1st patient death on my watch

[Peds_Nurse]

Hello, fellow nurses...

I just need to hear from some of you on your experiences when your 1st patient passed away.

Last night, I had my first. He was on comfort care, so it wasn't a surprise that he passed, but I really wasn't prepared when my CNA came to me not 15 minutes into my shift to inform me that "something is wrong with Mr. XXX".

So, I went in there and did my assessment, yes...He passed.

I contacted the family, did the necessary facility paperwork, did my nurses notes, got a release from the MD for the funeral home, etc...

I even helped the CNA prepare the body for the family (cleaning, removing tubes, etc.)

I thought I had it together until the family came in and the minute they saw me at his bedside, they started to cry, which made me cry, which made the CNA cry! It was a mess...

I tried to stay strong and not cry, but I couldn't help it. The family was so upset, even though it was inevitable.

What is your experiences? Is it ok to cry with the family? or was I unprofessional? I know I had other patients to care for that night and I did my entire shift, but I had to take a 15 minute break before going back on the floor.

Any "words of wisdom" from those of you who have worked LTC and have dealt with death?

Thank you.

[LINJOH8571]

I have been a CNA for a long time. Im now an LPN. Throughout my career as a CNA, I have had lots of paitents pass. I get so attached. Many times I've kept it all together up until the family comes. Then I'm bawling like a baby and have to excuse myself. It just shows how much you really care. I am getting ready to start my LPN career (just passed the NCLEX this april) I am sure that I will be in your shoes at some point. Bless you for caring!!!!

[Peds_Nurse]

Thank you, Lin -

I've dealt with death in my personal life with family members passing, but I don't know why this one death is affecting me in this way. It's almost like I feel that because it was on my watch, it is somehow my fault. I know that's crazy, since I was only on the floor 15 minutes when I was notified he had passed, but it is still bothering me. I took excellent care of him when he was alive and maybe that's why, I'm hoping it will get better as time go on.

Thank you again and congratulations on passing the NCLEX!

[Lorrie34]

Wow, I really feel you there. I just had my first resident die on my shift, my assignment too.

She just took a sudden turn on the daylight shift, and was put to bed and started on IV antibiotics on the evening shift. I came in for night shift and got report that she was not doing so well, but being that it just started at noon, nobody expected her to expire so quickly.

I went in to check on her as soon as I finished report, and I didn't like her respirs. I took my stethoscope to her chest to listen to lung sounds, and she suddenly opened her eyes and looked right at me. I assumed that I had woken her and startled her, so I put a hand on her shoulder and told her it was okay, and while she was looking into my eyes, she took her last breath!

.

I lost it. It was so unexpected. It was my first death. And it was just the two of us and she was looking right into my eyes, and I had my hand on her shoulder. I was a mess for the rest of the shift, and to be honest, I took the next day off to re-evaluate if I can handle losing patients all the time.

After a few days, another little lady, about the same build as her, moved into her bed. I still get a chill when I am in the room if I'm in a hurry and just glance at her while working with her roommate.

All I can say is, at least she didn't take her last breath alone with nobody comforting her. That is my biggest fear in life for myself, so I hope that I served some kind of purpose to her in that last moment.

[Peds_Nurse]

I hear ya, Lorrie...It's hard and since this incident with me, I've had 3 more residents pass away on my shift. Although it gets easier each time, the emotion is still there. The last one, the aid went in to do her rounds and came running out of the room because the patient had coffee ground emesis. And, you know what that usually means. After the call to the transport, I went in to evaluate her and, like you, she made eye contact with me. She looks so scared. I comforted her and let her know that I was there and she wasn't alone. She closed her eyes and that was it, she expired. She was a DNR and we just stood there at her bedside for a few moments. I had to take a very long break before calling her daughter to give her the news. It was hard, very hard.

I don't know if it that part will ever get any better. The more seasoned nurses tell me it does, but I'm not so sure.

I'm just thankful we have this type of website where we can voice our concerns and emotions to others who have had this experience and we can draw strength from each other.

[kythe, LPN]

With the first death I had on my shift, the family came out of the patient's room crying and told us he had died. I looked at the patient long enough to declare death with the RN, then excused myself and cried in another room so I wouldn't break down right in front of them. It was my first day on that unit and I didn't even know the patient, but I tend to be easily moved by the emotions of people around me, and I still felt their loss.

Within the last few months of working at my current facility, I've seen several patients pass away. All of them have been "expected" since the patients were very old or very sick. One happened literally right in front of my eyes in the presence of a hospice nurse who was evaluating the patient. She simply stopped breathing as we were trying to take her vital signs.

I haven't cried over a patient's death since the first one. I don't mean to seem so impersonal, but I've gotten to a point where I can separate myself professionally from the patients enough to be able to make decisions without my emotions getting in the way. If someone dies and then just a few minutes later, an emergency comes up with another patient or family, I can't be so incapacitated by grief that I can't deal with anything else. It does make it easier when the death is not a surprise. I still do not know how I will handle a code or other unexpected death.