First patient death...

TazziRN, RN · Dec 7, 2006

You are definitely cut out for the job! There is nothing wrong with caring enough about your pts to cry over their deaths. And you never forget your first death. You will experience many more of them----some you will forget, but you never forget your first one.

As for how the others talk about pts, I am guilty about complaining about PITAs too, most of us are. It's wonderful that you have a different outlook on those same pts, and it doesn't mean that the other CNAs are cold and uncaring. They may see a different side of those same pts, or they may be grumpy.

Keep up the good work, you sound like a wonderful tech!!

TheCommuter, BSN, RN · Dec 7, 2006

I work in a nursing home and will always miss the patients of mine that die. It is normal to have feelings for a patient that you have gotten to know and admire.

I'll admit that I'm not a tearjerker, but I miss my deceased patients. For example, I admitted a cute little 93 year old lady on Sunday. The hospital nurse who called report from the hospital deceived me into believing the patient was in stable condition. However, she was about to die when I received her 15 minutes later. I immediately called for continuous care hospice and felt a profound sadness that this dying lady had to suffer the trauma of being transferred.

TheCommuter, BSN, RN · Dec 7, 2006

By the way, what is a PITA?

RazorbackRN, BSN, RN · Dec 7, 2006

By the way, what is a PITA?

That would be pain in one's posterior region.

miko014 · Dec 7, 2006

PITA = Pain in the A**

I work oncology/inpt hospice/palliative care, so deaths are nothing new to me. In fact, there was a day last week when we had 6! It was nuts. Everyone was in a hurry to get somewhere, I guess.

I take care of a lot of these dying pts over the course of months, or even years, and sometimes it really hits home when they die. It's really hard, especially the young ones. But it's a part of life. I like that I get to help people die peacefully, and help their families make the transition. The fact that you are upset that someone you got close to died does not make you too emotional. It means that you ARE cut out for this!

I had a sweet lady in her seventies not too long ago. I took care of her for almost two weeks. The day she died, only one of her three dtrs was there. She called her sisters to come in just before she died, and the one sister didn't make it in time. She saw me in the hall and grabbed me and hugged me so tight and cried for like 5 minutes before she went into the room, and she hugged me again and thanked me before she left. It made me feel good to know that I had helped the pt and the family. To me, that is what nursing is about.

And hey, if the death part doesn't work with your "style", choose a floor where it doesn't happen much. I have had other floors call me and ask me how to do morgue care - they don't know, because they do it so infrequently. True, it is usually expected where I work, but that's not to say that I haven't seen my share of people die who weren't ready, or who coded and didn't make it.

As for people talking about pts, it happens everywhere. Your coworkers are just blowing off steam. And don't forget personality - some people just don't get along with other people. I have had pts who everyone loves who didn't like me, and vice versa.

It's hard, but you're doing great! Just keep your chin up! Talk to your religious leader, or even a chaplain where you work. You'll find a way to cope with these feelings. Just be proud that you made a positive impact on her and her family! Good luck!

miko014 · Dec 7, 2006

That would be pain in one's posterior region.

You beat me to it! :chuckle

Lacie, BSN, RN · Dec 7, 2006

I cant tell the countless times I have cried for, about, and with patients and/or thier families in the 24 years I've been a nurse. There is nothing wrong with this, in fact you would be surprised how many families remember "that nurse that loved my mom or dad". Or sitting with the mom who just lost her little one in the neighbors pool who you havent even met really except for the last hour you were coding her child. They remember and they do appreciate. It also gives them permission so to speak to express thier grief at the moment feeling that you know what they also may be feeling. It may have been your first but I gaurantee you it wont be your last. It only shows you have compassion and your cut out for this work when you have that. It's the ones who dont have the compassion or become "hardened" that I worry about.

TheCommuter, BSN, RN · Dec 7, 2006

PITA = Pain in the A**

:roll

Thanks for the clarification, as I'm not good with acronyms!

carolinapooh, BSN, RN · Dec 7, 2006

I don't know if this will help the OP, but I was at the receiving end of nursing care that was the last push I needed to pursue my new career choice.

My dad passed away in April 2005; the nurse caring for him that day had cared for him before (he was in ICU for 12 days and intubated for 7). She had struck me as very competent, but not huggy-feely. I trusted her, but she made me nervous.

