I agree with P_RN, such beautiful replies here. Especially you Ted, thank you for sharing.
I think Ted has been "lucky" in a way, as it sounds as if his hospice experience, most pt's and families have acknowledged the inevitable as a reality. I am sure it is harder now for you Ted, in ICU's as you see pt's fight who are not ready to say goodbye, and family members who are taken by surprise at a trauma, and acnnot make a No Code decision b/c their emotions are in turmoil. Maybe their last words to their loved one were angry. This is when it is the hardest, for me, to see death.
I also agree if it ever gets "routine", you belong in another job. Don't ever let anyone tell you not to cry with a family. I had one death that is still so painful to think about, a young child, her grandmother was the only one here with her from Nicaragua, and only spoke Spanish. I won't go inot details, but all the nurses in our unit were affected by this child. WE had reports of her surgery throughout the day, how she was "doing great", and held her own for 20 minutes post-op, then she crashed and crashed hard. They cracked her chest, put her back on bypass, she had tubes in every orifice of her body and thensome. It was the first time I ever understood what a parent must feel. As an intelligent professional I knew she would never make it, but as someone who shared in her precious life for 6 weeks, I didn't want the code team to stop. I was not allowed to be on her code team, good thing too, I couldn't see through my tears. I went up to the peds unit before I left, theywere still coding her, to say my goodbyes to her grandmother. Another nurse went with me. It was especially difficult, since we had another Hispanic child in the unit, and his father, who spoke English also, did not want to hear, could NOT accept the reality that if this child died, his son may also die. The grandmother looked at me and said, "Es muy mal." (It's very bad.) "Si" I said (yes) Michaels' dad cut in, and said NO, NO don't say that, it's going to be OK. I looked at him, and even grandma did, and she said again, No, es muy mal." Our nun, who was our pastoral care person was also there. At that point, grandma and I hugged each other, and I started crying, trying not to really bawl. Nancy, the other nurse from our unit tried to pull me away, saying , please don't cry. Sister Jane, said, NO, it's alright to cry. Then Nancy also lost it and everyone in the room cried. Very hard to even type this. I am ever grateful to sister Jane for letting Nancy know it was OK, she really needed to cry especially, she admitted the child, spent time with her pre-op, and she even had a drawing of herself by Yadsga (something I wish so much that I had.)
That child's death was a turning point in my nursing career. I gave up peds, a good thing for me, and it finally cracked my wall, of not geting to emotionally connected with pt's. I often wonder if God sent Yadsga to our unit to teach many of us tough cookies a lesson in her death. It has comletely changed me, and I am grateful for that.