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?
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
Hugs to you. Big, warm hugs. Allow yourself to FEEL.
Elephants and other animals mourn the loss of their own... we should not?
It's perfectly ok to "feel the moment"... and give what you can TO it, take what you can FROM it.... and then move on a stronger and even more caring person.
Yes, it is always hard on a nurse when their patient dies. I worked in the hospice room of a hospital for several years. After taking care of the patient and family for several weeks sometimes, I would be very attached to all of them. It was not at all unusual to cry along with the family when they died, as all of them had become very dear to me. It was also my way of doing things, to talk to the deceased while I was doing things.
One of the funniest thing that I ever had family do, was hold a wake for the deceased in the hospice room before they would allow the funeral home come. They hadn't been able to get in touch with the minister, and wanted the body prayed over before being removed. Since they hadn't been able to get in touch with the minister, they just called all their family and friends and invited them up to visit with them and view the body. They asked to have tea, coffee, and cookies brought up to serve to their friends. This went on for 4 ½ hours before the minister arrived. Must say was different.
The one death that stands out in my mind is my cousin's. He had been in poor health for years, kidney and heart problems, plus had aneurysms from head to toe, and frequent gastric bleeds. I got a call one morning from his wife to come assess him, as the home health nurse was too busy to come out until afternoon and had told them to just get the ambulance there and take him to the hospital to been seen. They live out in the country 35 miles from the hospital. My cousin knew that if he went to the hospital he wouldn't come home again. He told his wife and son that he wouldn't go to the hospital under any circumstances that it was his time to go and that he wanted to die at home. When I was assessing him, he again reiterated this to me and the family. We sat down and talked about everything quality over quantity of life, how comfortable the family was in allowing his wish to die at home to be granted. They decided to grant him his wish, of no heroic measures to prolong his life Thanks to the help of my DH and mom, plus his wife and son we accomplished his wishes. He wanted to be left laying on the couch so he could look out the windows at the ranch that he loved and worked all his life. It was just at sun rise the next morning that he died, very peaceful with the cows in the pasture gently mooing and the coyotes howling a farewell to him.
The first several deaths I had were the worst. I think it was b/c I was a newer nurse, and felt responsible that I missed something, rather than realize the heart muscle that was left was mush and there was nothing anyone could do to save the pt.
But, I have felt the same exact way you do when I realized I was burned out from ICU nursing. After 17 yrs of ICU, I just wanted to work with well people, do preventative nursing, so I went into home health, and I feel much better.
I have also had 2 out of hospital CPR expereinces, both were horrible, and the more people I speak to who have had to do CPR in that situation, it makes me wonder if it weren't just better that we do nothing, and just comfort the family and spend the time telling them to softly whisper their goodbyes into the person's ear instead of doing futile compressions. Honestly, after working in SICU for so many years and being involved in so many "saves", then transferring to MICU and seeing those "saves" six months down the road, I know I made the right decision for me. I am done w ICU nursing, I just can't handle it anymore.
You can also have IMMUNITY from feeling too bad if you already witnessed the death of a parent or very loved person. When the first PT I ever knew died I wasn't there, it happened a shift latter. I'll never forget that lady and she has become part of me. Once you get shocked really hard by death it doesn't phase you as bad. I am emotionally effected by any death, but I don't think i could ever cry and control my limbic outflow since i went all the way on the shock and saddness scale. Seeing anyone die now is different, and I would remain compossed to help the person whose heart is stopping, or others around who are being shocked :-)
and reading all the warm, supportive, insightful posts here have once again reminded me why I became a nurse. And I feel great being a part of such a loving group of people.
We learn how to feel our feelings, be empathetic without becoming too overwhelmed...in time. So in that respect, yes, it does get easier.
Some nurses become numbed which is sad....it is a delicate balance we strive for, isn't it??
Yesterday I attended the funeral of a dear friend from high school. He killed himself (on Thanksgiving) and no one is quite sure why. His widow was my best friend in high school (we had a falling out, but it's funny how traumatic life events can reconcile people) and they have two beautiful little ones (a baby and a toddler). We're all under 30. He was studying to be a medical assistant. No matter how many times I am touched by death, I am always TOUCHED by death. It always affects me. Yesterday at his funeral it brought to the surface all of my emotions and I cried like a baby. But I would rather cry than be totally cut off from the humanity of it.
Specializes in Psych, Med/Surg, Home Health, Oncology.
Hi
Definitely, the first time a patient dies is the worse. It's almost 40 yrs. for in this job--the majority at the bedside--and I still get a bit teary eyed and feel bad when patients expire.
There are different kids of death, tho---on an acute patient who suddenly codes and doesn't make it I feel much worse then if it's a patient who has been very sick and terminal and who we have been expecting death. I guess sometimes it depends on the goals you set for yourself.
