I knew it was coming...

[Jessies_hope]

I watched the tele monitors as my patient who was on comfort care went asystole and then was asked to help provide post mortem care. She was still warm and I kept thinking she was going to wake up or move. After all, she was awake and talking when I left for home just 12 hours earlier. It happened sooner than I expected and I think I still feel numb from it. I wish I had read about post mortem care before so I could have done more. At the time, I felt like I was spending too much time cleaning her but looking back, I feel like there was way more I could have done. I was careful. I was gentle. I spoke softly in the room. I did my best to treat her respectfully and not cause any damage to her delicate skin. When I took out her central line and took her EKG pads off I was so careful. I cleaned her face and chest but I wish I had done it better. She didn't pass feces and had a foley in place so there wasn't much to do there. I hated every second of putting her in a bag and zipping it closed. I was lucky enough to have a compassionate nurse there talking me through every step of the way. It happened at the beginning of my 12 hour shift and to be honest, the whole rest of the night was and is a complete blur.

I still feel weird about it, a couple days later. I don't know why. And I can't stop thinking about it. I didn't cry, and I feel like that makes me seem callus or insensitive. I feel bad for not crying but really, I am glad they allowed me to help clean and care for her. Why does that feel so wrong? Why does it feel like people will judge me and think I'm morbid for not hurting more but being happy I was able to provide that care as a final gesture of service to her? I'm glad she's not suffering. Death is terrible for all the people left behind. We are the ones who continue to have heartache and pain. We are the ones who are left with a void. I prayed for her family and friends as I cared for her. I hope their hearts heal soon.

As inevitable as death is, it's the one part of nursing that I'm not looking forward to.

[Been there,done that, ASN, RN]

" Ask not for whom the bell tolls, it tolls for thee."

It's good that you didn't cry. We cry at death when we have an emotional attachment. You were not attached to the patient, but I suspect this is the first time you have seen death up close and personal.

It gets easier... if it doesn't , get some professional help. You do not have to suffer every time a patient dies.

[Libby1987]

Compassion is in action, not tears. There's nothing wrong with tears, they are just a way one can experience emotion but they don't qualify emotion.

I haven't forgotten my first postmortem care. Almost 30 yrs ago.

(((Hugs)))

[JBudd, MSN]

There is no rule that says you have to cry to be able to feel. It is a kindness to treat the body well, in honor of the spirit that no longer needs it.

[jadelpn, LPN, EMT-B]

Take some time to speak with a hospice person to put into perspective your feelings. They are such a wealth of knowledge, and any number of hospice offices have wonderful reading material and books.

The first time it is such a shock. Gives depth to the finality of death, when life was present a short time earlier.

Peaceful and pain free. Take all of the good nuggets of communication that you had with this patient and file it away. It makes for lovely memories down the line.

[Riawahine, BSN, MSN]

It's obvious you care. This memory will never leave you. However, it shouldn't haunt you if you find you can't get past this death, find a professional to discuss your feelings with. Take care.

[FurBabyMom, MSN, RN]

I had patients die when I worked the floor, and I've been involved in several deaths in the OR. I've found the floor "comfort care" deaths easier to handle than the OR deaths.

It's so different, providing post-mortem care on patients who die in the OR. In our facility, all OR deaths are medical examiner cases. We cannot remove tubes or lines as they have to stay in place for autopsy purposes. We still wash patients up well (and ALL the other stuff except we don't remove lines), and make them look "presentable" for their families (if they have family and if the family chooses to see the body prior to transport to the morgue). We accompany the patient to a location their family can see them, and handle transfer to the morgue.

My first death as a nurse didn't hit me as hard as my first OR death. My first death as a nurse was a comfort care patient with terminal cancer who chose no more interventions and had their family surrounding them, very peaceful. My first OR death was anything but. We'd been desperately trying to save the patient - trying everything surgically, and spent more time doing chest compressions than not. It was a traumatic way to go - the only comfort for staff being that the patient was "under anesthesia" when we ceased resuscitation and called time of death.

I felt appalled at how it happened - my first OR death. No family with the patient. We didn't know who they were at the time they arrived in the OR, they were identified "unofficially" by the time we called time of death - really puts it in perspective (we don't change patients from their "disaster"/"unknown patient" name to their real name while in the OR - it makes labs and all kinds of other things disappear). No sense of comfort at all - being under anesthesia was the "only" comforting factor. Talking with coworkers helped me - and one of my coworkers framed it as "what if it's not that they had NO family with them but they had SO MANY strangers trying so hard to help them?"

I don't know. Bad things happen. Doesn't make every day easy. Kind of off topic, and for that I'm sorry. I agree with the others though, not crying doesn't make you a bad nurse or mean you aren't compassionate.