A Hand to Hold

How to comfort a patient dying from coronavirus? Hetty Breed, a third year medical student, took up the responsibility of working as a Healthcare Assistant during the pandemic. She shares the vital lesson that medical school could not teach her.

“I’m scared,” my patient whispered, between their shallow breaths, underneath a tightly sealed oxygen mask. In spite of all the communication lessons I received in my medical training, I had no idea how to respond, my mind went completely blank, and I froze.

In March, I was offered training through my placement hospital to work as a healthcare assistant during the coronavirus pandemic. And, it was during my first week that I met one of the biggest challenges of medical school – what to say to a patient dying of covid-19? They had a DNACPR in place, meaning they were unsuitable for resuscitation or for escalation to another ward for more invasive treatment if their heart stopped. My patient had not spoken to their partner for days and the deterioration was so quick, that it was too late to make plans to visit. Their partner was also shielding at home for health reasons and had no access to transport, leaving my patient alone and distressed.

We are trained to always try to comfort patients and alleviate worry and concern, but I still did not know what to say to a patient dying from coronavirus. I know there was no hope of recovery. It wasn’t all going to be okay. We didn’t know if they could see their spouse before dying. Still lacking the words I thought they wanted to hear, I took my patient’s hand into mine.

This gesture somehow conveyed everything I was not able to articulate. Sometimes there are no words.

Witnessing the effects of covid-19 has led me to accept that although a lot of our job as doctors is about improving a patient’s quality of life, sometimes all we can do is to improve the quality of their death.

Sometimes all we can do is to improve the quality of their death.

The virus has stripped family members of precious goodbyes, and even when exceptions to the visitor policy have been made, the overwhelming fear of the virus has forced families and friends to stay home.

I wish I could tell you what happened next - if the final conversation took place and if they expressed their love for each other. Unfortunately, due to the nature of shift work, we are often transferred, in the same day, to wards that need more help. We may not encounter the same patients or staff again. A few days later, I was told that my patient had passed away. Although I don’t know what happened in the end, I can guarantee the staff did all they could to make those final conversations happen.

During this pandemic, NHS staff have gone above and beyond what is expected of them to make sure patients are connected to their families and are not alone. Nurses and Healthcare Assistants have given out their own phone numbers so relatives could video call. Ward Sisters have bent the rules to allow daughters and sons to say their goodbyes together. I witnessed that compassion and love will always be at the centre of the work done by the NHS.

I witnessed that compassion and love will always be at the centre of the work done by the NHS.

In medical school, we spend our time learning about signs and symptoms, treatment flowcharts and medication uses. We become driven by exam results, application points and job prospects, losing sight of the real reason we are all here. My time on the wards during covid-19 has taught me about two of the fundamental pillars of being a health professional - communication and connection. Most of all, I am inspired by the hospital staff. They have taught me that, in the end, even the smallest interactions with our patients make all the difference – whether a cup of tea or a hand to hold.

All patient identities have been anonymised.