I don't like dead people

Altra, BSN, RN · Feb 23, 2011

In my experience, there really isn't much correlation between providing great care and a patient dying on your shift.

Agree.

In the ER I have about one patient death every 3 weeks or so, sometimes more.

In the unit it's one patient just about every week. That's the reason they're in the ICU in the first place - because they're at death's door.

Altra, BSN, RN · Feb 23, 2011

Yep- I said what I ment. In my experience there is a great deal of correlation between providing great care and patients living through your shift. As to the "comfort care" patients- like I said it isn't always possible to save every patient. I work in the area I do because CC patients are rare and the care phylosophy is to care for the patients like the world depends on it even if the chances of a positive outcome is remote. I have seen nurses who "decide" it is time for a patient to die and just slack off when it lookes like a loosing battle. I can't do that. Yea- most of the time the "long shots" do die- but almost never for me. And every now in then a long shot comes in a winner and leaves the hospital to spend some quality time with thier families. It's difficult, and demands aggressive, proactive care. Saving patients lives is my motovation. There are times when I can't imagine them getting through the next 24hrs, but, God willing, and my good care, they aren't going to die on my shift. If the next shift feels the same the person has a much better shot at going home. (not thier heavenly home)

I have had the exact opposite experience. The more I work in critical care, the more I believe that even the most aggressive, high-tech interventions are simply support for the body's healing. Some will heal, some will not -- no matter what you do.

I'm sure you don't mean for your post to come across as sanctimonious as it sounds.

PaperPencil · Feb 23, 2011

I find it interesting that everyone keeps telling suanna what she meant to say. Also I think what nurses do, does matter. Her believing she is making a difference is a good and true thing.

allnurses Guide · Feb 23, 2011

I find it interesting that everyone keeps telling suanna what she meant to say. Also I think what nurses do, does matter. Her believing she is making a difference is a good and true thing.

No, they are looking at it from the standpoint that in the overwhelming number of deaths, it is due to the progression of a physiological or pathological process that is irreversible. Or to flip it to the converse, if a patient does pass away on a nurse's shift, is it somehow his or her fault -- and that same patient would not have died if better care were provided? Do you want to include NICU nurses and pediatric oncology nurses and trauma nurses in your pronouncement?

We start to wade into some really dangerous waters when we accept that as a premise. It confers a power over life and death we don't have, and if it were widely accepted as true it would pit nurses against each other, and lead to a liability nightmare for all of us. (sorry to the OP for off- topic)

exnavygirl-RN · Feb 23, 2011

Not stupid at all. I was very nervous about post-mortem care when I first started nursing. What helped me was that I would offer to help other nurses who had a patient die and assist them with their care. I guess in a way I have become desensitized to it (if that is the right word to use). Don't get me wrong. It does bother me when when a patient dies especially if I've taken care of them for a long time. You will find your own way in handling this.

Like you I had a parent die suddenly. It was a traumatizing experience.

You will surprise yourself:redpinkhe

well, yes, I don't mean that in a bad way...I am just scared. I know it sounds stupid to the experienced Rn's and pct's, etc...but I get anxious thinking about it.

suanna · Feb 23, 2011

I have had the exact opposite experience. The more I work in critical care, the more I believe that even the most aggressive, high-tech interventions are simply support for the body's healing. Some will heal, some will not -- no matter what you do.
I'm sure you don't mean for your post to come across as sanctimonious as it sounds.

I guess there is no need for me to come to All Nurses anymore- I can just let others who are so much more wise post for me since they know more what I mean to say than I do.

I had thought I said that in my practice, death is the enemy and I will fight with all my skills to defeat it. I don't work hospice, I don't work LCT, I work critical care and expect NONE of my patients to die. Some do- but I believe strong nursing and aggressive, proactive care, if provided 24/7 can work miracles. As to the start of the thread- I agree that dead bodies at times give me a CREEPY feeling, but if I fought against that outcome with every skill God gave me, I can care for the persons body with a clear concience and hope thier family knows there was nothing more I could have done to help them recover.

If this isn't what I ment to say- please feel free to quote and post-I'd love to know what I intended to say. I promise I won't think it's "sanctimonious" of others to correct my thoughts and feelings.

rn/writer, RN · Feb 23, 2011

Staff note: Please, let everyone speak for themselves. It's okay to ask for clarification or qualify your "interpretation" as a guess, but it crosses the line to put words in someone else's mouth or attach a meaning they didn't intend.

