First Death Experience

[DenaInWyo]

Last night at work I had my first experience with death.

I'm not freaked out about it, just, well, affected by it and it's heavy on my mind.

I've never even been around anyone dying in my personal life..the closest I've ever been to a dead person was twice at funerals. Wow..how lucky I am, at 34.

Went to work (CNA at a nsg home) at 1400..checked on this lovely lady on my first rounds..she said she was cold so I got her a blanket. She's normally very independent..talkative, oriented and altogether 'with it'. She'd gotten up for lunch that day, then laid down for a nap. The aide who had vitals that day took hers (routine) about an hour later and her bp was 70/28. She told the nurse, and word spread like wildfire through the building..the lady was a favorite of many. By 1530 she was mottling and her respirations were only 8 per minute. At about 1600, another aide poked her head out the door and waved me in as I walked down the hall..wasn't sure if she could find a pulse. I checked her with my stethoscope, told my co-worker we'd better get the nurse. It's a very odd sensation, putting your stethoscope where you know the heartbeat should be, and hearing nothing. The thing is though, you know by looking at them that you won't find anything, before you even check.

I got a little teary eyed, but thank goodness didn't disolve into a blubbering mess, which has been one of my greatest fears since starting nsg school. I'm one of those people that cry over sappy commercials on TV.

And then, I went on and got my run up for dinner. The funeral home came for her within about an hour.

I am overwhelmed by the permanence of it..the fact that it's done and there's no getting it back. I'm not overcome..a little sad for her family, but not totally freaked out or anything. Not even close to what I thought I might be. I've never experienced death firsthand like that, and just wanted to share. I did feel kind of weird about just letting it happen, and it added one more click to the wheel that is turning that will determine where I want to work in nsg. I think I want to be someplace where I can at least try to defy that permanent, irrevocable final step..or at least be part of the team that is trying to save that person. I totally understand and agree with DNRs..this was no exception, but it was till kinda weird..like I should have been doing something. I guess that goes back to the time I heimliched a 10 year old when I was a waitress. That's an amazing high.

Anyway, I'm disolving into a ramble, so I'll stop now. There's no other place in the world that I could have related this with knowledge that I'll be understood..thanks from a truly green student.

Deana

[P_RN, ADN, RN]

I'm very sorry for your loss. Your post made me cry also. What a good Nurse you will be! Even if there had been no person sitting with this lady, I believe she had your and your coworkers' loving care to ease her way. You will never forget this experience you were privileged to have. Bless you.

P

[prmenrs, RN]

I had another baby die after I had been working many years. It had been a very bad day, baby critical, lots of drips, coded, yada, yada. At this hospital, Security came up, took you and the baby down. As I was sitting there, baby in my arms waiting for Security, we got a call for a transport: TWINS. The charge nurse took the baby out of my arms, told me that I was going w/another nurse on this transport.

I was next to useless on this transport! The other nurse just ran circles around me. She knew I was sort of 'out of it', just kept telling me what to do, having me chart, etc. It was the worst transport I've ever been on, I think!! I might have started an IV, but I do not remember a thing. And the transport made us ~ an hour late going home. Not a good experience.

[suzanne4, RN]

Thank you for sharing. I admire your compassion.... Wish that there were more like you. :)

[TreetopAngel_RN]

My first death as a student was, prophetically, a premie. I had helped the pediatrician code the baby, but he died.

I thank God every day that there are good nurses like you who can take care of the babies.

I learned quickly during my Peds rotation that nursing little kids and babies is not for me. I cry even when they are just sick, it would do me in to have one die.

Love my old folks...

[RN@34]

]Had my 1st pt. die during my last week of my last semester. I will have to admit that I broke down. MD had just discussed with pt. her poor prognosis and at 1200 she had decided to make herself a DNR. I walked off floor to get coke at 1245 and when I got back to floor at 1250-CNA informed me that pt. had passed. Once I was over initial shock, I walked in patient's room and just held her hand and prayed at her bedside. I immediately had a strong calming feeling come over me. I saw her at peace and no longer struggling to breath-(pt. had interstitial lung disease). ]When I got into nursing I knew that death would be something I would have to deal with and I definitely do not see it getting any easier. I am so tenderhearted! I am sure all this falls under the aspect of caring and if I cry everytime then so be it. The only pt. population that I could not deal with as far as death would be infants and children-can't even watch St. Jude telethons.

