Published
How do you deal with it (cope)?
Seen Three now. What takes place for you during the first 24 hours afterwords?
Oh my gosh soo many deaths in the NICU. You have to get used to it and still be objective, that's why we nurses should be made of tough stuff. I have seen countless, and it really haunts you, especially when the baby's being resuscitated to no avail, you can almost feel the exhaustion of everyone- doctors, nurses, etc. The thing that makes it harder though is the sound of crying (or howling) of the parents as they are called in. You still have to do your duty, while keeping a straight face to them.
that right there is why I don't prefer to deal with Pediatrics. That right there. Parents, families... they have to live without that child... the baby/child had all that medicine could offer, but the family is left behind. That just kills me.
This hits close to the heart. I've been working in PICU for more than 12 years now and count myself lucky to have had very few patient deaths. The ones I have had had are all very vivid in my memory and will stay with me forever. Each one is different from the others and each one evokes different emotions; some of these babies were living on borrowed time and some were the victims of unfortunate events. I've taken something away from each of them.
My first was a 9 month old from an impoverished community who had fallen head first into a 5 gallon pail of human waste. The result was overwhelming sepsis and DIC. We knew by noon of my second day with him that he was not going to live, but the family were not informed of that information before he coded. My lesson from him was to hold the doctors' feet to the fire and not allow them to avoid the hard parts of their jobs - having the difficult conversations with families thus depriving them of the chance to prepare.
The second was a neonate with multiple congenital anomalies who struggled through a month of "treatment" that amounted more to torture before dying in my arms. Lesson learned - it's possible to feel joy when a baby dies peacefully in the arms of someone who cares.
My third was a 3 month old SIDS. The guilt that mother expressed still tears at me, but I really feel that I helped her see that there was no one to blame. I have always seen the important part that caring for the patient's parents represents, but this was truly the first time that it was my primary focus.
The fourth was 22 hours ago... a 3 month old with a very complex heart defect who arrested out of the blue on the peds floor, then despite the ready availability of ECPR at our hospital, died anyway. The nurse doing CPR was horrified when the healed sternotomy scar tore under her compressing thumbs. Baby's parents didn't arrive on the unit until after we had abandoned our efforts. Mom collapsed when she saw her baby for the first time and Dad tried valiantly not to reveal any emotion, but both of them amazed me. The image of this big, very masculine and tough Dad sobbing as he cradled his baby in his arms, the strength in this Mom's voice when she said, "I want her death to mean something, please find out why she died," and the steady hand she used to sign consent for autopsy tell me I can't predict how people will behave in the worst moments of their lives - they often surprise us.
tewdles and JoeDEDRN point out some flaws in how our profession has been altered for the worse. In the quest for budgetary balance, flexibility of scheduling and a shift in attitude, we've lost the team approach. 10 years ago when I experienced my first such death, I was supported 100% by the coworkers I saw every shift, people who knew me almost as well as my best friend does and who understood how I would feel and react. Looking at last night, I feel that the hodge-podge of my coworkers who were there and didn't even realize that I had been the nurse in the room AND whom I'm unlikely to work with again for weeks, cannot possibly provide me with any real support. To know that this situation is the norm now is very sobering.
LLLLiiiFFEsaveer, do you have someone who knows you well who also understands the world you live in at work? Please tell me that you do and that you'll call them now. We allnurses folk can only help so much because we don't have all the pieces of the picture that is you. If you can hold onto the notion that millions of babies live into old age and never really even have an awareness of the few that don't, it will help. Gentle hugs to you.
MassED, BSN, RN
2,636 Posts
that stinks. =( MadTV usually helps to distract... maybe you'll fall asleep while some comedy is on...