Both my patients died the other night...my first ones

bluesky, BSN, RN · Feb 2, 2006

Melanie. I am so proud of you! You were brave enough to actually feel the drama of the experience that we live everyday. And you dealt with your feelings in a healthy, honorable and productive way that not only helped your patient in her final hours... but also her family in it's grieving and recovery. This is not an everyday occurence that you will relive over and over again that will damage you permamently, I guarantee it. This was a special woman, a nurse, one whom many others like yourself felt comfortable morning. You will come out of this a stronger, even more thoughtful and empathetic human being. Your instinct drew you into this experience, trust it.

This day you dared to go beyond the basic tasks of your job description and open your heart to a whole new realm of caring.

I salute you.

Lexi

djv · Feb 4, 2006

You done your job, now let GOD do his . You did what you really are a RN with love it can't get no better then that.

DutchgirlRN, ASN, RN · Feb 4, 2006

I don't like having to take on a dying patient but there is such a calm that comes over the patient and over the room and I feel as though I have experienced something very special. I believe that death is not a bad thing. The person who has passed is in heaven with their loved ones, they are no longer suffering, no longer in pain. The problem with death as I see it is the loved ones who are left behind. They are left to grieve, to miss that loved one, to be miserable. In actuality the one who passed is fine. We are miserable. I know that cannot change. When I lose one of my parents I will be a basket case even though I know they are in a better place. Even though that I will be with them again in heaven. It's difficult no matter what or how you believe. I just hope that when I lose someone that I will have the opportunity to say goodbye. Sorry you've had such a rough experience. You have to do what you feel is best for you but I have never been to a patients memorial service. IMO it's carrying your job too far, not that that is a bad thing but only makes your job that much harder when you get so emotionally involved.

pugmum · Feb 5, 2006

I went to the memorial service, A Celebration of Life, they called it. I was able to meet the daughter who I spoke with over the phone and saw the rest of the family. I met the granddaughters, whose pictures were all over my patient's room. I also learned what an incredible lady my patient was and it was a catharsis to hear all of it. I know she led a very full and wonderful live so it's much easier to let her go.
My nursing instructors were there as well (my patient had been an instructor up until a few years before I got to that school) and my son's school nurse (my patient had trained her and had worked at my son's school until she fell ill). I sat with my nursing instructors and listened to all the great stories that the friends and family told. I also stood up and spoke a few words about how I was honored to have cared for her and that she was well liked and respected by all the RN's in our unit. The family came over and gave me lots of hugs and tears. It was a good thing I went and I'm glad I didn't listen to my fellow nurses who told me that going was a mistake and I needed to "distance" myself from it. I don't have that kind of personality and it would have made things worse.
After speaking to my supervisor, I feel even better. She says she still goes to the occasional service when a patient passes on and understands how it made me feel better about the situation. She said not to let anyone disuade me from doing what I feel is best and that everyone handles death in their own way. The most important thing is that I was able to do my job proficiently no matter what my emotions were at the time.
I'm so glad I went to her service...I feel as though her death wasn't in vain and it also reminded me that I need to make the most of everyday I'm alive...she certainly did!
Melanie = )

Good for you for going to the memorial service! You will find as you go along that some deaths will bother you more than others, and you have to do what you have to do in order to help yourself to cope. You will get a variety of answers on this forum advising you to go/not to go, or to distance yourself, etc. Everyone is different, and a patient death will never affect all the nurses involved in the same way. More studies have been done on critical incidents (which a pt. death can be) in the work place which emphasize in a given situation, each nurse may react differently. Some nurses may be greatly affected, some a little bit, and some not at all. I would suggest that if there is an employee assistance program that offers counselling, take the opportunity whenever you need it, now and in the future.

One last thing - as nurses we are just as involved in health promotion as we are in the care of those who are ill in hospital. By going to the memorial service, you not only helped yourself, but you also helped the family. By showing that you honoured and cared for this patient, the family was greatly comforted by your actions. Anything that decreases stress, improves future health! (get where I am going?). Good on ya, girl!

LilRedRN1973 · Feb 8, 2006

The ICU supervisor stayed over until 1am the other night, just to check in and see how all of us noc shifters were doing. She sought me out to ask how I was dealing with all of this. I told her about going to the service, etc. and she told me that even after 20+ years of being in the nursing field, she still attends the occasional service, depending on how that patient's death affected her. She said I sounded a lot happier and not as depressed than when I had spoken to her right after my patient died. She told me that every nurse deals with death in their own way and that she was happy I had found peace with the situation. I do feel so much better and when I think about the memorial, I smile because I feel as though I learned a lot about my patient that made me feel her death wasn't in vain. She truly lived a full life, had many adoring friends and family. I would do it again in a heartbeat.

And for the poster who mentioned about burnout, I think not going to this woman's service would set me up for burnout much faster than attending. It's my personality and by going to the service, and speaking....well, it gave me "closure". It may not be for everyone, but I do know myself. Had I not gone, I would have wondered about that lady's life and how she had lived it before she died. Now I don't have to wonder. And seeing my instructors there helped a lot too...I was able to sit with them and have support. They knew me better than any of my current coworkers simply because of all the time I've spent with them through school. I was very close to my instructors and seeing them there and having their support was incredible.