I want to be the best nurse I can possibly be--but with a terminal patient who is a no-code--my goal is very different than with an acute patient--my goal is do everything I can to not only make my patient comfortable, but to prepare him for death, give the emotional support he might need, listen to his fears and concerns;l and most of all, I try to be WITH my patients especially
if there is no family. I just hate for patients to die alone.
So that with my acute care patients my goal is to see them leave and go home; but with my terminal patients I feel good if I made there passing easier & if I was there for them.
I think all nurses feel emotional when a patient dies;especially when we have really pulled out all the stops.
I too, work in a teaching hospital and share your feelings.
IMHO the day death no longer affects you is the day you need to look for another career. Let me be clear though, I'm not saying you should be distraught after every death and I'm certain it becomes a little easier to deal with death with each experience. Having said this, though, I don't believe becoming cold towards death is natural either.
I remember my first, and only experience as a nurse, with death was about 3 months after I graduated:
I had a pt in his early 60s. He was in for kidney stones, but was pretty much a train wreck--psychotic, CVA which claimed his left side of body, HTN, DM, sleep apnea (so wore a CPAP) and several other things. On the second night I had him they had just performed the stone removal procedure, so he was in a bit of pain. I medicated him with 2 vicodin. About 40 min later he was hallucinating and becoming agitated (trying to crawl out of bed to let the person in who was knocking at his closet door). So now I gave him 1 mg of ativan IV. This all happened about 0400. At about 0600 I went into his room to reset his IV pump to record his I&Os. All seemed fine--he appeared asleep. At 0730 I was in an inservice for the hemovac when I heard the code called. I realized who it was and promptly left the inservice to see what was going on. Immediately I was telling myself that I had missed something and started 2nd guessing whether he was really ok during my 0600 rounds--maybe he really wasn't breathing and we could have saved him. I went into the restroom and was balling my eyes out, praying that I hadn't done something to harm this man. I talked to several people that morning and something else I learned is that it is a very natural, and in fact healthy, response to look at the experience and say...what could I have done better. I can tell you, I make sure I see a rising and lowering torso when I check my patients now. And if I'm pretty sure I saw what I saw I return just to make 100% sure.
I feel your pain... I cried several times when I lost a patient that I got attached to or the family. I've taken care of patients for months and I see them die all the time.
What I tell myself its that they are not suffering anymore and they are in a better place.
A couple of weeks ago, I had to start a terminal wean, gosh talk about emotions, you have the family there, the wife and kids, and the patient was alert and wanted to be taken off the ventilator.... it was a hard time, but you get stronger with time. I think after ony 3 years of nursing I have learn a lot of how to control your emotions, but still we are all human and its always good to cry if it helps you feel better :)
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
I do not know how you perceive Death---- but sometimes it helps, really, HELPS---- to have a healthy concept of death/dying. Get in touch with your spiritual/religious roots, whatever they may be and draw your strength from these.
You asked: Does it get easier? LORD I HOPE NOT!!!!!!!!!!!!!!!!!!!! I don't think so. But do we learn to COPE BETTER???? ah..now... THAT IS THE QUINTESSENTIAL QUESTION, and the hopeful answer is YES. It is for me,anyhow.
As for personal experiences: Death in OB is always unexpected and tragic. Everyone "KNOWS" OB is the happiest place in nursing------usually is. But when our patients die, they are SUPPOSED TO BE YOUNG AND HEALTHY!!! How hard it is to grapple with maternal or fetal/neonatal death, let me tell ya. The first death for me was heart-wrenching and made me want to quit. It was awful. I have seen a few since. Nope not easier, but I am learning what to do with my feelings in order to remain emotionally healthy and be therapeutic to my patients/families. You will, too with time and DEEP introspection. I look at death as a spirit "opting out of" life on Earth and moving to another plane. It sure helps me grapple with the tough cases.
Get some good books about death/dying and spirituality. Or turn to your Bible/Torah, or other religious teachings. It does help. Get counseling if you really have a tough time of it.....take care of YOURSELF first.
Really, my best recommendation is: Take care of your spiritual self. I offer you an ONLINE HUG and best wishes. Take care and hang in t here.
It's perfectly ok to "feel the moment"... and give what you can TO it, take what you can FROM it.... and then move on a stronger and even more caring person.
jnette...Couldn't have said it better...
Hugs to you for your bad day. If you didn't feel, you wouldn't be human. Yes, it gets easier, but never lose your feeling for others. It's what makes you a great nurse!
jnette, ASN, EMT-I
4,388 Posts
Hugs to you. Big, warm hugs. Allow yourself to FEEL.
Elephants and other animals mourn the loss of their own... we should not?
It's perfectly ok to "feel the moment"... and give what you can TO it, take what you can FROM it.... and then move on a stronger and even more caring person.