advise; how do you handle the loss of a patient?

[idnurse2b]

I am a fourth semester nursing student and last semester I experienced my first code (she actually coded three times). I felt like I had mulitple personality disorder after it. Part of me was really excited because I had never been involved in a code blue before and I had never seen CPR performed on a person. It was a learning experience and I took advantage of it. The other part of me was horrified at what I had seen. This patient was young and her children who were my age were in the waiting room. I managed to keep that side of me at bay until I got off from clinical and went home and started to process the whole thing and then I burst into tears.

So, my question; Am I supposed to have a "nursing" mode and a "normal human" mode? Or am I supposed to find a happy medium between the two? It almost felt like a defense mechanism so I could function through the situation.

I am planning on being a NICU or peds nurse, and sometimes I worry about how I will handle it when my patients don't make it.

Any advise or comments would be appreciated :)

[Flying ICU RN]

his eyes rolled back, and I lost his pulse. I started compressions immediately, the crash cart was already in the room

You cannot possibly do it any better than this, BRAVO.

[Tait, MSN, RN]

Two nights ago I had to call a code on a patient who I responded to as a rapid response call. The patient died. I thought that I had become really good at dealing with death, but this one has jarred me. I keep remembering how the man clutched at my hand crying "help me" before his eyes rolled back, and I lost his pulse. I started compressions immediately, the crash cart was already in the room, anesthesia was on the way anyhow (MDs had decided to intubate just to be safe), and two MDs were standing in the hall outside his door. After 30 minutes they stopped the code since we weren't getting a carotid pulse even during compressions, and the most likely cause of his arrest was a rupture of his recently repaired aortic aneurysm. When the MD first mentioned stopping the code, I could not help but whisper/blurt, "He's only 36." She snapped at me, "It would make no difference if he was 86!" Oh, but it does, it does.

I get a little twinge sometimes when daughters sons and grandchildren come in to pay their last respects to grandpa who died after a long drawn out illness. I bring them tea and tissue boxes and set up chairs next to the bed, but I am clear and professional and mostly unphased. When the 36 year-old man's wife showed up at the hospital and learned of his death, I was almost paralyzed. The most I could do was to hand the MD a box of tissues for the wife and scuttle away to focus on my charting. I couldn't tell his wife that the last five minutes of his life were spent calling for her. Yes, it was touching that he was thinking of her, but she might have felt guilty since she had decided not to sit up with him in his room that night. We had called her to come in at his request as soon as he'd become short of breath, but she arrived at the hospital a half hour after his death because she had to take time to find someone to mind their two small children.

I so wanted to tell the MD running the code, "It is so effing NOT the same as losing an 86-year old."

Sorry, I'm realizing that I'm not helping you with your question at all. I guess how I'm dealing with this is to vent to anyone who might have some inkling of empathy. In two days I'll be fully functional.

**hugs**

I agree, it is NOT the same thing.

Tait

[Esme12, ASN, BSN, RN]

When the MD first mentioned stopping the code, I could not help but whisper/blurt, "He's only 36." She snapped at me, "It would make no difference if he was 86!" Oh, but it does, it does.

When the 36 year-old man's wife showed up at the hospital and learned of his death, I was almost paralyzed. The most I could do was to hand the MD a box of tissues for the wife and scuttle away to focus on my charting. I couldn't tell his wife that the last five minutes of his life were spent calling for her. Yes, it was touching that he was thinking of her, but she might have felt guilty since she had decided not to sit up with him in his room that night. We had called her to come in at his request as soon as he'd become short of breath, but she arrived at the hospital a half hour after his death because she had to take time to find someone to mind their two small children.

I so wanted to tell the MD running the code, "It is so effing NOT the same as losing an 86-year old."

Sorry, I'm realizing that I'm not helping you with your question at all. I guess how I'm dealing with this is to vent to anyone who might have some inkling of empathy. In two days I'll be fully functional.

We did everything we could.........I am so sorry.......His last thought was of you and that he loved you.......................~

Recognize that we are given a drive to be the best that we can be. Empower yourself with knowledge. I realize that not all nurses are religious but the things I have learned......

There is a greater power and meaning to it all......What? I don't have a clue. I believe That I am given a special talent for what I do but I don't guide the outcomes because if I did.... children would never know cancer,pain, or heart ache. They would never be hit by cars. They would never be murdered or abused by anyone. I am the best that I can be and every code,death or trauma will be whatever it will be...That we live our trial in this time and only move on to something better. That I am no significant to ask WHY or HOW COME!!!!!! because I am not privy to the big plan.....and someday when I get to that place I am requesting an open table discussion about a few things.

It does matter that he was 36 and anyone who says different isn't really telling the truth........one has lived a long and fruitful life and another is taken away too soon............so you count your blessings everyday,never go to bed angry, and hug your loved ones and tell them how much you love them for you don't know what tomorrow will bring.

There are 4 things in this world that are certain......**** flows down hill......you will be born....

you will die................and .....................you WILL pay taxes.......

[Esme12, ASN, BSN, RN]

oops :)

[royhanosn]

honey, you WILL devlope a thick skin to people dieing, or passing on, whatever the term. They are dead. You see a corpse laying on the bed, or see them take a last breathe and die.

Get used to it, part of life! you will develope a NURSE MODE! dont get too involved emotionally with your patients, they leave one way or another.

Nurse mode, keeps me emotionally intact to do my job, when everyone else is freaking out.

[sassy_squirrel]

This is sort of related. Sorry I'm just curious - do hospitals/LTC/Hospice have a debrief after these sort of events? Like in Police and Fire, if there is a fatality they have a debrief. There are also psychologists to talk to and also a Padre. Do your hospitals have this sort of support?

[tralalaRN]

I was a dialysis nurse for awhile, and we, of course, lost quite a few patients - some elderly, some not. We were never offered any kind of grief counseling or debriefing of any kind. I have friends who are RNs in hospitals and nursing homes, and I do not recall any of them going through any type of counseling following patient death either. Employers often offer some type of counseling though their health plans, etc. but other than that, I think for the most part, you need to seek this kind of thing out on your own, unfortunately.