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- by Darkfield Sep 13, '12I'm taking an informal survey here. I work in critical care and I see quite a lot of death. My attitude towards death has become quite callous - when someone is sick, they should be a DNR, and when someone is really sick, they should be comfort care. I'm more relieved than upset when people die and death in general does not bother me.
My question for all of you who have had experience with dying patients is this; does touching and handling death on the job change your perspective when one of your own family members is dying? Are you more likely to make Grandma a DNR or be at peace with someone's passing?
I'm also interested in this; do you think it is normal and healthy that nurses are comfortable with death or is there something wrong with people who can joke on the way to the morgue and cry during lifetime movies?Last edit by Joe V on Sep 14, '12 : Reason: spacing
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- Sep 13, '12 by MsSocalRNYou are totally normal! Well at least what I consider normal! Lol! I totally feel the same way! You are just being realistic not callous! I was a mortician before becoming a nurse and I know that helped me in accepting death and that we will all die one day it's inevitable. I hope this helps!
- Sep 14, '12 by Kay28I currently work on an inpatient psych unit where we don't have patients dying on us. However, I used to work long term care and have helped many older patients through the dying process. I think that its normal to become "desensitized" or "used to" dealing with death. However, I will never forget some of the sadder cases I've seen, there is one in particular I will never forget. This poor elderly woman literally drowned in her own secretrions (end stage CHF) on Christmas day with her son by her side. I will never forget the look on this womans face as she died, in agony. The physician refused to order this woman any pain medications and she died a terrible death.
- Sep 14, '12 by Good Morning, GilI am there with you, OP. If the patient truly does not have a chance of "making" it or actually living other than being biologically alive, I always talk to the residents to make sure a discussion occurs with the family, and if the family show up, I gauge their understanding of what's going on. I work critical care, too, and many patients have many chronic conditions that at least one of which, is end stage.
I think a sense of humor is self-protective. We deal with death and tragedies of one form or another every night/day we work, so a sense of humor is healthy.
- Sep 14, '12 by rita359In some ways I agree with you. However, I don't necessarily agree that all ill people should be dnrs. I think the discussion of what the pt wants should occur. I don't think health professionals should make the decision. I don't think insurance should make the decision. I don't think the government should make the decision.
Had a 65 year old cousin, masters prepared rn who was disabled. Went to hospital. Became critically ill. However, each time professionals asked her she stated she did not want to be a dnr. Should we make her a dnr against her wishes?
- Sep 14, '12 by anotheroneI work in med surg so almost everytime some one dies (99.5% of time)the pt is a comfort care pt. i am sure if we were coding people left and right it would be different. I have seen MANY MANY MANY of these patients die sometimes once a week, once a month, other times 3 a shift! I think it has influenced me a bit. i was always a "whatever happens happens" type ofperson . I am even more so this way now. Death is inevitable and our final destination for everyone. I haven't had anyone close to me die lately . Obviously, I think that loss would affect me. ESPECIALLY if the person was not sick. The last few people I have known that died ( friends of friends etc or not too close friends) were suicides, or murders. I think those are more difficult to deal with then if someone had been sick with a poor prognosis for a long time. I do not cry when a comfort care pt dies and do not think there is anything wrong with making jokes on the way to the morgue as long as no one is listening. ( a like minded co worker I guess would be ok) It is a coping mechanism. If we fell apart everytime a comfort care patient died then our other patients would be in reallllllly bad shape.
- Sep 14, '12 by anotheroneQuote from Kay28Wow, that is awful! Why did the physcician refuse to order pain meds? When we have comfort care pts palliative medicine is usually involved and I would say in my expereince every doctor is willing to order almost any med that may help the patient feel "more comfortable" whether it is to help with anxiety, pain, secretions, etc.I currently work on an inpatient psych unit where we don't have patients dying on us. However, I used to work long term care and have helped many older patients through the dying process. I think that its normal to become "desensitized" or "used to" dealing with death. However, I will never forget some of the sadder cases I've seen, there is one in particular I will never forget. This poor elderly woman literally drowned in her own secretrions (end stage CHF) on Christmas day with her son by her side. I will never forget the look on this womans face as she died, in agony. The physician refused to order this woman any pain medications and she died a terrible death.
- Sep 14, '12 by nrskcI think as nurses we are subject to death more often than most. I think each death is an individual experience. If it is a sudden death and your coding someone who you thought was going home, yeah that's a tough one. Then there is the sick ,elderly or the terminal patient, that it just seems natural. I think it is the same outside work, sudden or unexpected death is never easy to deal with.
- Sep 14, '12 by uRNmywayI think no matter what, our first patient death is hard. Some, maybe most of us enter nursing thinking we can make a difference, save lives, etc. Once we start working, we notice that 'making a difference' might just be providing comfort, caring, or simply a presence during final hours. It might be about giving someone dignity or pain relief. I think that while each death is a little less difficult, like another poster said, some stick with you. If you had someone for a long time and got attached (after all, we are human, and doing everything for someone inevitably makes you attached in some way). Senseless deaths, unexpected deaths, pediatric deaths, I think those tend to hit harder than most.
I do think we need to desensitize ourselves to death and dying to prevent complete mental breakdown. However, if I get to a point where I no longer hurt in some way that someone dies, I think I will feel the need to evaluate a possible career change. But that is just for myself, it doesn't mean everyone needs to do or think the same.
- Sep 14, '12 by xoemmylouoxWell I have to say I just went through a lot with my father. He had an accident and went approx. 45 min without air or so we thought. He was taken to ER, put and a vent and sent to the ICU. My dad had all of the classic signs of a brain injury: posturing, seizures, inability to maintain appropriate temps, etc. We had recently talked about his last wishes in case something would happen, so I knew he did not want life support long term. The doctor told us to wait 48hrs before I made any decions to remove life support. I was ready after 24. It was the worst thing I had ever seen in my life. I will never forget the torture my father's body did to itself. However, my dad wake up, right around that 48hr mark. He made almost a full recovery. He "woke up" a little everyday.. It was not easy and we had many ups and downs, but after all was said and done his only realy injury was the loss of his ability to swallow.. That's it. Speech therapy was hopeful this would return. Sadly since then my father passed away from infection caused by the initial injury. So I have changed my opinion. I was always the one who judged those who kept their family members on life support.. Now I understand to a point. I would have prematurely ended my fathers life, and lost all of the time I had spent with him. I don't support leaving patients on life support forever, but I do understand the hope of a loved on waking up.. because mine did.Last edit by xoemmylouox on Sep 14, '12 : Reason: spelling