I want to be a RN but don't want to deal, with you know...

[Back2Nursing09]

I want to become a RN but Im not really into the death/dying part.Is it wrong of me to feel this way ? What happens if a patient dies in your hands ? What happens next ? Who deals with the body ? Also,how many of you guys ever dealt with a situation like this ?

[BrnEyedGirl, BSN, MSN, RN, APRN]

People die every day. I guess if you stay in an out patient setting you could minimize your contact,...but people die. You might just learn that being with a patient that dies and the family is a blessing and just as important and rewarding as helping those who get better and go home..:)

[NeoPediRN]

No matter what field of nursing you work in death will touch you in one way or another. Whether you work in hospice or as a school nurse, you will have patients who pass away, whether you're caring for them yourself or hear through the grapevine. You're obviously more likely to encounter death in a hospital-based setting. Mother/baby is a field of hospital nursing that sees death less frequently than other fields, but it does happen and it is devastating. If you have a patient die in your arms they either had a DNR or you better have hit that code button! It depends on hospital policy, but generally the RN and nursing assistant prepare the shroud and wrap the body, and either you take it down or security comes to take it...rarely have I experienced a funeral home come take a body off the floor.

[Back2Nursing09]

No matter what field of nursing you work in death will touch you in one way or another. Whether you work in hospice or as a school nurse, you will have patients who pass away, whether you're caring for them yourself or hear through the grapevine. You're obviously more likely to encounter death in a hospital-based setting. Mother/baby is a field of hospital nursing that sees death less frequently than other fields, but it does happen and it is devastating. If you have a patient die in your arms they either had a DNR or you better have hit that code button! It depends on hospital policy, but generally the RN and nursing assistant prepare the shroud and wrap the body, and either you take it down or security comes to take it...rarely have I experienced a funeral home come take a body off the floor.

Oh boy.I think I might reconsider my decision to become a Nurse :-/

[Forever Sunshine, ASN, RN]

I was a little scared of death at first with patients but there have been a couple of deaths since I started.

Theres great articles on here about Death and Dying. Also the blog "Body, Mind and Soul" really did help me get through my first couple of patient deaths.

It does come with the territory whether you like it or not. Educate yourself and read more about it and maybe you will become more comfortable if you have an idea of what its about. Its not about a dead body. Its about the care, such as keeping the patient comfortable, the family updated and aware of what is happening.

[CaLLaCoDe, BSN, RN]

Actually once you experience seeing people pass or deal with the corpse of an expired patient it becomes less and less shocking, less traumatic. Just a natural occurrence that most people are denied seeing on a daily basis. Just think of the pioneers, what they had to face, dying perhaps was a more common occurrence. Sure there are times when a death occurs speedily and you're caught unawares, but that is rarer than the DNR patient or the very ill patient.

Before I became a nurse I would wonder to myself how I would handle a hemorrhage, or projectile vomiting, or feces. With time these things became less and less a bother and I took on the practice of dealing with these uncomfortable things quickly and be done with it, less it had to linger in the minds of the patient or myself. Death is something like that.

One time I had this patient in Step Down (I was a CNA at the time) and this patient had on a venturi mask set at 100% and he kept taking it off of his person. I proceeded to place the mask back on his face.

The family members said to me,"That's ok, he knows what he's doing." Well, I was a bit taken aback. He looked really grim, grasping for every breath. After leaving the room and continuing my duties, I overheard his physician telling the nurse that the patient was a physician who had smoked most of his life and had gotten lung cancer and that he was aware of his prognosis. Later in the day he expired. I remember going back into the room and seeing his corpse. What a complete change. He resembled a classic greek statue. I remember thinking this is what poise looks like. I mean he looked peaceful and behind that peacefulness you could see this great physician, who he really was prior to his disease. Wow, I would not trade that experience for all the tea in China.

[casi, ASN, RN]

First thing I have to ask you to do is try and figure out what it is about death and dying that turns you away from nursing. I'm sure many other nurses have had the same fears and anxieties.

Is it wrong of me to feel this way? No! Death is difficult to deal with. Unfortunately death is everywhere. As a society I feel that we do a really good job at hiding death and this tends to make death really scary. As a nurse or even as an aide you start to become more comfortable with death. There are some deaths you'll be comforted by and some you'll be horrified by. It's never going to be easy to deal with but it becomes easier with time and experience.

What happens if a patient dies in your hands? It really depends on the situation. If someone has died or is trying to die who is a full code the first thing you do is summon help. Personally I go into an auto-pilot mode. Call a code, get the crash cart, get the person on a board, start cpr, start bagging them and so on. This is never the task of one person you will always have a room full of people to help in these situations.

