There were a bunch of things I was afraid of before starting nursing school. I was afraid of giving injections. I was afraid of starting IV's. Etc, etc. And somewhere in that list was "I'm afraid of my patient dying."
I've been around death before, personally and professionally. My family was the kind that brought kids to funerals, and I had an inordinate amount of funerals occur in my early twenties. I also saw a code run for a patient (who they declared deceased) when I volunteered in ER before nursing school, and I remember the nurses telling me "oh just wait until it's YOUR patient...". Well now I'm in second semester, my third clinical rotation of my program, and it happened.
To be transparent: the patient didn't die due to my care or the RN's care, and he didn't die in front of me. I noticed a change in status that led to his transfer to ICU, where he died. I found out he had died when I was gathering information for my care plan and saw the doctor's note.
I keep thinking I am okay with what happened, but every time I sit at my desk to work on the care plan I get a sinking feeling in my stomach. I cried writing the "how did your shift go?" portion of the care plan, but otherwise I have just been dreading writing him up. When I look at his labs I can see he was obviously very sick and it makes me even more sad to acknowledge. Picking out NANDA's....I've already written 6 because he had so many problems. What I'm trying to say is that I know it was his time to go, but this logic is not helping with how my heart feels. Everyone I've talked to, including my instructor, says this is a normal reaction and a good reaction because it shows I care, but I am surprised at how strongly I reacted and how it still feels (clinical was last week).
Has anyone else gone through this? How did you deal with it?
Feb 7, '11
I coded about nine or ten people as a student. Not a single one of them made it. You look at it and realize you did everything that you can and move on. Do what you have to do. My preceptors and I would debrief and talk about it. Learn from it. But just know this:
You cant save everyone.
Feb 7, '11
When I was in Med Surg 1 my patient that I was assigned to the previous week, died while we were on break. I cried and cried all day long, me and his mother hugged and cried together. He was such a nice and sweet man, even through his suffering. I had the honor of giving him post mortem care. What helped me was grieving and the chance to say goodbye. I also talked through it with my instructor and family as a way to vent. This will probably help you in your situation. I don't think I will ever get used to it... it was my first real encounter with death so it was surreal.
Feb 7, '11
My very first patient ever was last semester. She was my patient on Wednesday and she died on Sunday. She had metastasized breast cancer but she wasn't expected to go so quickly...
Feb 8, '11
I remember the first time I just SAW a pt die (I was a tech) and it still sticks with me to this day. It was somewhat dramatic (a chatting lady who had a massive PE and was dead in 30 mins). I thought about it every time I went to the hospital for a good 1-2 months.
The big take-away for you is the experience. You can feel good that you NOTICED - you saw a change in the pt. Although it was the beginning of a downward slide for that person, catching things early is the BEST thing you can do as a nurse. I'd say you probably have some pretty good assessment skills. Keep that in mind - you'll learn to trust those things because you'll always know "what could happen."
I'm now an ICU nurse and my biggest worry is that I won't notice if something is going wrong when everything is already wrong with my patient!
One last thought is that it's probably hard for you to get closure because you weren't there when the patient died. Often, being there and seeing/helping the family is what helps me cope with the death - the families are so thankful for caring nurses when their loved one is in that position. It takes some truly rough and sad times and turns them into moments where you know you made a difference.
Feb 8, '11
It is very hard when a patient dies and even now with over 20 years to my belt it can be hard and I don't want it to get easier but remember as long as you did your best then remember the patient with good thoughts and that in some small way you made their last days good days
Feb 8, '11
I am not a very religious person but I do believe there is something AFTER now.
So, for me (and I too have been doing this over 20 years), it does bother me when a pt dies but I have come to the realization that I have to separate myself from my pts in order to do what's best for them and me.
Feb 9, '11
Thank you everyone for the kind replies...my email must be wonky because I wasn't notified of all of the responses...
After a few days I decided to call what I was feeling grief, and grieving is a normal response/healthy to go through after death. Even though I was only with him for one morning, I still have the right to grieve. After I realized this, the heaviness in my chest started to disappear.
I didn't think about how I never got closure with his family. To be honest I was relieved that I didn't have to talk to them, but now I see how that could have been a valuable experience.
I definitely feel good about my assessment skills! I've had other experiences where I noticed things (none other ending in death) so this was a good confirmation for me.
Again, thank you so much for the responses.:redpinkhe
Feb 9, '11
I work with the families/visitors in an ICU waiting room. There was one family there that was there every shift I work, since I started working in this ICU. They would stay all day and all night, every day. They were ALL incredibly nice. I connected with them very easily. Their family member passed away a few weeks ago. It was a rollercoaster for them because they would think he would be passing, then he would come back. This was on and off since he had been there, lasted about a month.
I wasn't working in the location he was moved to when he passed, but the family walked by me when they were leaving the hospital that night. One of them came up to me, shook my hand, and thanked me for everything I did for them and being so nice to them. I apologized for their loss and I started crying. It just broke my heart to see this family like that. I sent them a sympathy card a few days later. It was incredibly heartwarming to know, that even though they were grieving, they took time out to thank me. I was not expecting that, at all. What wonderful people.
I already know I'll cry when my patients pass away. But there is nothing wrong with that as long as you can still do your job. I was able to shed a few tears and continue working. It just shows the families that you really do care, and they appreciate that. :heartbeat
Feb 9, '11
I have had a few patients die and it was pretty hard. Before losing my brother recently those patients were probably the "closest" people I have had die. I like to get my patients stories and talk to them a lot so I really feel like I knew them when they died. 2 of them it was sort of unexpected. I mean they were sick yes, but didn't think it was at that point. One patient I didn't find out until my next shift. My instructor went to look her up for me because she went downhill fast on my shift and was sent to ICU so wanted to see the outcome. He record said she was "discharged" and so I was thinking YEA she recovered. Turns out it meant discharged to heaven or whatever it is people believe in and that is just how the hospital has to word it :|
Must Read Topics