How many deaths have you had on your unit since you started?

BarbPick · Dec 20, 2003

The day I cried in Nursing was the day I realized that it didn't phase me doing post mortem care. It was just another day at the office. Might want to read "On death and dying" by Eliz. Kubler Ross.

EmeraldNYL, BSN, RN · Dec 21, 2003

This is something I myself have struggled with as a new grad. I work in a MICU, and it seems as though someone has died almost every single day for the past three weeks. We often do terminal weanings, but there is no protocol to follow, so many times it is the nurses vs. the docs vs. the family members about what should be done, how much should be done, etc. For instance, giving high doses of morphine to a patient who is dying to make them more comfortable. In addition, some people will want their family members to be a DNR, but they will still want their family member to receive pressors if necessary. I think more formalized guidelines are needed in dealing with family members. In addition, a lot of times the docs say "Well we can try this one last thing..." even if they know it won't help, and the families feel obligated to try it because otherwise they feel like they are killing their family member. Sometimes these situations are really tough to deal with, so I understand where you are coming from! I have been told that it gets easier with time, I sure hope so!

germain · Dec 21, 2003

I'm not a nurse yet, but work as a hospital assitant right now and have been acna for 10 years. I've done a lot of after death care. It usually doesn't bother me, I dont know, I'm not flippant, I just see it as part of life that people die.

This week it got to me. I was a constant observer with a guy in the ICU, really confused and scared, when I read his chart the nurse had noted how scared he was before surgery, and then when I went in the next day he was dead at the shift change. that touched me, but cleaning up and transport didnt, just so sad to see someone go- I heard he was a really nice guy, but no family had visited. another lost soul.

The questions and saddness that come up when someone dies, thats what makes up human and connects each of us. This day here today is a gift. :)

kc ccurn · Dec 24, 2003

Having a patient die can be difficult. I've been in critical care for almost 12 years and have had many patients die. Some you remember vividly, others don't seem to stick with you as much. You have to remember though that death is not always a bad thing!

With regards to withdrawl of care, remember that one of the nurse's job is that of patient advocate. As difficult as it can be in dealing with the doc's, I feel that we have to speak up for the patient and if there is "just one more thing that we can try" that more than likely won't help, we need to speak up and discuss the plan of care with the doc's. Why torture the patient more than we already do. Just because we can do/try a lot of things, doesn't mean we always should.

Our doc's are really good at giving liberal orders so that the nurse's can provide adequate pain control for our patients that we withdraw care for. Providing good education for the family and letting them know what they can expect and giving lots of emotional support can make a world of difference in the dying process.

As a new nurse just experiencing a patient death, it is vital that you talk about it. Remember, you have to grieve to some extent, in your own way as well. Some deaths will affect you more than others. Having support in dealing with those deaths will help keep you emotionally healthy.

The same is true for the first time you ever have to "cor" a patient, do chest compressions, etc. It is a stressful situation all the way around.

jessjoy · Dec 26, 2003

I've only been a nurse for 6 months and had never had a death on my shift .....until recently. We had someone die two days in a row. They were both 91, one male and one female. It was interesting to see how the two families dealt with the death. The one family was glad the death was peaceful and accepted it. The other family had people coming in for several hours literally wailing in the hallway. I'm sure there will be more to come but these were my first two and I'm sure I'll always remember them. It was sad that the deaths were so close to Christmas.

weezieRN · Dec 26, 2003

There have been many deaths in my facility since I started 6 months ago. My first death was of a gentleman that came in many times for respite care Every one knew him for years this occassion was my second at taking care of him. He would call everyone "honey and sugar" things like that. He had been going down hill the last few days and we knew it was going to happen shortly. I told the family that it wouldn't be long respiration were only between 5-8 a minute, unresponsive pulse ox 70's. They went out to get a smoke, ailing wife went home a few hours earlier and there i was with this gentleman while he passed on...... (still makes me cry!) there i was holding his hand while the lpn looked for his family and sat there till they came in. Hugged them all and let them visit them while I called the superviser. She is the rudest person ever " He had to die 5 minutes before the end of my shift. I guess that means I got to do all the paper work" She was so rude when she pronounced him and made what i feel was a big spectactle in front of the family telling me what should be done and what papers needed done etc...... I told her this isn't the time or place and lets step out please...... Nurse manager comes on and sees me so upset and later calls me at home wondering what was wrong and i told her that it wasn't so much that the patient died but that the night superviser was just plain ignorant and I didn't appreciate it. She told me that is how she is and she has been told about it many times. I told her if she doesn't like the job then get out..... Poor her, I was the one there when he passed and was there for the patient and family all night not HER!!!! I too hope that it gets better dealing with deaths but I'm someone that cries at a commercial so I don't know if I will ever get used to it. Sometimes I think families appreciate that you cared enough about them and their family member to show a little emotion.:kiss

angelbear · Dec 27, 2003

I had alot of deaths to deal with when I worked in geriatrics. Not so many now that I am in LTC for those with special needs. How I deal with it is I look at it as the last nice thing I can do for them. I try to provide comfort and reassurance during the process and dignity with post mortem care. Works for me I hope this helps you.

purplemania, BSN, RN · Dec 31, 2003

EmeraldNYL has an excellent idea: formalize guidelines on palliative care so that family/MD and nurses will all know what to do. The problem is, a guideline can be construed as a "rule" and this is one time when we really need to be flexible. You have to decide who the guidelines benefit, the patient or the nurse who wants to be able to say: sorry, that is hospital protocol. I guess that is why guidelines do not currently exist. BUT, your preceptor (I hope you have one) should be able to offer advice on dealing with death and dying. Do you have an employee assistance plan to handle grief? If not, please take time to read about caregivers and grief, because dying is part of life and you will have to learn to cope or be ineffective. You must take care of yourself if you intend to be able to care for others.