My First Loss

greenfiremajick · Apr 16, 2010

:hug::hug::hug::hug:

Oh Allnurses.com, how I do enjoy thee so.
It has been some time since I have even a moment to peruse these forums, and unfortunately sadness brings me back to them today.
Three and a half years as a nurse and my first shift death happened tonight.
Admitted at 0130, deceased at 0440 this tiny DNR/DNI pneumonia will stay with me forever. Watching someone gasp for breath, watching their slender fingers turn blue and cold as you plead with the respiratory therapist to work faster getting the BiPAP on the patient, only to have them sigh at you and say "Isn't this woman a DNR?".
I don't know if it was easier or not to pass a DNR patient as opposed to a full code pt, in some respects yes, but in others I am still in frustration.
I have cried my tears, hugged my husband and received applause and praise from her family, but I still sit with a little hole in my heart and the threat of sobs in my throat.
Fortunately this evening will be one filled with family and dinner out, so I move on with my life, touched by a patient, my co-workers (whom supported me unflinchingly at every turn), and the soft shoulder of my ever present husband.
Tait

clemmm78, RN · Apr 16, 2010

Losing a patient does become easier, but it doesn't mean it doesn't affect you in ways you don't expect.

By the time I was working in palliative care and after having worked in areas from rehab to ICU, I had had many, many patients pass while I was with them. Some stay in your mind forever. Up to my last patient, there were some that stayed.

gtoko · Apr 16, 2010

Big hugs to you. You are a kind and compassionate nurse. I always try to believe that patients are in a much better place ,after they have passed on.

netglow, ASN, RN · Apr 16, 2010

Tait, my buddy-pal :kiss

katkonk, BSN, RN · Apr 17, 2010

But you can know, in yourself, that you were compassionate and kind, and perhaps much more so than a more "jaded" nurse. I don't think it gets easier, if you are not in an area that has patients die frequently. If you were able to offer them some comfort and offer the family the opportunity to share their grief, then you did as much as you could. God Bless you. And thank GOD that you still have the humility and humanity to care as much as you do.

zofran · Apr 17, 2010

I still remember the first pt I had who died....She was also a 88y/o DNR who had advanced lung disease...It was awful to watch this poor woman struggle to breathe and to witness the anxiety.

I called a rapid response for this woman, because what we were doing wasn't enough to keep her comfortable. I wanted orders for more morphine and ativan and I wanted them fast. I got some flack for calling a rapid response because she was DNR. Well just cause they are DNR dosent mean we cant do something to ease her suffering!

That night, I also went out to dinner with my husband and kids...

So glad to hear your co workers were supportive...lean on them when you need to. Hugs to you, take care....

justbreathesrw28 · Apr 17, 2010

I've been a nurse almost two years and lost my first patient after 4months on my own. She was 29 yo mother. I had the privilage of caring for her on and off during the last 2months of her life and got to know her and her family very well. I even went to her funeral. It was a life changing experience for me and I will forever be greatful for knowing her and her family. She fought so hard to live and I will never forget her looking at me and asking me if she was going to die, and I had to say yes. She was thankful for my honesty, but it did not make it any easier. Because of my experience with her, my goal everyday is to make a difference in the lives of my patients even if it is in the smallest of ways. I love my job and I love being a nurse and these little heartaches makes us better nurses and better at caring.

netglow, ASN, RN · Apr 17, 2010

I've already had my first one, as a student. I learned how poor management in all disciplines really just cannonballs. I learned that as a nurse you can walk into such a mess. It's like someone ordered for the patient to be blown-up and then walks away. I come on, and seriously? what a mess you are giving me off-going RN/surgeon. Why did you even do this? How long has this been going on RN, all nite? You have the power and you didn't override? Now it's just too late. But then none of this should have even happened to begin with IMHO -- had no chance of being a good outcome. And that's the thing, I will still have to be the one to deal with everybody else's mess.

Major loss of innocence for me, I guess. Zofran, like you, I know I won't hesitate to force orders in my practice. However futile to others, I will at least not drop the ball and walk away...

Tait, MSN, RN · Apr 17, 2010

I've already had my first one, as a student. I learned how poor management in all disciplines really just cannonballs. I learned that as a nurse you can walk into such a mess. It's like someone ordered for the patient to be blown-up and then walks away. I come on, and seriously? what a mess you are giving me off-going RN/surgeon. Why did you even do this? How long has this been going on RN, all nite? You have the power and you didn't override? Now it's just too late. But then none of this should have even happened to begin with IMHO -- had no chance of being a good outcome. And that's the thing, I will still have to be the one to deal with everybody else's mess.
Major loss of innocence for me, I guess. Zofran, like you, I know I won't hesitate to force orders in my practice. However futile to others, I will at least not drop the ball and walk away...

I hear you on this. It was hard to have the rapid response nurse and the Dr stand there and tell me "hmm it must be a neurological change, not respiratory. Let's do a CT."

I was like "CAN'T YOU SEE SHE CAN'T BREATHE?"

I am beginning to think half of the stuff they did that night they did because they were trying to appease me because I was so tense, despite my best efforts to stay very very calm for the patient.

Thank you all for the responses :)

Tait

leslie :-D · Apr 17, 2010

I still remember the first pt I had who died....She was also a 88y/o DNR who had advanced lung disease...It was awful to watch this poor woman struggle to breathe and to witness the anxiety.
I called a rapid response for this woman, because what we were doing wasn't enough to keep her comfortable. I wanted orders for more morphine and ativan and I wanted them fast. I got some flack for calling a rapid response because she was DNR. Well just cause they are DNR dosent mean we cant do something to ease her suffering!

that's the killer, for me...

that if a dying pt isn't medicated enough to quell symptoms, all the compassion in the world will do little to ensure a peaceful death.

it is 100% cruel, to dismiss any type of suffering...

and these types of hcw's, just shouldn't be.

leslie