I feel like I caused a patient's death and I can't get over it

Nurses Safety

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I am a new nurse working in a sub acute rehab facility/LTC. I am typically assigned to care for 28 to 40 patients on midnights. I have been trying to get into a hospital but not having prior experiance or a BSN forced me to accept this job for experience. I have been concerned from the being with patient safety and the patient load I have.

Awhile back I had a patient whom I was not familiar with. She had a trach site, on O2, with continuous tube feed, and a mental illness condition. Later the CNA said she told her she was having difficulty breathing. So I checked her spo2 I raised the HOB from 30 to 45 degrees and increased her o2 and the sp02 increased. I notified the doctor on call.

When I later entered the room I noticed the patient looked really pale and asked if she was ok, the nurse replied "no she isn't, get a suction machine". I was in a panic, I thought "should I have suctioned her ?!?" I ran out to the find someone who knew where suction machine one and was told that there was one on the crash chart so I grabbed the crash chart and ran toward the room. When I came closer to the room someone said it was a code and to announce it on the overhead.

I feel like I did not do all I could for her and I have been crying almost daily because of it. I even started smoking again after quitting 6 years ago. I can't sleep without sleeping pills and I see her pale face in my head over and over. I would love some honest opinions from more seasoned nurses on this event because I feel so horrible about what happened.

Specializes in Neuro ICU/Trauma/Emergency.

I am not going to beat you over the head as the other nurses. But, tube feed and the patient was less than 45 degrees?

De-sats and anxiety means one thing, your patient is crashing! There is either something cardiac going on, resp, or neurologically going on.

Anytime you have a patient who is dyspneic from here on out, if the patient is desating(despite having o2 on) auscultate lung sounds.

A trach should cue you in to a potential problem with aspirations.

I can't say do not worry, but further educate yourself please!

People do die, that's generally a fact. Medicine can make their bodies live on, but...

Aside from that it might be a 'wild and crazy' thought for that place to have bedside suction on hand for trach patients?

Specializes in Surgery.

Much has been said already. I will only say that the first one is the hardest. I still see mine and it has been over 30 years.

Christ. Have some empathy @doppelganger. Your comments took my breath away.

1 Votes

Many many organizations and staff contribute to Nurse burnout which EBP shows aides in errors and inadequate care. I'm sorry you went through this. I wish I knew what to say but I have witnessed so much and struggle as well. It was not intentional you are human. Seek counseling and find actual support. Take a break if needed. Self care is vital. I hope in time you find some peace somehow.

I used eap the counselor was not helpful and a tragedy happened anyway and I received zero support. It has been a nightmare.

There is an important distinction between causing someone's death and maybe missing an early opportunity to intervene. If you had given her medicine that caused her death or put a pillow over her face then you would have caused her death. Maybe suctioning would have helped but maybe she had an MI? Maybe she would have went into respiratory arrest later? Nursing is a really hard job and you will need to get some help coping with the hard parts. did the doc recommend suctioning? Did you listen to her lungs at the time you assessed her? What about a breathing treatment? We are not all knowing even if we like to think we are. You cannot be sure suctioning would have changed her outcome.

Specializes in Hospice, corrections, psychiatry, rehab, LTC.

This thread is more than five years old. I doubt that the people who you are responding to are even reading this.

Specializes in CardiacStep-down/Progressive Care Unit.

Don't be too hard on yourself. I know it takes a toll on you or might even feel like a nightmare. It is hard when your patient dies on your shift. You have questions. Instead of ruminating those thoughts and feelings, learn from it and let go of those thoughts and feelings. Forgive yourself. Stay strong. You cannot always save everyone. We are all going to die here on earth. What matters is your values, your compassion and service to human kind.

Specializes in ER.

The patient was too sick for your facility, but you didn't accept her, not your fault. There should have been suction set up and ready at the bedside, but I assume you are sharing a suction machine among a group of patients, Still, not your fault. She needed more attention paid to dropping sats (and a continuous sat machine, I didn't see if you had that or not) but you had 39 other patients. Still not your fault, but maybe with more experience you would have been back in the check her more often, or known to try suctioning.

IMO you get about 20%( maximum) blame for her death, and if you had done everything perfectly she might have still died. She could have easily had an MI, with the same symptoms, and if you'd called 911 immediately she would have still arrested.

It's disgraceful that facilities put new RNs in situations like that.

I have a similar patient I care for. Number one you must forgive yourself. It sounds like you have PTSD. You should get some help for yourself and number two. I work LTC and 40 patients is normal at times and you need to raise concerns immediately. Never be afraid to ask for help from other nurses. Never be afraid to call the doctor it is their job to care for their patients.

Take some classes about tracheostomies and educate yourself a bit more.

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