Having issues with death anxiety

Stephalump · May 25, 2013

I have problems with death anxiety - I have since i was just a kid.

All I can say is, as with any type of anxiety, the best thing you can do is NOT let it control you, and face it head-on. Whether sick or dying or injured, everyone has a sad story if you listen close enough. There's a delicate balance between empathizing and internalizing...and with practice you'll get better at avoiding the latter.

Realistically speaking though, it's not as if you have to work somewhere full of dying kids. My hospital has a tiny peds department that doesn't deal with any sort of critical kids (immediately shipped to the children's hospital), so I've never even come into contact with a dying child.

carolinapooh, BSN, RN · May 25, 2013

It wasn't death that scared me - it was dealing with the families of the dead and dying that petrified me. It's the only thing I really got anxious about (and I've worked in oncology since day one, so it was a very real fear!).

I learned - and sort of through my own experience when my own dad died - you don't have to say anything. Everyone knows that no one knows what to say when someone dies - that even that simplistic "I'm so sorry" goes a long way. So does a hug. So does just sitting with someone and letting them cry, or letting them talk about the dying person. I used to distract little kids with cups of ice or cookies if it was allowed - people are very appreciative when you think of their kids. I'd bring someone a blanket if they were sitting with the person, or an extra pillow for their back in the chair (when I could find one).

Once someone was dying and they were dying alone. I hate that - I know sometimes it's inevitable, that sometimes you're the only family they have. Our shift was slow and I'd learned by reading this man's chart and by looking around his room he was Catholic. I'm not terribly religious, but I have Catholicism in my family (and my dad was Catholic - long story) and I know how important their religion can be. I put his rosary in his hands and I read to him from his prayer book when I had time (they say hearing is the last sense to go as you die). I do know the Lord's Prayer and a few verses and I'd share them with him as he lay there, pretty much comatose in his last hours.

It scared the crap out of me but I thought, gosh, I'd hate to die alone - someone should let this man know that regardless of what mistakes he may have made (and of course I didn't know him from Adam), he matters to someone, even if it's only his God. And I thanked him for letting me sit with him, letting me talk to him, and I hope he didn't mind my reading to him, that I hoped he'd gotten to hear some favorite prayers or verses and that I didn't bother him. He died the next day when I was off.

I'm saying this to let you know that I think the best thing you can do is face it, don't let it control you. It's part of what we do. If someone is actively dying and alone as the man above was, I encourage you to sit with them, even if it's in silence. You can hold their hand if you like but you don't have to. I think they know you're there. And I think if nothing else, they would know they were helping you - that they mattered to someone at some point. We all need that, I think.

Death IS scary, and I get that. I'm about to turn forty and the thought petrifies me. I have an almost eighty year old MOTHER, a brother pushing 60, a 50 year old sister. I think about it a lot sometimes. My dad is, as I mentioned, already gone and sometimes, in some patients, I've seen him, and for a little while it's like losing him all over again. I'll admit that. I don't dwell on it, but I think about it, like any normal middle aged person does, I think. It just sometimes hits a bit closer to home for us.

I sat with my daddy and held his hand when he took his last breath. I told him the whole time I loved him, that we all did. I'd like to think I can do that for someone else. It's how I deal and have dealt with death so far.

carolinapooh, BSN, RN · May 25, 2013

I didn't know nurses had to do post mortem care. I'm a Cna and everywhere I've worked, the Cna does it. The nurse only comes in and calls time of death. As a nurse, what post mortem things do you all do? And as for death anxiety...if you want to be a nurse you just have to face it. One second at a time. I'm only a Cna but I've done post mortem care about 4 or 5 times now. It's not easy. But you get through it. Each time it gets a little easier to handle. (I work at a nursing home if that makes a diff)

Oh, yes, we do it. :) We did it on the civilian floor I worked on and I've helped my military techs do it. We do the same stuff you do - tag, bag, help clean, leave IVs and lines in place, record the death, put the drops in the eyes. We also call donor services, who is notified as I'm sure you know with all deaths.

The CNAs that took care of my grandma are the ones who took care of her in death. I appreciated the care that was taken with her. You weren't one of them (I don't think, anyway) but I thank you regardless.

Anoetos, BSN, RN · May 25, 2013

Yes, there probably are areas of nursing where you can modify your exposure to death but most nurses do not have the luxury of doing so right out of the gate. Most grads have to get their feet wet on the floor in a hospital and people code even on low acuity medsurg units.

I would urge you to get some help with this. If nothing else, nursing will probably provide enough exposure for you to arrive at some kind of acceptance or resolution.

Anoetos, BSN, RN · May 25, 2013

Yes, in hospitals, we (the RN's) always participate in and supervise the preparation of the body for transport to the morgue. We don't pronounce, we have to call up the MD to do that.

