Dealing with a patients death

[abby.reece]

Hi,

I'm in my second year of the RN program in Ontario, and recently I found out that a patient I had died. The patient did not die while I was at the clinical placement, however I was still very sad when I heard the news. All of my school friends and clinical instructor kind of brushed me off when I told them, but I was devastated when I found out. Is this a normal thing? I was really hurt by it, but I'm thinking that I shouldn't be that hurt because the patient didn't die while I was assigned to her. Any thoughts? How did you guys deal with patient death as a student?

Thank you!

[shanny1185]

I just applied to a nursing school, so I am not a nurse yet, but I am an EMT and I had someone die in the back of the ambulance with me. The few things i told myself was, what kind of state were they in. How was their quality of life. And it wasnt good...so I told myself his 9ain and suffering was over. Its totally ok to have those types of feelings. People deal with death in their own way. I hope that helps.

[stephaniehowe]

Death is always a sad time no matter the circumstances. And you will also remember your first one. Mine was as a CNA, I worked wkend doubles and left my little lady who was too cute for words and always looked fwd to having me take care of her on wkends. When I came in the next day she had passed, she had a seizure then went into cardiac arrest. I had bad dreams afterwards for a few wks like I had been there watching the night nurse code her. I have a wall of crosses by the front door one for each patient that impacted me as a nurse and reminds me this is what I am meant to do even with the hard days.Those sad memories are now happy ones because they made me the nurse I am today. Hopefully it will become easier in time for you.

[NKS82]

I think it would be more abnormal if you didn't react. Never happened to me as RN student, but I had my first death when I was only 19, working as HCA in eldercare and found one of "my" oldies dead in his own bathroom (cardiac arrest). It was truly horrible and took me weeks to overcome. Now I'm working in palliative care and see death rather often, but I'll never forget the first. If your instructor is just brushing it off you might want to find someone else to talk about it? Maybe one of the nurses working where you had your clinical placement?

[ePerfect]

I work LTC with hospice residents. There are always patients that will stick with you. Having emotional connections with patients isn't always a bad thing! Assess the situation and know where your emotions lie. Find a good way of dealing with these feelings when they come. These emotions are perfectly normal for most health care workers. Everyone gets hurt when a patient dies, some just don't show it as well as others. It's all in how you deal with these emotions that matters. Unfortunately there will always be death in nursing but, then again, there will also always be life.

chin up!

[MedicalPartisan]

As wrong as it sounds, you'll get used to it. I'm not yet a nurse but I remember being dumbfounded when I started at the ED I currently work in five years ago. During traumas the staff is laughing and making jokes (albeit focused) and when a patient would pass the TOD would be called and that was that. I couldn't believe how "cruel" these people were. But over time, you cannot let it get to you or you will become dragged down. And when you're trying to save them there's no time to feel bad for them; you must remain focused and stress-free. We become nurses because we want to help and heal people. If you know in your heart you and your team did everything in your power to help this patient then be that as it may. We, as humans, die. That's not to say when your patient passes you should have no feelings or care, but know they left this world in the best possible care; yours.

Again don't take this the wrong way, but it does get much easier with time. Especially with floor nurses. See, in the ER, we just focus on stabilizing and getting the patient dispo'd; wash, rinse, repeat. On the floor, the nurses have a much closer relationship with the patient and family as they are with them for many days so I'm sure it's much harder.

It's always sad, though. I often find myself looking at the deceased patient thinking, wow, their life is over. Regardless of religious stance, everything they have ever known and experienced is over; it's done. There's nothing left. I sometimes do the same for the elderly living. It's got to be so scary for them. Even if they're not in the hospital for something we'd consider 'bad', they've got to be nervous... realizing that they're getting older, not knowing what their symptoms could lead to. They know they are close to the end of the road. I feel so bad for them and do everything in my power to make them feel at ease. And as talented and dedicated as my crazy coworkers are they can be so ruthless and loud sometimes; talking about the patients at the top of their lungs almost right outside their door. I digress... The simplest smile can change it all for them. They comment on it too. A lady told me the other day that my smile was warm and made all the difference to her and I couldn't have felt happier.

Again, as long as you know you did everything in your power to treat the patient and put them at ease, you should be proud.

[nurseprnRN, BSN, RN]

Death is not always a sad event. Sometimes there are worse things than death, seriously. Everybody dies, and you do know that; when someone says, "I would rather die than ...," many times you should believe him, especially if you know what he knows he doesn't want to endure will mean.

It is not a measure of lack of caring to accept the death of a patient. It does not mean you have no heart, or will be seen as cold and callous, or that you aren't fit to be a nurse. The thanatologists will tell you that "every death recalls all previous deaths," meaning that when you experience a death, the emotions of the previous ones come back to you. Eventually, clinical deaths will fall into a different folder than family or close friend deaths; family/friend deaths will be additive in a way far more painful than the patients'. Losing your mother will hurt more than losing your grandmother; losing a sibling will hurt more than losing your grandparents and your parents, because of the ones that went before. But losing patients is, for the most part, an occupational hazard, and you will need to learn to distance yourself from those emotions when they involve people whose only relationship with you is occupational. In this case, it literally is not about you.

Once (well, more than once) upon a time I had a nursing student who was "devastated" at the days-later death of a patient she knew only for half a shift on one clinical day. She found herself with deep feelings of hurt, had a hard time holding it together when she returned to that clinical area, and talked about how it had affected her sleep and concentration since she heard. This went on until I got her to see the wisdom of seeing a pro about this.

If this is you, this is an overreaction and not normal. You need to find a safe person to talk to about this-- a trusted faculty member, a clergy member, a counselor referral from the school health clinic, a hospice nurse or volunteer, a family member-- to get a better handle on why this death of someone who is almost a stranger to you is affecting you so and how to let it go. "Devastated" is a big word.

[NurseOnAMotorcycle, ASN, RN]

So in other words, yes. This is a normal feeling. You got to know your patient as a real person and have suddenly discovered that they are gone.

The reason you are getting the "ok, whatever." From the other students is that for them, it was a faceless, nameless patient.

Also, it is true that in the emerg dept we joke about everything (sometimes seemingly inappropriately). It isn't because we don't care, but because we do. But we have to stay separate from the pt to function. It's a way of putting up a wall to protect ourselves.