Dealing With Traumatic Patient Deaths

Nurses Stress 101

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Hi, this is my first time posting on this site, but I have lurked around for a while and thought now might be the time to get some advice.

So the story is, several months ago I had a patient brought to the ICU intubated after several cardiac arrests with plans to palliate because of their clinical picture.

The patient arrested again in ICU with a DNR order, so the patient died. The family was very distressed/angry and accused me of killing their loved one etc and kept telling me he was still alive and breathing after he had died (he wasnt). 

For a few days after their dead I reflected, was quiet anxious and worried I had done something wrong etc. (Even though the logical part of me knows I didn't)

But now it has been several months since this has happened and I have flash backs to that day and become stressed about it. I have had many patient deaths but never have I had one that has affected me so badly. 

Does anyone have any advice on how to move forward?

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Specializes in Psych (25 years), Medical (15 years).
On 12/7/2020 at 4:45 AM, holyroyd said:

But now it has been several months since this has happened and I have flash backs to that day and become stressed about it. I have had many patient deaths but never have I had one that has affected me so badly. 

Does anyone have any advice on how to move forward?

Flashback, or rumination over an event, is a way that we attempt to find the knowable in the sometimes unknowable, holyroyd. Our brains get locked on the event and the thoughts and feelings cycle over and over, again and again. The feelings don't go away; we relive the event and our bodies react by cyclically feeling the stress.

On moving forward: Therapy helps. A good Therapist can validate our feelings and guide us to a level of understanding comfortability.

Or there are self-help techniques described in several sources such as books and online support groups.

Personally, for me, journalizing and art has helped me deal with trauma. Case in point: Several years ago, I was stabbed in the back with a pair of scissors by a client diagnosed with schizophrenia.

My employer paid for services with a really good Therapist, which helped. However, those services were limited and I didn't feel as though I had totally resolved all my feelings over the incident.

My supervisor knew that I was into art and suggested an Art Therapist. The cost was minimal and I regularly met with the Art Therapist over a six month time span.

 I can easily say that art therapy changed my life. I learned techniques to make my thoughts and feelings tangible to better deal with them in a multitude of life stressors.

 I could go on and on, but this is not about me- it's about you, holyroyd.

I wish the very best for you. Please feel free to discuss your situation more here, or PM me if you like.

 

 

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On 12/7/2020 at 5:45 AM, holyroyd said:

The family was very distressed/angry and accused me of killing their loved one etc and kept telling me he was still alive and breathing after he had died (he wasnt). 

For a few days after their dead I reflected, was quiet anxious and worried I had done something wrong etc. (Even though the logical part of me knows I didn't)

A little amateur-ish psychology here, I realize, but I think there could be something to it or I wouldn't bother you with it:

1) You know that the family's accusations were/are not true

but

2) You also know that their accusations were probably spoken out of genuine grief

3) Your brain hasn't figured out how to accept/respect/honor their grief while fully rejecting the wrong words that their grief produced.

 

It may help you to acknowledge that they were hurting very badly and that sometimes when people are hurting they say things that aren't true. Sometimes in grief people even say things that they later feel sad about having said.

Lastly...unrelated to the above idea, it is hard to witness others' raw grief, period. It hurts us too, and it changes us. It is okay to be changed a little by things like this.

Please do talk to someone. The process of doing so may help you work though things that are truly tough like this.

?

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Specializes in Psych (25 years), Medical (15 years).
5 hours ago, JKL33 said:

A little amateur-ish psychology here, I realize, but I think there could be something to it or I wouldn't bother you with it:

With all due love & respect, I beg to differ with you JKL.

If we know that someone blames us for something which occurred through no fault of our own, we can still be bothered by that. Heck, the majority of people look to others for their self-worth and we often allow others to say who we are.

How often have we read on these forums, "They made me feel (in such and such way)"? as if others could control our emotions or how we react to  situations. We are allowed to feel any way we choose about any situation and not be judged. However, it is we who are responsible, and not another, for our feelings.