[Tweege]

I have not begun the journey of a nursing student, but will begin in the fall. Thank you Deana for sharing such a personal time. I was moved by your experience. I understand and can relate to some of the people who have posted to this thread, who consider it an honor and privelege to be with someone during their last moments in this mortal body. That is one of the reasons I want to become a nurse, to help those I can to live and those I can't to make the transition to eternal life, hopefully with God. I have had a several freinds who have passed away in the last few yrs, young (35+-) and often don't understand why. I feel in my heart that nothing happens in life without being sifted through the hands of God first, and I know His plans are perfect, even though they may not make sense to me now. We are all born to die, some young and some old, but it is part of life. Because of my faith I believe we transition from this fleshly body we reside in to a spiritual body that can handle being in the presence of an Almighty God, a place where there is no more pain, no more tears, no more heavy burdens, no more death or dying, just pure love for eternity. Because I have not been at the bedside at the time of death, I'm not sure how I will react when the time comes, I hope that I will be able to share Gods unconditional love even if no word is spoken, through my actions and just being there. I also realize that not everyone believes the way I do, and understand that that is there choice, but still hope that I can bring comfort to them as well. I will not push my belief on someone, but am willing to share if that is what they desire.

Anyway, God bless you Deana, I too think your compassion and caring attitude will provide you with the skills to be an awsome nurse, keep up the great work you are doing.

[AKAKatydid]

[This is a long one... sorry]

I just wanted to bump this one up, and say THANKS for sharing your stories. I just had the unfortunate experience of having my first and second death this past weekend. (one at the beginning and one at the end of the shift)Thoughts of it just sort of linger, and I'm still not sure what to make of it.

The first patient I had not met before. She had an intracranial bleed, and came up several hours earlier for comfort measures only. Her entire family was in the room, spending the last moments with her. Everything seemed peaceful, and her family seemed quite relieved when all was said and done and they left the room. I had just begun my shift and was lucky enough that one of the techs (a fellow nursing student) with some experience in deaths stayed to help me.

Because I hadn't seen the patient until she had passed, there was an eerie detatchment with the whole thing... full of concern, but yet no personal experience with the patient to really put me in grief. (Hard to explain - I hope that didn't come out wrong) This woman seemed to have a wonderful family, and was very lucky to pass in such a peaceful manner. The tech that stayed to help me is considering going into hospice, and I couldn't have had a better person show me what to do. Every aspect of the patient's passing was full of dignity and respect.

About 10 or 11 hours later, towards the close of my shift, I started to pick up vital signs to help out the day crew coming in. (We always try to help the next shift when we can!) I heard one of my patients coughing like she was choking up something. (She had been alternating between delerious & comatose - I've never seen her A&O) Well she was fairly comatose... but breathing ok. She had stuff coming out of her mouth that looked white & chunky. I stuck a gloved finger in there, and pulled out a bunch of stuff. I went to get some Toothettes, and stopped at the nurses' station to let the nurse know I grabbed a whole bag for her room, and that we need to probably be giving better oral care on her. When I got back into her room, I moistened a Toothette, and stuck it in her mouth to clean it.

.... that's when I noticed her tongue didn't react ... and saw that she wasn't breathing. She was a DNR, so I ran back to the nurse's station and told her nurse that she wasn't breathing. Two of the nurses came running back to check. One came with the "crash cart" and after listening with the stethoscope, they connected the leads to confirm. It was absolutely awful.

The patient's 60-something daughter was asleep in the room with her. We woke her to tell her, and she freaked out. She left from the room (on the 3rd floor) and went outside to go smoke.... then came back upstairs and told us we had to recussitate her mom... saying "They told me we could change our mind on the DNR... you need to recussitate her!!!" by then it had been to late for us to do anything - even if we could. Her passing probably would have been ok with me had it not been for the daughter - who did not stop her tirade for almost 2 hours. It was really sad, because we all knew that in her condition, death was inevitable... She looked very peaceful, and had not been in any pain for some time.

Again, the whole thing lingered. It wasn't until I got in the car on the way home that I started to get teary eyed. I talked to my dad.. told him I needed a hug... and told him why. He gave me a half-hearted arm around the shoulder, and told me "You're going to have to get used to this in your profession. These things happen" ... that hurt. I took a long hot shower, and cried. I don't ever want to "get used" to people dying on me.

Thanks for sharing your stories. It's good to know I'm not alone! :icon_hug:

I've said it before, and I'll say it again... this is a great group.

[TreetopAngel_RN]

I don't ever want to "get used" to people dying on me.

