First year in nursing and 1st pt to pass away on me

[changeofpaceRN]

I knew it was bound to happen. I didn't want to think that life can end on my shift~ I was hoping that I wouldn't have to deal with it anytime soon.

WELL, it happened last night. It's very shocking to someone who has 1. never worked a code 2. never saw a dead person before 3. didn't know how to operate items on the darn crash cart and didn't know what to do:uhoh3:.

My mind went blank when I couldn't get him to wake up- he was a hard sleeper to begin with. I even looked at the CNA and said "He looks a little pale don't you think?" Tried to find a pulse and couldn't but you can't always find a nice strong pulse on older people. He was one of my favorites too :-( His family had just decided to make him a full code last week when all along he had been a DNR- argh!

To make matters worse, I did my med pass differently last night. I started at the opposite end because I wanted to see if it was quicker to put all my accuchecks and insulins last- WHY of all nights?!?!?!. Usually I see this man first. Well, he was dead for probably an hour before I got to his room. I know this because I had just gone in there a hour before because he was complaining of a toothache and I brought him PRN tylenol. I told him I would see him later for his accucheck and he said "ok honey thanks". If I would have done things differently, I wonder if he would be alive. I know I need to get over that line of thinking.. there are so many "what ifs" I wasn't even suppose to have that wing- I was scheduled for another one:madface:.

[NotReady4PrimeTime, RN]

CoP, I can't see anything that you did wrong in this situation. It's always hard to face your first patient death, no matter how likely that death was. For all of us, our time on this earth is finite, and no one can predict the end with any certainty. This gentleman had previously been a DNR... what made the family change their minds about that, I wonder? The probable outcome, had you followed your usual routine, is that he would have passed later in the shift, but have been put through the indignity of a doomed-to-fail code. Instead, he died peacefully.

There are things you can take away from this that will make you an even better nurse. Take every opportunity that arises to familiarize yourself with the crash cart. In our unit the cart is checked every single day. This gives people a chance to learn what's on it, where it's kept and to ask why it's on there in the first place. Ask your educator to arrange for some mock codes; they're great learning experiences because you can go through the motions without anyone's life in the balance. They give you the chance to "play" with the equipment and become familiar with how everything works together and how the usual series of events unfolds. If you're working when there's a code on your floor, offer to record. That helps to solidify what happens, who does what and how it progresses.

But most importantly, you need to let go of the guilt. You didn't do anything wrong. You don't have a crystal ball, and really you wouldn't want one anyway. You provided for his most urgent need at the start of your shift by giving him analgesia for his toothache and some human contact. That's what he needed from you.

[RN and Mommy]

[color=deepskyblue]i have been a rn now for just over a year and had 3 deaths and 2 near codes within probably 2 months. it was a little freaky! luckily they were all dnr patients and their deaths were somewhat expected. it was weird though to find them. one lady, both the cna and i were in there not 15 minutes prior taking her vs and checking on her. vs were all wnl by the way. 15 minutes later i went in to give her a pill and while i was crushing it up and putting it in the applesauce, the cna whispered "i don't think she's breathing". sure enough, she had passed away. it's hard, but hang in there. it sounds like you did nothing wrong.:icon_hug: