I don't know how you nurses deal with death - page 3
by Poochiewoochie | 6,877 Views | 44 Comments
Today I sat and watched as my mother lay dying in her bed at the NH. Horrible-not like in the movies at all. I sort of knew what to expect but actually seeing someone die is a lot harder than most can imagine. Her lungs were so... Read More
- 0Feb 25, '13 by anotheroneQuote from Poochiewoochiesorry for your loss. for some people it is not that difficult and s/he may be desensitized to it.Thank you. My post wasn't about the death of a relative vs. the death of a patient it was a question of how people in the medical field deal with death on a regular basis and how hard is must be to watch someone die regardless of whom they are. After all, it is a person that is dying. When we contacted hospice they gave us some information about the dying process but it would have been nicer if someone had sat us down and explained it to us in person.
- 0Feb 25, '13 by KelRN215, BSN, RNMany of us don't deal with it on a daily basis. It's been years since I actually had a patient die during a shift I was working. I have taken care of many dying patients and since I work in pediatrics, I often hear even from other nurses "I don't know how you do it." I've been doing it for so long that sometimes I forget that it's not normal for children to die.
In my current job doing pediatric VNA, I've had a few patients who have died (I think 3 over the course of a year) and several more on my caseload who likely will die but it is by no means something I see every day. I feel sad for the families I've come to know when their children die and know that they will carry the pain of losing their child with them for the rest of their lives... but seeing the way these children suffer, I also feel happy for them that they are free of their earthly bodies.
- 2Feb 25, '13 by chrisrn24Quote from tewdlesExactly.Fortunately, our mothers don't die everyday...but our patients do.
Death is as natural as birth although not as happy.
Establishment of good professional boundaries helps us to remain healthy despite the cumulative grief.
I sometimes feel sad for the family and their loss, but never really for the person who passed because I know they're in a better place. Even now reflecting back on my own grandfather's death, it was a blessing because he was in so much pain.
When you're a nurse, you have to have boundaries, and seeing death all the time as I do in LTC isn't awful like you might believe it is.
- 1Feb 25, '13 by leslie :-DQuote from Spidey's momas an aside...The hospice deaths are different for me than a family member and I have to say I haven't had one family try to fight EOL issues. Some need more education but no one has fought their loved one being in hospice. Maybe it has to do with our small town setting. I dunno .
We try to make end-of-life circumstances peaceful and painfree. Sometimes people do fill up with secretions and we have a portable suction machine to take if that happens or if they are an inpatient, suction is available in the rooms. Those are comfort measures.
1. i have to agree that it likely does have to do with nsg in a rural setting, vs an urban one.
where i am, lots of diversity and just lots more people...as one would expect in the city.
2. in our hospice, we don't 'do' suction...
as the med'l dir and DON strongly felt that suction in and of itself, was terribly invasive,
and that drying agents (scope, levsin, etc) were much more effective (if started at first sign of fluid shift) and less invasive.
i also know that hospices are as varied as the nurses who implement the care.
- 2Feb 25, '13 by GrnTea, BSN, MSN, RNIn hospitals it's more common for the IVs to be running, which contributes greatly to discomfort at end of life. No hydration = no need to get on and off the bedpan, no gastric juices to vomit up, no pulmonary secretions to drown in. It's not the same as when you're forceably dehydrated. When the patient doesn't want anything po, that's the cue to stop the IVs; anyone on comfort care only shouldn't be tethered to an IV anyway. If s/he is thirsty, s/he will ask to drink. If not, it's a natural part of the dying process and not painful.
- 1Feb 25, '13 by leslie :-DQuote from GrnTeato clarify, i was talking about suctioning in eol care, grntea.In hospitals it's more common for the IVs to be running, which contributes greatly to discomfort at end of life. No hydration = no need to get on and off the bedpan, no gastric juices to vomit up, no pulmonary secretions to drown in. It's not the same as when you're forceably dehydrated. When the patient doesn't want anything po, that's the cue to stop the IVs; anyone on comfort care only shouldn't be tethered to an IV anyway. If s/he is thirsty, s/he will ask to drink. If not, it's a natural part of the dying process and not painful.
but reading your post, the bolded (by me) jumped out at me.
even when a pt is severely dehydrated, many pts still 'drown in their pulmonary secretions'.
this is a prime example of fluid shifts and more often than not, lots of fluid is shunted to the lungs.
also, vomiting happens, with or without iv hydration.
still, we have used iv/sc as a palliative measure...
not specifically to hydrate, but to restore lyte imbalances that can cause a type of delerium.
also, since i worked in a picu (palliative icu), there were always some sort of lines being placed and maintained.
if they were 'stable' enough to be dc'd from picu, then less invasive measures were implemented.
- 0Feb 25, '13 by 1pinknurseI was with several of my loved one's when they passed yet I was present with a few patients when they too passed on. My humbling experience came with my families so when I have a patient passing, I am very much at peace. Since I have already been there with the family, I know how it feels. It's a terribly lonely place but having others around such as good nurses, it makes all the difference.
- 0Feb 25, '13 by VishwamitrMy dear friend,
First of all, please accept my sincere and heartfelt condolence.
Not to trivialize death, but as a nurse, I see life as a continuum where birth is the inception and death is termination. I also find that Kubler-Ross' stages of bereavement (denial, anger, bargaining, despair, and acceptance) are very pragmatic.
The reason that we can "deal with this" (as you have chosen to put it), we work with empathy and not sympathy (although, inadvertently and in a latent form, it is present to a certain extent). We call upon our belief system and then it is not so difficult.