I thought it was interesting that time of death is listed as the time at which the doctor has determined that the patient is dead rather than the time at which the nurse or aid discovered that the patient was actually dead. It makes sense I guess.

duskyjewel · May 25, 2013

This might seem flippant, but I really mean it: perhaps you should consider working for a hospice as a CNA during school. I'm a hospice CNA, and I have to tell you that it has utterly changed my perspective. As a society, we focus on negativity and fear when it comes to death, so most people never realize how much beauty can come from helping individuals and their families experience a good death. Yes, there is such a thing. Making a death a good ending can be the beginning of healing for that family. It's a release from suffering and worldly anxiety for the individual. Many times, letting go of the fight and accepting death can lead to amazing family time and cherished memories, because it's often the first time in years the family had slowed down to enjoy and just love each other instead of engaging in "the fight."

One of the most effective ways to get past our fears is to face them head on. As a nurse, you will eventually have to deal with death. You owe it to your patients to be able to do so without melting down. It's your responsibility as a nurse to get past this self-imposed roadblock so you can do your job. (I think the same of doctors. Their lack of training in helping patients deal with end of life issues is reprehensible.) You may decide hospice is not somewhere you want to work again, but I think it might be effective in helping you now, changing your perspective, and making you more well-rounded as a nurse.

I won't lie, I've seen some horrible things. Things that challenged me to the core and took every resource I had to remain professional. But I've grown and continue to grow in ways I never imagined.

$0.02

Kvedaa · May 28, 2013

Death is always going to be hard. I remember every patient of mine who has passed and there passing vividly. This is from my work as a CNA but I had patients from children to the very old. No matter the circumstances it isnt any easier. But you can find comfort in knowing that pain is over, and a new healing can begin. I am not really religious but some people find comfort in religious beliefs. If you can accept the fact that people will die, you will be able to rise above the anxiety and serve your patients. What you are feel is SO INCREDIBLY NORMAL!

These feelings will make you more empathetic. It is okay to lose it when you get home if you need. My first death took it out of me, I cried all the way home and balled all night. I still cry sometimes in the privacy of my home and that is okay. Grief is a natural experience just like death itself. You will eventually be able to leave work behind you when you go home more or less and you will not be hardened or cold, it is just a mechanism to cope.

The fact that you are having anxiety will make you a better RN, dont mistake that feeling for weakness.

determined_30 · May 29, 2013

I was a c.n.a. since 2005 I am now taking prerequisites for nursing. But when I first became a c.n.a. I was so terrified of death. I also thought about it before I started prerequisites. But being a c.n.a. relieved my anxiety somewhat. But I guess the more you are introduced to it your anxiety subsides. You will be fine you can do this.

determined_30 · May 29, 2013

I was a c.n.a. since 2005 I am now taking prerequisites for nursing. But when I first became a c.n.a. I was so terrified of death. I also thought about it before I started prerequisites. But being a c.n.a. relieved my anxiety somewhat. But I guess the more you are introduced to it your anxiety subsides. You will be fine you can do this.

amberdawn85 · May 30, 2013

Thank you :) I feel a little better, I think I will fine once I'm in the moment and not just thinking of what can happen.

Rlee1 · May 30, 2013

Think of it this way, you don't stop driving just because someone else had a crash. Death is not pleasant but in many cases it also is not unpleasant. Many times people are ready to die, they have found their peace and welcome whatever may be next. In many cases not only the patient but the family, finally feels the burden of pain,sickness, and suffering lifted from their lives. Don't let it reflect back on what if it were you or your children, instead let it teach you not to fear the inevitable and be able to share the emotion. Who knows, maybe it will help sometime with something tragic to the kids like a goldfish or a puppy, which may be devastating to them, but a life lesson that most endure. Many of us remember just such things. As time goes on you will become more familiar, although maybe never comfortable, and to many I am sure you will make a difference. Good luck.

bopeep82 · May 30, 2013

Death is the only certain thing in life. There is no need to fear death, as that is the point in which no pain is ever felt again. As someone who had to bury their only sibling at 24 due to suicide, I can tell you that I have a very accepting and liberal view on death. It's not a time to fear, but a time to celebrate the life and to realize death is only and end for the dying, but not for the living. Each death you encounter will form you and make you understand it more. Our culture does not deal with death in a realistic view and I believe that's where the fear comes from. We paint our deceased up and stick them in expensive tombs and caskets. We mask the death and dying process. Many other cultures see death as a continuation of life and not an end to all ends. It's a celebration of said life. I recommend a book called, "On Death and Dying" It's a book that should be required to read by everyone.