Death Happens. Get Used To It!

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    As a pre-nursing student the very thought of death and dying might make you anxious right now, but I assure you that dealing with this event will become easier with the passage of time and the accrual of more exposure. Whatever you do, please don't let your fears deter you from pursuing a career in nursing.

    Death Happens. Get Used To It!

    Here's a truthful horoscope for you: we're all going to die!

    Before we get started, ask yourselves the following question: What exactly is it about death and dying that disturbs you? Once you pinpoint the source of your fears, keep in mind that other people who once had the same reservations have moved on to become stellar nurses with solid careers in the nursing profession. If you cannot identify what it is about death that makes you fearful, that's also okay. It's probably a sign of our modern times. Let me explain further.

    In previous generations, death still remained a sad and dreadful time for people who saw family members die. However, the main difference between the past and the present is the fact that death and dying used to be highly visible, very out in the open, expected, and an accepted part of life. During yesteryear, 'passing away' was a personal event when people died at home encircled by loved ones who said their goodbyes. The surviving kinfolk lovingly gave post-mortem care at home in the hours after death.

    In the modern 21st century, the vast majority of death now occurs in healthcare settings such as hospitals and nursing homes. In other words, death has mostly been removed from intimate home settings, so many people fear what they have not seen. American society now does too efficient a job at hiding death from view and this contributes to making death seemingly creepy to some.

    Is it bad for you to fear dead bodies?

    No. Your fears are actually normal due to the society in which you were probably born and raised. Regrettably, death is all around us, and you will need to become acclimated to it if you plan to work in most areas of nursing. Don't worry, because you'll start to become more familiar with death as you get more exposure. You'll actually be relieved by some deaths and saddened over others. Although death will never be easy on you, it will get easier over time.

    What do you do if a patient dies?

    It depends on the code status, healthcare setting, and situation. You would immediately call for help if you find a dead or dying patient who is a full code at a hospital. Press that code button, call the rapid response team (if available), lay the patient on a board or hard surface, initiate CPR, and so forth. The sooner you summon assistance, the quicker your patient's room fills with people to help with the resuscitative effort.

    Patients who have current DNR/DNI orders are dealt with differently. We want to notify family promptly if the patient is in the process of actively dying. In an ideal textbook world, someone would remain with the dying patient until family arrives to ensure the person doesn't die alone. Dying patients who are on hospice or end-of-life care receive comfort care such as frequent turning, bed baths, pain control, oral care, and other measures to maintain dignity before death. When the patient dies, someone makes a pronouncement of death. In the state where I practice nursing, pronouncing death is within the RN's scope of practice. Some families want to spend time with the body, so we give them time for that.

    What happens with the dead body?

    The nursing department is usually responsible for post-mortem care such as cleaning the body and rendering the patient fit to be seen by any family members who may want to say goodbyes to their loved one at the bedside. At many hospitals, the nursing department is also assigned the tasks of placing the deceased inside a body bag, attaching toe tag identification, and transporting the body to the morgue.

    The mere thought of dead bodies might send chills up and down your spine right now, but I assure you that dealing with death will become easier with the passage of time and the accrual of more exposure. After all, death is a natural part of the circle of life. Don't let your fears deter you from nursing.
    Last edit by Joe V on Dec 2, '13
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    TheCommuter is a moderator of and has varied workplace experiences upon which to draw for her articles. She was an LPN/LVN for four years prior to becoming a registered nurse.

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  3. by   Amnesty
    I actually have yet to see a death happen or be in the presence of a dead body. I have been lucky enough to not have any of my loved ones die, or close friends, and we don't get a lot of dead bodies on the ortho floor . Death generally saddens me, but in and of itself, it doesn't scare me. I just know I'd be livid if it was anybody close to me who was taken.

    I know it's only a matter of time, given my profession, and I'm more curious than anybody to know how I'm going to react when it happens. I view death in a very scientific sort of way -- you're never gone, only changing forms. Your energy is still always here and always will be. I find that comforting.
  4. by   NurseDirtyBird
    Thank you Commuter. This is something that gets under my skin. Most of our culture prefers to deny death, it's not something that's talked about in polite company. People don't teach their kids that death is a real thing that happens to everyone, and we all grow up scared of it. Someone dying is scary, and doctors and nurses are expected to do everything possible to avoid it, to trump the natural process of life.

    There is a group, becoming more prominent in the online world, that is trying to change our culture's relationship with death from a negative scary thing into something that's just a natural part of life. They cover everything, from the dying process to what happens to the body after death, and the (completely natural) process of grief. They help people become acquainted with death and hope to dispel the fear and denial.
    Home | The Order of The Good Death
    It's worth checking out.
  5. by   BrandonLPN
    A wise man once said that life is a disease. One that's sexually transmitted an invariably fatal.
  6. by   rubato
    Thank you. I'm going into hospice nursing, so it's a good thing I'm comfortable with death.
  7. by   ♪♫ in my ♥
    I started out working in a mortuary many, many years ago so I quickly made peace with dead bodies... though I remember the first time that I touched one... and this was before the "wear gloves all the time" mentality so it was skin-to-skin...

