I am a new graduate working in a busy ED. I have some years working as a paramedic before becoming a nurse. I have seen death before both professionally and in my private life. I always was secretly concerned that perhaps i lacked a certain degree of compassion that I have seen some of the other nurses had. NOt to say that I am cold, but I see many people that put themselves in the ED because of their own stupid actions. I have even rationalized that perhaps this is a good thing because I am able to remain calm and think critically through a situation which benifits my patient.
On thanksgiving night, the place was jammed. You know, abd pain, gall bladder attacks, acute MI's ... normal fare..... However around 0230, a call came in that an attempted suicide was coming in. I overheard someone jokingly say, well the holiday season has offically begun... We get the trauma bay ready. IN rolls the squad, CPR is being done on the patient. As we are lifting the pt to the bed, we learn that this is an 11 year old that hung himself in his family's bathroom. HE became asystolic enroute. I took over compressions while an IO was placed.
After working this young kid for what seemed liked forever, His mother came into the rooom. Crying and pleading with him to breath. OF course I know its not going to happen. We perform another round of ACLS for show basically, and I overheard the MD explaining to mom that even if we regain perfusion there will be no neurological function. Mom makes the decision to stop.
Nurses crying everywhere, family crying everywhere, clergy is called for the mother. I felt terrible for Mom. But yet, I questioned to myself why I didnt feel worse. Ice was applied to the pts eyes while the HOB was elevated. Later I returned to help bag the patient because no one else really wanted to go back in there.
Needless to say, I finished my shift at 0700. Then I slept for 20 of the next 24 hours. And 20 more hours saturday. I dont think i am that far behind on my sleep. IS this my coping mechanism? OThers seem to be able to express emotion outward. I didnt express any because yes i felt bad, but i didnt feel like i needed to cry.
Strange thing is,, I wish I had to go to work today. I am off until 1900 Monday. I dont know what to do with myself. I need to take a shower and shave but dont really feel like it. I should go to the gym and exercise, but I dont feel like doing that either.
I dont know if anything that i am writing makes any sense to anyone that happens to be reading this. I am not sure that it is helping me either. I jsut feel like I am in some strange sur-real state of mind. even while I am awake it all seems like a dream.
I love my job, but I wish I was able to express in words the strange feeling that I have.
There seems to be an attitude in our culture that crying is the only way one can express (or feel) grief. At the same time boys are inculturated to avoid crying. The fact that you're not a crier doesn't mean that this kind of tragedy hasn't affected you - I agree witht he other posters that the sleeping, empty feeling, and the feeling that you'd like to be at work are ways for you to cope.
The death of a child is difficult to begin with. That it was unexpected, the result of suicide, on a holiday, in an already-stressed ER, and with (understandably) distressed family, compounds that. If you weren't affected there would be more cause for concern.
i agree with Mike that medication is little premature, but talking about it is important - not just for this incident but also to reduce burn out - there's a thread here somewhere about preventing burn out that addresses this specific aspect - I'll hunt around for the URL in a minute. CISD sounds good because the department as a group is affected, but even venting here a bit may help.
Good advice and answers to your thread here. I agree with CCL Babe and the others about debriefing. That dream-like surreal feeling passes. You should push yourself to go to the gym today or tomorrow morning. Even 20 minutes of weights and a little cardio will help you to feel "normal" again.
I can really relate to the detached surreal feeling you are using as a coping mechanism. That's how I've always reacted to extremely stressful or tragic situations at work and in my personal life. I know I can feel grief, but staying detached helps me to concentrate on the problems at hand. It's almost like my mind knows it can only let a little bit of emotional pain in at a time. It took 3 days for me to get over that "unreal" feeling after the 9/11 tragedy. I kept thinking......"that didn't really happen...the planes didn't really fly into the twin towers...no one died...the world is still a sane place."
Try not to spend today alone. Take care.
