Did I cause my patient to die faster?

[lou_tango]

I am a CNA on a medical/surgical floor and am in dire need of clarification (from a nurse please) of what just happened at work last night. I work nights, came on the floor and got to work right away. I got a walking report from the 2nd shift CNA. One pt was an unresponsive very elderly woman who had suffered an acute MI several days earlier and wasn't expected to make it through the night. I was told in report by the CNA that the pt was being turned side to side every 2 hours (with oral care, checking for incontinence, etc.) and she was due again at 11:30, so I had him help me change her and turn her before he left. She passed less than an hour later. Here's where I need some help...

One of the nurses told me (not even the patient's nurse) that it was our fault the patient passed when she did. She didn't do it in an accusatory or mean way...just in a very matter-of-fact (and a little condescending) way. Like: "by the way, you shouldn't have turned her, that's why she passed so soon." I've been at this hospital for 9 months and somehow I have managed to skate by without any patient deaths...so this was my first. Needless to say I was speechless and felt terrible, as if I had taken her away from her family sooner than she was supposed to go.

She then gave me some explanation that I didn't understand. Something about when turning the patient, the blood floods the heart and the patient will pass soon after. First of all, we had to turn her to get her cleaned up. Second, I was told she was being turned every 2 hours all through 2nd shift. So did I really do something wrong? Is there truth to what she said? And if so, can someone give me a better explanation of what happened?

Thanks in advance...feeling confused and guilty here.

[annlewis]

That nurse was just plain mean and stupid. She should not be working as a nurse

[littlerhody]

You patient passed when she did because it was her time to go. You didn't speed it along, you gave her the care she needed. The nurse who told you that is a moron!

[ladyluck091]

while technically turning a dying patient on their left side will speed up the dying process u didnt kill ur pt --and u didnt rob her of time with her family--she was already actively dying and unresponsive--her disease killed her--u just kept her comfortable while it did--u did the right thing--

[Abbies]

The elderly patient that suffered an acute MI and was not expected to make it through the night might have wanted to say to you, if she could:

"Before you and your partner :angel::angel: came into my room my old bones and joints were getting very painful from being in the same position for so long, my skin was wet and burning, and I was beginning to feel ill from the smell of urine and feces. Thank you so much for making my last hour comfortable and peaceful!....."

[PEBBLES1]

you did not do anything wrong. It was her time to transition into the next life. Sorry to be so short.

[sue_rehn]

don't know where that nurse was coming from to make a comment like that to you (and your cohort).

you had a job to do and by asking the off-going shift to assist you, you showed foresight and i applaud that you did so instead of waiting til you were possibly alone a little after second shift had left, and faced with the task of creating her dignity all by yourself as one commentor stated "moving her poor aching bones" around without proper support!

you seem to be someone who followed their heart , wanted to make sure that the patient was comfortable, and having a rude individual to make such a comment to you at a time when you needed moral support at the outset of your first experience with a dying patient is unconscionable on that nurse's part.

i am sorry you had such an experience, when you should have received assistance with the mental aspects of dealing with death and dying for the first time.

good luck to you! =+)

btw, yes, i am an rn, bsn; have worked for 14 years with elders / death and dying:never heard of any nurse making such a callous remark to a staff member at such a time.

[Cathy Lites, RN]

You did EXACTLY what you were supposed to do. Patients HAVE to be truned every two hours when they can't do it themselves. I've been an RN fro 21 years and never would I have blamed anyone doing what they were supposed to do for a patient's death. There is really no way to know why she died when she did except it was her time to go. She went cared for, clean and important to someone. Not everyone is so fortunate. YOU DID NOTHING WRONG!! If I were you I would definitely report what she said to your supervisor. It sounds like harassament to me. CLRN

[KarenBuley]

You were conscientiously providing the care your patient needed. Thumbs down to the nurse who made you question your care; kudos for you.

[RyanSofie]

Death is not something we can control. The patient was elderly and post MI . The turning probably had nothing to do with her death as her death was going to occur despite any repositioning you did. The process of death is a taboo subject for most but understanding the physiologic process may help you to understand. She was being cared for lovingly and her comfort attended to that is a wonderful thing. Comfort is so vital to the dying and your being present offered comfort.

[1970butterfly]

OMG!!!! You did nothing but care for that Pt. Please PLEASE PLEASE.......do not beat yourself up. Each day we care for and possibly lose someone when it is their time to die. The fact that you wonder IF you did all you could do makes you a wonderful CNA, BUT it can not and will not change the fact that when our bodies fail....we die.....it does not reflect on you. I am very sorry that the nurse said that to you. I am not sure why she did......but anyway...just know that other nurses support you and keep on being that great CNA you are!

[Natessy]

I absolutely agree with all the responses on this topic. Isn't it amazing that we take out our frustration out on others and try to blame other people first before we get a chance to assess the clinical situation? If this nurse has done that, she would have hugged you and both of you can comfort each other. Enough said, don't feel bad at all; you did nothing wrong.

[NRSKarenRN, BSN, RN]

Thanks for your well thought out answers. Closing as OP received needed info.