caring for the dead

  1. In nursing I have had many fears to overcome But there is one that I am still really stuck on. I work at children's Hospital Oakland in a rehab unit which I absolutly love. But really I have always loved trauma and emergency nursing. I have been offered jobs in emergency but I am having trouble dealing with dead children. I have seen dead elderly patient's but i guess its just different with children. So my question is how do you deal with patients after they have died. What care do ER nurses do for dead patients and their families and do you have any little tricks to being able to handle the dead.

    Thanks Jessica

    I am only 19 I am an LPN going to school to get my BSN. I appreciate the wisdom of all of you more experienced nurses.
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  2. 9 Comments

  3. by   Disablednurse
    I can only imagine how hard it is. IN all of my 25 years of nursing, I managed to escape being on duty when a child died. Of course, I only worked in a hospital for 3 1/2 years so I know I have been lucky,
  4. by   traumaRUs
    I'm an ER nurse, level one trauma center for past seven years. You never get used to caring for dying children. However, you do manage to put enough distance between you and them so that you can effectively care for them and their families. It takes some life experience too - when the time comes, you'll know what you have to do. good luck...judi
  5. by   canadian
    I work peds onc...and get super attached to our kids who spend a lot of time with us...a little while ago we had a one year old die, he was a fav of all. My advice is let your emotions come. Through my tears I kissed his cool brow while he was in his moms arms, then did my best to care for my other kiddies during the day. That night I pigged out on comfort food and cried myself to sleep. I did go to the funeral, and left a card for the family sharing my feelings for them as a family. The nurses spent a lot of time talking about him and what happened. Slowly the hurt goes, and you can remember the child as he was. I keep all these angels in my heart.

    Dealing with the death of a child hurts sooo much, but it is a real feeling. I am not a nurse for the shifts or the money. I am a nurse because I get to experience real emotions each and every day. (this may sound superficial, but it is true)

    So my advice is this: be yourself, you do not have to be the super stoic professional when a death occurs, talk to the other nurses, see a counsellor to share your feelings if they are really rough or last, and keep a big container of your fav ice-cream in the freezer for prn use.
  6. by   caj
    I am a Forensic Investigator and deal with handling the dead and have to unhappy task of notifying the next-of-kin of the death. Although there are several types of death cases from the unexpected ER death to the inpt of a death at the hospital, notification is always the hardest thing to do.
    Always use compassion and treat the family the way you would want to be treated. It can be helpful to you to talk to your co-workers after the involvement of dealing with a child.
    Several things to take in your career as a Nurse is the rule of thumb is NEVER tell a family member "I know how you feel"
    mainly because you do not know how they feel. Even if you lost a family member, you can not tell another family how they feel. I deal with many SID cases (sudden infant death syndrome) and seen ER nurses mess up and say they know how the parent (s) feels and the family will lash out and take their frustration and anger out on you real fast.
    Grief has a process and the normal order is
    A. denial: They do not accept it or believe the death happened
    B. Anger: They lash out...example:How many times did I tell him not to ride that bike without a helmet!
    C: Confusin: what do I do now??
    D. Acceptance: very gradual and family support needed

    I reccomend that you provide emotional support and offer the family the services of pastoral care or social services.

    No two notifications are the same as no two deaths are the same. Use common sense and utilize your skills as a nurse to help emotional support.

    I always tell the ER staff as well as the law enforcement and EMS that it is ok to cry afterwards, but be strong for the families first. Trust me, in the 30,000 plus cases that I have dealt with over the past 20 years, I got plenty of tears and not afraid to say I still get upset. I can say I make a difference to the families as the spotlight is on them and not me. They need the support of you and you can seek the support of your co-workers later.

    Good answers from everyone on this!
    caj
    ((((( hugs)))) go a long way
  7. by   AlaskanRN
    NurseJessica,
    I'm going to go at this question a little differently. You asked what we do for the dead and their families.
    In this ER when someone dies (be it child or adult), we are the first ones to deal with the body. The doctor is the one that initially talks with the family, as they are not usually in the room at the time of death.
    Before the family comes in to see their loved one, we do all that is allowed to make the body more presentable. If there is blood or debris on the body or in the room, we clean up as best we can. Sometimes positioning the body and changing the lighting is the best we can do, but we try to do whatever we can to make it easier on the family when they come to see the pt.
    Usually all equipment has to be left in place (ET tube, IV's etc), but we try to prepare the family for what they might see. I stay in the room with them, and take my cue from what the family seems to need. Some need to talk to you, some have questions and some ignore you completely, but I am there if they need me.

    After it is all over and the family is gone and the body has been removed is the hardest time for me. Up to that point you do what you have to do to care for everyone else (the pt, the family etc). When it's all over is when I need help moving on (specifically with the death of children). I find talking helps the most. Your co-workers can be your most valuable asset. They are there and understand exactly what you are going through. They probably also need someone to talk it out with, so it's a benefit for all. If you need to seek out the clergy or mental health workers to help you deal with it, that's okay also. We all deal with things in our own way in our own time.
    Time itself doesn't make it any easier to deal with the death of a child...it doesn't matter how long you've been doing this...but it does give you more perspective and more coping skills.
    Hope this helped answer some questions...just my two cents worth...
  8. by   NurseJessica
    Thanks so much for all the wonderful advice.
  9. by   Jenny P
    My hospital will even use a grief counsellor to help the staff work through our feelings if a death affects us and we request it. We don't usually deal with children (there are some fantastic children's haospitals locally), but we still become very attached to some adult patients; and there are a few rare times when we do have to deal with critically ill kids that the Childrens Hosptials send to us.

    I don't distance myself from grieving; but I do view death as another process of life. I do cry with the family, give lots of hugs, and just try to be there for them and anticipate their needs.

    After the family leaves, I treat the body with the same respect and care as when they were alive, talking to them, etc., and also praying for them (silently) while doing post mortem cares. I guess this is my coping method and closure.
  10. by   fab4fan
    One thing that can go a long way is to just sit in sympathetic SILENCE with the family; maybe with your arm around one of the parents, or holding the hand of the mother or father.

    Many are uncomf. with silence, and feel that they have to fill up that silence with something...anything. Silence can be therapeutic, and quite frankly, there are times when there are no words to express what is going on at the moment.
  11. by   colleen10
    NRSKaren posted an excellent article on how to break the news to the family just later last week. It may be in the Activism section although I am completely sure.

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