I couldn't handle it and now I'm afraid...

[RevolutioN2013]

I need advice. I am working on pre-req's and about to apply to nursing school. I want to go, I'm excited to go and there is nothing else I would prefer doing. But my grandmother just died and I couldn't handle it. She was in the hospital with a bladder and kidney infection and all of a sudden out of nowhere she's on a ventilator and the doctor is calling me at 11pm at night asking me about her directives. My entire family was out of town riding ATV's in Utah so I drove to the hospital and got there around 2am (I live 3 hours away from where Grandmother lived). I knew what the deal was. I knew that she would not live out the night. Intellectually I knew it. And I planned to go and sit by her until she passed. I felt I could do this because I was with my friend just before she passed from cancer, and even though I was upset, I wasn't freaked. Anyway, I went into the ICU room and the nurse was explaining all of the equipment and the medicines they had her on and what was going on with her body (no pulse below the knee, minimal pulse in her finger, sats around 65, agonal breathing on ventilator). I'm standing there by the bed and all of a sudden I felt my axis tilt and realized I was about to faint so I sat down in the chair and put my head between my legs for a minute. I had to go out in the waiting room and call my dad and try to explain to him what was going on and ask him about her directives. I was feeling intense anxiety and was claustrophobic. I wanted to get out of there so bad and at the same time I felt like the lowest person for wanting to leave. After the directives were communicated to the doctor (DNR) and they decided to just let the IV bag with meds run out instead of taking her off the vent I had to go. I could not stay there and watch my grandmother die. The nurse assured me she would stay, but I felt so awful because I KNOW my grandmother would have wanted me there. I talked to her and held her hand and told her that I loved her and that if it was God's will for her to go that she should go and walk with Him. And then I left. How am I going to be able to be in this profession if this is the kind of reaction I had? All of the machines and beeping were just freaking me out. I wanted to just cover my ears and scream. I am committed to NS, but I am terrified about what's going to happen during clinicals. Am I doomed?

[himilayaneyes]

I'm sorry for your loss. It seems that your grandmother must have been a wonderful person. Your reaction is normal and no you're not doomed. Caring for a patient and caring for a loved one are two totally different things. I had an experience where my grandfather went into respiratory failure and coded. He nearly died. I was shaken up throughout the whole thing. My feelings toward him are completely different from those toward my patients. I care about my patients, but there not my family. Grieve and know that you can be still be a nurse. If you didn't have this type of reaction, then you might need to be worried. We need more compassionate nurses and you sound like you'll be one. Just take it one day at a time. :redbeathe

[RevolutioN2013]

Thank you all so much for the kind words and support. I have been beating myself up endlessly since this happened, and it's so easy to let your fears and insecurities have free rein. I'm just so emotional that I am having difficulty being my normal rational, logical self. Heck last night at the PTA meeting I cried when they presented the new activity bus that the PSA had raised funds to buy. I asked a friend who is an NP about how I am feeling and she pretty much said the same thing that each of you has said - that it's just different when it's your family - but during the same conversation she relayed a story in which she had to turn off a vent on a two year old who had drowned but still had some brain stem activity. I have a 5 year old and envisioning myself in those shoes just freaked me out all over again. My husband was like, "Are you sure this is what you want to do?" And I was like, "Yes, but do I want to turn off vents on little kids? Do I look forward to seeing people who are suffering and hurting and dying? No. But my job will be to give them the absolute best care that I am capable of and to do everything I can to help them recover and barring their ability to recover then at least to preserve their dignity and humanity in their last hours. And I know there will be times when I'm about to lose it and I have to take myself aside and tell myself, 'Man the fu@& UP these people need you!' " I was pretty vehement with him about it, and I do believe I can do this. I guess the death of my grandmother has just magnified the fears that all prospective nurses feel about the situations they will encounter. Thanks again to all of you for the support! It really does help to know that this is normal.

