so after being out of nursing school nearly 3 years, i have just experienced my very first patient death. i've been there to assist other nurses during their patient deaths but this was the first time one of my patients died while i was on duty. death and dying doesnt bother me and im definitly not squeemish about dead bodies...but i dont think i was fully prepared for what i would feel. so this had me thinking that this could be a good thread, to hear about other nurses' first patient's deaths, as i am sure that we will remember them forever.
so i work mostly night shifts part time in a long term skilled nursing and rehabilitation center, so im not on duty too often...i also float so i dont have the pleasure of working with the same ppl every shift. i do, however, still manage to develop very good relationships with my residents and the families. this past, week i was taking care of one of my "easier" residents....(he's bed ridden, does not speak, has a peg, o2, colonostomy, foley, and a slew of ulcers, Q6h accucheck, Q2h turn schedule, but doesnt EVER complain or use the call light:yeah:) and in report i got that he hasnt been soing too well since the last time i had the pleasure of taking care of him. a few days prior he started to run blood sugars that were off the charts and had no hx of DM.....well to make a very long story short...it became very clear to me that he was just about ready to depart, considering he's been at the facility longer than i've been a nurse and had even been on hospice once before but was taken off. so he's febrile with a temp of 104 all night and has tylenol ATC, which is doing nothing for his fever, his blood sugars are so high that my glucometer cant read it, and his respirations have increased significantly. needless to say i spent my 12 hour shift trying to keep him as stable and comfortable as possible (DNRCC) and on the phone with his very concerned wife. just about an hour before its time for me to go home his respirations have dropped very low..4-6, i have him on ice, room cool, cant give any more insulin.....i go in to change dressing and he takes his last breath....
ofcourse i feel so relieved that he doesnt have to suffer any longer but i would have given anything to see the rise and fall in his chest. was soooo sad for his wife, who couldnt be more involved in his care and super concerned about him this night. so this becomes the difficult part for me...calling her after just speaking with her a couple hours before to tell her that she needs to get there as soon as possible. the doctor was a dick:banghead:, i called to notify him and hes says..."k, bi" and hangs up on me..but wut more could i have expected, right???? the best part was hugging the wife and seing the relieved and appreciative look on her face when i told her that i was there with him when he passed and that i did my best to be sure he was comfortable and didnt suffer...she told me i was a credit to the nursing field:saint: the worst part was going on with the rest of my responsibilities, counting narcotics and going home as if this never happened. everyone seemed so impressed with how well i was taking my first death. it felt very normal to me...i know i chose the right field. i just hope i feel just as touched by all of my patient death experiences and never become desensitized....thanx for reading my very long post and i would love to hear your stories.........ndynrs:nurse:
Specializes in ICU, Home Health Care, End of Life, LTC.
My first one was very rough. I was working as a CNA doing home care for HIV pts. I arrived at a patients house within minutes of his committing suicide by shotgun. I entered the house with my key and searched for the pt. There was a faint smell that reminded me of hamburger (sorry that's the closest I could come). I the last place left to look was the shower of the upstairs bathroom. He was there (what was left). I knew it was very recent by the odor and color of the blood and the lack of any clotting or drying. It was a traumatic sight, it looked like a v-neck sweater with nothing above the v, everything else was completely disintegrated. On top of it all there was no phone working in the house and I had to run to a payphone to call 911. The responding police officers stopped the other police officers from going in...
I also had a pt pass while working in a nursing home. Right at end of shift the LPN was doing med pass and I was doing last round. I was right behind her in this pts room. I was struck by the coldness of her skin.
My first witnessed death was just few weeks ago towards the end of my senior leadership experience in the ICU. It was one of two pts assigned to me at begining of shift, then my other pt was reassigned due to the increasing level of care needed for this pt. My preceptor was adjusting a drip to get her BP up and I was on the other side of the bed. I looked up at the monitor and watched her HR go from the 50s to the 40s. I told my preceptor she was bradying down, she looked up and said check her pulse, it was not palpable. I started compressions my preceptor called for the crash cart and we proceeded to run a full code, twice. The family was present and agreed to have us stop when the second resusucitation attempt was not acheiving results after 20 mins. We had gotten a pulse back and with all the drugs it took another 30-45 mins for her ECG to flatline. It was strange to me that even as I closed the bag I still considered her my patient.
