Brain Death/Support

[critcarequeen93, MSN]

I've been in the ICU for a year, started as a new grad when I was 22 and I absolutely love it. I recently had my first patient who was in their 20s, overdosed, cardiac arrest, was resuscitated and ultimately ended up brain dead a few days later. I developed a close rapport with the family the week this patient was with us. I admitted the patient, worked with our donor network all week, and even attended the organ harvest. It was an experience I'll never forget and I'm grateful to have been able to be a support to that family. But I am so emotionally drained. How do you sort through those emotions?

[LongislandRN23]

Giving the gift of life through organ donation is really powerful, although emotionally taxing I try to leave my emotions and the job at the time clock when I punch out, doesn't always work but the emotional draining can be exhausting.

[coffeetalker]

Gotta make sure that you are doing your own self care- and making sure that you are keeping your boundaries; also the fact that you were able to help with organ donation is an amazingly positive outcome to a sad situation. Keep in mind the good things that came out of this, then do as much as you can to let it go.

[Sydryth, ASN, RN]

Pray for the family and yourself, and be thankful that you received that calling. I have done more than one organ procurement case. The work along is very taxing; especially, at the begging phase. One case was a fellow nurse that I used to work with own son, that was probably the most emotionally straining case I've done. I just pray for peace and comfort every night after I go home for the family and friends and through that I find comfort for myself.

[Rose_Queen, BSN, MSN, RN]

Does your facility offer any type of debriefing services? My facility had a rash where we did organ procurements on about 10 overdose patients in a span of about 6 weeks. They set up rooms with people to talk about it at various times if they needed to. If no such service is available, you can always contact a chaplain to speak to or utilize your EAP.

[madricka, BSN, RN]

Our donor network contact at the hospital would email the stats on the organs after they were transplanted -- eg. Mr X's organs helped 3 people (lady got his lungs, a teen got his liver and someone got his corneas). This helped me feel a LOT better knowing who was helped (no names, of course) -- especially after multiple brain death patients. Maybe you could request this information?

Take some time for you when you feel the weight of the work. Sometimes it's hard to leave work at work, it can be hard to shake. I usually need quiet time afterwards with little stimulus. Get a massage or take a short weekend trip. Think about how great it is that you have the power to help people every time you walk into the hospital -- even the brain dead/donors. You care for them as much as you would any other patient and when it's time, you help them move on while offering hope to others. It's really a beautiful and amazing thing, even if it is tinged with a bit of sadness.

[LadysSolo]

Be grateful for the people helped by the donation (so many are waiting for organs) and be thankful the family agreed rather than keeping the patient on long-term "life support."

[Axgrinder]

I never did figure that one out. I routinely "brought" pt's and/or their family home with me (in my heart), even worrying about them on off days sometimes.

One thing that did seem to help was talking on the phone to other nurses I had become close to. Obviously they had needed to decompress too, so it's not quite as isolated as you would think.

If you have a couple - or even one - fellow nurse who is a close friend to talk to that may help. You may find they need it as much as you do - especially if they are a coworker, and know the pt/family personally that is weighing on your mind.

Spending some quality time with a family - especially the really nice, thoughtful ones (you know - the one's who buy lunch for the unit, send thoughtful gifts, or who are just really kind people … they do exist!) can touch your heart in unexpected ways no matter how well you try to shield yourself. They get in - boy howdy do they get in, and some of them burrow in deep down to take up residency there permenently, to be remembered years later. After all, we're only human.

[greatpineimage]

I think that we all go through emotions like you describe, when we get involved. You need to sort out (I think) what touched you so much. The age of your patient (similar to your age, I assume). Getting close to the grieving family and feeling their grief. The organ donation. Not being able to save a young person and watching him or her die. What was difficult for you? Talk to a another nurse about it, maybe you can find someone who tried the same thing. Sharing is a way of getting through it. If you feel that you did well throughout and those people were glad that you were there - tell yourself that you made a difference for somebody. If something went wrong along the way, reflect on how it could be done in a different way. Ask other nurses how they go about it.

I work as a palliative nurse and sometimes I know my patients for a very long time and get close to the families and friends. I do allow myself to get involved sometimes deeply, and when it is over I am emotinally drained. When my patient die I find a quiet time and place in nature for myself, and I think about the time I have spent with this family and my patient. I quietly say goodbye and mentally store everything in a box that I put on my shelf along with other boxes that I can pull out later on if I am in a similar situation.

I am in Denmark, so unfortunately I cannot refer you to a book written Danish, but it is a book that helped me a lot. It basically talks about being touched, hit or all shook up. If you are touched by a situation, you can get by talking to other nurses or other professionals. If you feel hit, you may need some councelling, because you may have been too involved and cannot let go. If you are all shook up, you definitely need professional help to get through. I hope that this makes some sense to you, and good luck in your nursing career. You are a caring person and you also have to learn how to take care of yourself, which is necessary to survive in this world.

[hotwaterbottle]

I think the fact that this was due to an overdose is pertinent. I know when my junior high health class had a "junkie" (that's the word that was used back then) come in and talk to us about the dangers of drug abuse and I guess heroin in particular, it made me vow to never get anywhere near heroin. If you've seen the dangerous and even lethal effects of drugs on patients, you can share that info (without giving any patient details, of course) with siblings, cousins, your own children, etc., to impress upon them that drugs really can kill them. It does make it more real to people, I believe, than something just out of a textbook. And it's not guaranteed to work, but at least maybe you can feel you did something positive after the experience. Also, if you are allowed to contact the family at some point so they realize you really did care about them and their loved one, that would be a nice thing to do for them. I was a little hurt when there were a few people that did not return my calls when after my mother died, I'd wanted to give them each something small that had been my mother's--something for them to remember her by, and for me to thank them for their care (one was a hospital nurse who'd even visited my mother when I'd called her as my mother got closer to death, and the other was a hospice volunteer). I still appreciated all their caring work, of course.

[OnceMorewithFeeling]

I don't know if this will offer you any comfort, but I work in a Cardiovascular ICU. We do heart transplants, and I have worked with many patients whose lives were saved by the selfless gift that your patient and his family gave.

Just last week, a patient very well known to us, a lovely man in his late 40s, received a heart. He did amazingly well, and left the ICU post-op day three.

He will be able to dance with his daughter at her wedding thanks to the generosity of a patient and family similar to the one you write about.

[sarlou]

I did the same thing when I was new out of school. I agree that you learn to set boundaries for your emotions and involvement. I realized quickly that being emotionally exhausted doesn't work when you have years of nursing to do. My patients get the best I can offer and their families are included with my caring....but I realized with time and experience (for me, 31+ yrs) that patients and families move on and you are no longer a part of their lives...so don't send your heart out the door with them.