Hello everyone. I have been a nurse for one year and last night I had my first patient death. I should have recognized the symptoms they were textbook for hypovolemic shock, but I didn't. Her death is my fault and I should have recognized her deteriorating status sooner. I could go into the specifics, do a full SBAR, but at the end of the day it boils down to my inability to respond quickly and page the MD and do a further workup to see what's going on.
The purpose of this post is to ask how do you continue to be a nurse after this? How do I trust my own judgment and have faith that I will recognize other symptoms again? I consulted my charge nurse and talked to him about the patient's deteriorating condition, I even paged the night before detailing the patient's symptoms but those test were negative. Long story short I was thinking SBO when in reality she probably had a GI bleed and went into shock. I haven't been able to stop crying since my last shift and I feel like I failed my sweet patient who was just there for an elective surgery.
Anyways, I am questioning my abilities as a nurse and even though I love nursing and my patients I am terrified I will hurt someone again. Maybe I am not smart enough to be a nurse
Sorry that happened but it was inevitable. Let me share my coping technique for when I don't catch something that ends up in disaster.
Back in 2008, gas prices shot up and so I bought a motorcycle. I'd never riden before so I took the safety course offered by the local community college and subsequently obtained a motorcycle endorsement on my driver's license.
The very first time I rode my own motorcycle after the class, I dropped it. It happens so fast I couldn't begin to do any more than find myself sitting in the road at the edge of my driveway. That bike's heavy too, and very top heavy. It took me a while to get it back upright by myself.
I thought about what I had done and why had it reacted that way. I came away with the idea that I should never apply the front brakes alone.
Then one day at work I parked it in the parking lot on a slope and dropped it again. I thought about that one for a good while too, since it left me with a 1' (that's foot) square hematoma and having to buy a new helmet because I cracked my head so hard on the pavement. Left me a little goofy for a while too. Not good. I concluded to always park on flat ground, even if I had to walk further to get to my destination.
These are rules I've scrupulously adhered to since and I never dropped my bike again.
Now, how does this apply to you? You were presented with a set of conditions new to you and you didn't pick up on the danger. Welcome to the human race. It happens. What is important is learning something from this and never reacting the same way again. I seriously doubt the next time you are presented with a patient in the same condition that you will miss the markers again.
This is the difference between an experienced nurse and a newbie. You are going to screw up on a semi-regular basis; most times it won't really matter. What does matter is that you file away what happened and don't let it catch you unaware the next time.
BTW, don't forget we all are going to die at some point. If your patient had been at home, he'd be no more alive today than he is now. You screwed up but the nurse who claims they never do either hasn't actually provided nursing care or they're just a liar.
Hey, you can't be that dumb: you passed nursing school and the NCLEX, didn't you? That was the hardest thing I've ever done and I was a commercial pilot before I went into nursing.
I don't know how to cope with it. I am a nursing student. Make a 'my patients who are lost to death' chart, maybe on a pano, hanging on the wall while exiting your house to the occupation's daily occurrence.
"Every physician has at least one lost patient in his/her career." A clinician professor said that to one of the medical student friends of mine.
This is a very hard lesson to learn, sadly. Sometimes even when the symptoms are there we are distracted, overwhelmed, caring for other patients that we sometimes don't see the bigger picture until its too late. You said you were thinking pt was a sbo, just remember nurses don't diagnose because if you convince yourself shes this, often she'll be that. Your role is to report signs and symptoms to LIP, which you did the day before. And sometimes they don't listen, so its up to us to keep calling and paging until someone listens. So you ask how do I prevent this from happening again, the simple answer is don't forget that patient. Remember that patients don't read textbooks and nothing is cut and dry. If you are unsure if something is off and needs to be reported go check with a more experienced nurse, I've been a nurse for 13 yrs and I still will go to a more experienced nurse to troubleshoot so to speak. I am very sorry for your loss, its a hard thing to live with but don't let it stop you from nursing. I would recommend talking to a counselor to help you move on. Best of luck to you.
I’m sorry to hear. I’m about 3 years into the profession and my only deaths were comfort care patients; they were expected to pass anyway. Best I can say is that death is a part of life, and so are mistakes. It seems cliche, I know, but just like mistakes with cooking (only higher stakes) you learn as you go and hopefully never make the same mistake again. If every nurse quit after making a major mistake, the profession would be much more understaffed. If it weren’t for the high stakes, we might not have as much pride in our ability to do it, either. Everyone has made mistakes, myself included, and many of us keep them bottled up inside. You probably only need one or two confidantes to swap stories with to reassure you that you’re not alone.
JayHanig
151 Posts
Sorry that happened but it was inevitable. Let me share my coping technique for when I don't catch something that ends up in disaster.
Back in 2008, gas prices shot up and so I bought a motorcycle. I'd never riden before so I took the safety course offered by the local community college and subsequently obtained a motorcycle endorsement on my driver's license.
The very first time I rode my own motorcycle after the class, I dropped it. It happens so fast I couldn't begin to do any more than find myself sitting in the road at the edge of my driveway. That bike's heavy too, and very top heavy. It took me a while to get it back upright by myself.
I thought about what I had done and why had it reacted that way. I came away with the idea that I should never apply the front brakes alone.
Then one day at work I parked it in the parking lot on a slope and dropped it again. I thought about that one for a good while too, since it left me with a 1' (that's foot) square hematoma and having to buy a new helmet because I cracked my head so hard on the pavement. Left me a little goofy for a while too. Not good. I concluded to always park on flat ground, even if I had to walk further to get to my destination.
These are rules I've scrupulously adhered to since and I never dropped my bike again.
Now, how does this apply to you? You were presented with a set of conditions new to you and you didn't pick up on the danger. Welcome to the human race. It happens. What is important is learning something from this and never reacting the same way again. I seriously doubt the next time you are presented with a patient in the same condition that you will miss the markers again.
This is the difference between an experienced nurse and a newbie. You are going to screw up on a semi-regular basis; most times it won't really matter. What does matter is that you file away what happened and don't let it catch you unaware the next time.
BTW, don't forget we all are going to die at some point. If your patient had been at home, he'd be no more alive today than he is now. You screwed up but the nurse who claims they never do either hasn't actually provided nursing care or they're just a liar.
Hey, you can't be that dumb: you passed nursing school and the NCLEX, didn't you? That was the hardest thing I've ever done and I was a commercial pilot before I went into nursing.