Anybody have rituals they do when a patient passes?

Coffee Nurse, BSN, RN · Jan 7, 2018

Personally, I'd be pretty taken aback by getting this message out of the blue, and many people might find it depressing. I think the pay-it-forward act without the explicit message would be nice enough.

ETA: To answer the title question, no, I don't have any particular "rituals," except to provide the best care and comfort I can to both patient and loved ones, and then go home and hug my husband extra-hard.

CrunchRN, ADN, RN · Jan 7, 2018

I think that is kind of nice.

crnfaIwillbe · Jan 8, 2018

I just hate it when a patient dies because patients rarely die on my unit. And have thought of coping mechanisms for a long time. I thought about donating blood but I dont weigh enough. I weigh 96 pounds on a good day and after a large meal. I thought about having a drink in their honor but stopped myself because I know using alcohol to cope is heading down a dangerous road. I got this idea from facebook. A friend shared a facebook story of a woman who anonymously buys a cake on the day of what would have been her daughters birthday. Her daughter passed from I believe was SIDS, so she buys a cake because she cant get one for her daughter. I am really questioning leaving the note. I could say hug your loved ones extra tight tonight.

Munch · Jan 8, 2018

Yes actually we eat dunkin donuts! This started a few years back. Donuts are just so lacking nutrition so when someone dies someone goes to pick up a couple of boxes of donuts as a way to say life is short and to stop and smell the roses..indulge and eat a donut every now and again. With that said on my floor deaths are pretty uncommon so this doesnt happen often thankfully.

As for having one drink in their honor I don't think is going down a dangerous road. As long as you aren't getting drunk as a means of coping. Many people have a drink to celebrate a special occasion or something. You're celebrating this persons life. I agree the note sounds a little morbid and might make someone uncomfortable..some people are funny like that.

KelRN215, BSN, RN · Jan 8, 2018

I just hate it when a patient dies because patients rarely die on my unit. And have thought of coping mechanisms for a long time. I thought about donating blood but I dont weigh enough. I weigh 96 pounds on a good day and after a large meal. I thought about having a drink in their honor but stopped myself because I know using alcohol to cope is heading down a dangerous road. I got this idea from facebook. A friend shared a facebook story of a woman who anonymously buys a cake on the day of what would have been her daughters birthday. Her daughter passed from I believe was SIDS, so she buys a cake because she cant get one for her daughter. I am really questioning leaving the note. I could say hug your loved ones extra tight tonight.

I do think there's a difference between doing something for one's child and one's patient, though. It's natural to be bothered if it's something you have encountered rarely thus far in your career but I think it's important, for one's emotional well being, to be able to separate losses in your personal life from losses in your professional life. I know people who do acts of kindness similar to what you posted in your OP in honor of their children who have passed but these were their children and it's natural for them to continue grieving the loss years after they've passed. When you work in healthcare, patients will die over the course of your career.

I remember, towards the beginning of my career, two of our regular onc patients died within a week of each other. Both were toddlers with the same diagnosis who spent more time on our unit than they did at home. Some nurses who were particularly fond of these children suggested that the unit buy a star for them after they passed. Our manager stopped it because she said that it couldn't be done for these children if there weren't plans for it to be done any time a child died (and in pediatric neuro-oncology there are bound to be deaths, brain tumors are the leading cause of cancer-related deaths in children).

Does your employer have someone you could talk to through an employee assistance program?

crnfaIwillbe · Jan 8, 2018

Yeah I really think you are right about that. Just few days ago, a patient of mine gently tugged at his foley as he was trying to get comfy in bed and he thought he accidentally pulled it out. I told him that if he did pull it out, we would definitely know because pulling a foley out with the balloon still inflated, is a bloody mess. He got a weird look on his face and I apologized because I forgot that not everybody is numb to stuff like that.

crnfaIwillbe · Jan 8, 2018

I am bothered by it because on my floor, we dont really have deaths. We usually send dying patients away to hospice. This patient was the first to die on my shift, in my care. The beginning of shift, I took her vitals and I knew she was going to be passing very soon because her O2 sats were very low. I just offered her family some coffee and gave them some privacy. You're right. I need to separate my personal from professional life. Every once in a while, we have an employee stress seminar that all employees are invited to. Outside of work, nobody really understands this job. If I complain that I had a rough day, I just told "welcome to healthcare. You chose that field so stop complaining." Nobody except my coworkers understand why I still have keep doing this. So I decided to see a therapist. She taught me mindfulness techniques, my anxiety and stress has decreased quite dramatically.

cardiacfreak, ADN · Jan 8, 2018

When I worked LTC we always opened a window to "let the spirit out".

I work hospice now and once a month at our employee meeting we light a candle in remembrance of the patients that died .

JKL33 · Jan 8, 2018

I think the thought behind your idea is very nice. These are just our opinions, of course, but I kind of think that leaving the note is taking something away from the good that you wish to do and feel. After all, "please honor my patient..." is a directive that the person behind you might find touching, or might not give two hoots about. People are just like that; they haven't experienced what you have and thinking about this neutrally, they might not see a reason to honor your patient. I wouldn't like knowing that someone else's reaction could sort of sully my good intention.

Why not pay for the extra cup of coffee and keep the knowledge that you have honored someone for your own self - I think it would be special to someday look back on the number of cups of coffee you've given away as well as the number of people that you've privately honored. These feelings that you're having after having encountered death this way are natural and healthy and I hope you find a fulfilling way to process them - they will be incorporated into who you are as a person.

(hugs)

crnfaIwillbe · Jan 8, 2018

That is true. There's been a few times that I did something nice for a person, they couldnt care less, and it ruined it. I remember a teacher of mine saying telling a story similar to this. She found over $400 in cash, and returned it. The person she returned it to, didnt even say thank you. Like they literally just proved they were the rightful owner of the cash, grabbed the money, and walked away.

NightNerd, MSN, RN · Jan 8, 2018

This is a tough call. While many, if not most, of us choose this work because we want to serve others, we MUST develop a professional detachment. You will drown in your feelings if you don't. I think this is such a nice idea with good intentions, but it may have the effect of tethering you to the death instead of allowing you to move on. Paying for the person behind you may very well made you feel good, but it also may bring up a host of other emotions, or none at all. I just question how therapeutic this may be in actual practice, even though the spirit of it is lovely.

I feel like it is more beneficial to develop a self-care ritual, rather than a pay-it-forward ritual, to cope with death where we work. We work each and every day to be kind and compassionate at work, many of us volunteer and commit random acts of kindness, and we all have family and friends we look out for; but all too often we forget to extend that effort to ourselves. I love the ritual one poster mentioned, of eating donuts as a reminder to enjoy life. For me, while it's not a particular ritual, I always try to do something that nourishes my body and spirit when a patient's passing sticks with me - go for a run and be grateful for my body's strength and endurance. Walk outside and enjoy the feel of sunshine and wind or even rain. See my family or snuggle with my boyfriend. Listen to or make music. Whatever helps me to truly cherish my life in that moment.

My last thought is that, depending on the environment we work in, it's beneficial to develop a healthy relationship with death. It's a natural part of life, and while it is sad to lose a loved one, it is not always this horrible, awful fate. Obviously this is not something that, say, pediatric oncology nurses or nurses in the ER will be able to see as a positive thing, and that's today understandable; death can be very, very wrong. But in other scenarios, I think it's helpful to reach a sort of truce with the idea that life ends for all of us and it's okay. This understanding made my time working in hospice much easier; and now that I'm in med-surg, it is still a helpful outlook, even though I want to help all of my patients regain health and quality of life.