Com'on, you got one...What is your heart wrenching moment?

[CrunchBerries]

Mine was....

I was a very young, too young DON at a care home. I was working late one night doing paperwork. I heard odd noises coming from outside my office. I went out to investigate and I saw Marjean, one of my fav's sitting under a tree rocking back and forth.

I asked what was wrong, she kept rocking telling me she was just gang raped on the pool table of the game room.

Marjean was a hard core, paranoid schizophrenic. It never happened, while we had a game room we had no pool table and, we had cameras in that room. Naw, it didn't happen but SHE totally believed it did, it was one of her hallucinations.

While it did not *really* happen, it did happen in her reality and she was going through the same emotions as a true rape victim would experience.

I finally got it, I finally understood. Hallucination or not, it was still real for her. I just sat with her under the tree rocking back and forth.

We ALL have one or more of those moments, what is yours?

[NursesRmofun, ASN, RN]

All these stories are very heart wrenching...and I have shed tears.

I have had a few heartbreaking moments. Some for other reasons that the actual death. Once, we admitted a 30-something year old woman who was near the end of her life. She arrived, and a few minutes later, a "couple" arrived into her room as I was doing the admission. But I soon found out that this was the patient's husband and her best friend. You could immediately feel the tension...though it was sort of subtle. Later, I found out that the husband was having a romantic relationship with the best friend. I guess they must have bonded over the patient's illness. However, the wife/patient did not seem at all happy about it. That broke my heart because I sensed it right away. The patient died a couple of admissions later...maybe a few months later.

[Awesomocity0]

All these stories are very heart wrenching...and I have shed tears.

I have had a few heartbreaking moments. Some for other reasons that the actual death. Once, we admitted a 30-something year old woman who was near the end of her life. She arrived, and a few minutes later, a "couple" arrived into her room as I was doing the admission. But I soon found out that this was the patient's husband and her best friend. You could immediately feel the tension...though it was sort of subtle. Later, I found out that the husband was having a romantic relationship with the best friend. I guess they must have bonded over the patient's illness. However, the wife/patient did not seem at all happy about it. That broke my heart because I sensed it right away. The patient died a couple of admissions later...maybe a few months later.

That's awful. I try not to judge patients, but it would have been very hard for me at that moment to not ask what the heck was wrong with them, for flaunting an affair while they should have been supportive of her. :/ Selfish, awful people.

[OCNRN63, RN]

All these stories are very heart wrenching...and I have shed tears.

I have had a few heartbreaking moments. Some for other reasons that the actual death. Once, we admitted a 30-something year old woman who was near the end of her life. She arrived, and a few minutes later, a "couple" arrived into her room as I was doing the admission. But I soon found out that this was the patient's husband and her best friend. You could immediately feel the tension...though it was sort of subtle. Later, I found out that the husband was having a romantic relationship with the best friend. I guess they must have bonded over the patient's illness. However, the wife/patient did not seem at all happy about it. That broke my heart because I sensed it right away. The patient died a couple of admissions later...maybe a few months later.

I had a nearly identical experience with a hospice patient. Young woman, early 40s with a very bad disease...ovarian cancer. I'm not sure at what point her good-for-nothing husband started cheating on her, but he definitely was cheating by the time she was on hospice. In fact, he couldn't be bothered to help his dying wife...he had places to go and things to do with his new girlfriend, who was a friend of the couple.

When she died, he brought his girlfriend to the funeral, and a month later they married.

Sometimes I just don't get people.

[NursesRmofun, ASN, RN]

Exactly, OCNRN63...she was an Oncology pt....and also Ovarian Cancer dx, as I recall.

Adding-- I do actually remember being taught there is a dynamic where a terminally ill patient and their spouse sometimes start to separate a long time before death. It's very sad. I was happy that not all were like that.

[OCNRN63, RN]

Exactly, OCNRN63...she was an Oncology pt....and also Ovarian Cancer dx, as I recall.

Adding-- I do actually remember being taught there is a dynamic where a terminally ill patient and their spouse sometimes start to separate a long time before death. It's very sad. I was happy that not all were like that.

Whoah...(wondering if you and I were co-workers)

[Purple_roses]

I can tell how meaningful these stories are to all of you just by the care you've all taken in writing these so beautifully.

[Farawyn]

It took a lot to come back to this thread today. I can't stop crying.

We have so much experience with this, and I wouldn't trade it, but I sometimes don't know how we do it. I know that for each story told there are many, many more on the same level.