[SeeTheMoon]

I am so sorry for your loss, I know this was not easy for you. But don't sell yourself short just yet. I personally feel that going through this experience can make you a better nurse. You will know first hand what the families will be going through, if and when you are in this situation as a nurse. I am only pre-nursing student as well, so I don't have much experience, but I personally feel that the day that nurses and doctors become TOO complacent about death, is the day they may need to consider another profession. Plus, as others have said, it's just never the same when it is someone near and dear to your heart. I would take each day at a time, and remember that your grandmother would be so proud that you are helping others! Good luck to you!

[HollyHobby]

RevolutioN2013, (((((hugs))))).

Let me share my own story with you. I had been an ICU RN for ten years. I'd dealt with death and dying on pretty much a daily basis. One morning, I got the call that my mom had died at home. She'd been under hospice care and not only was her death expected, it was almost a relief: she died from ALS.

When I got to her house, I was surprised to find that I could not look at her. I could not even go into the same room with my mom's dead body. Basically, I hid in the kitchen and freaked right out. I had to take some clonazepam to keep from having a full-blown panic attack.

When I went back to work three days later, I was terrified that I wouldn't be able to handle the death/dying scene again. In fact, for about a week, I was pretty nervous and freaky about it; I asked not to be assigned any actively dying patients, particularly older women who were actively dying. Pretty soon, the anxiety/freakiness was gone, even though I continued to grieve for Mom.

On a related note, any time one of my kids get hurt, I have to force myself to stay calm. Once, my daughter broke her leg and I thought I would either pass out or run screaming down the street. I had to force myself to chill out, for her sake. Most recently, my son bit the end of his tongue really, really badly and even though he assured me he was okay, the sight of the blood made me lightheaded.

It is different when the patient is your loved one.

You responded the best you could in your grandma's situation, especially given the fact that you were alone, without the family support you needed at the time you needed it most. (I'm sure your family would have been there at that moment if they could, but due to circumstances you had to wing it alone.)

You did fine; you did great! You were able to hold your grandma's hand and tell her just the right things. She could go in peace because of you. Do not blame yourself for not being able to stay till the last moment. Your grandma would understand. You are human, you were pushed beyond anyone's reasonable limits, and you can be assured that you did a stellar job.

Because you have been through this, you will be able to reach out to your patients and their families when they need the kind of support you did. You will truly understand what that kind of pain and fear is like. When you are a nurse and you have the chance to help other people through this situation, you will feel so much stronger. It will remind you of your own grief, yes, and you might cry (not a bad thing) but it will help in healing your pain, too.

[mustlovepoodles, RN]

Revolution, I just wanted you to know that in the 25 years that i've been a pediatric nurse I have never had to pull a ventilator. There have been a few times where I got upset because of kids who were very ill or very hurt and that's just part of the whole package. But I've been privileged to work with many, many families of children who made miraculous recoveries and that makes the job fulfilling.

I have to tell you that I did have to leave peds ICU/ NICU nursing after my 3rd child was born. He was globally disabled and fighting for his life. I very much identified with the parents and it affected my judgement. I became paralyzed with fear & anxiety and I couldn't give myself the way I really needed to in that setting. Moving to another less stressful setting working with normal children undergoing mostly minor illnesses helped me regain my equilibrium. That's the great thing about nursing--you have a lot of flexibility and if one specialty doesn't work for you, you can try something else. Best of luck to you.

[Eliseinalaska]

So sorry for your loss. (((Hugs)))

What everybody else said.

Your grandmother's death was sudden, and a very personal event for you. Your reaction does not mean that you won't be able to work with dying patients. I may mean that when you work with families of a dying patient, you will be able to be compassionate with people who react in different ways. You will not disregard someone's feelings because they left at a critical moment. You will know that people react in unpredictable ways.

Most nurses encounter strongly emotional situations sometimes. But most nurses don't have to turn off ventilators on children. In school you will be exposed to various fields of nursing, and you can chose one that is a good fit for your personality. And, being a nurse, you can change your mind later. :)