It's also a good idea to be really careful about attaching labels or value judgments to another member's thoughts. Disagree (respectfully) with the subject matter all you want. Provide counterpoint messages. State your own opinion. Ask questions. But it rarely improves the discussion to delve into a fellow poster's motives or state of mind.

With these concerns addressed, please, resume discussion of the original topic and leave the other stuff behind.

Thanks.

rn/writer, RN · Feb 23, 2011

To the OP:

One of the most important things I can tell you is that there is a HUGE difference between the death of someone near and dear to you and the death of a patient. This goes double if the death of your close one was unexpected and/or you saw it happen. And it goes triple if you were a child when it happened.

Unfortunately, the impact of those early experiences stays with us long afterward, especially if there is no counseling or opportunity to talk through the feelings. Add to that the "unknown" element about having to deal with death on the job and that can greatly increase your anxiety.

I would encourage you to ask your coworkers to let you know if they have to do post mortem care and allow you to participate. Even if you do nothing more than observe, just seeing the deceased patient should help you to get acclimated to this part of the job. The fact that you don't know them should take some of the emotional sting out of your worries.

Take some time after you've done this to think about the experience. Allow yourself to examine your feelings--both about taking care of a patient and about seeing your mom in the ER. You may need to take care of any unfinished grieving that comes to the surface, but that's a very good reason for doing something like this. It will give you the chance to resolve anything that still needs attention so that you don't have to struggle to hold yourself together while you're doing post mortem care at work. That's a bad time to find out that there's a part of you that is still shook up.

The sooner you are able to face your fears, the less power they will hold over you.

I commend you for being honest about this and wanting to find a way to work through it. That is a good part of the battle already won.

Please, let us know what happens.

Altra, BSN, RN · Feb 24, 2011

No, they are looking at it from the standpoint that in the overwhelming number of deaths, it is due to the progression of a physiological or pathological process that is irreversible. Or to flip it to the converse, if a patient does pass away on a nurse's shift, is it somehow his or her fault -- and that same patient would not have died if better care were provided?
...
We start to wade into some really dangerous waters when we accept that as a premise. It confers a power over life and death we don't have, and if it were widely accepted as true it would pit nurses against each other, and lead to a liability nightmare for all of us. (sorry to the OP for off- topic)

Clearly I provoked offense from my use of the term "sanctimonious" and I apologize for having done so.

However, I was equally offended by the suggestion of a patient's death being controllable by the particular nursing care of a particular nurse, and the suggestion of what I personally inferred to be an arrogant, no-one-dies-on-my-watch sort of mindset. This was much better stated by nursel56 -- see above.

I was surprised at this poster's description of critical care nursing with "rare," avoidable patient deaths, as that has not been my experience as a critical care and trauma nurse. When I first considered a position in critical care, one of the first things that experienced ICU nurses advised me was to prepare myself for a lot of death. And working in the unit, I have found that to be true.

Some patients with what should be crushing comorbidities or overwhelming injuries to multiple body systems recover with no new deficits ... and some patients who are have been stable, awake, alert and enjoying the company of family code and die before your eyes.

Clearly, another poster perceives his/her experience differently.

snoopy29 · Feb 24, 2011

In answer to the original question many years ago when I started nursing I was so terrified of caring for the dying and dead that I almost gave up nursing. My terror stemmed from a friends "well-meaning!" mother who was also a nurse sharing all sorts of stories that I now know where not true about all the things that dead patients where supposed to do!

I would come on shift and if there was a dying patient I would physically shake. I was really scared but could not put into words why. After another death and knowing I would need to lay the patient out I hid in the linen cupboard. I was found bya wise old nurse. First she told me that what Iwas feeling was enitrely normal and second and most importantly that she would try to turn things around and teach me how to value this part of nursing.

Despite her shift having finished she came with me and did all the post mortem care. She chatted away to the patient telling them how much more comfortable she was going to make them. I found myself forgetting they were dead and just seeing them still as my patient. Every time I looked at my patients face I froze and my wise old nurse told me simply to stop looking and get caring.

Afterwards she took me for a coffee and told me that she felt as a nurse she was in a supreme position of trust in that she would be one of the last people that could make sure that the patient had the best possible care and was treated with dignity. She said to always remember they were a patient first, dead body second!

Now things didn't change for me overnight but with her patience they did change. These days care of the dying is an area I feel passionate about and rather than holding any fear I believe it is one of the most important roles I fill as a nurse. Its funny but having been scared means that I have some insight when family members are frightened and hope I afford them the same patience and understanding given to me.

My advice is to find a nurse like mine! Don't give up - the fact that you care and that it matters makes you a better nurse.