For those patients who have advanced directive that state they are DNR/DNI there are also protocols. If the patient is actively dying we try to get family at bedside as soon as possible. Until family is there someone will try to stay at the bedside with the patient if death is imminent until family comes. No one wants someone to die alone. For those that are on end of life cares who are in their last days we do a lot of comfort care. Turning the patient every two hours, making sure their mouth is moist, and making sure their pain is controlled. It's all about giving the patient the best death we can.

What happens next? Someone will have to pronounce the patient as dead. Who can do this depends on facility and state policies. If family wants to say their goodbyes we let them. Depending on facility there can be a lot of paperwork involved for the nurse.

Who deals with the body? Nursing is responsible for cleaning up the body and making them presentable for family who wants to view their loved one at the bedside. As a nursing assistant this was the thing I was most terrified of. With time it's become a lot easier for me. I take pride in making sure families can take away good memories of someones death. In the hospital setting I come from nursing was then responsible for putting the body in a body bag and applying identification so the patient can be sent down to the morgue. Either a transport person or nursing takes the body down to the morgue.

Also,how many of you guys ever dealt with a situation like this? I haven't had time to really get my RN shoes wet, but as a nursing assistant dealing with death and dying happened pretty frequently. When I worked in assisted living it was fairly common to have residents who were on comfort care and in the last days of their lives. In the hospital I worked on a cardiac floor where again death was fairly common. People with sick hearts are at risk of dying. I find that doing the occasional hospice case can be very rewarding.

[NurseNora, BSN, RN]

People die outside of hospitals every day. You could be in WalMart tomorrow and have the person in line in front of you drop dead. I say this because we recently had a person arrest the the WalMart next to our hospital. At least when this happens in a hospital there are policies and procedures in place to deal with the situation and everyone practices for it, so that when it happens, most people are able to respond based on all the times they practiced.

Although death is a daily occurance, not everyone has to deal with it every day at work. I work in Mother/Baby and it is a rare thing to have a mom or baby die, but it does happen. Babies die more than moms and it's sad. I don't want to say you get used to it, but you learn to deal with it. I usually cry along with the parents, not so much that I can't do my job. But it's normal to cry when you're upset. Very rarely, moms die. That really rocks everyone in the whole department even those not directly involved in her care. Often after that kind of event, there will be a session with the Psych staff for anyone who feels the need for extra help in dealing with it.

Death is as much a part of life as is being born. Although I prefer to work with the beginning of life, I feel just as honored to be present at the end.

[dthfytr, ADN, LPN, RN, EMT-B, EMT-I]

:up:Death is the price we all pay for the privilege of living. It's as normal as birth, growth, good health, bad health. The big difference is that the unknown is frightening; what happens after death. Incidentally I once worked with a doctor who had died, ie full cardiac arrest, and was revived. He described his experience as extremely peaceful and seeing a bright light. He said he'd never be afraid of dying again. It's striking when someone you've known personally for years tells you that! Anyway, fear of the unknown is normal, and a protective reflex. Many of your questions would be answered in nursing school. I feel your sensitivity to the subject of death to be an asset. As a nurse, you'd be more comforting to a patient and family dealing with a normal human process. Good luck no matter what you decide. Thanks for bringing your feelings here. And before I forget, there are many areas of nursing where you don't deal with death frequently.

[Maria Lenore,RN]

The unique role that a nurse plays in the health delivery system often puts her in what seems to be a “no-win” position. For instance, what should a nurse do when ordered to perform a task for which she does not feel qualified? Should she refuse and face possible workplace discipline, or should she attempt the task and face possible liability? Even when a nurse is superbly qualified to perform a task, however, sometimes issues of conscience may prevent her from fully performing the task. Again, failure to perform may sometimes mean discipline, but for many nurses, adverse employment actions are preferable to carrying out a task that is morally objectionable. So its clearly says that when a patient dies its our responsibility to do our duties to do post mortem care.

[Hospice Nurse LPN, BSN, RN]

Death is part of the circle of life. Everyone does it.

[traumaRUs, MSN, APRN]

My first experience with death was when I was 8 or 9 - we went camping and a boy drowned in the river when he fell out of a boat.

I've been a nurse 18 years now and yes, I've seen lots of deaths, been part of lots of codes.

For me, (and I don't want to get off topic), it helps that I have a spiritual belief that there is something after the here and now.