Awful night

[Kp168002]

So last night I experienced my first patient death and I can't help but feel guilty. Pt was admitted with UTI and confusion. Noted expiratory wheezing in lower left lobe upon admission. Pt was drinking bowel prep for a colonoscopy in the AM and unable to stand. Therefore I was in her room hourly checking her brief. I went in to check her brief and noticed she had developed crackles. Her fluids were running at 125ml/hr. I turned them down to 30ml/hour, pulled her up in bed, sat her high-Fowler's, assessed vitals and oxygen saturation. Aside from crackles the only thing not within normal limits was respiratory rate-22. Asked or if she was feeling short of breath- she denied. I immediately left the room and pages her DR anticipating an order for Lasix. Ten minutes went by, he never called. I went to reassess the pt- still alert and responsive, no changes. I paged the doctor a second time. When I went back in to check on the pt roughly 10 minutes later she was unresponsive. I did a sternal rub- no response. Pulse check- no pulse. Called code at that time. She did not make it and I can't help but feel guilty. Asking myself what I could have done differently...should I have ignored protocol and just called the Dr's cell. Did I let too much time pass between pages...just so many questions. How do I get over this feeling????

[happynurse49, BSN]

Hugs to you. I had a similar experience not that long ago. I debriefed with my manager and some very experienced nurses and they assured me there was nothing more I could have done. A respiratory rate of 22 is high but not so high as to call a rapid. You did everything you could and sometimes these things just happen. The body will compensate until it can't and then go quickly. I would suggest you debrief with your manager like I did. It really helped.

[icthusRN]

Hugs to you. Yes debriefing with another nurse really helps. Sometimes it is just their time to go and there is nothing we can do about it. You did what you could and really it doesn't sound like your patient showed much signs of decompensation. It was just their time and you happened to be their nurse.

[Snatchedwig, BSN, CNA, LPN, RN]

*e-hug* Do you have a good connection with anyone in a leadership role such as the charge nurse? Maybe you can vent to her.