Worst day of my life. My patient's family decided that they didn't want to leave her on life support so they decided to extubate her and let her pass. She has only been on the vent since the night before and was aware enough to be able to nod yes and no when I asked her questions, and I know that she knew what was going on. The doctor asked the family to step outside, and then he left too. I had no idea this was a nurse's responsibility. I had to kill my patient. My preceptor explained to me how to deflate the balloon and disconnect everything and pull the tube. I was in shock and totally not prepared for this. We had given her Fentanyl, but I don't think it was enough because she struggled. She took a few gurgling breaths, but they lasted less than a minute because by the time the family came back in, she had stopped breathing and they didn't have to see what I did, thank heavens. It really didn't hit me until I got home because I was busy with my other patient. I had to kill someone. And it was hard because I don't know if it was what she wanted. She probably would have died during the night anyway because she was losing blood pressure and was maxed out on vasopressor drips so it really bothers me that she had to smother to death instead of slowly going. I don't know how to deal with this. I cried all night. It wasn't the first time I saw someone die at work, but it was the first time I was actively involved in a death, you know? I'm devastated. How do I get over this? I don't want to quit or move to another floor because I love my job, but how do I keep from breaking down if it happens again? I really thought the doctor was going to do it. Even then it would have been hard, but it wouldn't have been me. I know that I'm still in shock because it just happened yesterday and that the hurt will fade. I thought that I was strong enough for the ICU. Who do I talk to? Will it get better? Will I get desensitized. I guess I will since it does happen and worse things happen and the nurses seem unfazed. But it is such a heavy burden knowing that I killed someone. And it wasn't an accident. It was intentional because the family wanted it. I did it on purpose. How could I do that to someone? Okay, I'm upset. Sorry.