First Patient Death Experience

[HenrySD]

Earlier this week, I had my first patient death.

I am a recently graduated nurse that just finished orientation at the hospital I currently work at; I'm about three-four weeks in off of orientation. I always knew it was coming but I did not expect it to be this soon. I was devastated by the experience despite the support of my lovely coworkers that guided me through the whole thing.

It was the end of my shift as I wrapped things up and prepared for report. The patient was stable throughout the night, vitals stable, rhythm stable, came in for a relatively benign diagnosis (Bowel Obstruction). I've been medicating her with pain medications throughout the night as indicated, every four hours as necessary. It was a pretty standard shift until I get the announcement from across the room.

"Your patient just went asystole!" I dropped what I was doing and ran into her room. I quickly reach for her carotid to check for a pulse, none. I scream for help and the code was called. My more experience co-workers rushed in to help me, I froze, I've never felt so dumb, so useless. I immediately began chest compressions as everyone readied the equipment. The code took 15 minutes but we could not revive her.

Long story short, I feel like I've failed as a nurse. She was a younger patient with a relatively benign diagnosis, no cardiac history to our knowledge. I froze up during a critical moment. I stayed after to perform all the necessary things, holding my head up as high as I could. As soon as I got home, I cried my eyes out. I called in sick that same day, I was so emotionally and physically drained.

Have you guys had any similar experiences...? If so, can you guide me through or have any tips on how to deal with these types of feelings?

[Lev, MSN, RN, NP]

For a young patient...15 minutes is short amount of time to code her...especially given that CPR was started right away...hmmmm....

[Here.I.Stand, BSN, RN]

It sounds like you did just fine. Over time you will gain more confidence in these emergency situations. Besides, I have a feeling that you weren't frozen nearly as long as you think. Seconds can seem like an eternity.

You called for help and started compressions--those are the most important things to do. Nurses on the code team--ICU charge, RR nurses, etc.--are there because they are experienced. Most of us, if not all including the code team RNs, have reacted similarly to you when we were new.

Be kind to yourself and hold your head high. You did exactly what needed to be done.

[0.adamantite]

Something just happened. You may never know. I've had this happen once or twice. These deaths are very devastating and unfortunate. It could be that she threw a massive clot. There may be an autopsy depending on the medical examiner's protocol or family wishes. Just so you are aware, a bowel obstruction is not a benign diagnosis. A family member of mine died of one last year after their bowel perforated while in the hospital. Depending on symptoms and clinical presentation patients can need emergent surgery to save their life. Fluid balance & electrolytes are important. Also a good abdominal assessment and watching for changes in pain. Keeping a close eye on those pesky NG's. I am always wary around patients with an obstruction, let's just say I have seen them go terribly wrong and not just with my family member.

[SubSippi]

Nobody expects you to know what to do in your first code. That's the whole point of being able to call a code...you get helping hands with lots of experience. If experience wasn't important, they wouldn't require RRT nurses to have years and years of ICU experience.

This patient obviously had something else going on with her health. If there was something you could have or should have been doing to prevent her death, trust me, you'd hear about it.