ICU initiative helping to fulfill wishes of dying patients

"We hear all the time about nurses' extra efforts to bring comfort and dignity to families, ranging from allowing a pet to be brought to their bedside to providing a meal for families as they process their grief," says social worker Sarah Smart, who serves on the Palliative Care team.

So when hospitalist Shauna Kern, DO, told them about 3 Wishes, a project designed to improve patients' final moments by identifying and fulfilling small but meaningful requests, the team began working to implement it at Ascension Via Christi St. Francis.

The 3 Wishes project is intended to spotlight the acts of kindness carried out by associates by giving them the support and, if needed, the funding required to make a patient’s or family’s wish come true.

"The wishes could include anything from bringing in a pet, playing a special song, dressing the patient in their regular attire, or wrapping them in a favorite blanket," says Dr. Kern, associate chief with Sound Physicians, who suggested the program to the Palliative Care team. "It also could include creation of keepsake items for the patient’s family members, such as a handprint embedded in clay or a family photo."

Although initially designed as a pilot in the MICU, it soon became apparent that opportunities for responding to a patient’s wishes exist all over the hospital and it has been expanded hospital wide.

"We want to focus end-of-life care on what matters most to people,” says Deanna Speer, RN, who leads the Palliative Care team at Ascension Via Christi. “Oftentimes the acts of kindness we do to recognize their values and hopes mean more than all the medical interventions carried out.”

3 Wishes started as a research project in a Canadian ICU in 2013 and has since been adopted in the ICUs of more than 20 hospitals in the United States and Canada.

The initiative, which involves patients, family members and ICU caregivers, dignifies patients and celebrates their lives prior to death, humanizes the dying process for family members and inspires a deeper sense of vocation for those providing end-of-life care.

"We currently have many new clinicians as well as many more seasoned ones who have just been through the incredibly trying times of a global pandemic," says Dr. Kern. "This program also serves them by lifting their spirits."