Guilt after patient passing away

Wuzzie · Jun 13, 2020

As a nurse there will be more times that you do not get the chance to say goodbye than the opportunity to do so. This is something you’ll just have to come to terms with. But there is something you can learn from it. I had an experience in nursing school with a patient on an IABP who was going to surgery for a correction that I did not understand at the time. The surgeon told the staff caring for her that she wasn’t likely to make it off the table. I felt like I was punched in the stomach. I had to care for this delightful, alert, funny and kind lady knowing full well she could be dead just a few hours later. So I was determined to make what could be her last hours on earth as pleasant as possible. That experience deeply influenced me. From that point on in both my nursing and my personal life I approached my relationships with a clearer understanding of the temporal nature of our existence. As a nurse I try to always give my best in how I treat my patients so if by chance I am the last person they have contact with they were at least met with kindness. In my personal life I try to make sure that the people I care about know, in a meaningful way, that they matter. I’m not always successful but it truly is what drives me even if the execution is a bit rough at times. Sometimes the goodbyes aren’t nearly as important as the hellos. ?

BTW: The patient I spoke about survived and was discharged a week later. ?

Editorial Team / Admin · Jun 13, 2020

7 minutes ago, Wuzzie said:
... From that point on in both my nursing and my personal life I approached my relationships with a clearer understanding of the temporal nature of our existence ...

Excellent, @Wuzzie. Amazing intuitive reasoning/understanding.

SilverBells, BSN · Jun 13, 2020

@JabuJabule, I am so sorry to hear about the passing of a patient that you had a connection with. About a year ago, I experienced a similar situation. I was working as a floor nurse in a SNF and had a schedule that allowed me to have over a week off every 3 weeks since I worked many 12 hour shifts in the previous weeks. Anyway, there was a LTC resident who I had worked with for a long period of time, who eventually was placed on hospice. I, too, wanted to be with this resident before she passed but the timing of her death and my schedule simply did not make this possible. I knew that after having over a week off from work, she would be gone by my next shift. I have tried to minimize any 'guilt' that I might have felt by knowing she received the care and attention she needed while I was still there. I'm currently in a situation where another long-term patient of mine is now on hospice and due to change in room assignments as well as change in nursing roles, I am no longer able to be with this patient as much as I would like. This one is a struggle for me because I've known this person for 4 years now. I've had a hard time of passing on her care to other people, but know that there are capable nurses working with her now. As much as I would like to be there when the time comes for her to say goodbye, maybe it will be a blessing in disguise to not be there due to heartbreak. Just keep in mind that there are many other patients who will want and need our attention as well. You may eventually have the opportunity to say goodbye to another patient, although I realize that person won't take the place of this patient. In my case, I have had an instance where I know my voice was the last one a patient heard, and even though I hadn't worked with this individual nearly as long as the other two I've described, it was still special. I know she left the world in peace with a calming presence.

Anyway, no real advice and I know I am ranting. Just wanted to let you know there are other nurses that get connected to their patients as well. Hugs ❤️

allnurses Guide · Jun 14, 2020

{Hugs}, Jabujabule. Don't feel bad about not saying goodbye to your patient. Throughout my years in nursing I've got a few deaths that have "stayed with me". I don't think about them all the time, but they still have the power to bring tears. So I've just learned to accept that's the way it's going to be, and fighting those feelings is harder than acknowledging them.

As you've got 8 months in nursing so far, I suspect you'll naturally develop the personal resources to deal with most of what comes along as a nurse, but expecting ourselves to be robots isn't "self-care".

Wishing you all the best as you continue your career.

Sour Lemon · Jun 14, 2020

16 hours ago, JabuJabule said:
I just have a general question. I had a hospice patient pass away a few days ago, and a week or so before she "wasn't doing so well", and I work per diem so I'm not there a lot. However, I did know this patient because I was her overnight nurse for months (along with other patients of course).
After she passed, I've been feeling guilty. I knew in my gut that she might not be there the next time I worked, and I was correct. I never got to say goodbye. I just feels so upset and guilty with myself because of it.
This is my first time feeling like this, as a nurse, as you guys know I'm still relatively new (8-ish months as an LPN). Does anyone have any guidance or tips for this? I feel horrible. ?

One huge thing to remember is to stay patient focused. It's not really about you, or your experience, or your feelings. This woman had an entire lifetime to reflect on, and you only met her as the hired help near the very end of it all. I doubt she passed away lamenting that the nurse who only works once in a while never said goodbye, although she may have been fond of you.

Your role was to provide good care when assigned to the patient, and it sounds like you did. It might help to focus on that.

Lynker, LPN · Jun 17, 2020

Thank you to everyone who commented on this thread. I've moved forward, with more knowledge on how to deal with these. It's okay to be sad, but it's okay to forgive yourself and move on as well. ?