Health-care workers impose heart-breaking rules to keep vulnerable patients safe

With health-care facilities now closed to visitors, dying patients have been limited to one designated person who can be at their side in their final days.

That means many loved ones aren't able to say goodbye in person.

"It breaks our hearts to have to impose these rules," says Nicole Hamming, director of care at Bobby's Hospice, a 10-bed palliative-care facility in Saint John.

Like most other health-care facilities, Bobby's Hospice has closed its doors in order to protect vulnerable patients and to stop the spread of COVID-19.

Some of these patients have five or six kids, or they have a spouse and children. Who do they pick? It's heart-wrenching and we hate seeing it.- Nicole Hamming

As nurses, Hamming and her colleagues know that the rules are in place for a reason, but for those who have to enforce those rules, she said it's been "incredibly challenging and stressful."

"It's just heartbreaking," she said by phone from the West Side facility where she's workedfor a decade.

"It's heartbreaking to witness patients and families that can't see each other."

She said families nowfaceincredibly tough decisions about who that one designated person will be.

"Some of these patients have five or six kids, or they have a spouse and children. Who do they pick? It's heart-wrenching and we hate seeing it," said Hamming.

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As palliative-care nurses, Hamming said her colleagues understand that "whole-person" care usually involves family and friends who can help make the journey to death a little easier.

"So it's crippling," she said to have to tell those people that they can't be a part of a patient's dying days.

"We absolutely hate that we have to do it, but we know we have to. And so, being that face to have to implement the rules, it's hard."

She said most people have been receptive. Although not happy with the new restrictions, Hamming said most people do understand the importance of physical distancing as a way to stop the spread of COVID-19.

"Most of the time it's met with silent tears," she said.

Both of the province's Regional Health Authorities have also limited visitors.

On its website, Vitalit Health Network states, "Only patients in palliative care, end of life care, in obstetrics or pediatrics may receive one visitor."

As the situation grew worse last month, Bobby's Hospice gradually tightened its rules on visitors. The facility went from a come-any-time-of-the-day-or-night approach, to limiting patients to four visitors who could drop by one at a time, of course between 10 a.m. and 6:30 p.m. By mid-March, thatnumber was reduced to two.

Hamming remembers an exchange with the wife of one of their patients around that time.

The woman responded by saying, "'I have two kids. How do I pick? How do I pick which kid can come to see their dad?' I didn't sleep that whole night," said Hamming.

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"We've been a part of the crying, because it breaks our hearts, too," she said.

And she would love nothing more than to be able to come up with a solution that would keep everyone safe, and allow family and friends to say their goodbyes in person. But so far, the solution eludes them.

Instead, staff members are trying to make the best of a difficult situation by helping families communicate with each other by video. They're also helping to facilitate window visits withloved ones standing outside on cell phones.She said families can also write lettersand send them to the hospice. Staff will make sure the letters are printed and delivered to the patient.

"We understand that it's not the same as being able to give somebody a hug or being there. It sucks, but we are doing our best to try to use the technology and the tools that we have to make it a little bit more palatable," said Hamming.

At his daily news briefing in Fredericton, Premier Blaine Higgs sent a shout-out to health-care workers who "are truly on the frontline of this pandemic."

He said it's important for New Brunswickers to "take whatever steps we can to keep them safe and healthy."

"By taking steps to protect our health-care workers, we are also protecting our province's most vulnerable residents, including our seniors. We have seen the devastating results that can occur if we are not vigilant or if we don't act quickly enough."