Portraits in Healthcare: 'The family was asking us to … hold her hand so their mother wouldn't be alone as she passed'

This is part of our occasional series called PortraitsPortraits in Healthcare logo in Healthcare to capture the changes happening in healthcare due to COVID-19 as experienced by providers. 

In early March, the University of Pittsburgh Medical Center (UPMC) began preparing for a possible surge in COVID-19 patients. At UPMC Presbyterian, Mary McFarland, a registered nurse and senior clinician at UPMC Presbyterian's intensive care unit, was part of a team that worked to convert a hospital ICU unit into the hospital’s first dedicated COVID-19 patient unit. On a typical day, McFarland's position is an administrative job that oversees the ICU. But the unprecedented nature of COVID-19 has led McFarland to be directly involved in patient care. This is her story as told to FierceHealthcare and edited for length and clarity.


Not having patients’ families around has been difficult. We try to keep families updated and make sure that the families feel they are involved and included in the care of these patients when they can’t physically be in the building with us.

If you are the nurse in the room, taking care of the patient, the door is closed and you’re very isolated in that room. From the nurses’ perspective, you can turn around and talk to people in the hall or someone can come in and help you. But for the patient, to be in there with the door closed, it is extremely lonely.

UPMC ICU nurse Mary McFarland

Two experiences in the past two months come to mind that stand out. We had a patient who was passing away and their family members were not able to be there. I was helping the nurse who was the bedside nurse that day. The family really wanted someone from our spiritual care office to be there, so we arranged for the chaplain to be on FaceTime. We took an iPad with the chaplain on FaceTime into the room, so we could pray with the patient, and then had the patient’s family on a different iPad so they could pray with us at the time.

I stayed with the nurse at the bedside to be with the patient and the family on FaceTime. And we reassured the family that we believed the patient was comfortable.

The family was asking us to brush her hair and hold her hand so their mother wouldn’t be alone as she passed.

They said, "These are things we would do if we were there with her, so could you please do this for us?" That’s a heartbreaking situation to be in. It’s a lonely experience for the patient and the family.

A second experience, at the end of March or early April, we had a younger patient who was about the same age as my husband.

When I came in that morning, the patient was on a little bit of oxygen and we were keeping an eye on him, and by the time I left, he was so, so sick. In my experience, it stands out in my mind as the fastest I’ve seen a patient decompensate. From walking around the room in the morning to—by that evening—he was on full ventilator support, he was in prone positioning, and we were calling cardiothoracic service to evaluate him for extracorporeal membrane oxygenation therapy because we weren’t able to oxygenate him anymore.

selfie photo of nurse Mary McFarland in protective gear
UPMC ICU nurse Mary McFarland

It hit close to me because he was around the same age as my husband and he was doing well early in the morning and then 12 hours later he was so severely sick and there was nothing else we could do.

My husband and I had decided early in this process that as long as I had the PPE that I needed, we felt comfortable with me coming home. I have two girls, a two-year-old and our oldest just turned four last week. So I‘ve always been able to come home and have my off time with my family, which has been great to decompress.

We have been fortunate in that we haven’t surged like other areas, like New York and Michigan. What’s been interesting in our case, with our unit, as our general population is typically trauma patients, as the weather has been getting nicer and I think people are getting restless being at home, we are starting to see more trauma patients coming in.

People are out riding motorcycles and people are trying to do some home improvement projects. Some people have had unfortunate falls off their roofs doing some home improvement things.

Right now, we’re trying to balance how we still care for COVID patients and keep them in the appropriate isolation precautions while also providing other services and providing care to other patients as well.

Are you a provider with a story about COVID-19 you'd like to share for our Portraits in Healthcare series, we'd love to hear it. Please email [email protected]. Please include a photo that can be used with your story and a telephone number where you can be reached if your story is selected.