My first patient to die really made me question my ethical beliefs... She was 50 years old, in a LTC facility (I don't remember for what). She had a seizure, sent her out to the ER, and she returned with a subdural. Her RP decided against a PEG (much to the rest of her familys dismay), and she was NPO. It took her 28 days, no food/water, to pass. I had only been a nurse for about two months and I had no idea people could last that long without food or water. I was also extremely frustrated because the other nurses on the other shifts refused to give her Roxanol (or anything else for that matter), because they said they 'didn't want her to die on their shift', though she was obviously in discomfort. :angryfire I gave her everything she was prescribed on day 28, and she died 30 minutes after my shift. I still think about her all the time.
This is its own thread in its own, but has anyone else run into other nurses refusing to give needed PRN pain meds because they're too lazy to do so, or just don't want someone to 'die on them'?
Mine was a litttle guy named Marcus, he was 4. He had been sick with some kind of stomach bug and his Nana was giving him some crazy Mag and K+ liquid herbal "supplement" she heard about or made herself or something.
He came to us with ARF, dysrythmias, ect and progressed from there. Complete train wreck... DIC, bleeding from every orifice- I mean liters of blood from the ETT. Coded multiple times on my shift- 5 pressors, CVVH, Transesophageal pacing- you name it. Nana just could not bring herself to say stop because she blamed herself. Finally, we could no longer pace him and he passed...(offically)
The worst part was trying to help Nana come to grips afterward- I often wonder about her and how she got herself through the whole process.
I was only 22 and on orientation-I can remember thinking how wonderfuly my preceptor and the other nurses and docs managed the situation. Unfortunately, in my area, I have seen many deaths... but I think the first one you experience is permanently burned into your brain.
I have not experienced the death of my own pt yet, we did have a pt on our unit that died while he was in dialysis (he was a DNR, still to this day don't know what went wrong because he was fine when we took him down) and my preceptor told me to go assist the CNAs/LPNs with post-mortem care (because I'd never even SEEN a dead pt in nursing school, and she knew I needed to do what all we do for a pt who has passed).
I am very glad you were there with the pt when he passed, dying alone (physically or otherwise) has to be the worst feeling ever. I'm sure you brought him comfort just by being there.
Specializes in LTC, assisted living, med-surg, psych.
My first was many years ago when I was a student NA. It was toward the end of my first week on the floor, and I was sent in to feed a 93-year-old man who, I'd been told, was dying from renal failure. He and his little wife lived in the same room, and they both nodded pleasantly to me as I brought their trays in.
I had been instructed by the charge nurse to make sure he ate at least half of his meat and vegetables before he could have the minuscule piece of chocolate cake on his tray. So I sat down next to his bed and dutifully forked up a bite of roast beef, which he refused by shaking his head silently. I tried a spoonful of peas---same response. He also declined to drink his milk and juice, but all throughout these efforts, his eye was on that chocolate cake.
This was one of life's AHA! moments, a time when "thinking outside the box" stops being just another cliche. I thought: "For Heaven's sake, I'm 35 years old, and I'm telling a 93-year-old gentleman he can't have his chocolate cake unless he eats his meat and vegetables?? Yeah, RIGHT!" I cut into the cake with the fork, offered it to him, and he accepted gratefully..........in fact, he downed the entire piece and finished off with a couple swigs of milk, belched contentedly, and smiled his thanks.
His wife also thanked me, saying, "That's the first he's eaten or drank in two days. They keep saying he has to eat all this other food, but if he doesn't get to eat what he wants now when he's dying, when can he?"
