[Shenanigans]

I'm sure there's many a thread here devoted to this topic, so apologies.

I'm a student on my elective (final) clinical placement at an emergency department, and I've only done it one day. (And I think its awesome).

However, first day on the job, never been in any emergency, critical or acute placement, and a 17 month old child died - they had collasped at home, not breathing for 15 minutes piror to ambos arriving, they'd been in asytole, and on arrival of the hospital still no pulse, or breathing on their own. I'm pretty sure the ambos did what they did as point of going through the motions to get the child to the hospital so the family could see the child hooked up to monitors that show a flat line - the doctor later said it was good for family to accept death.

Anyway, quite a few of the staff were upset and I wasn't. My views on death have religious leanings, and as such children go straight to paradise when they pass, rather, I have sympathy/empthay for the families. Basically, I dont' view death as something to get all worked up about. As death is the ultimate fairness, young, old, rich, poor - all are equal in death. Of course, the pain the families go through, I understand.

I was rather stotic about the whole thing. Is this normal? Or does this mean I'm some kind of sociopath with a stone heart?

[psalm]

You may find that you have a reaction of grief or sadness days or weeks or even months later. Your brain is absorbing so much now in clinicals. Perhaps you are still seeing it from a clinical viewpoint without the emotional ties.

And the ER staff there who showed they were upset: This is their "turf" and this was a "failure", there was not a happy ending. For a little one to die is different from an elderly debilitated person who has lived a long life.

Neither view is right or wrong, just different. AND subject to change.

[BlueHenRN]

It seems like my beliefs are the same as yours in this regard. I, too, can be rather stoic at times that appear odd. However, I did find that when I cared for a baby in the NICU for weeks and she went into liver and VDRF after a G-tube placement, I couldn't stop crying. I know it was the emotional attachment I'd developed. I also believe that if she had been dying on my first day in the NICU, my reaction would have been more, for lack of a better word, "robotic."
Jess

[StrwbryblndRN]

I agree completely with the feeling from the OP. I get very emotional at the thought of the families though. I can't imagine having someone taken from me who played a role in my everyday life. I do know it can happen at any
time and therefore enjoy my loved ones. (I even taught my 6 year old that
not everyone dies when they get old)
So I am very stoic and sometimes relieved to see someone out of suffering.
Only the feeling of loss for others tear me up. I'll break down a slightest view of someone upset.

[texas2007]

I just started nicu in march and have found that it's worst when it's your own patient who died because usually you have been working all shift trying to fight a losing battle. I also get affected after hearing babies I've cared for in the past have died, but not so much if I have never had that particular child before

ETA: you don't have a stone cold heart. The fact you came on here to ask the question shows you do care.

[sChOOLRN48]

I never believed it until it happened to me...

Wait till you have kids!

I was more stoic, although I think caring, before and now I am a puddle on the floor!

[smanion]

I think that as being a nurse sometimes you have to put your feelings aside, or just try not to show them. You are supposed to be there for the family and if you are an emotional wreck you can't be there. Trust me, there are been plenty of times that I have broken down and cried with them, but for the most part I try to keep that for myself at a later time. There is a difference between being "cold-hearted" and just not showing a lot of emotion about it. I don't really know how to put into words what I am trying to explain. I guess its just something everyone has to do themselves. There is no right or wrong, there is no fine dividing line on how you should act or feel when something happens. We all handle things differently and there are pros and cons to each side of it.

[NursStudent1980]

I was actually going to post with the exact opposite question lol... I am in emergency as well doing my final placement and had a MVA with a teenager recently... It wasn't the death I found so bad as when the mother arrived. Knowing there was nothing in the world that could be done to make her feel better broke my heart, I felt sick for 2 days after! Is this a normal reaction or do I need to toughen up if I want to make it there? (I've been with family for other codes but it didn't effect me this way)

[traumaRUs]

To the OP - nope you don't have a heart of stone! You are caring and compassionate but realize that if YOU break down, who will be there to do the job that needs to be done.

NursStudent1980 - Again - no problem. For most of us, its not the actual death but rather the family's grief that bothers us; mostly for the reason you stated - we are impotent in this case and can't make things better.

Its not easy dealing with the ER. However, it is the most rewarding job I've ever had. Take care nurses.

[ERTraumaJunkie]

I came on today to post a similar question. I have been in the ER for going on 3 years. I have found at times I almost seem to have PTSD after some deaths. I will cope fine while at work but then afterwards I dream about the patient, I will wake up thinking about them, I kinda obsess during my awake hours. I have flashbacks going over and over everything we did to try to figure out if something could have been changed.

One day recently was the worst. The patient was already there when I arrived (Im the second nurse in the ER so I work an odd shift). To make a long story short, we lost a teenager. I have reasons to believe the care before I arrived was not as good as it could have been, but from the moment I arrived I did my best to help this child.

This is not the first time I've had a young person die in my ER by any means. It always bothers me. But this is the first time I can truly say I believe they died without receiving the best care they could have gotten. And it is eating me up! I have written a letter to the DON pointing out some things but I keep thinking I could have changed the outcome somehow. And I can't stop thinking about it or dreaming about it.

The day following the incident, I was unable to work due to severe panic attacks every time I thought about going in to work with the same RN and doctor. I have since returned without any problems, other than my personal feeling towards these two.

But I guess my question is this, do any of you ever struggle like this? This was a first with the panic attacks, but I have had issues with the dreams and obsessing after traumatic (especially young) deaths before. I always recover after several days, but I am wondering if we (ER nurses) are sometimes dealing with mild cases of PTSD?