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ICU nurse describes emotional end-of-life journey holding patient's hand as he took his last breath

"It's really hard because... you shouldn't have to put a time limit on a family member to say goodbye," said Selena Juarez-Alvarado, nurse at Sharp Memorial Hospital

SAN DIEGO — It's National Nurses Week and News 8 is celebrating these healthcare heroes with a special series of stories highlighting the ups and downs they've faced during the pandemic, and their tireless efforts to save lives.

Some of the first nurses to care for patients sickened by the coronavirus in San Diego include Diane Ward and Selena Juarez-Alvarado. They work at Sharp Memorial Hospital and represent nurses everywhere who are providing a deeper level of care for their patients and their loved ones during the pandemic. 

Seven weeks ago today, Diane worked her first shift in the COVID unit. 

"I actually was struck pretty quickly on my very first day coming into our COVID unit. The thing that kind of got me a little teary-eyed in that first 12-hour shift was how isolated the patients are."

She treated her first COVID-19 positive patient that day. 

"That first patient that I took care of for five days in a row -- for four of those days, he was awake and chatting and he was just in that room, 24 hours a day by himself," said Diane. She said that level of isolation hit her harder and faster than she expected it to in those early days of treating patients with the coronavirus.

"Unless it's end of life, people aren't able to have visitors," she explained. While she believes it's the right call to limit the number of people who enter the hospital for the safety of patients, their loved ones and hospital employees, she said the most heartbreaking part of this pandemic is watching patients battle the disease alone.

Diane developed a close bond with that patient. "Having the four days with him, where we were able to interact, he was my only patient and I helped his family FaceTime with him," she said. "And he was very sweet and he kept turning the phone to me so that I could wave and say hi." 

She was hopeful he could beat the disease, but he had good days and bad. Diane explained he would have a great morning and afternoon, but then would have a difficult night. The next day, however, he would feel a little better, perk up and be able to talk more without running out of breath as quickly. 

On the fifth day, however, the patient's condition severely declined and he was placed on life support. 

Two family members were allowed to visit him in person, dressed in full personal protective equipment (PPE), for 30 minutes. 

When it was time for them to leave, Diane tried to offer a bit of comfort to his family. With tears in her eyes, she said, "I was happy I was able to say that I would be holding his hand when he passed and that he wouldn't be alone. And they were so kind and so grateful that I was able to do that," 

After the withdrawal of life support, Diane sat by the patient's bedside. She talked to him, hoping to bring him some peace, telling him he fought a good fight and that his family was safe. She recalls she said the same thing to her own father when he died two years ago. And just as she held her father's hand in those last moments of life, she held her patient's hand as he took his last breath. 

"There are certain patients that stick with you," said Diane. "I will never forget this patient, I will never forget this family."

In the weeks since those early days of treating patients with COVID-19, Sharp Memorial Hospital has established a dedicated Family Resource Center located in an outside tent. Loved ones can go there to bring gifts and cards to nurses, who make sure the items get to the patient. 

"There are situations that come up that need a little more support than others, and spiritual support is also available," said Acute Care nurse Selena Juarez-Alvarado. She played an integral role in setting up the Family Resource Center, which also helps facilitate virtual visits between families and their loved ones. 

"You have a mom that's a patient that wants to have her hand held, and unfortunately, we can't let that family member up there, and so we schedule a Zoom video call," Selena said. One nurse will take an iPad up to the room, while another nurse helps connect the family from inside the tent. 

Sadly, this is also where virtual end-of-life visits occur. Selena said it's heart-wrenching to watch families discuss which two people will get to say goodbye in person, as only two are allowed up to visit the patient in person.  

"How do you decide which two family members to be chosen? You can't, I know I couldn't. But right now, that's what we have to do," said Diane.

The two family members allowed to visit a loved one who is dying can only stay for 30 minutes. 

"It's really hard because, you know, you want to do more and you shouldn't have to put a time limit on a family member to say goodbye."

RELATED: The photos and tributes of thanks from San Diegans to nurses, as we begin our celebration of National Nurses Week

Both Selena and Diane said that it's taking an emotional toll, but they're staying strong and focused on supporting patients and their families.

They look to the future with hope. 

"When this is over, I hope it's just an amazing... I want fireworks after this is over," said Selena, "but for now, I think we're being a perfect example of what Nurses Week is right here in the front lines doing what we are called to do, and making sure that we're there for the patients and the family the best that we can be."  

Diane said the outpouring of support they've gotten from the community means a lot. She said if there's a silver lining to all of this, it's the camaraderie that's developed between all of the different departments and staff. "It's very much that everyone is in this together and there's a different level of teamwork," she said.

"I absolutely think the nurses in the medical field have learned lessons from this that we'll carry forward," she reflected. She also knows it will be a long journey for healthcare workers as people continue to contract COVID-19. 

"I think that we have done a great job in flattening the curve, as they say. But the aspect of that, that is going to be hard, is that this is going to be drawn out," Dian said. "I think we have managed to affect how many deaths there were, but this whole process is going to take a lot longer because we did that."

Diane said she is grateful for the slower pace, of course, as she has watched what nurses in New York are going through as they deal with an extraordinary amount of deaths.

"It's brutal, and I can't imagine the emotional toll that it has been taking on them," she said. "And so to be able to have some semblance of routine and normalcy here has been really beneficial."

For more of my interview with Diane Ward as she shares her personal story of life inside the ICU, watch the YouTube video below. 

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