My first lost patient

Specialties NICU

Published

Specializes in NICU.

I just need to...I don't know. I worked Tues, Weds, Thurs last week with an adorable boy with a hypoplastic RIGHT heart. I come in today and get assigned to the less acute floor. Not much going on, so I get into the computer and start looking up other babies I've had (I'm a student in my senior internship, so I spend a LOT of time just reading charts). Wait, where's my... oh. Oh. The first shunt they put in on Friday clotted. So did the second one. Kid made it back to the NICU being bagged, but as soon as they hooked him back up to the vent it was pretty much over. Coded him for a long time, apparently. Opened his chest right there at the bedside, epi, epi, epi, but he never came back.

They're having him buried by the hospital. I was okay, basically, until I read that. That sweet little boy in a mass grave in Potter's Field. I watched his mom hold him and bottle feed him and pray over him with her pastor. I'm not judging her; I have no idea what it's like to lose a child. But if it weren't inappropriate and also too late, I'd pay for his funeral myself.

I guess I have to learn not to get attached.

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Specializes in NICU.

I'm so sorry to hear about your loss. {{{{ Elizabells }}}}

When it happens to me, I just remember that we can't beat nature. I always have to remind myself that we have saved so many other babies that never would have had a chance years ago. We have about a 10% mortality rate for our unit, but if it was 50 years ago, we probably would only have had a 10% survival rate! I just focus on the fact that we did everything we could, and that the parents at least had more time with the baby than they would have if we'd done nothing. We tried to give the baby a chance at life. And if our advanced life support couldn't keep that baby alive, then its body was probably too damaged to ever have recovered anyways.

I don't think it necessarily gets any easier. And it really shouldn't. The day that a neonatal death doesn't bother you is the day you need to get out of NICU nursing.

As I've had more deaths over the years, things have changed for me. At the beginning, it was so shocking and I was just in a panicked numb state the whole time. It was terrifying and heartbreaking. Now I can deal with it better and focus more on the family than on myself. This is an event that they will carry in their hearts and minds forever. By making it as special and meaningful as possible, I feel I've done my job as a nurse. At that point, the baby's life is lost and there's nothing more I can do about that. What I can do is to take care of that family.

Take care.

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It really sucks when you get blindsided like that - especially when you're off for a couple of days and the kiddo takes a really bad turn so fast. The circumstances surrounding the burial certainly don't make it much easier to deal with, I'd imagine. I'm really sorry. :(

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Specializes in NICU.

One more thing...

About getting attached - it's going to happen. It's very hard to work with these babies and their families every day and NOT get attached. It's part of what we do.

Neonatal is a very different area of nursing. We're a part of these families during such an intimate time in their lives, and we spend more time with their babies than anybody else. Sometimes we'll go to a baby's funeral and realize that we're the only people there besides the parents that ever even met the baby. We spend time with these parents at the bedside, especially if the baby is very sick (1:1) and the family visits all day long. And it's normal to get attached to a sweet little baby. Spending a few shifts in a row with a baby is often enough to get you attached. There's a fine line between attached and inappropriate, of course, but most of us do get attached to many, many babies over our careers. The parents get attached to us, too. Why else do we still get Christmas cards from former patients, years and years down the line? The families recognize this attachment and they often honor it and are thankful for it. I've been to funerals where the parents ask the NICU nurses (and no one else) to give euligies.

Getting attached to these babies and treating them like they're our own, if only for that shift...that's what NICU nursing is about sometimes. Most of the time, it's a wonderful thing. And once in a while, it's heartbreaking. But we're human. It's okay to get attached. Don't kick yourself too hard.

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Specializes in pedi, pedi psych,dd, school ,home health.

((((Elizabells))))) it is never easy to lose a child.....especially when you are not there when it happens. Give yourself time to grieve, it is only natural.

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I'm so sorry... I cannot even imagine. Even though your compassion is a burden sometimes, please remember that it is still what makes you such an effective nurse. Keep loving.

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I would love to do neonatal nursing. I am just a student right now. I work at an assisted living home and I love the residents. There have been four that have died since I started working in december. I love the residents and I am sure it is a different kind of relationship because they can make their own decisions and tell you the stories of their lives. Would you all recommend pursuing going into neonatal nursing even with all of the hardships that you face?

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Elizabells, I don't work in the NICU, but I understand what it feels like to lose a patient that you've become attached to. It's hard. Very very hard, and sometimes you have to grieve like they were part of your family because that's what they felt like. But time passes, you begin to heal, and you open your heart to another child. I can tell by your caring for this sweet boy that you are going to make a wonderful nurse that's going to make a difference in many lives. :icon_hug:

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Specializes in NICU.

Thank you guys for all your kind words. It's nice to know I'm not a freak for being upset about this!

On the shift when I found out I wasn't with my regular preceptor, and NONE of the nurses I was with would talk about it with me. That was...not helpful. My preceptor has been on vacation, so going in has been optional, and I haven't been back. It's not that I'm scared to go to work, exactly, but I kind of don't want to be with any of the other nurses. It's not their fault, they didn't sign on for a student and I know it's an imposition to have one assigned to them, but it really didn't feel good to be a burden (and have it made clear to me that I was) when I was upset already, y'know? Also one of the chronic kids (LOS over four months) died the day I found out, so everyone was really focussed on that, and being sad and also relieved, and debating whether we did that kid a service or not. I know it's not about me, I KNOW that, I just wanted someone to say "yes, it's hard the first time. I'm sorry. Are you okay?" So I'll just wait until my regular preceptor is back.

Whew. Long post just to say thanks!

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{{{Elizabells}}} Sweetie, first of all I am sorry you feel like a burden to the nurses you are assigned. Its nothing personal. Secondly, its always difficult to lose a patient you have been working with. Thats when reality hits you in the face that we dont have control over everything. Take time to consider the good you did and that you made a difference. Have a long talk with your preceptor when she gets back and I am sure it will help you sort it all out.

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