Guilt over the death of a pt

  1. I am a CNA at an LTC facility. I do doubles on the weekend. On the 7-3 shift, I was feeding a pt who was bedridden and couldn't feed himself. He was on high oxygen and had a lot of mucous in his throat. I made sure to give him small bites of mashed potatoes and ground turkey. I also gave him small sips of thickened milk to help swallow the food. He ate about half his plate and then he started coughing a little. All the while I could hear the mucous accumulating in this throat. I asked if he was okay and he said yes and then he started coughing more. I went to the nurse and told her that I fed him, he was coughing and it didn't sound good. She said she was aware of this and that I should just stop feeding him and he should be placed on hospice and they were waiting for an order from the doctor. So I take away the guy's tray who has now stopped coughing and I go to the bathroom. I come out of the bathroom and another nurse stops me and says did you hear that the pt in rm 440 just died. She said yeah apparently he was aspiring and stopped breathing. I said that was my pt!!! I immediately started walking away crying. The nurse said what are you doing, it wasn't your fault! We knew that he was dying so there's nothing you could have done it would have happened anyway. I felt like crap and though I'm not crying anymore I still feel bad.
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    About dorselm

    Joined: Oct '05; Posts: 212; Likes: 85
    Staff Nurse as of Jan'09; from US
    Specialty: Med/Surg < 1yr


  3. by   SuesquatchRN
    Honey, there was nothing that you could have done. You told the nurse who made the choice not to suction him. More than that you can't do.

    You were kind to a gentleman in his last moments. You showed care and concern.

    You're a good person, and I would love to work with you.

    Stop questioning yourself. There was nothing to be done.
  4. by   burn out
    You did nothing wrong. It would have been nice if the nurses would have shared with you the fact that the patient was dying before you started feeding him.
  5. by   AirforceRN
    Had a similar thing happen to me just a few weeks started eating, aspirated and started coughing. I suctioned him, but it only went downhill. Within 45 minutes he was dead. I spoke to some of the other nurses about it because, like you, I felt horrible....if only I had made smaller bites, stayed by his bed side while he was eating, refused his mean due to the way his breathing sounded. In the end, I realize it wasn't my fault. If it wasn't in the hospital it would have been at home.
    We are responsible for our patients, but sometimes there is just nothing we can do. This is NOT your fault. Everybody has a time and a way to go, its just unfortunate that you had to be there. Keep your head up.
  6. by   GingerSue
    is there something that you think should have been done differently?
  7. by   dorselm
    Thanks so much for all of the comforting. Yes, it would have really been considerate if the nurses could have shared a little more info with me. I never experienced someone dying in my care and being new to nursing school on top of being new as a CNA, I was ready to quit it all! I'm okay now especially after all of the kind words of encouragement from my cyber nursing buddies!

    You know what Ginger, I think if they would have let me know that he was on comfort measures and that he may die soon then I would have been scared but at least I would have been expecting it and I wouldn't have felt like it was my fault. It was hard to continue on that day. I had to wash my face with cold water and continue on because I still had other patients to care for and I didn't want them to see me upset. I do take comfort in knowing that before he died early that morning, I made sure I gave him a good bed bath and put on a clean gown and cleaned his room. The nurses were very happy to see that he was neat and his room was very tidy beforehand.
  8. by   Flightgypsy
    Please don't ever lose your empathy and compassion! It is easy to get burnt out in the world of nursing but I can tell you that you will be remembered more for the little moments of caring that you show to your pts and their families than for any amount of booklearning.

    If you treat every patient that you have as if you are looking after them in their last moments of life the way you did for that gentleman you should never have any regrets about your care.

    Your first pt death is always hard. I'm sorry you didn't seem to get the support that you needed.

    Just keep up the good work and remember that making someone in his situation feel even more slightly comfortable and cared for has immeasurable value. Kudos.
  9. by   cheshirecat
    Sweetheart, you can come and work with me anytime you like. You showed compassion and love for your patient. Be gentle with yourself, you did nothing wrong.
  10. by   ShayRN
    Quote from cheshirecat
    Sweetheart, you can come and work with me anytime you like. You showed compassion and love for your patient. Be gentle with yourself, you did nothing wrong.
  11. by   kittagirl

    BIG BIG BIG hugs, first.
    then as weird as it may sound remember that feeling you have now and when you are a (wonderful) RN make sure no other person has this experience.

    You did nothing wrong in fact from your post, I would say that you cared for your patient really well. you gave the best care you could with your knowledge and experience (the person at fault, if blame needs to be layed is with the nurse in charge for not fully informing you)

    your first death is always hard it doesn't matter how or why or where it happened it will always stay with you.

    My first death was a blood bath, no other words for it, 17 years later it's still with me, but from that experience i have worked my a** off fighting and screaming at times to ensure as far as possible that my patients have a 'good' death. this will alway be with you, for the memory of this patient make it a good learning experience.

    More HUGS
  12. by   anniev
    You sound like a sweet and caring person I am glad you where the last person he was with,, bless you
  13. by   LPNJessi
    Don't feel guilty. You did a great job! I would love to have more CNA's like ou where I work. Keep up the good work.
  14. by   LoriChr
    LTC needs more caring, compassionate people like you.