    I "recovered" all kinds of corpses... very young, very old... expected and unexpected... traumatic and nontraumatic... so I made peace with the bodies and with the mourning of those around me.

    However, it wasn't until going through the home-hospice process with each of my parents that I finally made peace with the emotion of death on a personal level.

    As a nurse, I've had the honor of tending to several patients (and families) over the last weeks, days, hours, and even seconds of their transitions... and I do view it as an honor for it is the one experience that binds us all together and it is a very raw and vulnerable time... and it is an honor to be invited into that most personal experience.

    As an ED nurse, I do everything that I can to stave off death for as long as is appropriate based on the patient's clearly documented wishes and the orders of my physicians but I have also made peace with the inevitability of death and the reality that death can be done well and not so well (both of which I know first hand from the experiences of my family as well as my professional role).

    Often times, Emily Dickinson pops into my head: "Because I could not stop for death, he kindly stopped for me."
  8. by   TheCommuter
    One of our forum members from the distant past, dthfytr, once posted that death is the price we all pay for the privilege of living. These are some of the wisest words I've encountered.
  9. by   BSNbeauty
    For some reason dead bodies scare me. Always have and always will. As a nurse I have had my share of patient deaths snd performing post mortem care. However, I have always had someone with me and never been left alone. My aunt always told me that the dead cant hurt me but the living can. I guess that never sunk in. I now work in a specialty where patient deaths are pretty far and few between and Im much happier.
  10. by   schnookimz
    I was so scared until I had an amazing nurse friend make me comfortable with the process and see how beautiful and peaceful it all is. There is no more suffering.

    However, once we zip up the body bag, I still get the heebie jeebies as the plastic is settling and I just imagine there's a zombie in there trying to get out!!!!!
  11. by   poppycat
    I was exposed to deaths of close relatives from a very young age. When my grandpa died his body was "laid out" in the family home for 3 days before the funeral. This was the norm in our family. This was in the 1960's, by the way. Because of having the experience of losing many family members I've never been afraid of being around death or dead bodies. It was always just a natural part of life.

    When my dad passed away this past March I felt honored to be able to do his post mortem care. I saw that as me caring for the parent who had cared for me all my life.
  12. by   Aurora77
    Quote from ♪♫ in my ♥
    As a nurse, I've had the honor of tending to several patients (and families) over the last weeks, days, hours, and even seconds of their transitions... and I do view it as an honor for it is the one experience that binds us all together and it is a very raw and vulnerable time... and it is an honor to be invited into that most personal experience.
    This is so true. We don't have many deaths on my floor, but I've experienced a few. It is truly an honor to be there. I'll never forget my first patient death. I was there and saw him take his last breath. I was also able to hug his wife and promise her that I would take good care of her husband.

    That first death is rough (I cried all the way home). They do get easier, after all, we have to have a healthy separation in order to function. I hope that nursing students, and nurses, won't let their own fears stand I the way of what is a very rewarding opportunity to care for others.
  13. by   jlogan
    I'm an LPN student in my last week of nursing school and I experienced my first loss of a patient yesterday. I knew at some point this loss would occur I just never thought it would occur during my preceptorship. It was sad but at the same time I think about how this patient, who was young and had been vent dependent all their life and had been in the hospital the past 20 years, is in a sense free. Patient was DNR. I got to see the doctor come in and do the necessary things to make sure patient was really gone and how to call the time of death so it was a major learning experience for me.
  14. by   Retired APRN
    When I was a student the clinical instructors gave us all a standing instruction that if someone died on our unit, even if it wasn't our patient, we were to page the instructor. The first time a patient died on the unit where I was working I was so afraid of what I might have to do that I didn't page her, and I got in trouble for that.

    The next time it happened I paged my instructor. She took me into the room and showed me how to be efficient but also respectful and gentle while giving postmortem care. She placed a flower on top of the covering sheet when we were done, and then sent me to accompany the orderly and bring the patient down to the mortuary. As the orderly and I transferred the patient from the guerney to the sliding tray in the mortuary refrigerator, I was awkward and dropped my side. I was horrified! But my instructor had so impressed on me the need for being respectful (such as referring to the "patient" and not the "body"), that I automatically called out, "Oh, I'm so sorry Mrs. X! Are you hurt?"

    The orderly, not having been trained by my instructor, found it hilarious. I still think it was a sign of the excellent teaching I received. Fortunately I only rarely had to give PM care after leaving that unit, but it was an important and valuable experience for me.