First Patient Death..How do I deal?

neurorn6 · Sep 17, 2008

There is no easy answer about dealing with the death of a patient. Does it make it a little easier when your patient is 80+yrs and they pass, absolutely. Death is a part of life and all of us most accept. Personally, I try to approach it in such a way that I honor both the patient and the family. When I do post mortuem care and keep in mind that I some point a nurse will do the same for my family. I take time to connect with the family. A simple hug, or any simple kindness will help them through the process.

Ultimately, we can only do our best and the rest is in God's hands. I would love to tell you that it get's easier with time but that's not always the truth. Each of us in our own way finds the tools and strength that we need to continue on.

Take each day as it comes. Do the best that you can each day. I wish you much luck and peace.

joeyzstj, LPN · Sep 17, 2008

Listen, SH!T happens and people die. It sucks for everyone and it makes you sick to think you might have missed something or you might have not done this or that. The fact is, the guy is dead. Hes not comming back. SO............now what to do? Review his case and figure out if this were to happen to day, how would you have handled it differently. This is what seperates the good from the great. The drive to be better and to become better. Read and educate yourself about his disease process and what caused this. Did he die SOLEY from aspiration and code? Probably not. Was he sedated when he aspirated? This is BY FAR not going to be the worst of what you see. Get over it and pull yourself together and read and educate yourself so that next time it happens you will be the unit authority on treating it. Gain something positive out of this and you will be just fine.

allnurses Guide · Sep 20, 2008

Listen, SH!T happens and people die. It sucks for everyone and it makes you sick to think you might have missed something or you might have not done this or that. The fact is, the guy is dead. Hes not comming back. SO............now what to do? Review his case and figure out if this were to happen to day, how would you have handled it differently. This is what seperates the good from the great. The drive to be better and to become better. Read and educate yourself about his disease process and what caused this. Did he die SOLEY from aspiration and code? Probably not. Was he sedated when he aspirated? This is BY FAR not going to be the worst of what you see. Get over it and pull yourself together and read and educate yourself so that next time it happens you will be the unit authority on treating it. Gain something positive out of this and you will be just fine.

Wow, I mostly agree with your sentiments, but your bedside manner is somewhat lacking!

To the OP, it's hard and it doesn't get easier, it just gets a little easier to accept. People in critical care are critically ill, and all of our efforts focus on making them NOT DIE. Unfortunately, we don't have control over every variable (although we try!), and sometimes the man (?) upstairs has different plans.

I agree with Joey that reviewing what you did (often in the form of "debriefing") is beneficial. Speaking to more experienced nurses who were present, to get their point of view is often helpful too. The goal is to learn what your role was, what actually happened (sometimes it's hard to get the details when you're in the middle of such a stressful situation), and what you can/will do next time it happens.

Take it easy, be kind to yourself. We get blase, but it's a huge thing to witness someone sitting up talking, and then just.. dead. Take some time to get over it. If you need more support, speak to your colleagues/manager/staff counseling person.

joeyzstj, LPN · Sep 20, 2008

Wow, I mostly agree with your sentiments, but your bedside manner is somewhat lacking!
To the OP, it's hard and it doesn't get easier, it just gets a little easier to accept. People in critical care are critically ill, and all of our efforts focus on making them NOT DIE. Unfortunately, we don't have control over every variable (although we try!), and sometimes the man (?) upstairs has different plans.
I agree with Joey that reviewing what you did (often in the form of "debriefing") is beneficial. Speaking to more experienced nurses who were present, to get their point of view is often helpful too. The goal is to learn what your role was, what actually happened (sometimes it's hard to get the details when you're in the middle of such a stressful situation), and what you can/will do next time it happens.
Take it easy, be kind to yourself. We get blase, but it's a huge thing to witness someone sitting up talking, and then just.. dead. Take some time to get over it. If you need more support, speak to your colleagues/manager/staff counseling person.

Yeah, its was late after a long day. I didnt mean that to sound harsh, however after reading it I realize that it did sound that way. The point that I was trying to make is that death is a fact of life.........its going to happen and what you chose to do with it is what counts. We have people lose patients and quit after the first time becasue they are so shaken up or feel responsible and feel as if everyone looks down on them afterward. I think we have all felt that way, however you have to find a way to take something good from it. Some of the best doctors and nurses I have ever met have became great from making huge mistakes.

kvsherry · Sep 26, 2008

You have my sympathy, I am also a new grad in ICU and would not like to be in your shoes. The only thing i can say, from another noobs pov would be to go over it with your preceptor, that is what she is there for. If she says there was nothing you could do, believe her, if she is as great as you say she will tell you the truth no matter what.

Hope this helps, from your narrative I can't think of anything you could have done differently, BTW kudos on quickly calling the code.

sicushells, RN · Sep 28, 2008

After my first patient code when I was in orientation, I was very panicked and felt extremely guilty. My preceptor said, "You gave the patient the best care you could, you acted quickly. Whether or not there was something more you could have done is up to QI, not us." Not that I don't review what I did after my shift, or read up on pathology/procedures/etc. when I'm at home, but drowning in guilt because your patient had a bad outcome is going to paralyze you, not make you a better clinician. So I usually review what I did, congratulate myself for what I did well (especially when I'm feeling down, not in a cocky/stuck up way), and try to figure out what I need to know for next time. And it sounds like you've done that.

You acted quickly, bought the patient and family some time, and the patient was withdrawn on, on the family's terms (more or less). The hard cold awful reality is, Everyone is going to die. Sometimes all we can offer pts/families is that the patient didn't die alone, uncared for.

whipping girl in 07, RN · Sep 30, 2008

Remember that quote, "On any given Sunday, any team in the NFL can beat any other?" I've applied that philosophy to the ICU. All the patients are "critically" ill and any of them could die at any time, otherwise they wouldn't need to be monitored so closely, right? That's correct in theory anyway. Don't beat yourself up, it won't change what happened. You can learn from what may have gone wrong or think of things you may have done differently, but ultimately it's not in our hands.

poppy07 · Oct 2, 2008

You can always look at it this way, when everything you can imagine has gone wrong in a code, most codes after that will seem so much better, and you will know what to do and not to do. PRACTICE MAKES PERFECT! KEEP YOUR HEAD UP. It's only the beginning, babe!

neko11111 · Oct 4, 2008

Like they said above, there is no EASY answer on how to deal with deaths. I don't think you really ever 'get used to it.' Everybody has there own ways of coping, and going on. I've only been doing it for a year, and each death affects me in a different way, because each one is different.

The only advice I can give you, is just to know that you did everything that you could do for the patient and their family. After the patient has passed, the important thing is to be there for the family members and help them through the process. When I first started, I always worried about not knowing what to say to the family members, but then I found that imagining what I would need if it happened to one of my own helped me to find the words. Just being there with them is sometimes enough.... words arent' always needed - sometimes a hug, or a squeeze of the hand is the emotional connection that they need.

As for yourself - don't beat yourself up trying to figure out what if's... if you provided the best care that you could, and followed procedures by the book - then that's all that you could have done. Sometimes people are meant to go when they are meant to go, and there's nothing anyone can do about it..... at least, that's how I think about it.

I hope things get better for you, trust me, we all go through it. It's a natural response. It will be easier with time - unfortunately, we work in one of those areas where we see death all of the time. Stick with it - it's hard, but definately worth it when you do get to see a patient get well and transfer out, or receive thankyou's from patients and family members for the care that you provided. :nurse: