How do you deal with death?

Katnip, RN · Apr 11, 2006

Experiencing the death of someone you know personally or are close to is very different from that of a patient's death. Sometimes, though you do become close to a patient. And yes, it can hurt when that happens.

You do learn to deal with it. As an IMCU and ED nurse patients would die with sometimes alarming frequency. One weekend in the ED we had 7 kids die. That was a very bad weekend. We had crisis intervention by our unit psychologist, who was awesome.

But to answer your questions:

1. For me, though I got used to it most of the time, it's never something taken lightly. But rarely did I mourn a patient.

The most important coping mechanism you can have is to develop and know your own views about spirituality and death. Once you have that, you can rely on it to help.

2. There will be patients that may never leave you. I still remember my first gunshot wound from a few years ago. The police officer asked me to go through his belongings. Four coins fell out of his pocket: a quarter, heads up, a nickle, heads up and two pennies, one heads, one tails.

3. Usually we move on immediately. You have to. Because the world doesn't stop and you have to be ready for whatever comes next.

I just want to add: it's ok to cry at the end of the day sometimes. It's ok to over-indulge in chocolate (once in a while) but if it ever gets to the point where your coping skills become overwhelmed, it's time to get help or move on.

bopps · Apr 12, 2006

Yes, I agree with the above post that seeing one of your loved ones die is a lot harder/different than seeing someone die while you are at work, but we are humans and sometimes it can really hit close to home especially if you began to compare the patient who died with a loved one. I have learned not too do that but sometime it happens automatically. For me the hardest experience I had was being one of the first EMTs on the seen with 3 DOA's. I definately suffered from mild PTSD after that because two of them were the exact same age as my brothers and the other one was my dads age. Hard, but there are ways to deal with death.

1. Like the above post stated. Know what you personally believe about life and death. This is a must. It will help you mentally reconcile the whole death process. For me it is my faith in Jesus that keeps me going.

2. Don't feel like you are the only one on the team who is struggling. Everybody deals with this issue a little bit differently and even if they don't verbalize it they are in the same boat you are.

3. Don't ever be afraid to cry.Ever. Even if you are in front of family members. I have shed tears while perfoming CPR in front of pt's family. Just make sure you are in control.

4. If your emotions are affecting your ability to provide pt. care, get someone else to take over. Don't feel stupid if this happens periodically. There are always plenty of people(in the ER setting) to take over. Better that than the pt. not recieving care.

5. Finally, never underestimate adrenalin. In a critical situation your adrenalin will usually kick in. Hope this helps. Good luck in your nursing career.

Jo Dirt · Apr 12, 2006

You know, seeing a terminal patient go through the stages of a peaceful death can be comforting, in a way.

A lady dying from lung cancer was in my care recently. She was bedridden and very sick, but I felt good about the job I was doing, which was basically keeping her medicated with morphine and phenergan to keep her comfortable. And when I heard her name on the local radio station's obituary news I felt relief for her, and I feel like I (as well as the other nurses) helped make her last days easier to deal with.

I will never forget the little lady with dementia who was always wheeling herself in her wheelchair and the smile never left her face. She would laugh and talk to herself and was the happiest person in the nursing home. One night she died suddenly and the smile was still on her face. It wasn't sad.

We are all going to die. It is part of the cycle of life. Some deaths are not easy to handle, such as the death of a child or tragic deaths like car accidents, but it is something you learn to deal with, but as nurses we must learn to accept that death is the end of that person's journey on this earth and is not necessarily a horrible thing.

Katnip, RN · Apr 12, 2006

I agree. Sometimes the patients do hit very close to home. My teenage son died in a car accident. I worked in ER. I stuck with it about a year, but it got more and more difficult when I'd get a teen patient in a car accident.

My coworkers tried to protect me as much as possible, but they could only do so much.

And there were some other good points. Develop a good relationship with your coworkers. Be there when they have a situation that's difficult for them and they'll be there for you.

