New Grad

GingerSue · Apr 6, 2007

it's good that you are thinking of this now

so that you can handle yourself

we all have different reactions

It is the nature of the human condition.

What does life mean to you and what does death mean to you?

Daytonite, BSN, RN · Apr 6, 2007

hi, cmad!

so, much depends on your own feelings, experiences and thoughts about death. if you haven't already had the experience of being with a patient who has died then i can understand your curiosity about this. who knows how you will react when you experience your first patient death?

i still remember mine. i was working in a nursing home on weekends and one of my elderly patients passed away. i wasn't sure, however, that she had died. i didn't cry. but i was a little scared and my heart was pounding. i desperately was checking for a heartbeat or respirations and wasn't finding them. the charge nurse came into the room, took one look at the patient and said something like, "oh, honey, she's gone," in a very sympathetic tone. i guess at that point i knew it too. and, i was sad, but i didn't cry. i really didn't know the patient very well. i remember thinking about how awesome life is and how it can be over in just a second.

shortly after graduation from nursing school, one of my classmates died in a violent car crash. for weeks i thought about what must have gone through her mind at her moment of death. it didn't help that they had an open casket at her funeral and her head injuries were very evident.

from what i've seen, sometimes death is better than some of the other suffering i've seen. i had more difficulty dealing with my own emotions over patients who have been shot and stabbed by other people than i ever had working with patients dying of cancer, copd, heart or renal diseases. my mother recently died here in my home. i worried that i would have difficulty at the exact time of her death. something woke me as she was taking her last breaths (she has metastatic lung cancer) and i sat with her until she was gone. it was just very sad moments. i cried off and on through the remainder of the days. but, honestly, and please don't chastise me for this, i cried more when i lost one of my boyfriends years ago (three full days) and i can't tell you why. perhaps i've just come to a better realization of the consequences of death. i don't know.

what i can tell you is that this is a journey, like life, that we all make on our own. i can only wish you well and hope there are people available to help you if you need them when these experiences occur for you.

welcome to allnurses! :welcome:

GingerSue · Apr 6, 2007

this topic of death reamained on my mind this afternoon

thinking of my own reactions

I can't change the reality of death

Maybe I can keep a person comfortable,

or know how to resuscitate (with hope) someone who can be

or provide a supportive presence to someone who needs it

I ask myself - what is it about death that concerns me?

I've wrapped patients in shrouds (two one night as I came on report said they had died).

I can picture them on the unit.

Perhaps it is my own thoughts of alleviating any suffering in their existence.

Is it reallly death that concerns me, or is it something about living? Or the loss - whose loss? what is lost?

Then I think of the Mexican calaveras who laugh at death:

Even though, it's the day of death in Mexico, death brings laughter, and in that celebration, the Mexican people play with death, making people laugh. The celebration includes jokes, parties, dancing, music, and a lot of delightful food.
Everyone buys smiling candy skulls with the names of the people, family and friends written on the forehead. These skulls are made of sugar, and the children eat them like candies.

Photo: Sandy Peters
They make small toys that look like skeletons, and they tell funny stories about death. This skeleton is playing a musical instrument.

Los Dias de los Muertos is a traditional Mexican holiday honoring the dead. It is celebrated every year at the same time as Halloween and the Christian holy days of All Saints Day and All Souls Day (November 1st and 2nd).

GingerSue · Apr 7, 2007

this is a catrina, one of the calacas

and to understand what catrina represents i wanted to include this explanation from wikipedia:

a calaca (a colloquial spanish name for skeleton) is a figure of a skull or skeleton (usually human) used for decoration during the mexican day of the dead festival. tracing their origins from aztec imagery, calacas are frequently shown with marigold leaves and foliage. as with other aspects of the day of the dead festival, calacas are generally depicted as joyous rather than mournful figures. they are often shown wearing festive clothing, dancing, and playing musical instruments to indicate a happy afterlife. this draws on the mexican belief that no dead soul likes to be thought of sadly, and the death should be a joyous occasion

cmad · Apr 8, 2007

Thank you for your input

The feeling I quess is what is going on with this person are they suffering or are they comfort. DO they wish for death, are they ok with the condition, or was it sudden. I then start to think about how the family is going to react to the circumstances. I wanted to be a nurse to help and care for people however i know that it is not always a good out come. I quess I'm afraid to die how can i deal with this? :sniff:

Daytonite, BSN, RN · Apr 9, 2007

i think i can safely say that we are all afraid to die. we all have to find a way to deal with it. how i deal with it may not work for you. if you get too hung up on this issue, how will you be able to work unless you specifically look for jobs where the death of patients just isn't a regular occurrence? living in fear is not a way to live. part of life is facing our fears. do you want to live forever? one of the characters in conan, the barbarian said that or something like it. i've had a couple of patients that made it to 100 years of age--i, personally, don't want to live that long. however, i think that watching and helping others through the process of dying has helped me with my fear of it and i think you should consider that. this same kind of issue might come up about something like cancer.

cmad · Apr 10, 2007

Thanks again for the information. I have been thinking about this and I think of other such as family and what they are going to go through. I do not what to live forever and especially not on machines. Were I work I hope there will be leaders guiding me through my first.

Annabelle57 · Apr 10, 2007

Really good question, cmad.

I am finishing up clinicals on a burn/trauma ICU and step-down, and since I'm interested in that area after graduation, I asked my instructor about what to do when you know your patient is dying: they're DNR, they're exhibiting Cheynes-Stokes, etc.

Her answer: one of the greatest qualities you can possess as a nurse is compassion, especially for the dying patient and his/her family. Most families want to know that their loved one is comfortable (no pain, which usually translates to morphine IV) and most of all, that their loved one is not alone, particularly if the family cannot be with the patient for whatever reason. Our hospital has a program where a chaplain or spiritual care dept volunteer will stay at the bedside of a patient who is dying, 24/7, so that they do not have to die alone; many times, if death is imminent and is sure to come quickly, the RN will stay at the bedside with the patient.

The nursing skills you learn in your head, but the compassion comes from your heart. I highly doubt you'll be alone for your first patient code or passing: don't be afraid to talk with others (particularly the ANM, charge nurse, or EAP).

And just for the record, it is never a bad thing to cry with the family or with the patient. It shows you care :-)