Both my patients died the other night...my first ones

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Specializes in ICU, psych, corrections.

I know that working where I do, I have to expect I will lose patients from time to time. Guess I didn't think it would be so soon in my career. The other night, I took care of 2 older ladies, one who had been an RN for 40 years (she also went to my church and was very active in my smaller community). Both of them did not make it and from 4am to 7am, I did my job with tears streaming down my face. At one point, the one lady's daughter called from Ohio and I put the phone to her dying mother's ear so she could say what she needed to say. I don't know if I'm cut out for the ICU, even though all the interaction with the family made me feel "needed". I am going to the RN's memorial service on Wednesday.

It was hard enough to deal with psychological and emotional impact of having to deal with ONE dying patient and their family, but then I had to do it with BOTH of my patient's that night. Besides caring for my dying grandmothers, it was the hardest thing I have ever had to do.

Since that morning, I have no energy, don't want to get out of bed, and am basically miserable. I've wondered if maybe I should see if my hospital offers some sort of grief counseling or at least go in and talk to the ICU supervisor, who's always got her door open. The family said they really appreciated having their mother cared for by a nurse who showed emotion, which reassured me somewhat. I was able to still do my job, which included titrating up to about 700mcgs of Neo, 30 of Levophed, and max her out on Vasopressin, giving liter after liter fluid bolus and only getting a pressure of about 50/32. Yes, I was tearing up while doing all of it, but I still did what was expected of me. I also managed to put on a brave face, pull the family out of the room, and explain the situation to them. At the time, the patient was a full code and I wanted to the family to understand that CPR wasn't really going to benefit their loved one. They listened to me and then quietly said, "let her go". I was able to get through that part of it without any tears and look somewhat professional. But I can't stop thinking that I didn't handle things well and I'm doubting myself.

I don't even know what I expect to gain by writing all of this here.....it's just been a hard week at work.

Thanks for letting me vent.

Melanie:crying2:

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Most of us chose nursing because we care and want to help people. However, we must learn to distance ourselves emotionally from those we care for. If we cannot do that we won't survive the profession.

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Sorry to hear what happened to you,:o but find comfort in the fact you were there for both of them. Working as we do with the sick etc this situation will come up time and time again but you have to look for the positive and push down the negative. Go and see your supervisor and chat with her sometimes we just need another to listen to us. you will get over this but you will never forget but like I said look at the positive.:)

Gale

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Specializes in pedi, pedi psych,dd, school ,home health.

(((((RN in training))))))

what a hard nite!!! I am soo sorry you had such an experience!:o Yes, I understand what JThorpe said about distancing yourself, but you need to still be able to feel that emotion. I dont doubt for a minute that you are feeling depressed about the two deaths... that is normal! will your hospital allow you to take a day off ? maybe pamper yourself and allow yourself to feel those emotions! the idea of speaking with your nm is also a good idea!!! I have been a nurse for 25 years and still allow myself to cry when a favorite patient dies.... does not make me less of a nurse, as a matter of fact i think it makes me a better one! peace, my friend...your patients and their families were lucky to have someone who cared so much . Mary

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Death is hard to deal with for the living. I once told a dying patient that her family was on the road and would be there within the hour. She died before they got there. I was crying as I told the family. They were pleased that someone who cared was with her at the end. Sometimes the family needs the tears and hugs. You will learn over time which family needs what to help them start the grieving process.

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Specializes in Hospice, Med/Surg, ICU, ER.

Remember your Death and Dying studies in school.

You are experiencing loss; just like any other caregiver would.

Give yourself some time to learn how to deal with these feelings.

May God bless and keep you.

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Melanie,

I lost my first patient as a student in march 2004. The first one(s) will always haunt you. That one I did not take when when she died on me. I went home upset and depressed. (At the time, I was mired in the worst depression of my life due to the fact my anti-d stopped working)

I learned after that to leave my patients at the door. As well as my emotions. I have since then lost several as a tech, and one as an RN.

The one that I loast as an RN was a slow code on a 98 yo that had been on our unit for atleast 6 months.

There will be times as an RN you will deal with death, and some patients you will be closer to than others. And the ones that you are close to will be the ones that when they do go, they will hurt.

Every RN deals with this, and it comes with the territory. But it also shows something else, you're human.

Adam, RN

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Specializes in Emergency.

I am with you. I am a fairly new nurse--I have witnessed a few codes but no pts I really knew. This week 2 of my patients died, one of whom I had spent 3 hours with while he was alive and well (I know to you ICU nurses this doesn't seem like a close relationship, but 3 hours is a long time in the ED:) . Anyway, I too have been struggling with it. I notice I try to avoid the family at all costs and tend to let others deal with them--it is SO much easier to detach from the situation when you don't have to talk to the family. Only problem is, now I am feeling guilty for not going to talk with and sympathize with them. When I get home I just keep going over everything in my mind over and over again and thinking of what I could have done better. I love my job but at the same time I feel like it is draining me. I wonder if I really want to be desensitized to all of this. I am usually a big cry baby but I have never cried over my pts--I am afraid it is because I won't let myself experience what I am really feeling about all of it. I think it is all just too big to comprehend.

Maybe it will get easier with time.

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Specializes in ICU, psych, corrections.

I went to the memorial service, A Celebration of Life, they called it. I was able to meet the daughter who I spoke with over the phone and saw the rest of the family. I met the granddaughters, whose pictures were all over my patient's room. I also learned what an incredible lady my patient was and it was a catharsis to hear all of it. I know she led a very full and wonderful live so it's much easier to let her go.

My nursing instructors were there as well (my patient had been an instructor up until a few years before I got to that school) and my son's school nurse (my patient had trained her and had worked at my son's school until she fell ill). I sat with my nursing instructors and listened to all the great stories that the friends and family told. I also stood up and spoke a few words about how I was honored to have cared for her and that she was well liked and respected by all the RN's in our unit. The family came over and gave me lots of hugs and tears. It was a good thing I went and I'm glad I didn't listen to my fellow nurses who told me that going was a mistake and I needed to "distance" myself from it. I don't have that kind of personality and it would have made things worse.

After speaking to my supervisor, I feel even better. She says she still goes to the occasional service when a patient passes on and understands how it made me feel better about the situation. She said not to let anyone disuade me from doing what I feel is best and that everyone handles death in their own way. The most important thing is that I was able to do my job proficiently no matter what my emotions were at the time.

I'm so glad I went to her service...I feel as though her death wasn't in vain and it also reminded me that I need to make the most of everyday I'm alive...she certainly did!

Melanie = )

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Specializes in PeriOp, ICU, PICU, NICU.

I am so sorry!

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Yes, talk to your superviser and the facility you work in should surely have some form of counseling service for staff. Do something about how you feel or the job will become harder and we need all the good nurses we can get.

Good luck.

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Specializes in Critical Care.

I'm not knocking it, but I have never, in 13 yrs, been to a memorial service for someone I took care of.

And there have been a few I strongly considered.

But I figure, if I go down that road, it'd be very difficult to keep a proper perspective.

Everybody copes differently and I'm not - by any stretch - saying you shouldn't.

But the service you described, and the role you played in it. Man, that would burn me out, and fast.

~faith,

Timothy.

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