3 deaths in one day:(

  1. I had a special rotation day in the ICU yesterday. Started at 1400. The first patient I saw was DNR/DNI w/ Aids and pneumocystis carinii pneumonia. He was on 100% 02 trach and his sat's were in the 50's. By 1530 his sat's weren't registering and the nurse knew time was near. He had no family w/ him( we called them @ 1400and told them to come in as the end was near but no one came) so we sat with him. He started Cheyene-Stokes and that only lasted about 10 minutes...and he passed. He passed looking right at me. I just told him it was OK to go now- I didn't know what else to say.

    At 1615 another patient coded that was DNR/DNI. He had ARDS. All we could do was sit with him again. . Again, no family/friends. His death was a lot more painful to watch. I think also because the other patient had JUST passed- it was like I was in a nightmare trance.

    At 1720 my instructor found out that I had been w/ 2 deaths and so she pulled me to follow respiratory therapy ( this is Med/Surg 1 rotation). As soon as I was with RT- we got an ER call for an emergency intubation. The patient was only in his 30's but had fallen 6 stories. They didn't allow me in the room but I was right outside and things didn't turn out. They worked on him for 40 minutes. I went to the waiting room and sat w/ his wife.

    After that my instructor pulled me back to our floor ( ortho) and told me I could go home if I wanted to because it had been such a traumatic day. I told her I would stay but I guess she decided it was best for me to leave because about 10 minutes later she came back and said no I really think you should go home. You have a lot to digest.

    I came home and I think I was in shock because I wasn't feeling *anything*. I thought I would be crying or something but I wasn't. I was OK all night but had a horrible nightmare that I kept trying to save people and couldn't. Then that turned into a patient who coded and they called it- but as I was doing postmortem care she came back to life and I was screaming that I could have saved the others if they had let me stay.

    Woke up in TEARS.

    I talked to my instructor today- she said it gets easier. She said she has never had a student witness a death in her 3 yrs. teaching- let alone 3 in one day. She told me I handled it well - I guess I did. I don't know. It's hard to shake the feeling that there was nothing I could DO.
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    About BoonersmomRN

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    8 Comments

  3. by   locolorenzo22
    Whoo, and ouch. Not much I can say that I'm sure you haven't heard. Death never gets easier, especially when there's no family around. 3 in a day is a heck of a time. Take a breath, sit and think, remember that nobody knows when their number's up. We do the best we can, but we're not superwomen or men. Sometimes, there is nothing we can do, and it's just the fact that someone's there. Your aids patient may have just heard you say that phrase and passed knowing that he's moving on...
    Keep your head up, take a breath, and concentrate on providing what care you can. Hugs to you and yours.
  4. by   Tweety
    Gee, in all my years I've never witness three in one day. That would definately take an emotional toll on the most hardened of us nurses.

    Sounds like your instructor gave good advise.
  5. by   LanaBanana
    I had 2 in 1 day last weekend when I was working as an aide, but we knew they were coming - that didn't make it any easier. I had a post on here about it. We're a telemetry unit, so all I could do was watch the monitor as the heart rate went to 0. They keep saying it gets easier. I don't know. For the first couple of nights I kept having dreams that I was in the bed with the dead person - ugh. I think I'm past that now.
    I can't imagine dealing with 3 deaths, and I'm so sorry you have to do this. Take care of yourself!
  6. by   CaseManager1947
    I don't know if this will help u or not... but here goes. I've been a nurse for a lotta years (lookin' at my 40th year in nursing here pretty soon. What I would like to share with you are these things. 1. Some of our patients will die, despite excellent care and good management. Sometimes their illness/sickness/condition/comorbidities/and the inevitable cascade that occurs in some patients can't be fixed. 2.) It is a privilege to be there at the time of dying, especially as you say, two of your clients had no family there. What a gift you gave to them, by your presence. Their journey is complete. 3. Death is a part of the continuum of life, and is an inevitable factor that can draw humans together, as this experience is shared. 4) just as birth is a spiritual experience, so is death (IMHO). I have been present at many patients passing, some asleep in the OR, some in their hsopital beds in the CCU, like the patient you wrote about, with no family. We extubated, and within 6 minutes, he was gone. We spoke to him during that time, tried to make him comfortable, nursing gave meds for anxiety,
    it was very peaceful. Oh well, I'm rambling now, but I just wanted you to know that this is an experience you will never forget, just like the ones I have never forgotten. Nurses have a collective memory of their most special patients that they've cared for, I know I do.