That is the best attitude to keep. Every death deserves a tear. Most often our tears are not in grief, but in memory of the person who we have cared for and the loss their family is feeling.

Thank you for caring,

Elizabeth

[RainDreamer, BSN, RN]

Again, the whole thing lingered. It wasn't until I got in the car on the way home that I started to get teary eyed. I talked to my dad.. told him I needed a hug... and told him why. He gave me a half-hearted arm around the shoulder, and told me "You're going to have to get used to this in your profession. These things happen" ... that hurt. I took a long hot shower, and cried. I don't ever want to "get used" to people dying on me.

((((BIG HUGS))))) for you, I know it's not real, but the thoughts are still there. I know exactly what you mean in that paragraph ..... other people just don't understand, they think it's something you're just going to have to get used to dealing with. Thanks for sharing :icon_hug:

[pricklypear]

Again, the whole thing lingered. It wasn't until I got in the car on the way home that I started to get teary eyed. I talked to my dad.. told him I needed a hug... and told him why. He gave me a half-hearted arm around the shoulder, and told me "You're going to have to get used to this in your profession. These things happen" ... that hurt. I took a long hot shower, and cried. I don't ever want to "get used" to people dying on me.

Getting used to something and being unmoved by something are two different things. You do need to 'get used to this' because families depend on us to be strong enough to lead them through the process. If you break down with every death you experience, you're going to exhaust you own stores of emotion. Grief is something loved ones and friends experience - sorrow, empathy/sympathy are our emotions when a patient dies.

These things do happen - death is just another stage in life. Sometimes it can be prevented, sometimes not. Sometimes it should, and sometimes it shouldn't.

The thing I can't get used to is how some families are unwilling to let someone go. They are OK with seeing someone suffer, on a vent, having seizures, basically miserable...but not with letting someone go. Or families who reverse DNR orders requested by the patient at the last minute. I see this ALL too often, and it breaks my heart. I just find it so incredibly selfish. It takes more strength of character to honor a loved one's wishes than it does to keep them alive because "I don't know what I'll do if she dies"

We had a lady who had a DNR order (self written on admission) who ended up intubated at her daughter's request at the last minute. When she woke up, she was P****d. She self extubated a couple days later, told everybody in NO uncertain terms that she NEVER wanted to go through that again, she was miserable (over 300lbs, about 100 of that edema that was weeping everywhere. Covered with blisters, tearing skin etc...) and was ready to go. Well, her loving daughter reversed her DNR a second time when she became unresponsive, and had her intubated again. She woke up, and self extubated again. This time a stop was put to it ( I think the docs refused) and she was allowed to die - not peacefully, but on bipap (which she hated). She lingered for days - and there was nothing we could do. Guess who wasn't around in the end?? It's pretty emotionally draining and heartwrenching to take care of someone who begs you to let her die everytime you're in the room. Mouthing "why are you doing this?"

OK :) that's my beef for the day!! Didn't mean to rant and rave!

[prmenrs, RN]

I'm concerned we might accidently derail the thread w/'war stories'. Let's focus on "first death" experiences. IMO, they are the toughest and have the greatest impact on students or new grads future career. The death of a patient is a fact of nursing life; supporting a new nurse coping w/the event is critical. How did you cope? What support can you give a young nurse?

In my short stint as a night supervisor, I always asked if this was their first trip to the morgue. If so, I went down w/the nurse and security guard. It seemed to help.

[TreetopAngel_RN]

I am truly grateful to the nurse when I had my first death experience as a CNA. We had learned how to do post-mortem cares, but when faced with the actual event I froze.

My nurse told me exactly what to do and to remember that what I was doing was the last thing ever this person NEEDED me to do for her. That is a lesson I still carry with me, I will never again be asked for anything by this person.

As for "getting used to" death, we should never do that. Learning to cope is what we must do. Even after five years, I still cry...not at the bedside and not in front of family members, if I need to I'll take a break once my services are no longer needed or wait until I get home. My spousal unit is THE BEST sounding board and realizes it is something I have to get through on my own...talk about someone with total empathy.

My first coping mechanism was destructive, I denied the emotion felt and held it inside of me until I could no longer feel. This made me come across as cold and uncaring. In order for me to avoid future heartache, I began the process of closing down when an end-of-life patient was admitted. I was an automaton, doing the right things, but had no support for family and my co-workers.

Two ends of the spectrum, it was hard finding a middle ground, but I did it.