death

  1. I AM A NEW NURSING GRADUATE AND I RECENTLY CAME UPON MY FIRST DEATH OF ONE OF MY PATIENTS. I FELT HORRIBLE EVEN THOUGH IT WASN'T PREVENTABLE AND THERE WAS NOTHING ANYONE COULD HAVE DONE. DO NURSES GRADUALLY BECOME IMMUNE TO THINGS LIKE THIS? WILL I ALWAYS FEEL THIS BAD WHEN PATIENTS DIE ON ME?
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  2. 53 Comments

  3. by   reyna
    it's not something you get used to...but eventually, you'll learn how to cope with such an experience
  4. by   debbyed
    The joys and sadness associated with nursing are just that Joy and Sadness. Sometimes we laugh with out patients and sometimes we cry with them, we share a part of their lives and that is what is so special about nursing.

    It is when you become immune to these feelings that it is time to choose a new field.
  5. by   Ted
    I used to work on a hematology/oncology unit . . . for about 7 1/2 years. During that time, I've seen a lot of people take their last breaths. My goal, during those times, was to make sure that the patient was comfortable and pain-free, and that the patient and family had lots of time together to say "Good-bye". I'm still at awe whenever I witness someone die. For me, it's a heart-ache and a privilege at that same time. It's a heart-ache because of the tremendous loss the family feels. It's a privilege because I'm part of a person's "last moments" on this earth. . . many times I was the last person the person heard or felt the touch of a caring hand.

    The hematology/oncology unit had a wonderful memorial program four times a year for all patients, that we cared for, who died (either on the unit or at home). It was an ecumenical service with prayer and song (being a piano player, I usually played the music). It was a very nice way for the family and staff to grieve and heal together.

    I don't think I'll ever get used to death. I love being a source of support for someone who's "fighting for their life" . . . especially as an ICU/CCU nurse, now, I enjoy the feeling of "saving lives", watching them recover and go home.

    However, when the person has done all that they could do to "fight the good fight" and come to the realization and acceptance that death is their only choice (as is the case for many end-stage cancer patients), I do all that I can do to ensure that their last days on earth are comfortable, dignified, and filled with the love of their family and friends.

    It's when a person hasn't even had the opportunity to "fight the good fight" AND they find out that there's absolutely nothing that can be done which bugs the crap out of me. . . usually they're young with children, etc. Man, does this instance break my heart. I respect their wish to have "everything done" for them (full code, etc.). Even when it's obvious that they will not survive the code, at least they died knowing that the nurses and doctors did everything to help them live (as futile as it may be). This may sound strange, but I believe that knowing and trusting that their care-givers did everything they could to save their lives (as in a code situation) might bring them a peace of mind/spirit during their final moments on earth.

    I would much rather help a person "fight the good fight" than play the role of a hospice nurse right now in my career. I still have some death issues to work out.

    Don't keep things bottled up, though, whenever a patient of yours dies. In my book, it's o.k. to share the grief . . . it's o.k. to talk amongst your colleagues, go to memorial services . . . do whatever needs to be done to heal your heart.

    Ted Fiebke
    Last edit by Ted on Oct 2, '01
  6. by   eventsnyc
    Ted, Thank you for the post. It is very sincere and moving. Excellent education for me.

    Christina
  7. by   prmenrs
    I believe that one of the privileges of being a nurse is to be present at significant events in the life of both an individual and a family. One of the aspects of this privilege is to validate the individual and the family.

    This takes time and experience--and reflection. You might start a journal about the experience you've just been through. If you can talk to your own family and friends about it, great, but they may or may NOT be receptive. That's why I'm suggesting a journal. Doesn't have to be only about patients who've died, maybe you'll have another experience with a pt. you might want to record and think about.

    Good luck and God Bless!!
  8. by   P_RN
    Such beautiful and wonderful responses. Thank you all.
  9. by   semstr
    No, I never want to get used to it! In the same way; I still cry when a new human being gets into this world and I am there, to assist.

    I don't know whether in your educationsystem, there is place for "dyingseminars"
    we do those with our students, the 1 one takes 3 days at the end of the first year, the 2 takes 2 days at the end of the second year.

    Here we try to make our students feel not useless and hopeless, having a bad conscience about the dying patient. And also how to deal with the families.

    But the first thing we do, is selfexperiences- well, diificult of course, but the important thing there is, to really think about ones own death, how would you want to die, how not, why, why not. Very heavy stuff!
    That's the reason there are always 2 trained educators in the room.
    I held about 5 of these seminars and they were absolutely great! For allof us!

