The Dark Side of Nursing...

Specialties NICU

Published

Well it was just a matter of time before I experienced it, but it officially happened this week: my first death.

It wasn't my patient, but I'm an employed student nurse on a medical floor, so I was asked if I'd like to see the process following a death. Of course I said yes, and felt quite prepared going into it. But oh man. No matter how prepared you think you are, how can you really be? I helped with bagging the patient and transferring them to the morgue. When we got to the morgue, there was not enough room, so I had to help with moving several bodies around.

Even though it was educational and a necessary part of nursing for me to learn, I've been having a bit of a hard time with it and on the verge of tears a few times. It was the rigamortis and the modelling of the skin that really gave me a good shock, but I think what has been the hardest for me was moving the bodies around in the morgue. That is something I never thought I would have to do (the hospital I work at is very small and the morgue is tiny, so they have shelves that bodies need to go on to make room...of course, no one wants to do that, so the job falls on the unlucky person who gets there last...). It also doesn't help that it was a very unexpected death. This patient was set to be discharged the next day.

My one saving grace was that I had an incredible care aide who was showing me the process. She really helped debrief me and role modelled a very respectful way of dealing with death. I am so so thankful that she was the one to teach me.

I guess my expectation of this post is to get my feelings out to those who understand (I tried to explain a little to my husband, but it's difficult for him to relate). Is there anything you do to help deal with the death of a patient? Have you found it gets easier over time? Or just bear it because it's "part of the job". I'm in my 3rd year and have a palliative rotation coming up next, so I'm sure I'm about to experience a lot more in the coming months and want to work on some good coping skills.

Specializes in Pediatrics, NICU.

I have found my role as the RN is mostly just to support the parents/family of the baby. We will help the parents give the baby a bath if they want to and dress the baby in an outfit or bereavement gown of their choosing. We take pictures or arrange for Now I Lay Me Down To Sleep (https://www.nowilaymedowntosleep.org) to photograph the baby if they would like that. Our NICU also has memory boxes that can be used to get footprints, handprints, and a little tuft of hair. The key is really to do whatever the parents want and will bring them comfort. We also will contact pastoral support if that's something the parents request. There is also a bit of paperwork that needs to be done and eventually the baby will need to be brought to the morgue.

As for dealing with neonatal deaths (or any patient deaths), I think the key is to develop healthy coping mechanisms (journaling, exercise, cooking, etc.) and employing them when something happens (avoid binge drinking or eating). I hope this is helpful for you. :)

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
was the rigamortis and the modelling of the skin that really gave me a good shock,
Hi, there. I hope you had a nice holiday. :)

FYI, the correct terms are rigor mortis and mottling. I'm providing these corrections as a learning experience, not because I'm policing anyone's terms. Anyhow, let me return to the subject at hand.

Your views on death and dying will solidify as you continue to accrue these morbid experiences. The first couple of deaths may disturb you until you come to the realization that death is a very normal end to the circle of life. Although we live in a death-denying society, the processes of death and dying are inevitable and nothing to fear.

Good luck to you!

Oh my goodness! Thank you, I'll correct it in my post, thanks for not making me feel stupid about it!

Thank you for your views on this as well. I agree, it is a very death denying society and maybe that's why I felt so affected by it, I've obviously denied it myself.

I started out in oncology and I now work in L&D. I worked a few other specialties in between, but particularly in those two specialties, I have seen a lot of death and a great deal of variety therein: the death of the old, the middle-aged, the young adult, the neonate. The way people mourn and what people mourn for varies, but I've certainly come to appreciate death for the relief that it often represents, even in the very young.

You too may come to find eventually that death isn't always the "dark side" of your professional experience.

I started out in oncology and I now work in L&D. I worked a few other specialties in between, but particularly in those two specialties, I have seen a lot of death and a great deal of variety therein: the death of the old, the middle-aged, the young adult, the neonate. The way people mourn and what people mourn for varies, but I've certainly come to appreciate death for the relief that it often represents, even in the very young.

You too may come to find eventually that death isn't always the "dark side" of your professional experience.

Thanks so much for your reply. I definitely hope I'm able to see it as you do the longer I'm in nursing. It was difficult to be smiling and chatting with someone one day then the next day being the one to zip up the bag, but I am slowly moving on from it. All I can say is at least I have finally experienced death and now I can build on my experiences with it.

I have found my role as the RN is mostly just to support the parents/family of the baby. We will help the parents give the baby a bath if they want to and dress the baby in an outfit or bereavement gown of their choosing. We take pictures or arrange for Now I Lay Me Down To Sleep (https://www.nowilaymedowntosleep.org) to photograph the baby if they would like that. Our NICU also has memory boxes that can be used to get footprints, handprints, and a little tuft of hair. The key is really to do whatever the parents want and will bring them comfort. We also will contact pastoral support if that's something the parents request. There is also a bit of paperwork that needs to be done and eventually the baby will need to be brought to the morgue.

As for dealing with neonatal deaths (or any patient deaths), I think the key is to develop healthy coping mechanisms (journaling, exercise, cooking, etc.) and employing them when something happens (avoid binge drinking or eating). I hope this is helpful for you. :)

This is so helpful, thank you so much! I always felt like neonatal death would be especially difficult because it's not the "normal" experience of birth, so I can imagine the pain that the families go through would be tough. It sounds like a lot is done to keep them comforted though, which is wonderful. I've found talking to my coworkers (and all of your views on here as well) to be the most comforting so far, so thank you all [emoji4]

I am just glad that we don't have a morgue in our hospital. Moving boxes around in the supply room is one thing, but bodies?

I've only been to our mourge once and it was definitely a low person on the totem pole job. Anyone that's never transferd a 250 lb body has no idea what dead weight really is.

Specializes in Med nurse in med-surg., float, HH, and PDN.

My mother was also a nurse; I found her view to be quite comforting: The body is merely the envelope worn by the soul when it comes to earth. When a person dies they have shed the thing that tied them to this plane of existence, the body. So the "THEY" of them is not really there anymore.

I prefer to think they've 'gone on to a better place', where they no longer need a solid body to still exist.

This viewpoint serves in a small way, to help regain your professional ability to distance yourself from difficult tasks that need to be performed regardless.

The expected death of a "palliative" patient is very different from the unexpected death of a baby (or adult, for that matter). Sometimes it's sad, but lots of the time it's just kind of peaceful. I've heard folks describe it as "going home." When you go into your palliative rotation, pay attention to how the patients and families cope with the prospect of death. I think you'll find it really interesting, and probably in many ways much easier to handle.

My mother was also a nurse; I found her view to be quite comforting: The body is merely the envelope worn by the soul when it comes to earth. When a person dies they have shed the thing that tied them to this plane of existence, the body. So the "THEY" of them is not really there anymore.

I prefer to think they've 'gone on to a better place', where they no longer need a solid body to still exist.

This viewpoint serves in a small way, to help regain your professional ability to distance yourself from difficult tasks that need to be performed regardless.

This is a great way of looking at it. I've always been of the same belief, but I have to work on actually applying it when I'm right there faced with it. Thank you :)

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