Daniel Gilbert stated a truism in his great book, Stumbling On Happiness, something like "We feel better when we have someone to blame for our pain" and we have a tendency to lash out at the closest or nearest person to us. This is probably what happened in holyroyd's case.

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Specializes in retired LTC.

holyroyd - If you're still reading this, please consider your facility's EAP Dept, if they have one.

In one sense, you were attacked by a grieving family, albeit through no fault of yours. Sounds a bit like PTSD that needs to be talked about.

12 hours ago, Davey Do said:

Daniel Gilbert stated a truism in his great book, Stumbling On Happiness, something like "We feel better when we have someone to blame for our pain" and we have a tendency to lash out at the closest or nearest person to us. This is probably what happened in holyroyd's case.

 

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15 hours ago, Davey Do said:

With all due love & respect, I beg to differ with you JKL.

If we know that someone blames us for something which occurred through no fault of our own, we can still be bothered by that. Heck, the majority of people look to others for their self-worth and we often allow others to say who we are.

How often have we read on these forums, "They made me feel (in such and such way)"? as if others could control our emotions or how we react to  situations. We are allowed to feel any way we choose about any situation and not be judged. However, it is we who are responsible, and not another, for our feelings.

Daniel Gilbert stated a truism in his great book, Stumbling On Happiness, something like "We feel better when we have someone to blame for our pain" and we have a tendency to lash out at the closest or nearest person to us. This is probably what happened in holyroyd's case.

Oh, if I understand what you're saying I think we completely agree. Or at least I agree with what you're saying even if that's not what I said. Ha.

I was just thinking about the additional stressor caused by the fact that in a case where we know that someone was grieving when they hurt us (or when we otherwise have some kind of empathy for them) we may find it even more difficult to allow ourselves to feel that what they did or said was completely wrong and unfair. And if we decide that we shouldn't feel it was unfair of them then we might just be likely to kind of think what they said was okay. In other words, empathy for their grief might contribute to legitimizing what they said (in our own mind).

Whew. Sounds kinda confusing. Sorry if I'm not conveying my thought well.

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On 12/14/2020 at 5:53 PM, JKL33 said:

A little amateur-ish psychology here, I realize, but I think there could be something to it or I wouldn't bother you with it:

1) You know that the family's accusations were/are not true

but

2) You also know that their accusations were probably spoken out of genuine grief

3) Your brain hasn't figured out how to accept/respect/honor their grief while fully rejecting the wrong words that their grief produced.

 

It may help you to acknowledge that they were hurting very badly and that sometimes when people are hurting they say things that aren't true. Sometimes in grief people even say things that they later feel sad about having said.

Lastly...unrelated to the above idea, it is hard to witness others' raw grief, period. It hurts us too, and it changes us. It is okay to be changed a little by things like this.

Please do talk to someone. The process of doing so may help you work though things that are truly tough like this.

?

thanks for the reply, I think your fairly spot on in your analysis in that I know that I did nothing wrong, but there is a part of my that is upset that some family is out there living their life thinking that I killed their love one (even though I know that is completely out of grief on their behalf and completely understandable).

thanks to everyone else for your replies aswell and advice. I have booked an appointment with my works EAP to try and sort through my issues. 

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1 hour ago, holyroyd said:

thanks for the reply, I think your fairly spot on in your analysis in that I know that I did nothing wrong, but there is a part of my that is upset that some family is out there living their life thinking that I killed their love one (even though I know that is completely out of grief on their behalf and completely understandable).

thanks to everyone else for your replies aswell and advice. I have booked an appointment with my works EAP to try and sort through my issues. 

I think the family knows you did nothing wrong and death was inevitable, they just weren't ready and willing to accept the loss. Nevertheless, I'm glad you booked an EAP appointment and hope all works out for you. We all need to talk about the stressors of work sometimes.

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