Now I will never forget her.

When the monitors overhead began to beep constantly as Daddy started slipping away, she cut the noises off - and it was then that I realized she had been in the room with us for over an hour. When the lines went flat, and she pulled the ECG strip off the monitor and turned it off for the last time, I noticed that she was crying. Not sobbing, but tears were running down her face. She hugged my mom and then she hugged me - a real, warm hug. (That's when I lost it.)

I wish I could remember her name. I know I'll never forget her face. I would love to invite her to my pinning next December if she could come. As silly as it may sound, what I saw that day just convinced me that this is where I needed to be, and I'll always remember her for that.

People do remember. The families care. I wouldn't worry about what everyone else thinks. Your actions don't go unnoticed or unappreciated.

TazziRN, RN · Dec 7, 2006

My dad passed away in April 2005; the nurse caring for him that day had cared for him before (he was in ICU for 12 days and intubated for 7). She had struck me as very competent, but not huggy-feely. I trusted her, but she made me nervous.

My brother was in the ICU for a week before he died. One nurse I knew was very very competent but I never thought of her as "nice" either. She was assigned to my brother on that last day, and when I ran into the hospital after being told to come immediately, I'll never forget how she put her arm around me and calmy told me what was happening, and then she held me as I cried.

BJLynn · Dec 7, 2006

Caring should be a prerequisite for being a nurse as far as I'm concerned. If death doesn't touch you on SOME level, you have no buisness being a nurse. Having said that, that doesn't mean you have to cry a river everytime someone passes. One of the most compassionate caring things we can do as a nurse is to make sure someone is comfortable and cared for during the dying process. I used to work in a nursing home so I have seen a fair amount of death. This is going to sound rather morbid, but when a patient passes on with a peaceful look on their faces, that there makes me feel as if I've done my job making sure that paitient has had a chance to die with death and dignity on their OWN terms.

Two deaths stick out in my mind, and will forever. Because of these two deaths, I am still giving serious thought to becoming a hospice nurse.

The first time I had to call a family in because a loved one was extremely ill was the hardest. This lady had a systolic pressure of 48, and I couldn't get a diastolic pressure period. I had to stand there in a darkened room and explain to three generations of men (ranging in age from 12 to 70) what death looked like, what it was going to smell like in the room(this lady had a GI bleed in response to extreme dehydration, and that is a distinctive smell all of its own) , and what to expect from the staff as far as response to a death. I felt like crap having to tell them this, but they all looked at me and hugged me and thanked me for my compasion and taking the time to talk with them. I stepped out into the hall and bawled. This lady didn't pass that night, but a few days later on my day off. Still, I made sure she was she was clean, was in as little pain as I could manage (god bless morphine), and her family had unfettered access to her for a chance to say goodbye.

The other death was a nursing home "warehouse" patient. Her family basically coulndn't take taking care of a developementally disabled elderly lady, so they shoved her in a nursing home. They visited about twice a year (even though they were local). Well, this lady had more and more trouble eating and drinking, and eventually quit altogether. Her family consented to putting her in hospice care, for which I am eternally grateful. When I was alerted to the fact that this lady had something very wrong with her (again, a MASSIVE lower GI bleed that you could smell from two doors down) I assesed her, called the doc who agreed with me that she probably only had hours left, called her family (they just wanted to make sure the proper person was notified so she could pay for the casket), and called hospice. Within an hour I had morphine and ativan delivered. This little lady was washed frequently by the CNA staff, she was calm, felt no pain, and had volunteer off duty CNAs sitting with her until she passed early in the morning. Many CNAs who knew she did not have a supportive family stopped by to hold her hand and say a short prayer for her. Even my muslim CNA.

I feel privileged that I could be part of these two ladies passing. I helped them get through the dying process with dignity and relative comfort. They also passed on knowing they were cared for.

You can't have life without death, and you can't have death without life. It's ok, and even good and nececarry to grieve death, but just remember it is a natural and inevitable part of life. As nurses we will never be able to avoid death, but we sure can make it a little more comfortable for all those involved (One little clarifying statement here: Within the scope of our practice and within doctor's orders of course!) Compassion is a good thing for a nurse.