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“Heartbeat in a bottle” helps ICU nurses provide comfort to families who have lost a loved one


Northwestern Memorial Hospital nurses print off the patient’s last few steady heartbeats from the EKG machine, place the sheet of paper in a glass bottle and attach a ribbon with the patient’s name

"Heartbeat in a bottle"

CHICAGO, IL – February 13, 2024 – February is Heart Month, a time when people are encouraged to focus on heart health. But what happens when the heart stops? Inside the Medical Intensive Care Unit (MICU) at Northwestern Memorial Hospital, the nurses are going above and beyond with a simple gesture that involves a “heartbeat in a bottle.”

In the summer of 2023, Northwestern Medicine clinical nurses Hira Malik and Lydia Hillary were caring for a patient who was actively dying. The patient had been in the MICU for several days, and the patient’s family was extremely grateful for everything the nurses were doing. As the patient was nearing their final breath, Malik remembered something she learned in nursing school called “heartbeat in a bottle,” where the patient’s last few steady heartbeats from the EKG machine are printed off, placed in a glass bottle, and a name tag is attached with ribbon.

“In the ICU, especially during the COVID-19 pandemic, we saw death much more frequently, and a lot of the deaths were lonely due to visitor restrictions at the time,” said Malik. “I remember thinking, now that family is able to come and be with loved ones, is there anything we can give them to remember them by?”

Hira in the MICU

At the time, Malik and Hillary didn’t have a glass bottle or ribbon on hand, so they improvised and used a clean, empty pill bottle, along with the strings from a surgical mask to attach a name tag. They gave the “heartbeat in a bottle” to the patient’s spouse who was extremely grateful for the gesture, and it offered closure to the patient’s family. 

“The family really enjoyed it and gave Hira a hug when she presented it to them,” said Hillary. “A lot of times, the ICU can be a scary place for patients and their loved ones. That’s one of our main roles as ICU nurses, is to help walk our patients and their families through this transition.”

Khalilah Gates, MD, a pulmonary and critical care specialist in the MICU, noticed Malik and Hillary’s kind gesture. Dr. Gates spoke with other physicians on the unit, and they agreed to purchase the necessary supplies for “heartbeat in a bottle” so the nurses could continue doing it for families in the future.

“Our nurses are really the heart and soul of what we do here in the MICU, in fact, they’re what critical care medicine is all about,” said Dr. Gates, who is part of the Northwestern Medicine Canning Thoracic Institute. “The nurses are always at the bedside, taking care of patients and interacting with families during some of the darkest moments. ‘Heartbeat in a bottle’ demonstrates the empathy and sympathy our nurses have during the transition from life to death, which is very important.”

Hira with "heartbeat in a bottle"

To date, the MICU nurses have created approximately three dozen “heartbeat in a bottle” keepsakes with the new supplies, which includes glass bottles, purple name tags and string. 

“There have been so many beautiful memories, but one that stands out, is when we presented a ‘heartbeat in a bottle’ to a patient’s family, and they were so moved by the keepsake that they requested ten more bottles for the rest of their family,” said Hillary. “It helps me to know that the family of my patient will remember the care their loved one received during those final moments.”

“No two deaths are ever the same, and from an ICU nursing perspective, we want each patient to die with dignity, in the most painless manner, surrounded by familiar voices and family. It’s one of the greatest comforts we can offer them,” added Malik. “My hope is that when families look at that little keepsake, it reminds them of all the precious, happy memories that define their loved one.”