We all have patients who get under our skin. It's ok to feel it.

Spritenurse1210, BSN, RN · Apr 12, 2006

Death is a very sacred thing. So many people view it differently. It is a part of life, and we in the medical profession come to grips with our mortality quite often. sometimes it can be hard to come to terms with, but the longer you are in the profession the easier it's going to be.

ca43 · Apr 12, 2006

I've been a nurse for 21 years and in the last ten I have worked in Hospice. I expect my patients to die and the goal is to give them a peaceful death. I don't think this job would work for me if I was not comfortable with my own feelings on life and death. It is also helpful to know that some patients and families will affect me more and it is OK to grieve a passing, and knowing that my relaionship with that family will now for all intents and purposes be at an end. They must grieve and move on and so must I. I have a little ritual for when I lose someone very important to me. I listen to Vince Gill sing GO REST HIGH ON THE MOUNTAIN. I cry and I let it go. If you can develop your own comfort ritual to help you accept your loss, it will help. Whatever works for you is OK

LoriAlabamaRN · Apr 18, 2006

It has helped me to remember that I did all that I could. We had a resident die recently who had been in a lot of pain. I had realized several days before she died that she had become unable to request pain meds because her condition had worsened to a point beyond the ability to communicate, yet she was able to squeeze my hand when I asked if she was in pain. I immediately gave her the ordered dilaudid, and made sure that her pain meds were administered as often as necessary, with her squeezing our hands to indicate yes or no. Because of this, she was in relative comfort until the end, and that in turn comforted ME. Knowing that you have done your best for the patient and for their family offsets the grief I feel when I lose someone. As the night supervisor of a nursing home, I have seen many residents whom I cared about pass away. It's always hard, but remember that you have done your best. Your compassion will shine through and the patient's loved ones will derive comfort from knowing that a nurse who truly cared about their dear one was there.

burn out · Apr 18, 2006

After 20 years of nursing it still bothers me to see one of my patient die or even another patient on our unit I may not have even care for..and no it has not gotten any easier you just learn to see it coming sooner and can prepare yourself for the inevidable. Usually I find a private place afterward to have my cry time then pull myself back together and get back to work. As a coping mechanism I think I block all my patients after I have taken care of them. After so many years it is hard to remeber them even more than a day, I do good to remember who I cared for yesterday I just leave it at work and don't bring it home with me.

Tweety, BSN, RN · Apr 18, 2006

Death of my patients bother me when it's unexpected and tragic.

I sometimes need to dwell on a patient's death long enough for closure if it's tragic.

As crude as this sounds, I must move on the next thing, "on to the living" so to say. Sometimes it's quickly if I'm busy, sometimes it stays with me a day or too. The other patients need my best and not my drama. It helps to jump right into helping someone else get well. That's just me.

beautifulb · Apr 18, 2006

I work on an ortho/oncology floor with a mix of all medical. Most of the patients on my floor have had an illness or cancer where death was imminent. You provide the best care to make the patient as comfortable as possible. When the patient dies it is sad but at the same time it is time for them to go and hopefully go to a better place. I find it hard for the loved ones who have a difficult time when someone close to them dies. For the most part I try not to dwell on my patient's death because otherwise I think it would consume me. I just move on and think peaceful thoughts of my patient and take care of my other patient's that need me. Basically I just move on.

kmwb · Apr 18, 2006

I have worked in a LTC facility for about 6 months, I am a first year Bsc Nursing student and I was really scared about my first death. I too had a friend die in high school in a tragic car accident and found it hard to come to terms with such a sudden loss.

I found in my job, that it was easier than expected to deal with death. (especially LTC) While you become close with your patients I find I am able to distance myself enough professionally. That does not mean that seeing their families doesn't make me hold back tears sometimes.

I think some people in particular really touch you, but your grieving process is so different from experiencing a death close to home.

I do rememeber every resident that has passed away since I have been working, but I am sure that as I continue my career I will probably just remember my first and any very close to my heart.