Difficult conversations during a pandemic

By Sue Kreitz, RN

Sue Kreitz, RN
MNA Board Member
Member, CARN

Board Member, Member of CARN

I know I’m not the only one in horror watching the situation of our colleagues in places, including Italy and Spain, who are dealing with during this pandemic. I think one of the most heartbreaking stories I’ve heard is that a doctor describing how he had to make decisions about who gets the life-sustaining treatments with ventilators and who doesn’t. Just last week, the Washington Post had an article about hospitals considering placing Do Not Resuscitate (DNR) orders on COVID-19 patients. Unfortunately, this could become real for us in the USA.

This morning I was listening to a program discussing ethics in the time of a pandemic and what this means for our health and society. Dr. Jeffery Kahn a bioethicist from Johns Hopkins and MPR’s Kerri Miller were discussing this difficult situation.

I know nurses will treat our patients responsibly and ethically. For those of you wondering how you can best support healthcare workers caring for COVID-19 patients right now, I have an idea. I encourage you all to have a conversation about end-of-life choices. I encourage everyone to have those conversations. By having these conversations and letting your loved ones know exactly what you do want for end of life care, this will take the responsibility off your family and assist the medical care team make the right decision.

I understand this conversation is a very difficult one to have however, it is essential to do so.

Here’s an example of a conversation:

It is even more important now to have your healthcare wishes recorded due to the fact that during this pandemic, family may not be with you in the hospital to relay those wishes if you are unable. This is easily done with a Healthcare Directive.

What is a Healthcare Directive?

It is a legal document where in which you give instructions regarding your health if you are unable to make decisions for yourself. These instructions help your healthcare team guide your care. It includes choices like CPR, mechanical ventilation, tube feeding, dialysis and comfort care.

You do not have to fill this out alone. I want you to be comfortable with your decisions. I want you to have the healthcare you want.

There are a lot of resources online to help you write a healthcare directive. A great place to start is the Minnesota Department of Health’s Questions and Answers about Health Care Directives page.

Susan Kreitz RN, Board of Directors, Ethics Committee Member





  1. Remember, each hospitalization, on admission, a patient will be asked whether they want to be DNR. The doctor must write the DNR order. A doctor does not read a patient’s health care directive before asking that question. The family should read it. Developing a directive should be done with the family and updated regularly.

  2. I have had 9 surgeries and my husband has had 10. Neither of us have ever been asked that question; if we want to or have health care directive by the admissions nurse. And then not every time. When and under what circumstances are you saying this question being asked by a physician? I completely agree that the questions in a health care directive need to be discussed amongst family members – especially in this current health care crisis.

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