Emotional day at work

[EmeraldNYL, BSN, RN]

Today was the first day that I witnessed a patient die in my short career as a MICU nurse. The patient was ESLD, was bleeding everywhere, and was receiving the maximum dose from 3 different vasopressors. The patient was a s/p code from last night, and it was clear that she was rapidly going downhill. The family decided to remove her from the pressors, and I stood by the monitor and watched as her BP dropped and her heart rhythm changed and became erratic until eventually she was asystolic. I then had to perform post mortem care.

When I came home tonight I cried-- I didn't think I would be this emotional at a patient's death. After all, this is part of our job as nurses. While I love my job, tonight I felt that most of what we do in the ICU is in vain-- most of our patients seem to die despite our best efforts. Even when we realize that a recovery is futile, we continue to prolong life by any means possible in the interest of academia (I work at a huge teaching hospital). I suppose I'm just frusturated by my own feelings, and definitely a little bummed.

Anyone else care to share the story of the first time they lost a patient? Does it get any easier?

[P_RN, ADN, RN]

Bless you, it's hard the first time....and every time after the first too for me.

Sometimes the hardest thing to do is to do nothing.

The lady had a kind, compassionate, feeling nurse at her passing.

You did well.

[Noney]

Yes, it gets easier. Providing good pallitative care can be very rewarding. You're actions can help ease the transition not only for the pt, but for the family. As far as being discouraged, remember you are getting the sickest pt's in ICU, look at how many pt's recover as opposed to not making it.

Give yourself sometime, and see if you feel different about things if you are still discouraged a month or so you may want to consider a different type of unit. The fact that you care so much says a lot about you.(this is a compliment) :)

Noney

[Rapheal]

It is very hard to lose someone. It just seems like their passing should be handled with some sort of sacredness or ritual. But instead we are busy. There is the family, the coroner to call, life bank and then the most final part- placing them in a body bag. When this is done it's back to caring for the living- no time to dwell on it until after the shift is done.

I feel guilty when I am trying to perform the tasks that my job demands. I feel like there is something more I should do to mark their passing. The best I have been able to come up with is to say a prayer and to tell them I am sorry that they have died. I make sure they are clean and handle the body with respect. I also tell them what I am doing. I know this sounds strange- but perhaps just an hour ago I was explaining what I was doing when I administered a medication- so I explain it even after their passing. I think they couldn't hear me then- but what does it hurt to do this- what if they do hear in their final moments- or shortly after.

EmeraldNYC- I am sorry for your sadness. I know you did your best and will continue to do so. What else is there to do? I hope you find comfort. I think nurses must allow themselves to grieve over the loss of a patient. Nursing is a job- you are taking care of people between life and death- but it is more than a job as well. Take care and I hope that you will be feeling better soon.

[Sarah Kat]

I don't start LPN school until January, so I have never had a patient/client die. I was with my mother-in-law last year when she passed in the CICU. She was slowly going into multiple system organ failure from liver cancer. We opted for no heroic measures. It was the hardest decision my husband ever had to make. The nurses seemed to be more sympathetic than my husband's family (his mother's brothers and sisters). The nurses expressed to us how brave we were to make such a hard decision. Meanwhile the relatives couldn't understand why we didn't want to "save" her.

One of our nurses said it best. "When it is her time to go to God, why keep her from her creator?"

I am not a religious person, but it seems to me that if someone is needlessly suffering and their death is immenant, then it is important to let them go. At that point the care is focused more on the lessoning of the pain of the family. Our nurses did that. They made sure the whole process was as painfree as possible for her and for us.

That experience is why I am persuing nursing myself.

So grieve, let yourself remember her, but don't dispair. You are valued and what you do is necessary.

[angelbear]

It is not often that I find myself able to whole heartedly agree with prn, but this time I gotta say she said it best. You done good.

[heatherbless]

YES...

the compassionism and being human is sooo what it is all about. I know many of you have a lot more experience than me--but, when you go through something like this--it brings you closer to the real meaning of life's importance, minus the trivialities. Like for example, today--I saw on TV--how these people are fighting and pushing each other going into the shopping malls for sales, etc...forgetting the whole purpose behind any type of Thanksgiving, etc...

kudos to all of you/hty:kiss

[LilgirlRN, ADN, RN]

Sometimes a good death is better than living a terrible life. It does get easier. We are taught in school to prolong life, but sometimes it's just not of a quality that should be prolonged. Letting someone go with grace and dignity is the kindest thing oftentimes that can be done for a suffering human being. I always hate it when Great-Grandma comes in with advanced directive and we have to code her and end up crunching her sternum and popping her ribs in a futile attempt to sustain her life for the sake of making her family happy. When I get old I'm having DNR tattood on my chest. Hugs to you, know you did a good job and death is just a part of life. Sounds harsh but you do get used to death.

[Tweety, BSN, RN]

Hugs. You've got a big heart.

[renerian, BSN, RN]

The first death is always the hardest. I have worked at teaching hospitals and have had my loved one in them as well. There is a huge focus on cure and not on fulitlity. The family get swamped with huge medical bills and many times the patient dies in pain/agony. The family watches this and it is horribly traumatic.

Each experience is needed to help you develop your abilities/thoughts/ethics as far as a nurse. Sometimes your feelings and the families are not the popular vote and you have to step up to represent the family in the best way you can sometimes putting on battle armour to defend what you think is right for the patient in light of their health care crisis. I have done it many times and have had to do the same for a suffering family member in a teaching hospital with docs focused on cure or recovery that sometimes will only bring misery for the client.

What I am trying to say is each time you deal with an experience like this it shapes and molds you.

Does that make sense?

renerian

[lanilpn]

the first is hard,and they do get a little easier. my first incounter with death was as a CNA. i worked in the nursing home 11pm-7am. she was a DNR. I sat by her side all night(inbetween rounds) and held her hand. Her family lived in another state(they dropped her off and split)! i cried but was releved that she no longer suffered, she passed in the middle of shift switch- we were all in there discussing the nights events- so she wouldn't be alone. She was a beatiful lady- and i will never forget her!

[EmeraldNYL, BSN, RN]

Thank you all for your stories and words of encouragement. I do feel better today. I think dealing with situations like this will get easier with time, it was just hard because this is the first time I've had to do this. I still love my job though. Nurses have such an awesome job to do. Thanks guys. :kiss