How do you cope with the death of a patient?

SFCardiacRN · Dec 3, 2005

I always do my very best when taking care of patients. I always put patient safety first. When a patient dies I can sleep well knowing I've done my best and that I am not responsible for the disease in the first place.

Bipley · Dec 3, 2005

I'm a senior nursing student taking a Life Transitions course. As a class assignment I need to informally communicate with a nurse on how he/she copes with the death of a client. Anyone want to help me out???
Thanks!

The setting really makes a big difference. If it is your first contact with the patient and they die, sure... you are sad for the situation and the family. But when you work in a LTC facility, those people become family over time. It has always been a much greater loss for me when a patient I know quite well passes on.

It's been 15 years since I worked LTC and I still miss a few of my patients. One was more like my grandfather vs. my biological grandfather. I loved the man dearly. He gave me advice when I needed it and stern lectures when he thought I needed them! :) Thinking back, he was likely right.

I'm not sure I'm the one you want to be talking to about this topic because I never really found a way to deal with the death of my patients well. I've never been very good at drawing that professional line. But on the other hand, I think that is one of the issues that makes me a good nurse.

nurse4theplanet, RN · Dec 3, 2005

I don't know if this will count because i am a tech, but I work in ICU and deal with death often. I am given much responsibility and my own pt assignment, as I have proved myself to be competent. ( I am still double checked by an experienced RN for those who are concerned...but so are the new grads:) )

The first time I saw an expired pt it was a shock. I wasn't expecting it. The nurse asked me to help move the pt and I thought nothing of it. But this lady looked a little strange... but had died only 15min before so still had good color. When I noticed how stiff she was then I realized she had expired and I was so shocked that I couldn't react. When I got home that night I cried, not because of the loss of that pt's life because I did not know her, but the fear of dealing with death.

I have to say that working in the ICU has made me accustomed and comfortable with death. Sometimes I even pray for the death of a patient who is deeply deeply suffering and has expressed willingness to pass. I embrace death as part of life and it no longer saddens me. My spirituality also assists me in looking at death not as an end, but as a new beginning into an eternal existence.

With personal relationships and unexpected deaths I find the grieving process much more intense and drawn out. Comfort comes less readily even within a spiritual sense because I feel a personal loss. I find healing in expressing my feelings with those who share my pain, and reminiscing (sp?) about good times shared with the person who has passed on.

yankeesrule · Dec 3, 2005

For myself. I work in a group home with 8 ladies. I have been there almost 10yrs and have known the ladies about the same time. When you are in training you are told "dont get attached, too involved." At my job. I am to these ladies family. I am there voice. I do get attached. And I mourn just like most people do with a death of a loved one. I can say that my coworkers and myself have special relationships with our ladies. One lady we call "mamma" she is the oldest of the bunch. On the 8th she is having a PEG insertion completed. When this is done she can no longer reside in this home that she has known for 20+yrs. We the staff have had 3wks to prepare and we are sadden. Mamma doesnt fully comprehend what is going to happen.

When one of my ladies died in 97 this was the 1st one i got so attached too. When I found out she had passed ( I heard the call go out on the scanner at home) my heart sank. I balled my eyes out. For me coping was speaking at her funeral. Giving her Eulogy. It took months for me to get over her passing. I think it comes with the job. And we all have our ways of dealing with this. To this day I still have her picture on my desk. Good luck with your paper.

nurse4theplanet, RN · Dec 3, 2005

For myself. I work in a group home with 8 ladies. I have been there almost 10yrs and have known the ladies about the same time. When you are in training you are told "dont get attached, too involved." At my job. I am to these ladies family. I am there voice. I do get attached. And I mourn just like most people do with a death of a loved one. I can say that my coworkers and myself have special relationships with our ladies. One lady we call "mamma" she is the oldest of the bunch. On the 8th she is having a PEG insertion completed. When this is done she can no longer reside in this home that she has known for 20+yrs. We the staff have had 3wks to prepare and we are sadden. Mamma doesnt fully comprehend what is going to happen.
When one of my ladies died in 97 this was the 1st one i got so attached too. When I found out she had passed ( I heard the call go out on the scanner at home) my heart sank. I balled my eyes out. For me coping was speaking at her funeral. Giving her Eulogy. It took months for me to get over her passing. I think it comes with the job. And we all have our ways of dealing with this. To this day I still have her picture on my desk. Good luck with your paper.