    Plenty of time processing with the Instructor would be my RX for your spirit
    right now, and post here if it will be of any assistance also.

    Morghan , ARNP
  7. by   chelli73
    Prayers for your inner strength are with you from chicago...you handled all of that very well...you will become stronger from your experiences.
  8. by   VivaLasViejas
    Wow........the worst I've ever had to deal with was two deaths in one shift, and that was as a seasoned---dare I say battle-scarred?---hospital nurse. I am amazed at your strength, BoonersMom, and I commend you on your willingness to try to stick it out to the end of the day even after you'd been through all this trauma.

    I would like to offer a couple of thoughts: one, your instructor was very wise to ask you to go home---what you witnessed was enough to turn the crustiest nurse into an emotional wreck! We MUST take care of our own needs before we can care for others properly; sometimes, toughing it out isn't the smart way to go. What we stuff down inside ourselves will always find its way out eventually........into depression, overeating, self-medication, marital difficulties, and so on. It's far better to allow yourself adequate time to process what has happened, acknowledge your feelings and then move on. There are no "wrong" emotions; they just are.

    The other thing is this: Good nurses never "get used to" dealing with death, especially those which are unexpected and/or tragic. We learn to handle ourselves professionally; we don't go to pieces in the middle of things or run around sobbing hysterically, but there is nothing wrong with shedding tears while we comfort the family, or feeling sad for some time afterwards, or even attending a funeral if we were particularly close to the individual who has died. Nothing is less helpful than a nurse who can't feel.

    So, be proud of having gotten through this experience, but please don't think the world expects you to be stone-faced or to shut down on your emotions. Not every death you witness in your career will have exactly the same effects; some will barely make a blip on your radar screen, while others will be much harder to bear. I have 'pronounced' the deaths of more than three dozen people during my career (this is done quite often by RNs in LTC), and witnessed the passing of twice that number; and I've still never gotten used to it. And if the day comes when I can stand at the bedside of a passing soul without feeling some emotion, that's when I will walk away from nursing for good.

    Once again, you are to be admired for your strength and compassion, and I hope this experience doesn't scare you off..........I'd be willing to venture that few of us outside big-city trauma centers EVER see three deaths in one shift. Hang in there, sweetie, and if you ever need a shoulder to lean on, you know where to go.
  9. by   P_RN
    What a hard day. I think two is all I remember.
    CaseManager 1947 said it very well
    1. Some of our patients will die, despite excellent care and good management. Sometimes their illness/sickness/condition/comorbidities/and the inevitable cascade that occurs in some patients can't be fixed.
    2.) It is a privilege to be there at the time of dying, especially as you say, two of your clients had no family there. What a gift you gave to them, by your presence. Their journey is complete.
    3. Death is a part of the continuum of life, and is an inevitable factor that can draw humans together, as this experience is shared.
    4) just as birth is a spiritual experience, so is death
    I'm sorry about the nightmares, I don't think I have ever had one like that, but we don't have control over our dreams and this was probably a way to rethink your day. I admire so much that you were able to tell the first patient that "it is ok." That was the perfect thing to do. And no it doesn't get easier, we just learn how to channel our feelings .
  10. by   carolinapooh
    Bless you. I don't know if it's any source of consolation right now, but I think you did a beautiful thing for both of those patients, and I'm sure you were a bit of comfort to that last man's wife, whether you or she know it or not.

    I'm so sorry that you had to face so much so quickly. I can't imagine what this must be like for you. Seek out someone you trust (do you have clergy, perhaps?) if you need more time to talk - and we'll always listen, too.

    I admire your strength. I'd say what's happening to you right now is probably very normal (though I'm sure it's terrifying in the process). Hang in there - we're here for you. I hope I can face situations like that with your steadiness.

    Peace and prayers to you. :heartbeat

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