Would like some advice on children dying....

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    Hello all! I have applied for and gotten a position in my hospital's PICU. A little background on me first - I was a med-surg nurse for 2 1/2 years and experienced many patients deaths, mostly DNRs but a few full codes. While a dead body isn't the most comfortable thing in the world for me I certainly was able to do my job after the patient passed away and wasn't traumatized really. I actually came to somewhat like (if that's an appropiate word) comfort care patients and found being there at the time of death to be an honor. I switched to general pediatrics 4 years ago and obviously have seen much less death - I only had one child pass away in my care. She was a DNR, 16 year old with an 8 year history of medulloblastoma and ALL. Obviously the hardest death I have seen. I knew it was coming all night from the physical signs I was seeing but still couldn't help being a little shaky as I had to wake up the mother sleeping at her bedside and break it to her that her baby was gone. My heart broke for the stoic mom, the father who kept yelling that he couldn't even help his own daughter and the grandmother who could do nothing but climb into the bed and hold her granddaughter. I went home from work that day and cried but kept coming back and continue to care for terminal children occasionally on my floor - a few I know who have since passed away but not while I've been there. I obviously know that although most children I will care for in the PICU will make it, I will encounter numerous whose lives will end. I feel that I will be able to handle the deaths of chronically ill children in a pretty healthy way by rationalizing the suffering they were going through. My personal beliefs and faith over where I believe they go will also be a comfort. My biggest concern is how to handle the death of a child which is unexpected, and mostly how to deal with the grieving family. I was fine with this when it was an adult patient but I'm nervous about how to act around parents. I obviously know I can't (and won't) turn into a puddle of mush in front of family and need to provide them with some strength but do any of you have some suggestions for things that I can say/do for the family or things I need to avoid? Is it appropriate to shed a couple tears in front of the family, so long as you hold yourself together and continue to put them first? Is there anything that you and your coworkers do to help eachother through a child's death, especially when unexpected? I am really looking forward to starting PICU several weeks from now but this is just a little anxiety that I'm hoping you amazing experienced PICU nurses can help me with. Thanks in advance!

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  2. 3 Comments...

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    thank you very much! i will certainly look over all of those.
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    Be emotionally available to them and dont be afraid to show while still maintaining composure. It is painfull for everyone but still an honor to comfort a grieving family. Remember there is no right or wrong way to grief and you will see many different responses to that. I try to involve the family in all aspects of post mordem care if they are willing because you dont get those moments back. Momentos are important...hand and good prints and hair locks even in big kids. And if they dont want them store them for several months....they often call back asking for them. Remember to take care of yourself because it takes a toll and you cant give from an empty cup. After 21 years I can hardly remember all the children who have died on my watch but I know thier familes remember me. Just be present and remember parents are not supposed to watch thier children die....sometimes just validating that is enough.
    ChristaRN likes this.


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