Guilt

[Whitesranch, BSN, RN]

I am experiencing unbearable guilt for not noticing chf/pe/mi symptoms on my neighbor. Instead of calling 911, I told him to lay down, elevate feet and sip on some ginger ale. His symptoms were masked by having status post hip replacement one week prior. Now that I look back in hindsight he was, sweaty, weak thready pulse (which at the time, I brushed off as me unable to feel it right so I listened to his heart with my stethoscope to take pulse), bp was good, edema bilateral lower ext (which I attributed to him not elevating his legs since surgery). He had a Doppler done 2 days prior with neg results for dvt, so I wasn't thinking PE. I checked on him by phone an hour later and he said he feels fine, better. No c/o cp, sob. The next call 2 hrs later, was his wife saying he is dying come quick. At that point Cpr was initiated by me until paramedics came, but pt died. Would like to know if any others had a similar experience at work or personally? Or any suggestions of how to heal or kind words. I feel horrible.

[Magsulfate, BSN, RN]

Wow, sorry to here this! I'm not sure what to say. You can't turn back time and save him. I would like to say that you've learned a lesson from this but I would be putting it mild. Things happen, keep your head up.

[Whitesranch, BSN, RN]

Thanks. I have learned a lot. I hope someone else will learn from it too.

[heron, ASN, RN]

As I pointed out in another thread, nurses are not responsible for fixing everything that happens to everyone everywhere, ever. I recommend you do some maintenance work on your own boundaries. It's humanly impossible to be the ultimate nurse 24/7.

ETA: remember that the retrospectroscope is the only infallible instrument in medicine.

FWIW, my partner was having abdominal pain w/nvd and diaphoresis. I, with my 43 years of experience, and her most excellent primary doc both assumed she was fighting the current virus "going around" at the time. We believed this right up until she fell over dead on our bedroom floor. When EMS got there, she was already in asystole.

The medical examiner declined to do an autopsy and I can't afford a private one, so I'll never know what we missed. My theory is that she was evolving an MI. I know the kinds of symptoms women are likely to have besides the classic ones. I know how to recognize an impending code. I missed it and my DH died when she maybe didn't need to.

I was finally able to let go of the guilt when I remembered that denial is a powerful force and is often our very first grief response. There's a reason why nurses should not be caring professionally for family and close friends.

It comes back, of course. And I deal with it again.

Life really does go on.

[calivianya, BSN, RN]

As I pointed out in another thread, nurses are not responsible for fixing everything that happens to everyone everywhere, ever. I recommend you do some maintenance work on your own boundaries. It's humanly impossible to be the ultimate nurse 24/7.

This is what I was going to say. He was your neighbor, not a patient of yours. We think differently at work than we think at home. I bet you would have recognized trouble if he was a patient in the hospital.

It's like when you see someone you know outside of work in regular clothes, and you can't figure out who they are right away. You don't have a problem recognizing them at work, but when the setting/appearance is different, your thinking is different. That's just how our brains work; it's not your fault.

If someone around you has a concern, call 911 or tell them to call a physician/NP - there is too much liability in doing anything else. If you don't already have malpractice insurance, get it - and make sure it will cover any lawsuits brought against you from this point regardless of when the incident happened. We are not covered under employers' malpractice insurance when we give advice/care off the clock.

[Whitesranch, BSN, RN]

Wow, I like what you said about being outside the hospital setting. How your brain thinks differently. That helps. But, if no one goes to assist another, how would anyone have a chance to survive. And also, since his death was within a few hours, would the outcome have been different if he made it to the ER. Knowing the answer could make me feel worse or better, my brain is on overload.

[Been there,done that, ASN, RN]

The only thing you need to take away from this is... never take responsibility for friends, neighbors, or strangers.Anytime anybody asks for nursing advice... refer them to their provider.

If he died 2 hours after you last saw him, I would say he was already a goner.

[Whitesranch, BSN, RN]

Thank you. You are all very wise.

[Whitesranch, BSN, RN]

Thank you for sharing your story, it helps me a lot. My mind knows I cannot take full responsibility, but this had made me question all my abilities. This sucks.

[TheCommuter, BSN, RN]

Do not beat yourself up over this situation. It is unfortunate your neighbor died, but ruminating over bygones is a surefire way to navel gazing and unproductive regrets.

Learn from this situation to ensure you grow as a nurse. Finally, avoid giving medical advice to family, friends and neighbors.

Good luck to you. (((Hugs)))

[Hollybobs]

You couldn't have predicted what happened Whitesranch.

I'm sorry it did. It can help to talk or write it out, on here or with a close friend, don't keep it all in your head. I hope you can make peace with it, there will be feelings of personal grief exacerbating and complicating your feelings too. ((OP)).

[Whitesranch, BSN, RN]

Yes..the funeral is today and the wake was last night..I am taking part in both hoping it will help me grieve and heal. I am so grateful for this website so I can share this experience with other nurses. You all have helped me so much.