Jason, I was not a cryer in the ED or pre-hospital either. Often I would have that hollow lackluster feeling, especailly after a emotionally charged situation. I wished I could cry, but just not in my nature. I could do pedi codes and other situations that others in my dept would avoid.
Jason, I agree with whoever suggested debriefing. But, I think, since you are asking the questions, then you are probably in some phase of dealing with this.
I have been a nurse for 11 years. 8 of those in the ED. I have yet to walk away from a bedside in tears. I dont know why, I am usually the one who maintains calmness while other nurses are becoming emotional. I think some of your reaction has to do with your EMS background. As a young RN in the ED I was trained by paramedics, and I learned early on that if I am not in control of the situation, then my patient suffers. Just like you were trained as a paramedic to maintain a safe scene, if the rescuer is injured, then what good are you to the patient, right?
good luck, keep us posted on how you are doing, ok?
Jason, if you liked the way you responded to the child death, then you would have not reached out for help here. If it bothers you that much, that you feel your emotionless, then you should speak to a psychologist. They can help you to understand why you feel the way you do, without mdication. As for nurses finding humor in others suffering, well, I just could never get that. To me that is very cold....good luck...
I think you have gotten great advise here...debriefing is the way to go.
After forcing myself through the doors of my first debriefing (from a 16 y/o stabbing death) I know it is really the way. Our crisis team came out...EVERYONE involved was invited. EMS came, ED staff and docs, Med Imag people, Lab, many people.
Everyone just came together...
Some talked
Some didn't
It was good.
I could finally sleep.
Good luck my friend
And remember we all have each other to get us through
No matter what they teach about death and dying in nursing school, I don't imagine that any of that textbook theory stuff comes immediately to mind when your pt dies on you (especially when its a pediatric pt in an emotionally draining situation like the one you experienced). But, even though its natural for nurses to go through some type of grieving, not everyone cries or falls apart when a dying pt passes. There's nothing wrong with you. This is just your way of grieving, and after a while it will pass.
It may sound callous to say this but such is life in the ER---pts are going to die on you from time to time. If I were you I would go out and do something fun. I like the gym idea because there's nothing like a good workout to get stuff out of your system. Then, think about all the people who'll need your help in the ER tomorrow, and let that be your motivation to get back to work as soon as possible.
Specializes in jack of all trades, master of none.
Jason, I am the opposite of you, I can cry at just about anything, from seeing someone in pain crying, death, new life, anger... My family laughs at me b/c I am a "cryer." I still cry at all the Disney Movies that I've seen time & time again.
We all have different ways of dealing with the stress of healthcare... I also agree that meds may be a tad premature to consider, & I would certainly get over to that gym & work out... A good release of natural endorphins may be helpful to you. But, by all means, if this self doubt you have continues, make an appointment & talk to someone.
I have never worked ER & probably never could... I'd be bawling all day long.
I jsut want to say that I really appreciate everyone taking the time to respond to my post. I respect everyones opinion here, and once again thanks... I think sleeping for 2 days and the majority of the 3rd day helped me out. When i woke up monday morning I felt like my self again.
One poster noted something to the fact that if I did not like my response perhaps I should talk to a pshycologist. Its not that I didnt (like) my response but I noticed such a strange surreal feeling that i have not experienced and started to question if my feeling this way was normal. I guess I am in a continuous learning process of self actualization. Not everyone will react to the same situation the same. That being said, perhaps I would like to find another avenue to express my self during these trying times other than sleeping for 3 days.
However, I made a "deal" with God a long time ago for him to put me where I best serve him. I believe he has done just that. NOt tooting my own horn, but during my time as a paramedic and now an ED nurse, I know that I have helped lots of people when they needed help the most. The instant gradification that sometimes comes to ED nurse when we can relieve pain or stop an acute MI in its tracts is indeed fullfilling, but there is also a flip side to that instant gradification coin. That is sometimes things dont always go the way Jason thinks they have ought to have went. But my faith reminds me that things will go the way God has intended for them to go even if my human-ness would have wanted the outcome to be different. All I can try to be is an open channel through which he does his work.