    Take care and vever forget: first of all you are a human being!!
    Renee
  10. by   Charles S. Smith, RN, MS
    Culturally our society views death in a final way. There are many cultures that view life as a mere stepping stone to the treasures on the other side. If you have difficulty with the concept of death maybe you will want to do some reading about other cultures and the death experience. It has always been an honor for me to be present when a patient transitions from this life to another. It has always been an honor to feel the emotions with the families and loved ones. Look inside and see what troubles you about the death experience and grow from there. You can experience true compassion sharing this experience with your patients and their loved ones.

    my best
    chas
  11. by   aimeee
    Much depends on the circumstances surrounding the death. I had a couple of instances while working in long term care where patients who had been doing fairly well just suddenly crashed and we just couldn't save them. Those were very difficult.

    In other instances, where the patient has been sick for a long time and everyone is prepared, then the actual death sometimes comes as almost a welcome thing, both by the patient and by the family, particularly if they have a strong faith and believe that they are now in a better place with no suffering and with their loved ones. They have made their peace, grieved over and accepted the idea, and the actual moment of passing becomes a very spiritual time...a completion of the circle of life. Still sad, yes, but mixed with a feeling of awe.
  12. by   hoolahan
    I agree with P_RN, such beautiful replies here. Especially you Ted, thank you for sharing.

    I think Ted has been "lucky" in a way, as it sounds as if his hospice experience, most pt's and families have acknowledged the inevitable as a reality. I am sure it is harder now for you Ted, in ICU's as you see pt's fight who are not ready to say goodbye, and family members who are taken by surprise at a trauma, and acnnot make a No Code decision b/c their emotions are in turmoil. Maybe their last words to their loved one were angry. This is when it is the hardest, for me, to see death.

    I also agree if it ever gets "routine", you belong in another job. Don't ever let anyone tell you not to cry with a family. I had one death that is still so painful to think about, a young child, her grandmother was the only one here with her from Nicaragua, and only spoke Spanish. I won't go inot details, but all the nurses in our unit were affected by this child. WE had reports of her surgery throughout the day, how she was "doing great", and held her own for 20 minutes post-op, then she crashed and crashed hard. They cracked her chest, put her back on bypass, she had tubes in every orifice of her body and thensome. It was the first time I ever understood what a parent must feel. As an intelligent professional I knew she would never make it, but as someone who shared in her precious life for 6 weeks, I didn't want the code team to stop. I was not allowed to be on her code team, good thing too, I couldn't see through my tears. I went up to the peds unit before I left, theywere still coding her, to say my goodbyes to her grandmother. Another nurse went with me. It was especially difficult, since we had another Hispanic child in the unit, and his father, who spoke English also, did not want to hear, could NOT accept the reality that if this child died, his son may also die. The grandmother looked at me and said, "Es muy mal." (It's very bad.) "Si" I said (yes) Michaels' dad cut in, and said NO, NO don't say that, it's going to be OK. I looked at him, and even grandma did, and she said again, No, es muy mal." Our nun, who was our pastoral care person was also there. At that point, grandma and I hugged each other, and I started crying, trying not to really bawl. Nancy, the other nurse from our unit tried to pull me away, saying , please don't cry. Sister Jane, said, NO, it's alright to cry. Then Nancy also lost it and everyone in the room cried. Very hard to even type this. I am ever grateful to sister Jane for letting Nancy know it was OK, she really needed to cry especially, she admitted the child, spent time with her pre-op, and she even had a drawing of herself by Yadsga (something I wish so much that I had.)

    That child's death was a turning point in my nursing career. I gave up peds, a good thing for me, and it finally cracked my wall, of not geting to emotionally connected with pt's. I often wonder if God sent Yadsga to our unit to teach many of us tough cookies a lesson in her death. It has comletely changed me, and I am grateful for that.
  13. by   semstr
    O my God hoolahan, I started crying reading your post!
    What an experience!
    Yes it is so important to show your feelings, the joy and the grief.

    I find hospice-work awfully important, and i think it's a shame there are not enough hospices for all terminally sick people.
  14. by   BadBird
    I think the ultimate goal of all nurses is to see our patients improve. However, there are times when death would be better than the life we can offer the patient. I work in ICU and there are times when the families make the patients full codes and I think that is a crime. To see an 80 lb cancer patient on a ventilator , vasopressors, cardioverted, cpr, etc.. and you know all you are doing is inflicting pain is cruel. I blame the physicians for not be straightforward with the families and letting us keep the patients comfortable and let nature take it's course. I have actually heard physicians telling medical residents, the patient has no chance but get the family to consent for arterial lines, swan ganz catheters, etc... as it will be a good learning experience for you. There are other scenerios I have witnessed such as family members wanting the government check to keep coming in so they insist everything be done to keep the patient alive even if they are suffering. Suggesting an ethics meeting is another problem as most physicians don't want to be involved. How sad.

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