Dealing with death

Nurses General Nursing

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I am looking for advice on dealing with death.

I graduated in May and began working in June on a tele unit. Aside from feeling quite similar to many new grads in the sense of feeling really stupid at times, I find my hardest dealing at this time to be with the death of a patient.

Since I started, I have had two Code Blues. Although I knew it would come sooner or later, I was hoping for later.

1st, for both codes, I feel I was ill prepared in the actual code process, again feeling stupid, not knowing how to document the situation as it proceeded. As the nurse, I understand my role is to report to the MD and be prepared as to the patient history etc. This part of the process I can improve over time and I am not concerned with.

However, my bigger problem is this, I made it through the codes as all the action was taking place, stumbling a little of course, but made it through. But, when the end came and the patients did not make it, I lost control of my emotions and cried. I questioned my abilities, my assessments, and my view of myself as being a weak individual for my expression of emotion. I also feel my peers see me as weak as well, although they state they don't. Both times I have taken this home with me and brewed for days over it.

I have had a very supportive team of nurses to help me, but some, with their explanation of "death is part of life" and "you'll get used to it as time goes on" just doesn't cut it for me and almost feels cold to me.

I was not naive to the fact that death would be a part of my career. I guess I feel some how I have not prepared myself well enough for it mentally.

I would like words of advice from others in how you have dealt with this throughout your careers.

Thank you in advance.

One thing that helps me when a patient dies is remembering what one on my nursing teachers told me once; that nurses do much more than helping people live, they also help people die and that is just as important.

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Specializes in Nephrology, Cardiology, ER, ICU.

Death is part of the nursing process for many of us. Just yesterday, I placed two patients into hospice. I agree that you have to develop your own coping mechanisms that suits you. For some, its religious, for some spiritual, some take a fatalistic attitude.

I worked in a busy ER for 10 years and saw lots and lots of deaths...some pretty gross ones. I also do pre-hospital EMS work and we've had two suicides recently. The crews are still dealing with the aftermath of those.

For your own sanity and ability to care for the patient, you have to have a separateness from the patient.

Critical Incident Stress Debriefing is usually available too at hospitals and ambulance services.

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Specializes in RN, BSN, CHDN.

I think it is always harder to come to terms with the death of a patient whom is not expected to die, In my career I have nursed many pts who have died but I bet I can remember every single pt who died unexpectedly more vividly than thoses who were not 'supposed' to die. I feel is it normal as a nurse to feel a sense of loss, we wouldnt be human if we looked at the dead person and 'OH well, another one bites the dust' I would want somebody who was looking after me to feel a sense of loss.

Have you ever watched City of Angels I felt when Meg Ryan's character sits on the stairwell and sheds a tear and tries to understand why she lost a patient is so how I feel at times. I have survived 17 years of nursing and I still feel a tear and sad, and I have been very sucessful. I would also worry about a junior nurse who didnt show emotion after what you had experienced:wink2:

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Specializes in med/surg.

All the above is good, sound advice! You don't have to be one of those who deals with death by being hard but you do have to find a way for you to cope with it when it does happen. From the sounds of it the place you're working seems to be somewhere it might happen more often than most.

I think you're doing really well dealing with all this so soon after graduating. Take these experiences & use them to help you to become an even better nurse than you are already. I'm sure you can do it!

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Specializes in Telemetry, OR, ICU.

Some hospitals have support/discussion groups for all staff members involved in a code. This discussion allows everyone to voice how they are dealing with the entire process, rather than what went wrong, or right. Does your hospital have such a group?

I was involved in a code right out of nursing school. I did find it a little upsetting while I was talking to the wife of the deceased. However, I thought I handled it well. I was somewhat conditioned at a early age to the loss of a loved one. My father passed away when I was 10 years old.

IMHO, you are not a weak person. These are traumatic events you have been through and you need time to deal with such. Find someone [another nurse where you work] to talk to about your feelings and try not to be so hard on yourself.

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For your own sanity and ability to care for the patient, you have to have a separateness from the patient.

quote]

I agree with Trauma. It's not a matter of getting used to it as much as it is finding a way to separate yourself from it. We all do the best we can to heal and fix people, but sometimes, it's just a person's time to go, and no matter what we do we can't change that...It's not that one stops caring or just "forgets about it"..but I think for the sake of self preservation, in time we all learn to sort of detach our feelings, because we still have to do this job for the rest of the day and still have to come back tomorrow. And it's sad and nobody likes it, but people die, it's a part of life, and one we deal with more often than most in our line of work. So I guess when people say "you'll get used to it", maybe that's what they're trying to get across-that with time you'll find your way of coping. It just takes some time and experience, just like knowing what to do in a code.

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Dealing with death came as part of my experience as a Squad Leader in the Infantry in Vietnam. The "defense mechanisms" and counseling methods that I learned in Vietnam helped me a great deal as a hospice nurse.

