Published Jun 29, 2009
I guess I can post this in pediatrics, too, but it seems that this forum is a bit more active, and this may sound morbid, but you all do have probably more patients who pass away than we do in general pediatrics... I looked for a post like this and could have sworn I'd read one in the past, but now can't find it...
Just looking for... I don't know what's the word... resources or strategies doesn't sound right... but how you deal, get through, when seems like so many kids around you are dying in a short time, including one who has been in and out of your unit her whole life and you have cared for her pretty often, bonded with her family...
I have had patients die before, but it never seems to get easier and it always tears me up, especially when work or life is stressful anyway. I know that, this patient especially, is happier now. That does help some, actually. But what about the traumatic deaths... like drownings, car accidents...
I am kind of thinking out loud here, so pardon if this wanders. I have my own ways that I do try to get through, like writing things out, or talking them out with someone who also knew the patient, my faith. Just looking for what other peds nurses do and how they cope and just... venting a little I guess.
Thanks for listening.
Sounds like you are doing what we all do in my unit. We cry together, we talk about our patients. We also have great pastoral care support that's there when we need it. When we've had "bad runs", our NM makes sure we have pastoral care on the unit just for the staff.
It's tough to lose a chronic child that you've cared for over their lifespan. Just a few months ago, we had a precious little girl we'd cared for alot in the unit for her final time. Her mom knew that Precious wouldn't have a normal lifespan and her hospitalizations were becoming much more frequent with more and more time on the vent with painful interventions. She decided this time for comfort measures only and to let her die a natural death. We were all in and out of her room that day saying good-bye. We all cried with mom & dad and the rest of her marvelous family. She slipped away from this life in her mom's arms, peacefully.
The traumas are tough. The non-accidental traumas are always hideous. We have the most trouble with those. It really takes a lot to get over those.
I try to leave work at work. I have my hobbies. I have my faith. I have my family and friends here at allnurses to vent/cry on their shoulders.
Oh, and if loosing a patient ever gets easy, I'll quit. I will have lost a part of my soul.
ChristineN, BSN, RN
I am also a peds nurse who has also experienced the sorrow of having a child I've taken care of (some of them for months on end) pass on. While I work on the floor and have only lost two children so far, there are others that I take care of that aren't expected to make it through the year. Some of these patients are like family to me. When they receive bad news, I cry too. I always try to be strong and brave in front of families and patients, but I have been known to cry at home, or even at work on a co-workers shoulder. Probably the hardest thing is having a patient die half way through your shift, and have to keep acting like nothing happened since you have other patients that need taken care of.
This might be the thread you were looking for, perfectbluebulidings: https://allnurses.com/picu-nursing-pediatric/how-deal-death-174043.html
Our unit has had a run of deaths in the last few weeks; ten of our patients have died in the last month and that's really unusual for us. Our most recent was just yesterday, a beautiful little boy who was likely a SIDS baby. I admitted him and was with the family when we withdrew life-sustaining treatment. From admission to discharge he had only been on the unit 24 hours. It was a very emotional time for everyone, but what really got me through was that all of my coworkers came around very quietly to see if we needed anything, to see if we were still "okay" and to make sure that we weren't forgotten. I had been feeling burnt-out and in need of a change, but this weekend has made me see that I really am where I should be.
I've cared for many children over the years whose lives were all-too-brief. The ones who have congenital anomalies or disorders that are life-limiting and mean frequent admissions do crawl into your heart and take up residence there. You can't help it. And their deaths are always painful, but it's a bittersweet pain. Sometimes their last days or weeks have been so full of misery for everyone that the end comes as a blessing. Feeling that way isn't wrong. It's also not wrong to cry in front of the family, as long as you're not hysterically sobbing. It lets them know that you truly do care about your patients and that you're as human as the next person. On the other hand, if you're not a crier, there's nothing wrong with that either. There are so many ways to offer support and sympathy. The sudden senseless deaths are harder for some people and not for others. Yesterday I remember thinking that I never "knew" this little person when he was alive (he'd had >90 minutes of resuscitation before I got him) so I felt a little detached from it. The baby who died in my arms after being in my care for the entire month he was on earth still lives in my dreams. So as you can see, everyone will have different feelings at different times and in different situations. There are no rights and wrongs, we just do the best we can.
may god bless all of you for the hard work y'all do every single day, and for staying strong for the families.:redbeathe
perfectbluebuildings, BSN, RN
Thank you all for listening, and for your empathy and advice. I really appreciate it.