I've told mine here before. Woman with breast ca/mets all over. Her husband left her when she had her double mastectomy and lost her hair because he wasn't attracted to her anymore. She was in and out of our unit, and seemed to be getting better and then took a turn for the worse. Her daughter was getting married, and the mom begged her not to put it off. The whole wedding party came to the hospital to say goodbye the day of the wedding, and the mother (my patient) looking in to her daughter's face was the most beautiful and tragic thing I've ever seen as a nurse.

We all lost it, the wedding party lost it, and the daughter and mom were stunning and composed, just staring at each other with all the love in the world.

My patient died shortly after.

[FurBabyMom, MSN, RN]

I didn't think I had any, but as it turns out, I do.

The day, as an assistant where I was sent to CTICU (I was in the float pool and loved it). We had a patient, male in their mid 30s, on an LVAD. Intubated, sedated, coded three times that day. One of the senior residents for CT surgery was talking to the patient's wife and giving her a hard time for not withdrawing care. I overheard the conversation, I'd been waiting to go in to empty the foley and drains for I&O documentation. The nurse joined me so we could re-position. The wife, in tears, says to us "I am not really a monster. I don't like this either. I don't want him to suffer, but I respect his one final wish." The nurse says "What was that wish?" The wife says "Our daughter turns 8 today. His final wish? He asked if he was dying and didn't get a transplant - that I spare our daughter from his death falling on her upcoming birthday. I'll sign the papers. With one condition. That we wait until midnight to stop everything. To give our daughter what he wanted." I left the room a few minutes later fighting tears back the entire time, and the CT surgery attending was outside the room, had heard what the wife was saying, and was reduced to tears himself.

My first code as a nurse. My patient's spouse. He died twice on our unit. We coded him as a visitor, in the hallway (we had no empty rooms to move him into to work) sent him to the cath lab and to ICU. He was stabilized and extubated but not exactly conscious or oriented. Worked up to figure out what exactly happened (cath was fine) and it turned out he had metastatic cancer literally everywhere including mets to the brain. The children decided on comfort measures only and the house sup placed the patient on our unit on hospice so the family only had to visit one unit. I wasn't the primary for either patient when he died the second time.

I remember, one of my favorite patients and families from when I worked neuro stepdown. I had this spunky feisty 60-something year old female patient who was being worked up to rule out whether or not her breast CA had spread to her CSF. Turns out it had. She was so determined to beat it and would not allow her daughter to consider moving her wedding up. She had an ommaya placed for chemo administration, was by far my easiest patient - she did not complain about anything, insisted on walking and doing everything she could, refused anything other than Tylenol for her pain. She had an incredible family and her husband was incredible to her, we wanted so badly for the chemo to work, so she could make it 6 months to her daughter's scheduled wedding. We got a card about 12 weeks later, from the daughter. It turns out her mother had passed away - from the cancer, in her sleep, at home, medicated but peaceful. She was writing to thank those of us who helped her mother fight and helped the family to remain positive despite such staggering odds. She must have called our manager for names (or took really great notes) - the family had something specific to say about how all of us who were involved in her care had touched them during their time on our unit, and she called us out by name in the card. I can't imagine, despite what must have been immeasurable grief, they were kind enough to take time to thank people for just doing their jobs (admittedly doing our jobs in healthcare can mean we touch others in ways we don't imagine).

My first OR death. It's an incredibly tragic story that was all over local news. The patient I took care of and their husband were in a horrific accident. They were both airlifted to us, and were both in the OR at roughly the same time. We did literally everything possible for the patient I took care of, and were attempting to try to go on bypass but there was not going to be anything that would save the patient. The report from the medical examiner would confirm that (in our facility, all OR deaths go to the ME). I remember the exact time time of death was called and the instruments I was holding at the time (and what was being asked for and what was where, who was where in the room). There were no other "Hail Mary" plays left to be had. Then there was the realization that this patient died a barbaric death with nobody they knew around them (admittedly we tried EVERYTHING to save them so there is that to take some comfort in). But that ALSO their only family was under general anesthesia in another of our ORs. We couldn't even tell their family.

My second OR death was shortly after my first. It was a patient who was an MVC and in really bad shape but we brought him to the OR anyways. I was a runner and then checking blood with a coworker for the massive transfusion protocol. We weren't even in the room (in the OR) 10 minutes and we were coding them again (they'd been coded in the air on transport, and twice in the trauma bay - this was their 4th arrest). We were MAYBE in the room 15 minutes after arrival in the OR when time of death was called. In addition to post-mortem care, I was the one to call the blood bank to stop the massive transfusion protocol. It's strange to call another department and inform them to cease their efforts to support yours (and really makes it hit you more clearly).

