Mario experiences PT death for first time

Nurses General Nursing

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Today when I was in report, waiting for rm #'s and nursing assignments, about the 3rd thing the charge nurse said was that Mrs. U passed away over the night. My reaction was instant, and i flinched a little. I got to know mrs. U and Mr. U pretty good, hving been the cna for them during approx 30-35 days. Mrs. U often made my day, still being able to smile. I've popped her for CBG double. Her husband was with her every day, never leaving during my day shifts. Sometimes Iyd see him when I worked a 12. Man, thats love. Renal, cardiac, bka: but she had a nice personality. Gosh.

Well, it does suck when someone you get to know dies, suddenly. i knew this would eventually happen to me. pretty much i feel bewildered, and now i took it home cause i am typing about it here. All the help she received, and encouragement from our staff, and me, to just pass away, she was tired, poor woman, in 40's, renal transplant, she did suffer, grafts, i work with some patients who have been in the hospital months. Diabetes is mean stuff. My own perceptions are kinda tilted down now, seeing a person die trying to live and get well. Since it happened at "work" I know I should leave these feelings of death at work, as a proffesional, but this is my first time and I think about Mrs. U now when it's quiet. I should alighn and cover my feeling, still being proper, but making my peace with it before i leave the floor. I'm sorry.

Specializes in correctional, psych, ICU, CCU, ER.

((((((((((HUGS)))))))) Mario, compassion is one of those things that you either have or don't . You have it. congratulations!! but it also hurts. When I was a student, in 1971, the first pt one of us lost,(that was in the days when you went to a hospital run nursing school for 3 years, lived in dorms, etc) and his nurse cried like a baby. THe pts. MD came in, looked at her and all of us trying to comfort her and said "Better toughen up, kid." That sent her crying again-just wanted to belt the doctor. couldn't think of a quick comeback, so just stuck out my tongue at him as he walked out of the room. Very mature,,I know, but it made everybody feel better.(esp since all the others followed suit) ''This will get easier for you, but in the meantime, keep up the good work, we need more nurses like you. It would be a privelege to have nurses like you care for my parents.

Originally posted by adrienurse

This is another rite of passage as a nurse. The next part is learning to let go of patients who are welcoming death. These are the things that make you see life differently. There's nothing wrong with having this stay with you.

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You said this very well. I too, have a strongly developed sense of whatever comes after death, I think as nurses this helps us define and come to terms with it. 18 years ago I remember my first encounter with a patient death very well. An elderly gentleman was due to be discharged the following day. A bit confused, he looked at his wife & said-honey I'm giong home. She patted his arm & said-yes dear I know. 5 minutes later he died, very quietly. Did he "see" something? My best guess is that he did. Over time we learn how to deal with our own feelings about patient deaths, which are influenced by many factors. It is common to become attached to families, and in the small town I am in, it is common indeed possible be friends as well. It's OK to cry with them too. It's when we don't feel anything at all that we have a problem.

Wow, what a thread you started Mario.

Go to funerals?? Absolutely. Years ago when my son died at age 4 months, I was so wrapped up in my own grief, I paid little attention to those around me. I was so shocked to see former teachers and hospital personell come out of the church in tears. Some of those nurses related years later to me what an impact that awful morning had on them. And altho some of the events of those days are still a bit foggy, I still remember those I came into contact with. So I am never distant with those in the dying process, it may be just a touch or a word they remember but that may bring a little peace. One story--a friend recently went through her mother's death. She was the one who carried my son up the elevator the morning we took him in. She was at her mom's bedside all day and had not left. I called my husband & had him bring up stuff from my kitchen so we made sure her family ate. Darcy was very grateful, & I told her-no need, just payback, She looked at me quizically & I related the story about her carrying Robby up the elevator. She was dumbfounded and had no reply. So it really is the little things.

My husband also lost a daughter at age 1 1/2. She had been in & out of hospitals since birth and became close to all her caregivers, & 6 of her doctors acted as pallbearers. Imagine that! One of those docs, Dr Deering in Wisconsin, he still talks about, had a profound impact upon him. When I did a genetic course, I contacted Dr. Deering and believe it or not, he still remembered Mindy's case and was able to answer my questions without hesitiation. Must have made an impact on him too.

Dear Mario,

I am a student and during clinical rotations last semester, I experienced the death of one of my pts. I knew she was on the brink of death when I first took care of her. She was already unresponsive and was classified DNR. She had a G-tube and was hyponatremic and was very unresponsive to touch or verbal communication. I continued to talk to her that day as I gave her a bed bath and I found myself fighting back the tears as I attended to various decubiti on her fragile body. All that I could think about was that she was someone's mother, daughter, sister, and friend and she was all alone to die in that room. We were only doing one day a week clinicals that semester and the next week she was the first person that I wanted to see. But she had passed over that weekend. It was very traumatic to me. I think that will be something that I will have to learn to adjust to -- the death of a pt. It is so amazing that after spending such a short time with a pt. you can become attached. Even when they say nothing! But I find peace in knowing that there was something that I could do for her in her last days. God bless.:roll

Death is a part of nursing life. I did oncology long enough to know that it is our duty to ease the end of life for our patients (I don't mean cause it), as it is to help them get well. I guess what I am having trouble putting into words is that people today have been fooled into believing that there is no end to life. When it comes everyone is shocked.

