Dealing with the death of a patient...for the first time

[NursingStudent!]

well obviously in this field every patient that walks through the door doesn't walk out. so how did you deal with loss of your first patient? how do you deal with it now? what is it like having to talk to that patience's loved ones? any advice for new nurses?

[Roy Fokker, BSN, RN]

and even though it is unprofessional to have "favorites" in our profession, she will definitely have a place in my heart.

I doubt you'll find many nurses who can say with absolute certainity that they have no 'favorites'.

We maybe professionals, but we are first and foremost humans.

I'll never forget about losing "M". I wasn't even in the same state (I was over a thousand miles away). I wasn't even working the same job. But I kept in touch with my old work mates and one of 'em sent me a link to the obituary.

And yes, I cried.

It was a foregone conclusion that "M" wouldn't live long... but it still hurt.

Dealing with the dieing patient is nothing... dealing with the grieving family is the hardest part.

I wouldn't say it's 'nothing' but I understand your sentiment.

And yes, the family is usually harder to deal with.

cheers,

[JosefVernon Hodgkins]

Cry alone and be strong amongst.

-Joe

[Silverdragon102, BSN]

Moved to the General Nursing Discussion forum

[xtxrn, ASN, RN]

From a nursing standpoint, dealing with the families is the hardest part for me. Even if it's anticipated (which does make it somewhat easier if they've been struggling and suffering), it's still a huge loss for them... if it's unexpected, it sucks.

Had a little lady who had stroked at the dining room table- coma ever since, and when I got her her breathing was "wet" (this was before scopolamine for palliative care- late 80s) and had that musty "death breath" smell...she was OLD. Her husband of probably 65+ years was also in the room- sweet little man. I got him tucked into a recliner, and got the Mrs. "flipped, flopped, folded , and fluffed" after my first assessment. I checked on them often= went to the cafeteria to get Mr. something to eat....I was in the hall when Mr. came out and said he thought she was gone. I checked, she was...So, I asked Mr. if there was someone I could call for him (this is an 80 something man who just lost his life partner and he was alone). He said, no- his kids wouldn't come. I asked if I could call pastoral care= no, he just wanted to get home. I will NEVER forget the image of that proud, broken, grieving man walking away down the hall with his cane. It was horrible. I wanted to DO something for him (and yes, I know that he was offered, and refused- but nobody should be alone because nobody will come- if they WANT to be alone- that's fine). I cried and I didn't care. I got it together before having to go into another room- but it really bit rocks.

When my mom died (long story), my dad didn't want to leave. I thought we'd been there long enough, and knew that post-mortem stuff needed to happen before she stiffened up (not cold about this- realistic :)). He didn't want to let go of the image of her in the bed. I wanted to run screaming from the room and inflict bodily injury on an ED MD 2500 miles away... I finally got him away from the room for the LAST time, and we went home. The nurses were great. I know they had stuff to do (and she died around 9pm so shift change was coming up....). But they never rushed us. That was really important to my dad. He had been through SO much with her. He hadn't really believed she was 'going'....I had walked him through the mottling, breathing, etc.... but she'd always bounced back from SO much.....not that time....

[leslie :-D]

it's really incredible what the surviving spouses see in the dying process.

my grandma had advanced colon cancer...

the hospital had transferred her to a hospice home in nyc.

grandma's pain was kept in excellent control, in spite of the fungating lesions (and they SMELLED) that attacked her entire abd region.

yet grandpa sat by her side 24/7.

i was the only grandchild that grandma wanted to see before she died.

when i got there, she looked like death....and even not being a nurse, i knew her time was here.

yet my grandpa said to me, "les, don't you think that grandma looks better today? see the pink in her cheeks?"

i meekly answered, "no grandpa, i don't".

i quiety woke grandma up to let her know i was here.

she recognized me, and requested 2 wishes from me...1) to get a haircut (i was 22 w/long hair hanging in her face as i bent over) and 2) learn to sew (she was a master craftswoman...her hands worked magic).

after i assured her of her 2 wishes, she turned to grandpa and said, "albert, i'll see you soon".

she lapsed into a deep unconsciousness and died that night.

still, grandpa was in shock.

he never, ever saw it coming.

i stayes with him for a month after grandma died...

and i'm telling you, he never saw it coming.

these type of dynamics will never change.

some people's coping mechanism are such, that they are completely removed from the current reality.

so yes, families can be incredibly difficult to deal with.

let them talk, cry, scream...but let them feel your sadness.

and be present w/their pain, for a bit, anyway.

it's difficult, but in hindsight, it's one of the most meaningful memories the family will have of their nurse who helped them through this.

(31 yrs later, i miss my grandpa as if it happened yesterday...can't wait to see you, grandpa.:redpinkhe:redpinkhe:redpinkhe)

leslie

[CecileSF]

The first time I've dealt with death was actually during volunteering right because I got into nursing school. I was a little shook up to realize that a person who was just breathing isnt there anymore. After several more incident like that, I became more better to handle myself.

There are also times when a patient is just told they have a terminal illness. I feel like those situations are worse. But all you can do is comfort the patient and it makes them feel them better sometimes.

[joanna73, BSN, RN]

I have had many patients die in my short career, and each death is different. Some I am not that affected by, others I am. Death in itself is inevitable, but we are all human, and we are all touched in some way by the people we care for.

Last week, one of my favourite residents died. Although I know she is at peace, and her decline was obvious, I really miss her. I've cried a few times. This woman required a lot of medical care and psychosocial support in the year that I knew her, so it was inevitable that a few of us would become close to her.

During the past 5 months, 9 of my residents have died, but this one affected me the most. I'm ok with death, but I think it's the finality and the unknown that can be hard to come to terms with. I also find that death affects me differently working LTC than it did working a floor, because you become closer to the residents. Nevertheless, I enjoy working with the elderly.

[LouisVRN, RN]

3 years working on a med/surg unit this month and I've yet to have a patient die (knock on wood). Having not experienced it and the more time that passes the more I wonder about how I'll react. I've had several people come very very close but have managed to have them transferred prior to them actually dying.

[chicookie, BSN, RN]

I am one of those that always takes something away from that type of situation. Sometimes I break down, sometimes I am glad they are at peace, sometimes I get mad because they put themselves in that situation. We are humans and we get emotional sometimes and that is ok. You deal with it one step at a time and don't be afraid to show it.

Death has always scared yet amazed me. Every time I have to deal with a patient dying, it really puts my own life in perspective. I think every death I've dealt with has helped me be not so self centered and a lot more laid back. Sometimes when I am at a loss of what to do next, I think to myself what would have this person done? If I die tomorrow will this really matter? I think dealing with death has made me come to grips with my own mortality and in turn it makes me a better person. *Shrugs* That would be my advice to you. Learn from each patient you come in contact with and don't be afraid to show how you feel.

[nola1202]

I don't know what setting u work in. I find LTC,SNF, Home Health can be the hardest because u come to know the pt, family and even the dog and grandkids, either through photos or visitis. I think it will become easier for you. If it doesn't, try to think about and journal about what has happened in your life that reminds you of this situation. Did the pt remind you of a friend or family member, or was just one of those people whom it didn;t seem fair that they would die when there are so many horrible people in the world. Grief is a complicated thing and even if it isn't your direct family, it is a loss. Make sure you aren't feeling guilty about what u should have done differently. There are always things we could have caught earlier 20/20 hindsight. I would also consider utilizing your EAP or a grief support group or short term grief counseling. I'm sorry don't mean to be giving advice, nursing is a career that involves quite an emotional journey, I'm glad you are still sensitive to your feelings and talking about this.