Death?

racing-mom4, BSN, RN · Jul 9, 2008

I have witnessed at large handfull of deaths, large amount to me at least, less than 10 but more than 5, If a family member is there, I usually cry.

I have been known to hug and cry-- like aligator tears cry. Something about seeing the family at that time just breaks my heart, even if the pt was 95 and accepting of death, losing a parent/grandparent/sibling of any age has got to be difficult.

Of course I always follow the families lead, there was one family once that was very stoic(sp) they did not show emotion so I really didnt either. I asked if there was anyone I could call, or anything I could do and there was not, we had pronounced her and they left about 10 min later.

Another time the son would not leave moms side for over 3 hours, I finally asked him if he wanted me to walk him out when I got off work.

If there is no family there, i dont think I do cry, I am very almost clinical, I do what needs done, call who I need to call and work down my death packet check list.

I think every death is different. Always sad, even if the person was suffering, to me it is still sad. It is not something I dont ever think I will get used to.

Babs0512 · Jul 9, 2008

I can't remember my first death. I've seen so much of it. You know what? We may be nurses, but before being a nurse, we are human. If you cry - so be it. I've cried many times, sometimes with the patient or family, sometimes by myself in the bathroom, sometimes with co-workers. It's okay.

I remember when I first started working in the ER, we had a man come in, 32 years old. Was found sitting on the ground outside his car in the middle of the road, confused. The police called the ambulance, and during the ride in to the ER, the man became combative.

He was screaming, kicking, wild eyed look. We were trying to get him on the monitor, he was in a sinus tach (fast heart rate about 140). Then, all of a sudden, flat line, just that fast.

We coded him for a while, trying to figure out why this young man was dead. During the code, I could hear his small children behind the curtain talking, and one of them said "When daddy get's home, we're going fishing!" I lost it then and there. Started to cry. Then the wife came in, threw herself on his body, crying, his mother "begging" him to "come back". It was awful, especially because we didn't know why it happened.

Afterward, I went to the ER doc and apologized for "Crying" - he said, "Never apologize for caring - so long as the job gets done". I've never forgotten that.

Autopsy showed the man had a brain aneurysm that ruptured. Slow enough leak to allow him to stop, be found, brought to the hospital, but too fast for us to fix it.

Always do the best job you can, cry if you must, then freshen up and go back to work. Good luck

AirforceRN, RN · Jul 9, 2008

Don't ever feel bad about crying at a death. Obviously there is a time and a place and if you need to go into the med cuboard for it to be appropriate...so be it. Like a previous poster said, we are human...

Death is a part of life...we are all going to die, some of us much sooner than others. It is often sad, sometime unfortunate, sometimes devastating. My view is pretty cold. Death is just the end of life...what goes on after I don't know but once a pt is deceased, there is nothing I can do, crying won't help me so I say to myself, "I've done my job the best I can and that's all I can ask for". That doesn't mean I don't feel for the family...especially the children if they are present, but there are others I can help so I do.

My thoughts

Babs0512 · Jul 9, 2008

My biggest problem with death is "what to say to the family" I'm acutely aware that NOTHING I say will bring back their loved one or each their grief. I become uncomfortable with the family after a death. I need to work on that.

My husband and I lost our 22 year old son, Michael in 2004. I felt bad for others because "they didn't know what to say" We got the usual "So sorry for your loss" type of statements, which we appreciated, but they really didn''t help us in any way. Since I've experienced this, I know there is little I can say to comfort a grieving family. So I usually call the hospital chaplain to deal with this portion. She has a much better sense of how to handle the situation than I do.

moonchild20002000 · Jul 9, 2008

The very first death I witnessed was as a nursing student in the ED.A young couple

had a MVA,the hubby was drunk and ran a red light.His wife died..she was a beautiful young woman..the only child of older parents.I listened as the resident called her

family with news no parent ever wants to hear.I could hear the girls parents in the background...her mother screamed. When the doc hung up the phone he just cried.

I fought tears back until I had to take her to the morgue.

I saw many,many more deaths during the next 33 years and cried many times with families and staff.

I always found it very hard to offer words other than"I'm sorry" to the families...there is just not much you can say to make the grief less for the families.

I have also been to many funeral home viewings and funerals.The families all seemed to appreciate it.

NeosynephRN · Jul 9, 2008

I do not think that death is ever easy...however many times it is the best thing for the patient and for that I am gratefull. I know my first death was a guy brought to me from the ER.."slightly bradicardic" HR in the 60's nothing to write home about. I was in the room talking to him and doing his admission assessment...when he told me he thought he was going to throw up...I gave him a basin, and went to the other side of the bed to get suction set up...I kept talking and I turned around...he looked up at me and then he was gone...just that fast. He had just become a DNR in the ER, so nothing I could do. I had to go get his friends..no family and tell them he had passed...they had just been joking around with him 15 min prior. I felt that I could tell them he did not have any pain when he died, as I had just asked him that. I was glad that really comforted them. We have many deaths on our floor and many are a relief..at least to the patient, but it never seems to get any easier...

anurseuk · Jul 9, 2008

My first death after I'd qualified was quite sad; my patient must have had some sort of bowl obstruction, was peri arrest then faecal vomit erupted from her and she was gone after working on her for some time to prevent the arrest. Whilst all the chaos was happening I got the ward clerk to call the husband and ask him to come in.