My very first death was a lady who had end-stage CA of the lung. She couldn't breath, hadn't been alert for months, and was considered at "the end" for about two weeks. It was no shock to the nurses when the lady passed. But the Daughter said it was such a shock to her. Had I been a nurse for a longer period of time, I may have been able to ease the transition for this family member.

Mario, learn from this experience. They don't all make it, and you are allowed to have feelings about it. That is why you are a nurse, because you care.

Although I am agnostic, and don't follow any particular faith, I find caring for those on the brink of death to be a deeply religious ritual. Positioning them, studying their breaths, watching as consciousness slowly drains out of them, as muscle tone is lost is an extremely precious and personal thing to experience. It feels wonderful to provide the symptom control, to be there for the family -- just a presence for them. To teach them about the process, alleviate their fears, normalize the experience is very rewarding -- they never stop thanking you. I like to take my partner and cleanse the body before the person dies. This is so calming to them -- as if they continue to be aware that they are being cared for in arms of love, even though they have lost most of the awareness of the world around them. I know these people, I have cared for them for months, sometimes years. I talk the them. I tell them that there family is here. That they are loved. Give them permission to leave (amazing how it seems thay are waiting to hear this).

I'm getting misty.

I know this is different, but this ritual (I think of it as that) is my most rewarding part of working is personal care.

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

HUGS mario....I remember my first fetal demise like YESTERDAY...i carried that tiny, lifeless body, wrapped in a blanket to the nursery in tears, asking "Why God why this tiny one?" All my coworkers and the dr has seen countless demises and deaths...I was so green...Sad thing for me, She appeared physically perfect in every way it was just her time, I guess. She still holds a place in most tender heart of hearts, and I will never, ever forget her or her mother. Gosh infant/fetal deaths just make SO LITTLE sense sometimes, upsets the balance of things in my mind.

I am sorry for your "loss" Mario, and it IS a loss to you. You have a tender heart and will make a great nurse. Carry on, friend.

Mario, my thoughts are with you as you go through this event in your nursing career as well as your life. I still remember my first patient and I think we all do. There are others that will also be special. I also have said that I learned more about living from my terminal patients than I learned anywhere else. I had a patient her name was Betty and she had progressive CA. She had lost her hair so we all chipped in and bought various turbans, etc. Each admission we would all go in no matter what are day was like. Similar to you she only had her husband. They were never blessed with children. You could see that old fashion love in their eyes and words didn't have to be spoken. The floor I worked at the time was med/surg and mostly chronic respiratory that were more or less on borrowed time. Betty had let it be known to the staff that she did not want hubby there when the moment came as she did not want him to remember her that way. She felt it was a final gift she could give him. He would stay unless he had a tee time as they had been avid golfers. We would go in and give her a hard time about the particular turban she would wear on a particular day. We tried to get colors that matched his golf pants like the late Payne Stewart wore. Betty was granted her last wish and the staff were well aware it was not far away. In time, unfortunately that becomes a part of nursing as you see how quickly or how slow a patient lives and you learn to be able to tell in the future. Unfortunately, this is an aid in particular when family are not sure if they should come in or stay. I would use if it were my mom and yes I to had to hear those words from a colleague on the floor I worked. Betty was weakening quickly and her hubby had a 2:30p tee time so that he would be back for dinner. Well, he had left and just about the time he would tee of is when Betty left us. I felt honored that I had her that day and was with her because even all that she had been through she did not want to be alone. That is something else you will learn there are things that are never spoken but you gain a sense. I was priviledged to hold Betty as she took her lasts breaths and saw the peace before it was taken. She knew she had kept her promise for hubby not to be there. Some nurses deal with death in different ways. No matter how many you have they are never the same. Sometimes and I know it sounds crude we would shroud a patient and someone would crack a one liner so that the emotions were dealt with. If I had the time I would help the aids shroud a patient as that was also my patient. I didn't mind changing a bed or giving a bath if the family was on the way in. The hardest ones like you say are the ones you get to know. They are not just patients they are friends and sometimes feel like family. Unfortunately, twice I had to shroud colleagues that were so young. It really makes you think about what is important. Sometimes for closure I would go to the funeral home and or service. When that was not done a sympathy card. You will find the best way for you. Don't let anyone say " so or so what" because they are just as afraid as they have to face their own mortality which you may find you do from time to time. The hardest ones are also the patients that family and friends either don't exist or have walked away. So many of those such as HIV just want a human touch.

