I don't know how you nurses deal with death

[Poochiewoochie]

Today I sat and watched as my mother lay dying in her bed at the NH. Horrible-not like in the movies at all. I sort of knew what to expect but actually seeing someone die is a lot harder than most can imagine. Her lungs were so full of liquid and she rattled when she breathed. Then, at the exact moment she exhaled for the last time, all that fluid came up and out of her mouth and after a few seconds I knew she was gone. I am sad that will be my last image of her. Did she look peaceful when she was gone? No, she was just "gone". I've read so many stories about how peaceful they look at time of death and was a little shocked that it wasn't like that. It was a surreal experience and I will never forget it.

Yet in spite of it being so sad I am happy I was there at THAT moment. My Dad had gone out to have a smoke and the hospice nurse and chaplain were out of the room for a minute. I was the only one there when she died.

That being said I don't know how you guys can deal with this on a daily basis. I watched the hospice nurse and it was amazing how she helped my Mom so she didn't suffer. I have a new respect for the nursing profession-I know I couldn't to this every day.

[leslie :-D]

What I don't like, as an nurse, is how unprepared and unaccepting we are as a society in regards to death. So that frequently when I meet a patient that is dying, my experience is that there is no preparation or acknowledgement or acceptance of the event. This especially true for family members.

Please note, I'm am not talking about an untimely death or emergent situation. I am talking about death from old age or death from the natural progression of chronic multiple disease processes or illnesses associated with certain death. This is the most frustrating for me when I am working with a very old patient with heart disease, copd, diabetes, cancer, stroke , etc, etc and family members who are suprised and opposed to death.

It is stressful when a patient or family member does not understand/accept/have any interest in knowing about DEATH. Instead, in the hospital, its made to be some kind of emergency on a physical/emotional basis for the nurse. I find that extremely stressful for myself because the family members want something done right away so that the patient doesn't have to die....The kind of thoughts that go through my mind sometimes include, "are you kidding me?" when I'm told to get the doctor "NOW" to "FIX" someone who is dying.

as a hospice nurse, i get extremely frustrated that we as a society, are so anti-death.

more often than not, people seem to be more focused on the dying's quantity of life, and not quality.

that yes, we will do everything possible to prolong the dying process.

it is even evidenced on the forums, where a poster will start a thread about dying/death, and there is little response to it.

plenty of readers, but little response. :)

over the years, i have also learned that families for the most part, ARE unwilling to let go.

it doesn't matter if mom is 103yo or that dad has mets ca, arf, advanced chf, etc.

we/drs are expected to do everything possible to work God's miracles.

otoh, (too) many doctors are grossly inexperienced with eol issues, and for whatever reason, will aggressively treat til the pt's last gasping breath.

i have no problems working with the dying.

for me, it's a privilege and often a challenge...

as each death is unique to the person, their etios, their psych, their attitudes, fears, etc.

op, my heartfelt condolences for the loss of your mom.

may time bring you comfort and healing.

leslie

[Spidey's mom, ADN, BSN, RN]

I too was afraid of death as a teen and young adult; so much so I couldn't attend a family member's funeral when I was 14. I had never considered being a nurse until I was in my mid-30's so anatomy lab was initially scary but I ended up loving it. And my first patient death was made so much easier by a CNA who walked me through post-mortum care. It helps to have good mentors.

I became a nurse in a small rural setting where you do just about everything - start out med/surg and then do L&D and ER. I did that for 9 years. Left the bedside, got my BSN, started in hospice.

The hospice deaths are different for me than a family member and I have to say I haven't had one family try to fight EOL issues. Some need more education but no one has fought their loved one being in hospice. Maybe it has to do with our small town setting. I dunno . . .

We try to make end-of-life circumstances peaceful and painfree. Sometimes people do fill up with secretions and we have a portable suction machine to take if that happens or if they are an inpatient, suction is available in the rooms. Those are comfort measures.

I am very sorry for your loss.

[niskagirl]

For me, it is such an honor to be able to provide comfort and pain management for the patient at EOL. I am relieved and usually happy for them once they pass. Especially the little ladies that say outright they want to go because no one is left. It must be very lonely and isolating to be in that position.

The families and friends are another story, it is hard to watch them grieve and not be able to let go. If a family is pressing me for how long their loved one has left, I find comparing the stages of EOL as being parallel to the stages of labor helpful. Usually being direct and honest is helpful as well. I try to be upfront of how it looks, sounds, and what is going on physically with their loved one.

I feel very fortunate to have started in hospice. It has helped me realize how precious life AND death is.

I am so sorry for your loss. Take care of yourself.

[Caffeine_IV]

That wasn't my point. I was saying that it must be hard to deal with death and dying on a regular basis. To me it doesn't matter if it's a loved one or a patient-it's the part about watching someone die and the whole process. I just couldn't do it on a daily basis like some of the nurses do here regardless of who it is.