Anyway, when he came in I saw this little old man walking down the corridor by himself, with glasses and a white stick!!!! I had to take him in our quite room and tell him that she had died; I tried with him to contact some family members as he had come in by himself in a taxi but couldn't get hold of anyone... In the end I had to call him a taxi once he was ready to leave and I walked him out and gave him a hug. Bless him. I didnt cry though, personally I don't think it's professional to cry in front of relatives. That's my personal opinion. I think it's important to try and keep a certain amout of professional distance. And it's not your grief it's theres and they need some strength in those situations... no matter how bad you feel. They can tell that we care etc by our actions before, during and after the death.

Since then I have witnessed a lot of death in my career. The first time I withdrew on a patient was very hard ethically as I knew that by stopping the inotropes, giving sedation and turning the vent off would directly lead to this persons death. The wife of the patient was crying and asking him to forgive her. I stayed with her, but with enough distance but was there if she needed me. I had my arm around her when he died. Afterwards she thanked me for letting him die gracefully and for me being there with her, explaining what was happening and what was going to happen.... and for being her strength that day.

You judge situations as they arrive. But giving someone a peaceful and dignified death I see as a great honor. When the pt doesnt die peacefully I can take comfort in that when they were alive I did everything I possibly could in their interest, and I did everything possible to keep them alive. This also goes into continuing studying inh order to give the best possible care. Also treating the patient in a dignified way after death and knowing that they are not suffering gives me comfort. Also I believe it gives the family comfort. :)

kakamegamama · Jul 9, 2008

When my husband died, the best thing the nurse in the ER who had worked with he ER doc on my husband's code did for us (my youngest & me) was to say: "I am sorry for your loss". This was after the doc said "I'm sorry, but he's gone." The words "I'm sorry" when sincere, meant more to me, and still do to this day, than many of the accolades, flowery speeches, etc., that others made in an attempt to make us feel better. The doc and nurse that night showed their humanity. They also allowed us to wait with my husband until the medical examiner's crew came and got his body. That meant much too---we didn't have to rush off, and the hospital was a gathering place for family coming in during the middle of night. All in all, the compassion was tangible and helped much. Taught me a lot as a nurse, too.

rnin02 · Jul 9, 2008

The only time I cried with a family is when we had a long-term patient die. She had been at our hospital for months, going between ICU and our floor, with ups and downs, but we all knew where it was headed. She wasn't a really "well-loved" long term patient, they were a rather demanding family (I hate to type that!) but when I came in to work that night and saw her daughters crying, and they came up to me to give me hugs for taking care of her, I lost it a little. Nothing crazy, but I had to cry with them, it had been such a long, difficult journey for them, and it really didn't feel unprofessional at all. They had been part of our floor for so long, even though it was a somewhat expected death, it was still a shock. The only other time I have cried about a patient's death (that I remember) I did on my way home from work, we had a patient come in with a placenta abruption and by the time she got to our unit there were no fetal heart tones. They took her back for a stat c-section, but it was too late for the baby. There were 2 of us there as nursery nurses, and it was so, so sad. She wasn't quite "full term" but very close at 36 or 37 weeks and such a beautiful baby...mom had been scheduled for a c-section within a week or 2, since the same thing had happened to her at nearly the same time in her pregnancy about a year or so prior. It was one of the saddest things I have ever had to deal with, outside of my own friends and family deaths. Just so tragic for that family. And now that I typed that up, I remember one other time I've cried, that was for a baby being born that the family knew wasn't going to make it (I can't remember why, maybe Potter's syndrome?) and they had a priest there to do the baptism, and I got pretty teary when everyone was praying together. I think that time made the mom feel a little better, because she could see the staff (I wasn't the only teary one) wasn't being cold and distant, we were sharing her grief and giving her support.

Its hard to be "professional" when someone dies, and know the right things to say...but usually saying "I'm sorry for your loss" and looking at the family member(s) when you say that is fairly safe. It depends on your rapport with them, how long you've known the patient and their family, that kind of thing too. One of my very first days (maybe my 2nd shift) on the floor after graduation, still in orientation, while I was listening to phone report, I remember a nurse walking by me and saying "is that your patient? i think she's dead." I nearly died myself, that scared me so bad, to hear that while listening to report. In that situation, I certainly wouldn't have cried with the family, since I didn't know the patient at all...but the other family I cried with, I think that was okay, since I had known them and taken care of the patient for months. I don't think there's any magic formula to "dealing" with death, or blocking anything...just don't keep it bottled up inside you. Talk (generically of course, watch out for HIPPA) with your coworkers about it, your family when you get home, write in a journal, but don't bottle it up inside...that will not be good for you in the long run.