Colleague and friend my thoughts and prayers are with you as you go through this true nursing experience. Give yourself time to feel and don't let anyone tell you otherwise. If you are having any difficulties check with your facility chaplain or someone you can talk to

Originally posted by schrandt

Wow, what a thread you started Mario.

Go to funerals?? Absolutely. Years ago when my son died at age 4 months, I was so wrapped up in my own grief, I paid little attention to those around me. I was so shocked to see former teachers and hospital personell come out of the church in tears. Some of those nurses related years later to me what an impact that awful morning had on them. And altho some of the events of those days are still a bit foggy, I still remember those I came into contact with. So I am never distant with those in the dying process, it may be just a touch or a word they remember but that may bring a little peace. One story--a friend recently went through her mother's death. She was the one who carried my son up the elevator the morning we took him in. She was at her mom's bedside all day and had not left. I called my husband & had him bring up stuff from my kitchen so we made sure her family ate. Darcy was very grateful, & I told her-no need, just payback, She looked at me quizically & I related the story about her carrying Robby up the elevator. She was dumbfounded and had no reply. So it really is the little things.

My husband also lost a daughter at age 1 1/2. She had been in & out of hospitals since birth and became close to all her caregivers, & 6 of her doctors acted as pallbearers. Imagine that! One of those docs, Dr Deering in Wisconsin, he still talks about, had a profound impact upon him. When I did a genetic course, I contacted Dr. Deering and believe it or not, he still remembered Mindy's case and was able to answer my questions without hesitiation. Must have made an impact on him too.

I found that when we had a break over the holidays and summer I would check the newspaper almost daily as I knew that some of the patients I had cared for in clinical were not going to be there the next time. There were times when I questioned why we did things to patients who if they had been alert would have declined. For example, A woman who had either ovarian or uterine ca and it was actually sitting on the bed and the doc ordered a catheter. She hadn't had anything po or IV to speak of then why. She was in her 90s and had to be kept in high fowlers in order to stimulate respirations. We have one doc in particular that if you want to put even a posey on for safety will order a neuro, psych, nephro, and any other kind of consult he can. Why? do they get a kick back on the referrals. We had a nonresponsive older man whose IV blu and with the protocol of attempts as we did not have a team the doc was notified. The patient was not long for this world and did not have any type of nutrition or visitors He ordered a consult with an anesthesiologist to start a line. The anesth. did and it was a $350. consult as I have from time to time had anesthesia start myself. His was gone in no time as he did not have the vasculature to support one. He wanted another consult. The nursing supervisor got involved and unfortunately the order was called but the patient beat him to the punch.

Stevierae, it is never too late to speak to a family if you know where they are. I had a male patient that had the same first name I have. Marian We would kid a lot who had the better form and he argued for John Wayne otherwise known as Marion Morrison. He was worsening and in a semi private and we were able to work it out to get him into a private. Well, it wasn't long after that. Well, sometime later I was in a store that had the same last name but I did not know there was any kind of connection. As soon as one of the family spotted me the whole family was there. They had also asked me to come back when everyone was there so that they could talk to me about the little things that had made the difference for dad and for them. I felt that I should respect their wishes. I did. And I didn't do it to get a discount either. As it turns out the family had just found out that one of the sons had the same disease and was in the earliest stages. He was there and said he hoped that he would get anywhere near the care his dad got whenever he should get to that point.

Two short stories. We had a gal in her early 20s with CF. She had her infusaport put under her arm so she could still wear a bikini. Well, one thing she wanted was to marry and have a child which she did. The child was a little boy named Patrick after his dad. Today he is close to being a teenager. His mom passed away when he was about 6. She had left Florida and went to PA for a double lung transplant. Unfortunately, she ended up in ICU and never had the surgery. She fought with everything she had. When she was in for antibiotic treatments she would get passes and go to the park and have all kinds of activiities that she was able to tolerate with him. He became like a son to all of us. She was kinda crazy in the good sense. She would sit on the bed and order pizza and toss the ball back and forth with Patrick. Melissa was truly a wonderful person. We also need to stop sending monies overseas and take care of our homeless, those in need of medical attention and finding the funds to tackle some of these terminal illnesses so that people no numbers can have a life expectancy like anyone else. We need to support orphan drugs to help these wonderful people because you may have noticed it is usually the nicest people you can meet that have these problems.

Also, there is a population that we as nurses forget. When it is not possible to move a dying patient we need to consider not only his relatives but the other patient and his/her visitors or family. Some of these patients are with the dying while they are still with it so to speak and have established even if cursory a relationship. We need to have something set up for these individuals such as offering the chaplain or someone with counseling.

Thank you so much for keeping this PT alive for me. With new PT, and other PTs who could be on their way out, life goes on, and is effected. It's easy for me to think about it as a positive, after a good week and having completed more dancing and thinking of her/realizing the finate nature of our swirling electrons.

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