[Ruby Vee, BSN]

When I worked oncology, I had this really sweet patient with ovarian cancer. On her first admission, her husband was by her side constantly, involved in her care. On her second, he was on the unit constantly but not so involved in her care. On her third admission, it was pretty obvious that he was involved with one of my colleagues -- and that the patient knew it. We were able to get that patient to home care, but the husband hired a home health nurse to take care of her . . . my colleague. The one he was involved with. I cannot even imagine the pain that poor woman knew, her husband and her nurse cheating on her in her own home.

After the death, my colleague came back to work with us as agency. She was quite open about her boyfriend, the widower of our former patient. She displayed the gifts he had given her -- some while our patient was still alive -- and expected us to rejoice with her when they got engaged. It's the ONLY time in my life I've ever told anyone I hoped she burned in hell. And that if he'll cheat WITH you, he'll cheat ON you.

And he did.

[rowrowyourboat]

When I worked oncology, I had this really sweet patient with ovarian cancer. On her first admission, her husband was by her side constantly, involved in her care. On her second, he was on the unit constantly but not so involved in her care. On her third admission, it was pretty obvious that he was involved with one of my colleagues -- and that the patient knew it. We were able to get that patient to home care, but the husband hired a home health nurse to take care of her . . . my colleague. The one he was involved with. I cannot even imagine the pain that poor woman knew, her husband and her nurse cheating on her in her own home.

After the death, my colleague came back to work with us as agency. She was quite open about her boyfriend, the widower of our former patient. She displayed the gifts he had given her -- some while our patient was still alive -- and expected us to rejoice with her when they got engaged. It's the ONLY time in my life I've ever told anyone I hoped she burned in hell. And that if he'll cheat WITH you, he'll cheat ON you.

And he did.

WOW. I have no words. How can people be so cruel.

[CountryMomma, ASN, RN]

I have two.

My first is short. My first death. LOL admitted through the ER for COPD exacerbation, obviously hypercapnic. DNR. Admitted at 2100, family lived in town but didn't come at all NOC even though her ABGs were bordering on incompatible w life.

I got her the next AM. I asked the aides to do 15 min checks on her. Called family and asked if they were coming. Oh, they said, we're finishing up breakfast, well be there in a few hours. I say I'm not sure we have that. They say they'll *try* to hurry.

I never got to activate our no one dies alone protocol. She died 15 mins after I hung up with the family. I'm still angry with myself that she died alone. So angry.

Second was not my patient but someone I was frequently in helping a friend with. He'd come in with fairly straightforward cellulitis. Developed osteomyelitis. Seemed to be responding well to the IV abx. Suddenly developed a pleural effusion. Went down for a thoracentesis, had 500mL removed. Did well.

Then suddenly did NOT do well.

I tried so hard with my friend to stabilize him. BiPap, drugs, sedation...and when he regained a little bit of mental clarity, hr begged his wife to stop. To let him be.

They made him a DNR, and he died 30 mins off BiPap. His family sang to him, wrapped him in his favorite wolf blanket, and took pictures of their hands together.

Having those two days back to back killed me.

[Awesomocity0]

When I worked oncology, I had this really sweet patient with ovarian cancer. On her first admission, her husband was by her side constantly, involved in her care. On her second, he was on the unit constantly but not so involved in her care. On her third admission, it was pretty obvious that he was involved with one of my colleagues -- and that the patient knew it. We were able to get that patient to home care, but the husband hired a home health nurse to take care of her . . . my colleague. The one he was involved with. I cannot even imagine the pain that poor woman knew, her husband and her nurse cheating on her in her own home.

After the death, my colleague came back to work with us as agency. She was quite open about her boyfriend, the widower of our former patient. She displayed the gifts he had given her -- some while our patient was still alive -- and expected us to rejoice with her when they got engaged. It's the ONLY time in my life I've ever told anyone I hoped she burned in hell. And that if he'll cheat WITH you, he'll cheat ON you.

And he did.

That seems especially bad. We're supposed to be the voice of ethics and compassion? We're supposed to advocate for our patients, biopsychosocially. Ugh. It kind of reminds me how I had this patient once, who had STD-related discharge, who asked me NOT to tell his girlfriend, who was sitting by his bedside the entire time, about it. He made her leave the room during assessments and treatment. AND THEN at discharge, he asked me for my number.

My laughter? Uncontrolled. I laughed him all the way through the signatures on discharge forms and all the way down the hall he rolled down in his wheelchair. I have to admit that I did take some satisfaction from how red he turned.