I also know I did something positive for the family. Had you seen the look on the daughter's face when she realized I was the nurse who called her in the middle of the night, long distance so she could say a few words to her mother (she was unable to get to the hospital in time to say goodbye)....well, it was more than enough for me. After I stood in front of everyone and spoke, she came over and gave me the longest hug and thanked me from the bottom of her heart for caring enough to come and say a few words. She said her mother would have been proud. I have the type of personality that needs to be needed (does that make sense?). It's one of the reasons I chose nursing. This whole ordeal has taught me that no matter what happens to my patients in the end, I have done my job and done it well. You can't "save" everyone and there are those patients who will touch you in a way that no other patients will. I will always remember this woman, no matter how long I do this job or how "hard" I become (which knowing me, will probably never happen...LOL).

Thanks for all the support and kind words. They are greatly appreciated.

Melanie = )

Happy-ER-RN, RN · Feb 8, 2006

I don't like having to take on a dying patient but there is such a calm that comes over the patient and over the room and I feel as though I have experienced something very special. I believe that death is not a bad thing. The person who has passed is in heaven with their loved ones, they are no longer suffering, no longer in pain. The problem with death as I see it is the loved ones who are left behind. They are left to grieve, to miss that loved one, to be miserable. In actuality the one who passed is fine. We are miserable. I know that cannot change. When I lose one of my parents I will be a basket case even though I know they are in a better place. Even though that I will be with them again in heaven. It's difficult no matter what or how you believe. I just hope that when I lose someone that I will have the opportunity to say goodbye. Sorry you've had such a rough experience. You have to do what you feel is best for you but I have never been to a patients memorial service. IMO it's carrying your job too far, not that that is a bad thing but only makes your job that much harder when you get so emotionally involved.

Hmmmm...I know exactly what you mean by that calm feeling that comes over the room, but I find it very VERY disturbing. It feels to me like an almost cold empty feeling, like something is sucking all the energy out of the room. I find it unbearable actually and the second a code is called I leave the room never to return unless I absolutely have to. Sorry, kind of off topic.

GeorgiaBoy61 · Feb 13, 2006

Melanie:

You sound like one gutsy gal! I'm new to nursing, too, but I wouldn't have performed near as well as you did. Don't be so hard on yourself! I would be honored to have you as my RN. So what if you cried some? You are human, that's all. Anyone callous enough to put you down should be ignored. I, too, would have been a basket case if I'd had a night like that one!

Best wishes -

GaBoy61

Spritenurse1210, BSN, RN · Apr 6, 2006

Watching someone die is never easy. maybe you should make use of the workplace debreafing. it may help

S.N. Visit, BSN, RN · Apr 6, 2006

I'm glad you went to the service and recieved comfort from it. I would have done the same thing :icon_hug:

marylyric · Apr 14, 2006

I know that working where I do, I have to expect I will lose patients from time to time. Guess I didn't think it would be so soon in my career. The other night, I took care of 2 older ladies, one who had been an RN for 40 years (she also went to my church and was very active in my smaller community). Both of them did not make it and from 4am to 7am, I did my job with tears streaming down my face. At one point, the one lady's daughter called from Ohio and I put the phone to her dying mother's ear so she could say what she needed to say. I don't know if I'm cut out for the ICU, even though all the interaction with the family made me feel "needed". I am going to the RN's memorial service on Wednesday.
It was hard enough to deal with psychological and emotional impact of having to deal with ONE dying patient and their family, but then I had to do it with BOTH of my patient's that night. Besides caring for my dying grandmothers, it was the hardest thing I have ever had to do.
Since that morning, I have no energy, don't want to get out of bed, and am basically miserable. I've wondered if maybe I should see if my hospital offers some sort of grief counseling or at least go in and talk to the ICU supervisor, who's always got her door open. The family said they really appreciated having their mother cared for by a nurse who showed emotion, which reassured me somewhat. I was able to still do my job, which included titrating up to about 700mcgs of Neo, 30 of Levophed, and max her out on Vasopressin, giving liter after liter fluid bolus and only getting a pressure of about 50/32. Yes, I was tearing up while doing all of it, but I still did what was expected of me. I also managed to put on a brave face, pull the family out of the room, and explain the situation to them. At the time, the patient was a full code and I wanted to the family to understand that CPR wasn't really going to benefit their loved one. They listened to me and then quietly said, "let her go". I was able to get through that part of it without any tears and look somewhat professional. But I can't stop thinking that I didn't handle things well and I'm doubting myself.
I don't even know what I expect to gain by writing all of this here.....it's just been a hard week at work.
Thanks for letting me vent.
Melanie:crying2:

I think that nursing is a calling. I believe that it is a privledge to care for the sick. I believe some how this makes us closer to jesus, that he finds this good in his eyes. I think you are suppose to feel or otherwise you would not be human. Those patients were lucky to have someone such as yourself to care for them. DONT WORRY you will become stronger. God does not give us more than we can bear. God bless you. I hope that when It is my time to go that I will have a caring nurse such as yourself