First time doing CPR/losing a patient

[LilianGrace]

Hi guys,

So last night we found a resident on her bathroom floor unresponsive and VSA. I called 911 and started CPR, but by the time she made it to the hospital she had been pronounced brain dead.

I just can't get her face out of my head, I feel like I could have done more. I'm just so overwhelmed and upset right now. Does anyone have coping tips or encouraging things? This was the first time I have ever done CPR on a real person and the first time I have ever found someone unresponsive and VSA.

Ugh, this sucks

[kakamegamama]

So sorry you experienced this. I know it's traumatic as the only time I did CPR the patient also died. Know that you did your best, but it was time for her to go. I don't mean that to sound trite, nor to minimize your grief, but sometimes that is reality. If you are a pray-er, pray. If not, is there someone you can debrief with at work, or a chaplain, or anyone else? If you'r like me, you will go over and over again what you did and question if you did everything correctly. Don't.....while it may be a natural thing to do, it isn't really beneficial. Hang in there. I wish you the best.

[Horseshoe, BSN, RN]

By the time you found her, she was likely essentially dead. You're not God, so there was nothing else you could have done. The survival rate of unwitnessed arrests is abysmal. Don't take responsibility here.

[Sour Lemon]

I've only done CPR once and it was initiated immediately because the patient was on a telemetry monitor. She survived the initial code, transferred to ICU, then coded over and over for the next 24 hours before finally passing away. Death is not always the worst outcome. Sometimes it's more peaceful to go quickly.

[TheCommuter, BSN, RN]

So last night we found a resident on her bathroom floor unresponsive and VSA.

Since you are using the word 'resident,' I assume this was an elderly person at a nursing home or assisted living facility. Correct me if my assumption is incorrect.

The probability of an elderly, frail nursing home resident surviving CPR is approximately 1% and certainly no greater than 5%.

Source: Zweig S, Bioethics Forum 1998; 14(1) (Spring).

Compassion and Support - End-of-Life and Palliative Care Planning, MOLST for New York State

The ugly reality is that CPR usually does not result in long term survival in elderly people. Therefore, there is probably nothing more you could have done.

Please realize that death is a natural conclusion to the circle of life.

[MunoRN, RN]

People die, particularly elderly people, it's a normal and expected thing, you shouldn't view it as some sort of personal failure.

Under the right circumstances CPR can be a very good thing, when a patient is found pulseless for what was likely longer than just a few minutes it has little potential to result in a good outcome. You did what you could, there's nothing you failed to do, you didn't "lose" the patient, a normal process occurred and you're not expected to alter reality so that people never die.