PORTSMOUTH — April Greene is used to death. When you work in hospice and palliative care, it’s part of your job. With COVID-19, though, it’s different.
Instead of spending the end with loved ones, some patients spend their waning days comforted primarily by their caregivers. Instead of feeling the warm embrace of their family, some patients hear their final “I love you” through the speakers of an iPad.
“Usually, when people pass, they have such family support and love,” Greene explained. “With COVID, people are dying without their loved ones.”
It can be heart-wrenching, and not just for the patients or their families. It can be emotionally draining for the nursing staff, too. Greene admits there have been times when she has been overwhelmed and showed that emotion in a patient’s room. Although she does her best to control those feelings, they are a reminder of how invested health care workers become in those for whom they care.
A factor that can make the process harder is that, although many of Greene’s patients are already dealing with chronic illness, COVID-19 still cuts their lives short by years. For many families, it seems like it comes out of nowhere. This is something Greene thinks most people overlook when they discuss COVID’s impact on people who have other health conditions.
“People are like, ‘Oh, they died from COVID, but they had cancer and all these underlying comorbidities…’ The fact of the matter is COVID is what caused this downward spiral to the end of their life,” Greene said. “Without COVID, they could have had many more years of vibrant life. We’re talking about people who were living alone with their spouse and going to the store and going to church, and now they’re on their deathbed.”
Patients with COVID-19 can decline rapidly, Greene said. One day, they seem to be doing well and the next day, they’re on high-flow oxygen, drowsy and delirious. Then, even if they manage to overcome the virus, they can still feel the consequences of their infection for a long time.
“It’s not just about death. It’s about living with a lesser quality of life for some patients,” Greene explained. “Some patients are dealing with new oxygen requirements or experience shortness of breath after the smallest tasks.”
She has also seen cases where individuals who were relatively healthy contracted COVID and had bad outcomes. It’s just another reminder of why it’s important to take every possible precaution to reduce its spread. “I don’t think we should live in fear, but we have to have a very real respect for how bad this virus can be,” Greene said.
Greene is proud to work alongside other nurses who have stepped up to meet this challenge and thankful for the support they have received. As a self-described hugger who values being able to comfort her patients, however, there has been one part of providing care during a pandemic that has been especially difficult: the absence of physical touch.
“Even with my co-workers,” she said, “you see these nurses and know they’re struggling. You just want to give them a hug, but you can’t.”
That is one thing that April Greene is not used to.