomed in our setting of care. A staff nurse on one unit was particularly concerned about the emotional stress on families of patients who were dying. She brought forth an idea that could enhance the environmental milieu for families and facilitate the families' grief process. A grieving cart was subsequently created for use with end-of-life care. The professional staff and lay family members were overwhelmingly positive regarding this intervention. For the families, the cart represented a tangible demonstration of the staff's acknowledgment of their intense sorrow. This descriptive article addresses critical care nurses' difficulties with end-of-life care and delineates the rationale for implementing a caring model of family-based care in the ICU setting.