I know some people say they it's just part of the job but in reality the medical field is a job like no other.

Ok so we have a different view. Death doesn't "bother" me or rather I don't dwell on it. I work in hospice. My hope and work is that we can make their time left here as comfy as possible. Dealing with death isn't difficult for me...the ones left behind that have to cope is where the challenge and emotions may come out

[kat7464]

I am so sorry for your loss. I work in hospice and just love my job. It never gets easier, but I feel so honored to serve my patients during this special time of their life. It is an emotionally-charged event, for sure, but I wouldn't trade my position for anything.

[Poochiewoochie]

I felt a need to comment when I read this post... I think the original poster is asking a question that has been something that I've asked myself in my nursing career, "how do I deal with all this dying around me?" Yes, I agree that it is a natural process. What I don't like, as an nurse, is how unprepared and unaccepting we are as a society in regards to death. So that frequently when I meet a patient that is dying, my experience is that there is no preparation or acknowledgement or acceptance of the event. This especially true for family members.

OP, thanks for bringing this up and acknowledging an area of challenge for at least myself. IMO, you conducted yourself with sensitivity and thoughtfulness. I'm sorry for your loss.

Thank you. My post wasn't about the death of a relative vs. the death of a patient it was a question of how people in the medical field deal with death on a regular basis and how hard is must be to watch someone die regardless of whom they are. After all, it is a person that is dying. When we contacted hospice they gave us some information about the dying process but it would have been nicer if someone had sat us down and explained it to us in person.

Thanks to everyone for the kind words. I know in my heart she is in a better place and happy. Even though her death was not very pleasant to watch the suffering she went through since the broken hip and femur was even worse. Several times she said she was going to die. She even mentioned receiving a visit from my Dad's parents whom she loved very much because they treated her like their own daughter. I find that comforting and have a feeling they were there too when she passed to help her to the other side. We had decided a while ago not to prolong her life if she took a major turn for the worse-she wouldn't have liked to live that way. I believe that sometimes you have to put your own feelings aside and respect the wishes of loved ones in situations like this. As much as I am sad I am also glad that she is no longer suffering and her mind is as sharp as a tack once again.

[nurseprnRN, BSN, RN]

You know, a student reading this thread might think that most nurses deal with a death every day. Not true. Even in ICU and ER, people don't die every day, or even every week. When I worked ICU we would go months and months without a death on the unit-- we were sorta in the business of preventing that. A sense of perspective here.

Other than that, we got assigned the classic Kubler-Ross "On Death and Dying" as sophomore students. It was a new and radical idea; hospice was new in this country, Dame Cicely Saunders in England was just becoming famous. That book changed my professional life in many ways. For one thing, everybody dies, it's never like it is in the movies, and it generally takes about six months for most people. That helps.

[Rhi007]

It is the reason I don't work in areas where you see a patient on a daily basis. I've also learnt how to detach myself without seeming cold or heartless. It makes doing the job much easier. I provide high quality care to ALL my patients whether they are prisoners, security risks, or knocking on deaths door.

[anotherone, BSN, RN]

Thank you. My post wasn't about the death of a relative vs. the death of a patient it was a question of how people in the medical field deal with death on a regular basis and how hard is must be to watch someone die regardless of whom they are. After all, it is a person that is dying. When we contacted hospice they gave us some information about the dying process but it would have been nicer if someone had sat us down and explained it to us in person.

sorry for your loss. for some people it is not that difficult and s/he may be desensitized to it.

[KelRN215, BSN, RN]

Many of us don't deal with it on a daily basis. It's been years since I actually had a patient die during a shift I was working. I have taken care of many dying patients and since I work in pediatrics, I often hear even from other nurses "I don't know how you do it." I've been doing it for so long that sometimes I forget that it's not normal for children to die.

In my current job doing pediatric VNA, I've had a few patients who have died (I think 3 over the course of a year) and several more on my caseload who likely will die but it is by no means something I see every day. I feel sad for the families I've come to know when their children die and know that they will carry the pain of losing their child with them for the rest of their lives... but seeing the way these children suffer, I also feel happy for them that they are free of their earthly bodies.

[tewdles, RN]

Fortunately, our mothers don't die everyday...but our patients do.

Death is as natural as birth although not as happy.

Establishment of good professional boundaries helps us to remain healthy despite the cumulative grief.

[chrisrn24]

Fortunately, our mothers don't die everyday...but our patients do.

Death is as natural as birth although not as happy.

Establishment of good professional boundaries helps us to remain healthy despite the cumulative grief.

Exactly.

I sometimes feel sad for the family and their loss, but never really for the person who passed because I know they're in a better place. Even now reflecting back on my own grandfather's death, it was a blessing because he was in so much pain.

When you're a nurse, you have to have boundaries, and seeing death all the time as I do in LTC isn't awful like you might believe it is.