How much death do you see/ have you seen on the job?
I know this varies depending on your area of practice... For example, a Nurse working in an MDs office vs. Acute Care/Trauma. Nevertheless, I am just curious as to how many Nurses on this forum have witnessed/experienced death on the job in their careers, how it affects them, what keeps them going? A professor I had in nursing school admitted that she had never experienced the death of a patient in her entire career; and that she purposefully avoided working in areas/specialties where death would be at an increased likelihood.
She explained that she wouldn't be able to cope with "all that day-in day-out death" for the long-term... and I agree with her because I feel a similar way after witnessing/experiencing a lot of deaths in my career. I used to work in palliative care. I did that for many years and was good at it, but left because it became too much.
Working in long-term care for as long as I did, I saw a lot of deaths. Some were harder on me than others because I'd formed relationships with the resident and/or family, but I never let myself break down in front of family members or co-workers. I was always able to put my feelings away until I got in the car after my shift was over.
I've been out of nursing for awhile, and I don't miss the death and dying part of it. The last passing I witnessed was my husband's this past July, and I basically pronounced him because there was no staff in the room when he let go of life. He'd been battling pancreatic cancer for almost three years and he was suffering so much that it was time for it to be over, but I'll never forget how he reached out his hand at the final moment. And even so, I managed not to fall apart (I waited till later to do that), but maintained that professional demeanor that I'd perfected in my career. It stays with one, you know.
I see it a lot, either choosing to withdraw on a patient or unplanned code death...Either way it doesn't really bother me. Like someone said above it's harder to deal with the families.
Actually the only patient that has "bothered" me was a miserable patient who didn't want to be trached/pegged but family INSISTED. He was so miserable...death for him would be a blessing
More than I ever dreamed I would in school nursing, (not at the time of death) but have lost students in accidents (car and fire), from cancer, suicide...heartbreaking on a very different level.
In my first 6 months in LTAC, I had 2 of my patients die on my shift. One was on palliative care and expected, the other was in pretty bad shape. In that first 6 months, maybe three other other patients (not mine) died during my shift and of course an equal number died off my shift.
In the past year, I have not had any patients die on my shift at all, though some, of course, have died off shift. I can recall maybe three times on my shift when someone has coded, stabilized, and then died off shift. None of these deaths were unexpected.
I never considered these events to be personally traumatic. For those first few deaths, which were in the same month, I was somewhat wide-eyed and wired afterwards.
I was more traumatized by my first few codes in my unit: brittle bones, bodily fluids, and hysterical family members.
As others have mentioned, it is often not the deaths that are most traumatizing, but the suffering you witness leading up to the death of a patient...it used to make me sick to see families who said "do everything possible to keep them alive" when their loved one was never going to recover. I suffered some serious moral distress when I witnessed patients subjected to painful procedures that were not going to reverse their impending death from chronic illness and disease.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
After 30+ years in ICU, I realize that there are worse things than death and I've seen many of them. Sometimes, death is a sweet release and something to rejoice.
Early in my career, I worked hematology and bone marrow transplant. Many of the patients were my age or younger, and as I watched them cope with the new diagnosis, chemotherapy, remission, relapse and end of life care, it got to be too much. Then I switched to MICU, where we fought so hard to hold death at bay that sometimes we forgot what life is really all about. It's not just "not dead." As I get older, I find that I'm less frightened of dying than I am of being kept "alive" indefinitely on pressors and machines.
Sometimes there's a death that seems unjust, too soon or unreal. Sometimes there's a death that I take home with me and ruminate over. But I've learned that death is just a part of life and often it's not the worst part.
I worked in oncology as an RN before becoming an NP. I saw a lot of death. Death doesn't bother me as much as how the patients pass. I've seen peaceful deaths and I've seen patients die in agony as family members refuse pain medications because they don't want their loved one sedated. The agonizing deaths are what motivated me to become an NP and work in palliative care. Humans treat pets better in their final days than family members at times. My goal is to educate, provide support, and pain relief as needed so that patients can pass peacefully and with dignity.
I've seen patients die in agony as family members refuse pain medications because they don't want their loved one sedated... The agonizing deaths are what motivated me to become an NP and work in palliative care. Humans treat pets better in their final days than family members at times.
THIS IS SO DAMN TRUE! I have seen a lot of THIS suffering and it has certainly influenced my perspective on death, or the way people unnecessarily suffer during their final days. I have always hoped my patients would "go peacefully" and without much or any pain... Unfortunately, often (always because of family/POA meddling, and regardless of how much education they receive) this has not been the case, and it's horrible to bear witness to. Especially when, as a Nurse (the alleged savior of their suffering), your hands are tied... So, all you can do is to listen to the screams of agony and pleading to end suffering and legally can't do anything.
@Palliative Care, DNP I think you have one of the most challenging jobs and you have my utmost respect! To fight for individuals right to have a good death is... I can only imagine what you have to deal with... to try to manage the expectations, irrationality, or sometimes greed (i.e. pension scams/insurance to keep the pt. alive for money) of patient's families families who cannot accept that life ends eventually for all of us. And... to have to constantly champion that all humans are entitled to a peaceful, pain-free end of life experience. I have watched so many people die, with so much fear in their eyes as they were actively dying.... sheer terror, fear. Afraid because of the uncertainty of what/if anything was to come next, what was happening, where they were going, absolute panic in their final minutes/seconds... No one can go through the death process other than the dying person... it's disturbing how many people try to/successfully alter a person's decisions for how they wish to die.
As Nurses I feel we truly see the worst of humanity while trying to make it (humanity) better... out of a sincere love and passion of just wanting to see people be well. Sometimes though, it feels like an uphill climb in a cave made of sand.
I work in a critical trauma unit, so see quite a bit of death. Honestly what's harder for me is performing neuro checks, ET and subglottic suctioning, tubefeeding which results in caustic liquid BM, and all that jazz for a patient who will have ZERO quality of life.
Couldn't have said this better if I tried. I actually don't mind futile care for the just about completely brain dead post codes because I know they're not actually hurting because they're gone, and they are usually tasky and keep me occupied, but the people who can still think and feel but are never going to get better make me upset.
This time of year, we often have a death per shift if not more often. We can go a week without seeing a death in the summer, sometimes. We had four the last shift I worked, but most of our people who die need to. I'm usually sad for the family but glad for the patients, with a few exceptions.
I work MICU so I don't see many healthy people - mostly just elderly patients with 500 comorbidities and no quality of life. Bonus points if they have end stage Alzheimer's and multiple stage 4s when they come in, and family's trying to tell me that they didn't have the stage 4s yesterday. Uh huh. More bonus points if they also have metastatic cancer, or their POA rescinds their DNR the second they fall unconscious and all of a sudden we're coding and intubating someone who looked me in the eyes two days ago and stated he/she did NOT want chest compressions and did not want to be on the ventilator. That's the other part that sucks - knowingly going against the patient's wishes.
I work with a patient population with a terminal disease so that basically answers your question. I know when I meet all of my patients that they are going to die while under our care, unless they choose not to follow up with us.
It is sad. There's no denying that. I do get a tremendous satisfaction when I am able to provide care and comfort for my patients. They are grateful that I see them as a person, not just a disease. They don't have to explain their strange symptoms to me and they can be themselves. I'm not trying to cure them. I just try to do what I can to make their days a little easier or more comfortable for them.
I work closely with a group of nurses caring for the same patient population. We debrief often to support one another.
CaffeinePOQ4HPRN, BSN, MSN, LPN, RN
475 Posts
I am so sorry for your loss.