-MNC_RN- · Jul 9, 2008

I searched the forums, and I couldn't find any posts that answered these questions, but if you know of a post that does, please link me :)
I was wondering if you fellow allnurses.comers could describe what it was like the first time death was presented to you in a hospital. I have yet to witness it - and I understand death is a very very sad thing.
What happened to the person who died? What sort of feelings were running through your body? How did you deal with it afterwards? Did you have to comfort the family?
Sometimes I feel like my weakness to nursing would be that I would cry at the hospital. I am a pretty sensitive person, but I am sure that I want to do nursing! My nursing friend was telling me the first death she witnessed was in the NICU. Another said it was a 10 year old boy who committed suicide. I almost felt like crying to just the stories! Death is very devastating - how do you nurses 'block' or 'deal' with it overall?
Thanks in advance, and I apologize if this is previously posted or if it's a sensitive subject.

My first experience? I couldn't stop laughing. Seriously. I was an NA in my first job orienting to an oncology floor. My first day there, a nurse, knowing I was new, asked if I would like to help her with some post-mortem care. I did... and couldn't stop laughing. Part of it was nervousness--it was my first experience with death in that way. Part of it was excitement--I was actually doing something that mattered and I was on my way to nursing school and being a nurse! Family had long since gone; the nurse I was working with looked at me funny, though.

My first time seeing someone die was entirely different and definitely did not have me laughing. I was still a nursing assistant and was helping out in a code doing compressions. She was a little old lady--80-somthing, I imagine--and she didn't make it. Not even close. It was then that I realized that the woman dying didn't bother me. She was dead and ain't nothin' I coulda done. What bothered me then, and always will, is how much the family gets hurt by death. I will never forget the image of her husband standing at the end of the hall weeping. Families get to me. I remember one young man a couple of years ago in my ICU who commited suicide. He went on to be an organ donor. The night before he was brought down to OR, his mom came in and noticed that the nurse (I was charge at the time) was about to do some cares. She talked to the nurse and asked permission "to give my baby a bath one last time..." That was hard. Hell, I tear up even now just typing it.

It's never a weakness to cry when a patient dies, or when a family or patient cries. If your emotions interfere with your ability to do the job, that's a problem, but emotion in general will not hinder you.

Finally, don't "block" death. That will only get you into trouble (unless you want to be an alcoholic). It's the natural conclusion to life. Sad, yes. Sometimes tragic. As I have written in past posts:

Everyone dies sometime. The only differences are how soon and how well. We try to prevent too soon, and we try to make every death as good as it can be. That's all we can do. Really.

*Blessed2BaNRS* · Jul 9, 2008

"afterward, i went to the er doc and apologized for "crying" - he said, "never apologize for caring - so long as the job gets done". i've never forgotten that.

always do the best job you can, cry if you must, then freshen up and go back to work. good luck"

very good advice! i personally have't had a situation where i cried after a patient died, then again, i am an extern, not yet a nurse, so i haven't been assigned to an actual patient to care for. i have cried a couple of times with family/patients when they received bad news, and have been thanked. i have seen several deaths in the last 6 months, but they were all very frail, elderly people who had had a series of illnesses that put them in the hospital in the first place.

being in icu, we did have a patient last week who had a cardiac arrest, came in and coded 3 times. he was a younger man (early 50's) and his family was there with him. when he first came in, he seemed okay, but as the evening wore on, he became more critical. the nurse was talking to him and his family, getting info and doing assessments on him when the wife started screaming and crying. he was still alert and showing no signs of coding, so i am not sure what was said or done. anyway, she walked out to the waiting room, and within 15 minutes he coded. i haven't been back to work since that night, so i don't know if he made it or not, but to see such a younger person laying on the table getting shocked was a little disheartening.

as far as crying with the patient's family being unprofessional, i have to disagree. we are all human, and so many times (in my short career!!!) the patient/family have thanked me for being so caring and "feeling." when you have situations such as those posted above, it is human nature to feel for the families, and one of our responses is to cry. i tend to believe that when you lose the ability to show or even feel emotion, you need to get out, because nursing requires compassionate nurses who are able to feel and to respond. i may get flamed for saying what i have, but i have seen way too many nurses who have lost their compassion and who are horrible nurses. i realize that as you see more and more deaths and bad things happening to patients, you do have to close out a lot of it, but when you totally close off every emotion, you tend to become a bitter person. as a nurse, there is no room for bitterness. we are there to comfort and to heal.