This is why I am so glad that I don't have the opportunity to get attached to my patients (they are in and out in some form very quickly) because then....I don't think I could handle it and be able to stay in nursing...too much of a softie I am afraid.

Daytonite, BSN, RN · Dec 3, 2005

I think you have to resolve in your own mind just exactly what death is. For me, I see it as a passage to a spirit world which is where our true soul exists. This is a spiritualistic view and very early in my life I have held this belief. So, now when I have a patient who dies I believe it is only their physical body which has finally stopped while their soul lives on. With that idea in mind I am still very respectful around the body as I believe that it's possible the person's soul may still be present at the bedside. When it comes to patient's who are facing death, my beliefs, I think, bring out a level of comfort and acceptance that many patients find calming to them. I believe that one of the biggest fears that patients have is that they will be alone when they die. It is, afterall, a moment of great mystery to us all as to just what exactly is going to happen to us. We know we have to experience this moment on our own. I make every effort to look in on dying patients frequently to reassure them that I am watching over them and that I will be there if they feel something is wrong. For those few who want to talk about death, I will do that. Mostly, what I've had people ask is what my ideas were about death. You see, each of us is searching for an answer about just what it is. So, as nurses I think that is the biggest assistance we are giving the patient--helping them to form some kind of opinion about what death is that they feel comfortable with.

I don't have any problem coping with the death of a client. If they were in a great deal of pain I feel relief that it is over for them. In most cases, even when patient's pass away in their sleep, they still have been coping with long term illness. I see death as a release for them as well. My own beliefs are that we, the living, are merely handing over the soul of each person to members of their soul families who are waiting on the other side to take them back home. So, in a way, I feel like I am helping to escort the dying person back to their true home.

pricklypear · Dec 3, 2005

I think I cope by putting my energy into the family. The patient really doesn't need anything anymore, but the family is left behind in the wake of everything. Most families do pretty well, but I always like to make myself as accessible as possible to them before, during and after. Every little thing can make a difference.

Chaya, ASN, RN · Dec 3, 2005

Have to admit I got pretty creeped out the first time or two. We don't see a lot of deaths. I offered to assist with post-mortem care whenever the need arose until I felt more able to handle the physical care. As for the emotonal impact a lot depends on how the last few days are handled. If I feel the patient has been made to linger with the result of unnecessary suffering it makes me angry, also sad. But my attitude is that I am caring for the family as much as the patient at this point. Very few families in my experience have the awareness to recognize how close a family member might be to death or to have a sense of which treatments may bring comfort as opposed to interventions that have become inappropriate or even cause suffering. Sometimes no-one has actually said to them that death is very close, a matter of days or hours. Sometimes they may have been given information but in an overly blunt manner that makes it even more painful. Perhaps the most constructive action I can take as death approaches is to do timely and sensitive family education-I try to assess their need, which may be for info or may be simply to vent their feelings of helplessness.

This being said, we had a pt. recently who had the most peaceful, beautiful death. He was sedated enough to not be too uncomfortable as well as we could tell, but he was intermittently aware. The light was kept low in the room. His close family members were at his bedside the last few days, holding his hands, providing comfort care. They were active participants in caring for him in his last hours and that seemed to bring them acceptance and comfort.

TweetiePieRN · Dec 3, 2005

I work in oncology so we do see a lot of patient deaths. It is tough at times because a lot of them are in and out of the hospital and we get to know them and their families very well.

I am sad when a patient dies, but am able to rationalize the fact that they were suffering and are free of pain now. That is how I personally feel. I go home and leave work at work. From time to time, certain patients will pop up in my head, but over all I feel it is a blessing that they are no longer suffering. I do not fear death and I try to make the dying patient not fear it and to be as comfortable as they can be :)

alton · Dec 3, 2005

I'm a senior nursing student taking a Life Transitions course. As a class assignment I need to informally communicate with a nurse on how he/she copes with the death of a client. Anyone want to help me out???
Thanks!

jhawkgirl you will not get through it on your own. on our unit we have a group of staff that come along side our other staff and provide them support. we call one another and talk. we are very intentional in what we do. the best is having someone who truly knows how you feel to say "i know how you feel" :scrying:

jhawkgirl · Dec 3, 2005

Thanks for all of your wonderful replies! I have learned a lot!

For my assignment I need to ask a nurse a series of questions on the topic. Does anyone want to help me out???

Thanks!