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Why the “Tree of Peace” has become a permanent fixture at Hackensack Meridian Health

Since long before the COVID-19 pandemic, frontline healthcare staff have been going above and beyond to provide the best care for patients and their families. But even with the best care, loss is a sad but inevitable part of working in the healthcare industry. Time and time again, healthcare staff are called on to provide compassionate care and ensure a safe place for patients to spend their final days.

For our ongoing Human Understanding series, we wanted to examine the profound impact that human understanding can have on patients who are nearing the end of their life, and on their family members. To explore this topic further, we spoke with Kathy Taylor, Director of Nursing Organizational Effectiveness, and Linda Lopazanski, Weekend Nursing Supervisor, both at Hackensack Meridian Health Raritan Bay Medical Center. Together, we discussed why Hackensack implemented a “Tree of Peace” for patients and their families to show empathy in times of sadness, and how the concept of the tree underscores human understanding in healthcare.

What is the Tree of Peace, and why has it become an important fixture at Raritan Bay?

Lopazanski: During many years as a nurse manager of Critical Care, there were times I would walk into the unit and a patient was in the process of dying or had just died, yet the normal activities of the day would still be happening as usual. ICUs can be hectic with many things occurring at once, and I wanted to find a way to communicate across the team that a death was imminent or had occurred, a way to pay the proper respect to those patients, and in particular their families, as they were experiencing an extremely difficult time. A social worker I spoke with said that she’d once worked in a hospital where staff turned a light on when a patient was nearing death in the hospice unit. This sparked an idea to do something similar in our unit. I searched until I found a battery operated light which happened to be a cherry-blossom tree. The nursing staff suggested the primary nurse caring for an imminent patient would turn the light on to alert the rest of the unit, and this simple act of respect soon caught on across campuses.

Taylor: Linda discussed The Tree of Peace at one of our Nursing Management meetings. The other nurse managers loved the idea so much that I ordered cherry-blossom trees for all three of our critical-care units, which eventually spread to all inpatient telemetry and med-surg units at both the Perth Amboy and Old Bridge Divisions.

Lopazanski: The critical care unit created a saying that we framed and placed in the family waiting room as well as next to the tree on each unit. When our staff would speak to the family about the patient’s condition, many of them would ask, “What is the Tree of Peace?” or “What does that sign mean?” To which we would explain that if they saw the light on, there was a family currently in mourning. And from there, it has become part of our daily routine.

How did the concept of the tree and the team’s focus on human understanding remain constant during COVID-19?

Lopazanski: Our amazing team of nurses have been more committed than ever to continuing the Tree of Peace ritual throughout the pandemic, particularly because visitation was so limited and family might not be present for their loved one’s final moments. Tragically, the tree has been lit almost continuously over the last few months when Covid was so prevalent.  For the cases where we were able to video family members in, however, it made them feel good to know we were there and to see the tree lit in their loved one’s honor.

Taylor: We even interviewed some of our nursing staff about it, and one of them mentioned that when her own family member passed away at a different hospital—she said, “I wish there was something like this. I know it would have given us more peace in those final moments.”

Lopazanski: You could see it in the nurses’ faces, the toll the pandemic was taking on them. From what I heard them say and how they felt, not being able to have families there with their loved ones as they passed was really putting a lot of strain on [the nurses], yet you could really see through it all just how much they cared. It’s been a traumatic experience to go through, but a silver lining has been the facilitation of a much deeper camaraderie among our staff  that I don’t believe we would have today, had it not been for this horrible pandemic.

Taylor: As someone who is no longer on the frontlines and providing direct care for critically ill patients, even I have found it difficult to come to work throughout the pandemic. I could not imagine having to take care of very sick patients every day, particularly when their families can’t be there. So for me, it really shows the resiliency of our staff. They continued coming to work, each and every day, to do what they had to do. It has definitely brought the staff together.

What does human understanding in healthcare mean to each of you?

Taylor: For me, it means every patient experience is unique. I’ll experience it differently from Linda, from the rest of our staff, from any individual. We’re not just a diagnosis. We are someone’s parent, someone’s child, someone’s sibling—and the last place any patient wants to be is in the hospital. They want to continue living life the way they were living it yesterday. Because each experience is unique, we need to make it unique for each person by approaching the care experience as humans first, and as care providers second.

Lopazanski: I’ve been in nursing for more than 40 years and it still saddens me to talk to a family when they’re experiencing loss, which I think is just part of being human, a part of being compassionate. It doesn’t get easier.

What keeps you inspired to come back to work every day?

Taylor: Seeing how resilient our nursing team is. Death is a necessary part of life, and sometimes the only thing we can do for a patient is to make their death a peaceful one. The Tree of Peace shows respect for what the family is going through. When a significant family member or loved one passes away, people tend to remember the details of where they were and how they felt in those last moments. I still remember my very first patient who passed away in 1987. I remember everything about that experience. Our hope with the tree and what it stands for is that from something so tragic, if a family can remember a small moment of peace and calm, and feel the deep respect for their loss from the entire healthcare staff who are mourning with them, that makes it all worth it because they’ll never forget those feelings.

Lopazanski: Working in healthcare, you just can’t get it out of your system. I’ve put in extra hours throughout the pandemic, which at my age, I probably shouldn’t have. But I’ve just wanted to help in any way I could, which is really a common theme in the medical profession, whatever your position is—you want to come back and help, no matter what. And even before the pandemic, we saw how much families and patients came to cherish the sight of the Tree of Peace, as the cherry-blossom tree represents life, death, and the life beyond—a true representation of the beauty of life. We are grateful to this exceptional team of nurses at Hackensack Meridian Raritan Bay who dedicate their lives every day to improving the patient experience, even in times of great despair.

Is there someone at your organization who has led the charge to bring more human understanding to the patient experience? We want to hear about it! Share your human understanding story with us by emailing Megan Charko, Senior Content Marketing Manager, at mcharko@nrchealth.com to schedule your interview today.