The gentleman was still smiling when he passed away in his sleep later that very afternoon. And while I was definitely shaken and saddened by his death, I have never once regretted what I did, and am convinced to this day that he died a happy man.
My very first death was as a CNA. I was BRAND new and didn't realize I had the right to refuse a task deligated me. Anyway, I had a RN tell my to give a 8oz glass or "power" drink to a pt. I gave her one spoonful and she aspirated it. I went back to the nurse and told her the pt was aspirating. I'll never forget the rn said, "I don't care. Get as much into her as possible." I went back and gave her half the glass before I couldn't stomach anymore. She died a few hours later. The pt was a train wreck with 5 stage 4 ulcers and would have died eventually, but I always feel guilty like i hastened her death. I have had several DNR deaths since becoming a RN. But the death that sticks in my mind as a nurse is the one I had that we coded. He was a young man (45) who was in for pneumonia, but had been basically unresponsive since an anersym 6 months before. He had been a DNR in the nursing home, butthe paperwork had not been done to make him a DNR in the hospital so he had to be coded. When I got a hold of the POA she said to KEEP coding him. after 20 minutes he passed anyway. That is my asolutely least favorite part of nursing, coding DNR pts.
My very first death was as a CNA. I was BRAND new and didn't realize I had the right to refuse a task deligated me. Anyway, I had a RN tell my to give a 8oz glass or "power" drink to a pt. I gave her one spoonful and she aspirated it. I went back to the nurse and told her the pt was aspirating. I'll never forget the rn said, "I don't care. Get as much into her as possible." I went back and gave her half the glass before I couldn't stomach anymore. She died a few hours later. The pt was a train wreck with 5 stage 4 ulcers and would have died eventually, but I always feel guilty like i hastened her death.
a nurse told you to continue giving a drink, to an aspirating pt???
I work SNF and remember my first death. I looked at a DNR patient one evening and thought he might be close. I stepped out of the room for a moment, came back in and put my hand on his shoulder. He took two breaths, swallowed, took one more breath and died.
Strange but I felt zero emotions(using a tempanic thermometer i took his temp several times over a few minutes and was was amazed at how fast the human body cools down) Watching him die was as natural as watching him live.
I have experienced it many times since and I am lucky because I learned that I view death as a totaly normal process and part of life. I become very fond of my patients when they are alive and truly care about them but consider their deaths just as normal as their lives.
ImMrBill3, RN
116 Posts
My first one was very rough. I was working as a CNA doing home care for HIV pts. I arrived at a patients house within minutes of his committing suicide by shotgun. I entered the house with my key and searched for the pt. There was a faint smell that reminded me of hamburger (sorry that's the closest I could come). I the last place left to look was the shower of the upstairs bathroom. He was there (what was left). I knew it was very recent by the odor and color of the blood and the lack of any clotting or drying. It was a traumatic sight, it looked like a v-neck sweater with nothing above the v, everything else was completely disintegrated. On top of it all there was no phone working in the house and I had to run to a payphone to call 911. The responding police officers stopped the other police officers from going in...
I also had a pt pass while working in a nursing home. Right at end of shift the LPN was doing med pass and I was doing last round. I was right behind her in this pts room. I was struck by the coldness of her skin.
My first witnessed death was just few weeks ago towards the end of my senior leadership experience in the ICU. It was one of two pts assigned to me at begining of shift, then my other pt was reassigned due to the increasing level of care needed for this pt. My preceptor was adjusting a drip to get her BP up and I was on the other side of the bed. I looked up at the monitor and watched her HR go from the 50s to the 40s. I told my preceptor she was bradying down, she looked up and said check her pulse, it was not palpable. I started compressions my preceptor called for the crash cart and we proceeded to run a full code, twice. The family was present and agreed to have us stop when the second resusucitation attempt was not acheiving results after 20 mins. We had gotten a pulse back and with all the drugs it took another 30-45 mins for her ECG to flatline. It was strange to me that even as I closed the bag I still considered her my patient.