SOmetimes all one can do is to reflect on the actions that the team took. We all did the best we could and we put up the good fight. That is all that I can expect from my self.
I worked last night and was fortunate enough to be able to talk over the situation with many of the team members, and it was definately theraputic for all us to do that.
The truth is, I love my job. I will continue to strive to improve everyday. Actually it is so fullfilling, on a daily basis I am blessed to be able to aid people in there time of need. I couldnt have asked for a better opprotunity or situation to which I can serve.
I don't think there is an answer, or at least a right answer. I have to tell you that I have been through, a nurse who while trying to help somone on the freeway, was hit by a drunk doing 70mph. She was behind the vehicle, the car rammed her into the back of the vehicle, literally blowing holes in her body from the compression. I also have been there for a 6 yo who was run over by a truck, with his dads best friend driving, and didnt even know it. The boys left in the van, and the younger playing with a switch on the dash. The switch was for an electric seat, that came down. It pinned the older one's chest and he suffocated to death. Three girls shot by a friend at a gas station attempted robbery, one died after working for 3 hours.
Did I feel much? For the most part no. When I did, it was seeing the upset family crying, not because of the patient.
Bottom line? When you do it for two or three years, we become acustom to it I think? Maybe like Pavlovs dog? In the opposite though? You know, another OD, another death those things happen attitude. I think for most it's inevitable, you are not alone. Seriously it's usually new grads WITHOUT and exposure that show emotion.
At the same time I have heard some people wonder how, we can make the jokes we make? Let's face it, if you were emotionally affected by every person that came in that died, had permanent injury, or was newly DX with cancer.................... we wouldn't last 2 years in the proffesion. In the ER it's a every day thing. Reality? More people die in an ER than probably any other place in or out of the hospital............... war is the exception.
The fact you wonder about it, shows you do care. We all get that way.
I know exactly how you are feeling. I am a nurse in a pediatric er and see children die occasionally, I tend to go home and sleep the whole day away (I work nights). One night we had a really bad trauma, stabbing (8yr old). I was upset for about a week and slept the day away. Granted, I am quite emotional but I feel like no ones understands how I am feeling. It's okay if you don't cry. Everyone has different way of showing there emotions. I believe sleeping is a way to cope. My husband is an ER nurse and I am thankful I have him to "vent" to. Your hospital should have a crisis management team who you can talk to. So take care and get some rest.
I know exactly how you are feeling. I am a nurse in a pediatric er and see children die occasionally, I tend to go home and sleep the whole day away (I work nights). One night we had a really bad trauma, stabbing (8yr old). I was upset for about a week and slept the day away. Granted, I am quite emotional but I feel like no ones understands how I am feeling. It's okay if you don't cry. Everyone has different way of showing there emotions. I believe sleeping is a way to cope. My husband is an ER nurse and I am thankful I have him to "vent" to. Your hospital should have a crisis management team who you can talk to. So take care and get some rest.
talaxandra
3,037 Posts
There seems to be an attitude in our culture that crying is the only way one can express (or feel) grief. At the same time boys are inculturated to avoid crying. The fact that you're not a crier doesn't mean that this kind of tragedy hasn't affected you - I agree witht he other posters that the sleeping, empty feeling, and the feeling that you'd like to be at work are ways for you to cope.
The death of a child is difficult to begin with. That it was unexpected, the result of suicide, on a holiday, in an already-stressed ER, and with (understandably) distressed family, compounds that. If you weren't affected there would be more cause for concern.
i agree with Mike that medication is little premature, but talking about it is important - not just for this incident but also to reduce burn out - there's a thread here somewhere about preventing burn out that addresses this specific aspect - I'll hunt around for the URL in a minute. CISD sounds good because the department as a group is affected, but even venting here a bit may help.
Good luck