First and second patient death

akulahawkRN, ADN, RN, EMT-P · Feb 1, 2015

I'm a relatively new nurse, haven't found my first RN job yet, but I'm not new to having patients die on my watch. When I worked EMS actively, I worked about 20 codes, about half of those I was running the code. As a student, I had a patient that was DNR expire within the first hour or so of the shift and wasn't expected to go that soon. The nurse I was working with actually had a more difficult time than I did about the event.

Here's the thing: you do what you can, the best you can. Sometimes we're able to provide just enough of a nudge toward life that the patient comes back. We can't save them all, no matter how hard we try. Death is something that happens as a part of life, and it's something we all will face over the years. Those of us that work in healthcare will face it more "up close and personal" than most ever will. Try to at least come to some sort of peace with death. I'm not saying that we should just let people die, rather we should be quite willing to provide a good nudge, or even quite the shove toward life, but know that sometimes it's just "their time" and nothing we do will change that outcome.

It's OK to not feel quite right for a while. It's not something we are used to experiencing. It just, well, isn't. Just don't let yourself get into too much of a funk over it. You do the best you can and you absolutely can feel good about that, despite the outcome for the patient. When you go back to work, do your job the best way you know how, keep working on getting better at it, and keep going. For now though, it's absolutely OK to feel "off" about this. It's your first deaths... and they won't be your last either.

I guarantee that you'll remember your first codes and your more recent ones. After a while, you'll only remember the ones in between if there's something memorable about it. I remember my first... and I remember the last one I worked, and one that that I didn't (most recent) as that one was a DNR. I remember the 8 year old, the young guy in a parking lot, and one that happened on a couch and all of those had something memorable or remarkable about them that cause them to stand out. There are many more that are effectively "background noise." I know I did my absolute best for all of them, even those that I don't remember.

Don't beat yourself up over these... you won't help yourself or anyone else if you do. If anything, you hopefully have gotten through the fear of calling a code. We know what we have to do... making the decision to call a code is the toughest thing to do at times.

JessicaDanielle · Feb 1, 2015

On our floor, it seemed like the 'curse' would follow one person for a couple months or so and that person would be plagued with all the codes, rrts, and patients that were circling the drain. It will always jump to someone else eventually, this just may be your turn. Losing patients never gets easier, but you learn to cope with them better with time and experience. It's the worst part of the job. Hang in there. It'll get better!

Here.I.Stand, BSN, RN · Feb 2, 2015

Hugs!! Human mortality rate is 100%, and you happened to be the RN assigned to these two. I do think the "grim reaper" nickname is insensitive though. You're clearly taking this to heart although you and your NM agree that you did nothing wrong, but teasing someone about it isn't helpful. Is there anyone you're closer to on the unit, a preceptor maybe, who you could pull aside and say "I get dark humor is sometimes used, but this nickname bothers me"?

sugarmagnolia3 · Apr 7, 2015

Sorry you went through that, and I don't think it's ok that your colleagues are calling you "grim reaper"; It is very unprofessional and insensitive to say the least. If my colleagues gave me a nickname I didn't appreciate, I would call them on it, and/ or perhaps take it to my direct report.

Nibbles1 · Apr 7, 2015

I think a lot of nurses have been through this. I was 6 months fresh out of school and had 6, yes 6, die in 24 hours. Prior to that I was a cna and we lost 4 in 3 days. Hang in there.

AnthonyD · May 28, 2015

A friend of mine a patient code and die on both of her first two nights off of orientation. Similarly to you, it was not due to anything she could have or should have done. One was right at the beginning of the shift.

calivianya, BSN, RN · May 30, 2015

Death typically comes in twos for me. I had two patients die on a Friday the 13th this year, and then I had two die in the same week, but three overall this month. It's just going to happen, especially when you work ICU. Almost all of our patients are terribly unstable and could die, otherwise they wouldn't be in ICU. It's just a coin flip as to whether they die on you, the nurse before you, or the nurse after you.

betterinthesun · Sep 22, 2015

I'm sure people will forget soon enough. If your unit is anything like mine people joke around a lot and (hopefully) they don't mean any harm by the nickname. Try not to think about it too much, its just bad timing that you had those 2 in the same week.

VANurse2010 · Oct 4, 2015

Hey there,
I'm a new nurse. I got my license in June. I was hired onto a MSICU unit in July. I went through a critical care training program and have been on my own since November.
This week, on my first shift of three, I had one stable patient and an open bed. Half way into the shift I was told I was getting a transfer from the floor who was requiring a little more attention than the floor could provide but was overall stable. I received the patient at 2am and I called a code at 230. The patient passed at 249. It was my first code on my own, and my first death.
Two nights later I had a second death. The patient was dnr/dni.
I know there was nothing I could've done to prevent either death. My manager has assured me that I did everything I could and did everything correctly. I'm just having a hard time coping with two deaths so close together. I've earned the nickname "grim reaper" on my unit. Has this happened to anyone else? Any advice? Any truth to the superstition that deaths come in three's?

Believe your manager, and get used to it. That's the nature of critical care.