Anybody have rituals they do when a patient passes? - page 3

I am thinking about going to my favorite coffee place, getting myself a coffee, and paying for the person behind me. I will leave a simple note saying, "this act of kindness was done in memory of a... Read More

  1. by   TigraRN
    I do not have any rituals after a patient has passed, however, there are things that can be done to the patient who is nearing death and their family to make them comfortable. Since you don't have many patients die on your unit, it is understandable you want to create an act of kindness/ritual which can actually be a good coping mechanism for you.
    We have patients die every now and then (I actually had another patient pass away and a second one lasted several hours and passed 30 min after I left home during the same shift). For me personally, the coping skill is to accept death as a process and a normal stage in life and make this process as comfortable as possible for the patient and the family. If the person is full code, you want to bring in the family in the code and "walk them through" on what is going on and explain basic facts ("heart stopped beating, we are seeing if it can be restarted" etc). When family sees how hard the team works to bring the patient back, it is better for the family as it can ease their grieving process and they know their loved one's life was "fought for". If, on the other hand, the patient is a comfort care/DNR patient at the end of life, and you know they will die on your shift, you can do a lot to make the patient and family comfortable. Call the chaplain/SW if appropriate, talk to the family and tell them to talk to the patient and tell him/her their are loved and that the patient can still hear them, hold their hand. What I would say is: "I know I am in no place to give you advice and you are going through such a difficult time now, try to remember your ... how they were when they were well and talking, laughing with you and not how they present now in the hospital bed with lines and tubes". I find it very comforting for myself to know I did all I could, for example, comfort care/DNR patient was given appropriate amount of morphine (as ordered by Dr), did not check their BP (our policy allows it), provided blankets, pillows for support, they were clean and suctioned, the chaplain came and prayed with the family.
    There used to be one nurse in our department, who would call a minute of silence after a code and death. This was his ritual. And I see how it can give some time to gather thoughts together, leave it behind and care for your other patients.
  2. by   KelRN215
    Quote from NightNerd
    This is a tough call. While many, if not most, of us choose this work because we want to serve others, we MUST develop a professional detachment. You will drown in your feelings if you don't. I think this is such a nice idea with good intentions, but it may have the effect of tethering you to the death instead of allowing you to move on. Paying for the person behind you may very well made you feel good, but it also may bring up a host of other emotions, or none at all. I just question how therapeutic this may be in actual practice, even though the spirit of it is lovely.

    I feel like it is more beneficial to develop a self-care ritual, rather than a pay-it-forward ritual, to cope with death where we work. We work each and every day to be kind and compassionate at work, many of us volunteer and commit random acts of kindness, and we all have family and friends we look out for; but all too often we forget to extend that effort to ourselves. I love the ritual one poster mentioned, of eating donuts as a reminder to enjoy life. For me, while it's not a particular ritual, I always try to do something that nourishes my body and spirit when a patient's passing sticks with me - go for a run and be grateful for my body's strength and endurance. Walk outside and enjoy the feel of sunshine and wind or even rain. See my family or snuggle with my boyfriend. Listen to or make music. Whatever helps me to truly cherish my life in that moment.

    My last thought is that, depending on the environment we work in, it's beneficial to develop a healthy relationship with death. It's a natural part of life, and while it is sad to lose a loved one, it is not always this horrible, awful fate. Obviously this is not something that, say, pediatric oncology nurses or nurses in the ER will be able to see as a positive thing, and that's today understandable; death can be very, very wrong. But in other scenarios, I think it's helpful to reach a sort of truce with the idea that life ends for all of us and it's okay. This understanding made my time working in hospice much easier; and now that I'm in med-surg, it is still a helpful outlook, even though I want to help all of my patients regain health and quality of life.
    I think that, as a pediatric oncology nurse of 10+ years, we can see that while it's always wrong for a parent to have to bury their child, for some of these children, death is the better outcome. I have had 2 of my patients die in the past month (which probably means a 3rd is coming). Both had spent more time in the hospital than at home since I've known them. One didn't have cancer but some sort of immune condition that required a bone marrow transplant. She developed pretty much every complication there is from transplant and then died when her lungs finally gave out. She was only 2 years old. I thought it was beautiful reading the notes on the last day of her life when they wrote that her mother had come to the realization that it was time to stop being selfish and to let her go, that she had suffered for too long. This child had been born in the developing world and would have died 2 years ago if her mother had not adopted her. I both honor the chance her mother gave her and honor her for realizing that it was time to let go.
  3. by   Neats
    All of your experiences are wonderful (well most) I look at death as part of life. The minute you are born you are closer to death. With that said it makes me celebrate life such as it is the good and bad, appreciate each day we have. What dying patients have taught me is this...treat others with the fruit of the, joy, peace, forbearance, kindness, goodness, faithfulness, gentleness and self-control... this is my ritual to celebrate the dying and for those left behind.
  4. by   cwk84
    What does the stranger behind you have to do with some random person that passed? I don't want to be insensitive but this is sily. An act of kindness would be to donate in case the family is poor so they can afford to lay their beloved one to rest.
  5. by   ProperlySeasoned
    I keep it simple. At home with my family over diner, I say the patient's last initial, and we do a simple toast. EG - "Here's to Mr C. He had a good life." My husband and young children are present. It's HIPAA friendly, and gives me some closure. It's also lets my family know that I have had something significant happen in my day, and though I can't talk about it, I want them to be aware. And, I really do think about the patient and their family.
  6. by   audreysmagic
    I'm a coffee nut, but a rare one who's also a tea snob. I love the pay-it-forward, though maybe just doing so without the actual message might be best...out of the blue, it could be a little disconcerting to someone. But my rituals usually involve something the patient loved, if I knew them well enough. Or a quiet moment with my tea, saying, "this one's for you, (their name)," if they didn't. I'm fortunate that I haven't lost a ton of patients, given the areas I work in. One "ritual" I remember fondly was a child who LOVED to crunch empty water bottles in his hand, it kept him so happy for hours at a time. One of his other nurses and I, at the memorial, clinked our empty water bottles together and crunched them.
  7. by   ICU56
    Clean, tag, bag, call Translife.
  8. by   Axgrinder
    Years ago as a fairly green nurse I worked at an odd combination of SNF & long term ICU/vent hospital - it was a tiny little place. When someone died we would open the window.

    I guess it's with the idea that the spirit could fly free (as if walls, plaster board, and wood frames would be an impediment to the spiritual?). I think also the night shift had complained about rare hauntings too which perpetuated the practice (possibly too much free time on their hands, because working night shift once or twice we liked to tell ghost stories too in the wee hours of the morning to pass the time).

    Whatever the reason, it started before I got there, and probably continues to this day (despite changing names over the last 2 decades).
  9. by   thoughtful21
    When one of my patients passes away, I spend a moment (maybe 30 seconds) holding the patient's hand in silence. It can be hard to believe that the person who had a beating heart, blood pressure and breath a little while ago is now dead. This short quiet time helps me process my feelings and honor the patient.
    After the patient dies, the family members become my next patients. I try to take great care of them and be compassionate. Talking things through with coworkers (when I'm ready) is very helpful for me!
    It's a great idea to do something small to commemorate your patient and help yourself heal. This was the first patient to die in your care, and that is a touching and memorable moment. <3 Take good care of yourself, crnfalwillbe!
  10. by   bwrn70
    I work in Home Care, what I usually do is donate a small amount to an organization that was important to my patient or to a foundation for the disease that the patient had.