Hem-onc patients dies unexpectedly

[Encyfency]

hi

I had a horrible night a week ago...one of my patients died unexpectedly and i can't seem to forget the event. She was my pt. for 2 previous shifts. I knew she had low baseline BP, and SOB and was being treated for that. She was also transfused with platelets (plt=4) during day shift. When I came in she was doing fine, at midnight she was little SOB but it was not out of the ordinary, she recieved IV lasix for that 2 hrs prior to that. At 2 in the morning the nurses aide came up to me and told me that she was dead. I was very shocked. She was DNR, palliative pt and 93yr old but the death was very unexpected. I find myself guilty for not calling the doc for SOB and low BP at the time. She could have had more lasix to help with SOB. But looking at the situation, this was similar to her previous night. I was surprized that the family coped much better than I thought. I still think something could have been done in this situation.

Did anyone do thru similar situation, and what did u do to cope.

[blondy2061h, MSN, RN]

93 year olds die unexpectedly without having an oncology dx. If she was palliative I don't see how more lasix would be in order. It's always somewhat unexpected when a patient dies, especially when you're a new nurse (which I suspect you are). Try not to blame yourself.

[shortlittleRN]

Lasix would have brought her BP down further. Given she was palliative, morphine IV or nebulizer would have made her SOB better; making her more comfortable.

Not trying to be callous but, if she is DNR and receiving palliative care, her death was expected. Nonetheless, it is always difficult to deal with death, unexpected or not.

My first oncology patient that passed was very difficult. I knew he didn't have long to live, but I did everything I could to make him comfortable and not pass on during my shift. Though he expired 12 hrs after I left, I was a basket case knowing he not be there when I come back. :-(

I remember calling the doctor for his SOB, the doctor just said, give him morphine IV to make him comfortable. Nothing else you can do.