Nurses take on the role of spiritual guide and counselor when dealing with death.In my opinion, the highest art of nursing has to do with counseling,caring for and supporting dying patients and their families.

I served with the U.S. Army;4th Inf. Div.;2/8th Inf.;Republic of Vietnam 1969-1970

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My biggest concern so far is dealing wth death too well. From the first time I saw someone dead I was fine with it. Kinda interested. Not scared but numb to it. Of course they were strangers to me, but being numb and ok with people dying is what concerns me the most. I guess I'm on the opposite side of the spectrum as far as this topic is concerned eh?

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Specializes in Peds, Med-Surg, Disaster Nsg, Parish Nsg.
I am looking for advice on dealing with death.

I graduated in May and began working in June on a tele unit. Aside from feeling quite similar to many new grads in the sense of feeling really stupid at times, I find my hardest dealing at this time to be with the death of a patient.

Since I started, I have had two Code Blues. Although I knew it would come sooner or later, I was hoping for later.

1st, for both codes, I feel I was ill prepared in the actual code process, again feeling stupid, not knowing how to document the situation as it proceeded. As the nurse, I understand my role is to report to the MD and be prepared as to the patient history etc. This part of the process I can improve over time and I am not concerned with.

However, my bigger problem is this, I made it through the codes as all the action was taking place, stumbling a little of course, but made it through. But, when the end came and the patients did not make it, I lost control of my emotions and cried. I questioned my abilities, my assessments, and my view of myself as being a weak individual for my expression of emotion. I also feel my peers see me as weak as well, although they state they don't. Both times I have taken this home with me and brewed for days over it.

I have had a very supportive team of nurses to help me, but some, with their explanation of "death is part of life" and "you'll get used to it as time goes on" just doesn't cut it for me and almost feels cold to me.

I was not naive to the fact that death would be a part of my career. I guess I feel some how I have not prepared myself well enough for it mentally.

I would like words of advice from others in how you have dealt with this throughout your careers.

Thank you in advance.

Dear Savalife,

I have been a nurse for almost 30 years and I still find dealing with death to be difficult. As you said, you can learn all the right procedures to do during a code. But afterwards, there is still the death to deal with. There is nothing wrong with showing some emotion....the family will appreciate that you are so compassionate and cared for their loved one. Remember, after the pt. dies, there is still the family to deal with. And they do need to be cared for in a very loving manner. That is where your compassion can really be put to good use. Too often, medical staff learn how to perform well during a code but they are quite uncomfortable dealing with families afterwards. Caring for these families is an extension of caring for the pt. who has just died. Many feel that they don't know what to say. But sometimes just a hug says alot. There are many good books on knowing what to say in such difficult times. You might need to find some phases that you can use at such times. The important thing is to let them know that someone really did care enough to think of them.

Just recently, I was present for a very unexepcted death of a 40 year old man. He had acute pancreatitis. Things progressed very rapidly from bad to worse. The doctors tried everything they could but he still died. It really made an impression on his wife (and me too) when several of the doctors came to talk to her through their own tears. In spite of all their efforts, they still felt they had fallen short. There were lots of hugs and tears.

Don't worry about the strong feelings of compassion you feel when a patient dies. When we are present for the death of another person, we have the opportunity to share in some very intimate moments. Just try to find a way to channel your feelings into a positive avenue such as caring for the family. Whenever I stop having those feelings.....that's when I will worry.

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I have had to learn to deal with death (even though I'm 'justavolunteer') because I work on a pt. unit. I feel bad for the families, but I also feel empathy towards the patient's nurse. I know that nurses hate to lose a patient. I have told a nurse more than once. "I'm sorry your pt died" or something similar.

I just had it recently happen where I was talking to a pt. about the weather or other generalities. I went around the corner with her water pitcher to refill it. Before I could return, they called a code on her. I was probably the last person to talk to her.

I hope I never just shrug my shoulders & say "who cares". I think I would no longer be human if I got to that point.

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Savealife,

There is certainly a wealth of good advise here...that's what is so great about this forum. You said "Both times I have taken this home with me and brewed for days over it". I know this is easier said than done but try to leave work at the door... The one thing we realize by seeing death so often is how short life is.

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Specializes in Telemetry, OR, ICU.
Dealing with death came as part of my experience as a Squad Leader in the Infantry in Vietnam. The "defense mechanisms" and counseling methods that I learned in Vietnam helped me a great deal as a hospice nurse.

Nurses take on the role of spiritual guide and counselor when dealing with death.In my opinion, the highest art of nursing has to do with counseling,caring for and supporting dying patients and their families.

I served with the U.S. Army;4th Inf. Div.;2/8th Inf.;Republic of Vietnam 1969-1970

Thank you for your military service!

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