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.
If he had a Doppler for bilateral edema 2 days prior I guess you can find comfort in knowing that others missed it as well. Also, he probably had a history of CHF so he and his wife would have been aware that post op CHF symptoms were something to treat seriously, not something to ask the neighbor about.
And I imagine you understand this as well now, but bilateral edema is abnormal in a unilateral joint replacement.
Specializes in Adult and Pediatric Vascular Access, Paramedic.
I have a rule, if it isn't my family member then I don't give out medical advise, plain and simple! I don't want liability, so I tell people I am not a doctor you need to call your doctor or 911.
Yes, it all makes sense now, yest at the funeral I felt that I was responsible for everyone's grief. How could I have missed these symptoms? My mind was talking me out of such fatal signs...I guess I wanted to believe that it wasn't serious, just low blood sugar or straining to have a bm (clammy) or not elevating his feet. Lord please forgive me. Writing and talking about it does help...and the family does not hold any blame towards me..thank God. I have to work on forgiving myself.
Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
I have to work on forgiving myself.
Yes, work on yourself and be sure to forgive yourself. The shock and sudden sense of loss from the neighbor's death will lessen with the passage of time and grace.
You are a continual work in progress. Remember that...
It's not your fault, although you should work on your boundaries. There's a reason why I don't give out medical information/advice to anyone outside of work and ask them to refer to their own doctor instead. Or call 911 if I think it's serious.
That's the whole problem in a nut shell...I didn't think it was serious...or I would have had the wife call 911..I learned a lesson the very hardest way and someone lost there life...possibly all because of me..there I said it...man this is crippling.
I would feel the same way you do so I don't have any new advice than what others have said on here.
By sharing with us you ARE HELPING me as this situation has helped me understand the need for us to draw boundaries and tell people to call their PCP/go the ED.
Also as someone above said, he just had negative dopplers.
That's the whole problem in a nut shell...I didn't think it was serious...or I would have had the wife call 911..I learned a lesson the very hardest way and someone lost there life...possibly all because of me..there I said it...man this is crippling.
Maybe you should talk with a counselor about this as it may take you quite awhile to fully process what happened. I think people here have made some very helpful comments, but it sounds like you may need some regular sessions with a professional in the long run.
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.
Oh heron. I am so very sorry. [emoji17]
OP, you have received some outstanding advice here. I would like this post but it truly made my heart hurt.
I recall sitting in a support group for mental health providers. One of the members was a favorite professor who had mentored me extensively. One of her close family members took his own life. I will never forget the expression on her face as she shouted "I'm supposed to be a ****** expert in this and I couldn't stop it. I couldn't see it and I couldn't stop it." She was powerless at that moment.
There is such a thing as being too close. I don't fully understand it, yet I can relate to it from my own tragedy. OP, I will be wishing you well.
Libby1987
3,726 Posts
If he had a Doppler for bilateral edema 2 days prior I guess you can find comfort in knowing that others missed it as well. Also, he probably had a history of CHF so he and his wife would have been aware that post op CHF symptoms were something to treat seriously, not something to ask the neighbor about.
And I imagine you understand this as well now, but bilateral edema is abnormal in a unilateral joint replacement.