Losing a patient is one of the most difficult things that a nurse experiences. No matter how hard they’ve worked and how many interventions they’ve done, sometimes patients will still die. And telling the families is even more difficult.

Nurses in the Surgical-Trauma Intensive Care Unit at the Carolinas Medical Center (CMC) have found a way to bring some form of peace to the families, by giving them a Heartbeat in a Bottle.

Heartbeat in a BottleCharis Mitchell, RN, PCCN, Clinical Bedside Nurse II for Carolinas Healthcare System at CMC, says that the Heartbeat in a Bottle originated at Sentara Norfolk General Hospital. She states that Michelle Cox, a traveling nurse, learned how to make them and brought the idea to CMC, and nurses began making them there in 2012. Mitchell learned to make them in 2014 from coworker and friend Maggie Reynolds.

“When a patient passes away on our unit or when we shift to comfort-oriented care, we print one of their last heartbeats, and place it in an empty medicine bottle,” explains Mitchell. They then place a ribbon on it and seal it to give to the family. Because each person’s heartbeat is uniquely theirs, it’s even more special.

Mitchell estimates that since CMC nurses have been making them, they’ve made a couple hundred of them for families. When word spread about the Heartbeat in a Bottle, Mitchell received requests from nurses throughout the Carolinas Healthcare System on how to make them. As a result, she’s made a tutorial so that any nurses can make them. (See how to make your own Heartbeat in a Bottle here.)

“I came into health care to heal, so I remember when a death of my patient felt like a failure,” says Mitchell. “There are times, as a nurse, that I still feel defeated at the literal loss of my patient’s life—as if we lost a battle. No matter what the circumstance is of how and why my patient died, I have found it’s my honor to provide them with a dignified death. I see Heartbeat in a Bottle as a way to take care of my patient’s family in a way that my patient would want them to be loved.”

Mitchell says that there are two reactions in play when a nurse gives the family a Heartbeat in a Bottle—the nurse’s and the family’s. “As for the nurse, you have to mentally prepare yourself to tell the family what you have for them. There’s this temptation that you have to be the strong one. But the truth is, it affects us too. When you give the bottle, you have no choice but to show your emotions and your vulnerability. You know it’s going to take more out of you than you necessarily have to give, but to help the family being the healing process makes all the difference.”

Michele Wojciechowski

Michele Wojciechowski is an award-winning writer and author of the humor book Next Time I Move, They’ll Carry Me Out in a Box.

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