Does your hospital have an Employee Assistance Program? This is free, confidential counseling to help get through the really tough times. A few years ago we had a string of deaths that began with a co-worker's daughter dying on our unit. It was so horrible I still get tears to think about it. By the time the string of long, slow painful deaths was drawing to a close it was a beautiful, previously healthy, strapping teen who died exactly 6 weeks to the day from his diagnosis of leukemia. Those deaths about broke me so I finally called the EAP.
Hang in there. Grieving for these precious souls is normal and healthy, as long as it doesn't consume you to the point where you can't function and are starting to show signs of depression. Talking it out with anyone is helpful and we're always here.
What has helped me in the past seven years is my faith, the knowledge the patient is not suffering, and leaning on my co-workers. It's funny because Jim Carrey, of all people, said in an interview (and this is paraphrasing) those who shield themselves from bad feelings aren't strong; the strong ones let themselves feel every emotion, good or bad. You should let yourself feel it - because your patients need you to have compassion and without feeling, there can be no compassion.
It is hard. I am tearing up just thinking of all the patients I have seen pass and, mostly, the grief and sometimes dispair in the family afterwards. But, those patients and their families deserve these tears....they deserve our compassion.
You are blessed to be able to be a part of such an intimate time. I look at it as somewhat of a priviladge to be able to keep the patient comfortable and hopefully bring some peace to the family.
I am a travel nurse and just started a new assignment 3 weeks ago. I had a cardiac 3 month old patient with HLHS yesterday admitted for poor po intake and dehydration. The patient was stable all morning until he suddenly had a seizure and stopped breathing. Mom saw me in the hall and called me into the room. I grabbed another nurse and we called the code. The patient was intubated and I transferred him to the ICU only to find out that he coded again when the MD was attempting an arterial line placement. They could not get his heart rate back up, and he died. I have been crying and in bed all day because I'm so worried I missed something with my assessment and feel so guilty I wasn't in the room with mom when he seized. No one knows why this happened.I had given him his crushed aspirin and water about 30 mins before, and all I can think about is him aspirating on it and causing him to seize. He was alert though before I left the room and looking at his rattle I was holding in front of him. I feel so incredibly guilty and responsible since I was his nurse. The code was so awful because I am new and still don't know anyones names. I feel so alone and don't know how to cope with this. Please help.
Emily, please read my response on your other thread. When you feel like you're over this, PM me and I'll tell you a few things....
I think one of the hardest times I've had thus far as a PICU nurse is when we had a boy about 9 admitted for "the flu" as his parents thought. He was about my sons age and before that perfectly healthy. He was funny, witty, and sarcastic - as was his family (which made me think of my own). After an ECHO found that he had a 15% EF i think give or take. And soon after was diagnosed with cardiomyopathy, placed on a VAD and awaited a transplant. In the mere 4 months he had to wait he would cook for us and do magic in the hall. he became friends with a little girl who had ALL (i believe). She was in and out of our unit and they loved to play tricks on us. Shortly before he got his heart transplant, she entered the ER with a head bleed and hours later was fixed and dilated. We all cried the day he walked to her room to tell her goodbye. Like I said, he got his heart, was doing great and came back to visit many times to squirt us nurses with saline syringes :). No one knows why but 9 months after transplant, he went into full rejection. Parents took it in stride, always hoping for the best. He was placed back on the VAD and shortly after that stroked. I felt like he came in when I came to the PICU so I will always remember him. I still have his obituary on my fridge, as his 1 year passing was last month. These kids make me squeeze my own a little tighter each night, and take my baby out of his crib when I get home after a long day just to rock him and be thankful theyre healthy and safe. I love my job.
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