Feelings after first loss

Flatline, BSN, RN · Dec 19, 2017

In nursing like in life, things happen.

Don't stress about it, we care for the less than perfectly healthy and sometimes odd things happen.

I cared for a patient who spent just short of 2 months on my unit. Finally was about to discharge that morning and about 0300 she vomited, choked, coded, and died. Boom, done.

Davey Do · Dec 19, 2017

I am a first year nurse in Med Surg and just had my first patient pass. The patient was fine according to my assessment.
i worry will this come back to me in any way if I missed something? I honestly don't know what I could have done, what I could have missed, as there were no signs of respiratory distress or history..

It's difficult, dharmalove, loosing a patient and feeling as though you're responsible for this patient's welfare and perhaps could have done more to have prevented the outcome.

The fact is we can only do so much. "We do what we can, but the end result is in God's hands". Or the Fates. Or whatever gives you peace.

I was a brand new RN when a patient passed on my watch. Totally unexpected. The patient was in the detox side of chemical dependency treatment and I had rounded on them according to protocol. I was just passing the patient's room, going on break, and thought I'd just look in even though it wasn't time. The patient was laying in the same position as the last time I had rounded and this feeling went through me. I checked and found no pulse or respirations, called a code and we could not bring them back.

The hospital where I worked had a debriefing/support meeting thereafter which really helped. I've lost several patients before and since then and have dealt with it by realizing that I can only do the best that I can and that I cannot control everything.

The very best to you, dharmalove.

brillohead, ADN, RN · Dec 19, 2017

We had one a while back that shocked EVERYONE -- patient was alert and oriented and talking just fine in the emergency department, then just keeled over dead after being transferred to the bed on admission. We didn't even get a set of vitals on him, it was that quick! The ED nurse, the phlebotomist, and the respiratory therapist who had cared for him in the ED were all blown away... "He was sitting up and talking and looked great!"

My first patient death was someone I knew in my teens. We had spent the whole shift reminiscing about people we both knew, and then just before shift change he coded.

It happens. Death is an inevitable part of life.

Been there,done that, ASN, RN · Dec 19, 2017

"The doctor said it may have been a PE."I have seen many unexpected, quick deaths. PE is ALWAYS thrown out there as a possible cause.

The fact is... death happens, despite our best efforts. You will see many more.

Stay strong and carry on.

dharmalove · Dec 19, 2017

Thank you for your kind words, though there isn't too much reason for me to feel burdened, I do. Hoping it will pass soon.

smf0903 · Dec 20, 2017

I think it hits you differently when it's out of the blue.

We had a patient sent in one time with a suspected GI bleed. Patient was talking to us, joking around, completely alert, no pain, no anything. We went to reposition the patient in the bed and the patient literally let out a weird sound and then was just dead...literally like one second he was talking and 5 seconds later was dead. I don't think I will ever forget that because of the unexpectedness and suddenness of it all.

dharmalove · Dec 20, 2017

How did you deal with that? You're right, if my patient was severley, I'd probably understand. But they just got up with physical therapy, can back, and suddenly coded which is why PE is suspected. I just can't stop thinking about it

evastone, BSN, RN · Dec 20, 2017

I was a couple of months off orientation on my tele unit when my first patient died. He came for chest pain and was diagnosed with pneumonia and MI. His troponins were a little elevated and he was on some oxygen but his vitals were stable, he had no complaints, and he looked good.

His family was with him when he got admitted and one of them asked me to keep a careful eye on him and then left. I rounded on him often and he seemed fine. Then he flatlined. I ran into his room and a code was called but there was no bringing him back. The family member came back and cornered me, shouting "You said you would watch him!" I responded with "I am so sorry. My coworkers and I have rounded on him at least once an hour and he was ok. I was in his room as soon as the monitor showed something was wrong. We did all we could but he was gone."

There was no way for me to stop his death, and I did everything I could for him. It is what I tell myself every time I remember this patient and it is what you need to tell yourself. With time, you will move on.

NutmeggeRN, BSN · Dec 20, 2017

What we all need to rememeber is that medicine and nursing was first an art and then a science. There are times we have no control. I wont say it gets better, but it we learn to not be as outwardly affected by inevitable (and unpredicted) death. What I am learning late in my career is that you cannot completely bottle things up. I need to focus on more on me and have not done so and physically am feeling the effect.

malenurse69, MSN, NP · Dec 20, 2017

Ive seen more people die than I'd care to admit being in the ICU. Simple fact of reality is that some people will die regardless of what you do or how well you do it. I've seen 90+ year olds recover fully from a massive stroke while 40 somethings die to comparatively minor things. While not the norm, it does happen. It gets better with time and exposure.

nursemike, ASN, RN · Dec 20, 2017

I did a lot of soul searching after the first time I had a patient pass unexpectedly, and I feel like it was right to do so. The next day I discussed it with nurses I know and trust, and they said there was probably nothing anyone could have done, but I continued to ask myself whether that man might still be alive if he had had a better nurse, and even a decade or so later, I can't answer that with certainty. It isn't that I don't trust the opinions of those I know and trust, or that I don't understand the need to let go and move on. But my intuition is that the reflection I've done is something I owe the patient and his family, and more to the point, a way to improve the odds a little for the patients I've had since. Frankly, there are a couple of things I'd do differently if I had to do them over, and while I can admit it probably wouldn't have changed the outcome, then next patient will get the benefit of whatever slim chance there might be (although I'm sure I will have other questions to ponder, afterward.)