Losing a Patient

NooNieNursie · Feb 1, 2008

I lost my first patient today that I have been with for weeks now. We really bonded and I felt such grief when she passed. I know this is the nature of the job though...
Do any of you remember losing your first patient? How did you react?

The first patient I had that passed was relatively young (50) in for acute pancreatitis. She had many health conditions though, and coded in the night due to her CV issues.

I wondered if maybe there is something I should have done differently. Like, she was on a long list of medications at home for her cardiovascular problems; I wondered if she was receiving them or not, I should have made sure to find out (she had just been admitted and the MARs I had for her didn't have her cardiac meds on them). I do wonder if maybe she wasn't given her doses, or incorrect dosages, and this might have been the reason she coded and ultimately died. I have no way of knowing since I only spent a few hours with her. I feel bad that I didn't investigate the matter further. I assumed she was in control of her health conditions since she was a retired nurse and clearly more knowledgable than I was.

I always wonder about her, if it was a med error thing or what.

Ms Kylee · Feb 1, 2008

I've only lost one.. it was hard. I got stuck doing the postmortem care all by myself because the RN couldn't be bothered. She gave me some BS story about losing her ex husband and someone else close to her in the past year. I looked her straight in the eye and said I lost my Dad not too long ago too, but I'm in there doing what needs done. She tried to make me pull the IV and I told her no because I wasn't a PCT yet and I wasn't permitted. She said to me "Well, he's dead. You won't hurt him". Thought for sure she was going to write me up for refusing to do a task but she didn't. The other nursing assistants all hovered in the hallway waiting to see if I was going to freak out or break down in tears. I did just fine on my own, but I would have appreciated some help. He was a big man and hard to move. The RN that was in charge of him is one who doesn't want to be bothered doing anything but med pass and tries to delegate tasks that are out of a PCT or NA scope of practice to them anyway. When you tell her we can't do that particular task, she gets snotty. I refuse to do anything that I am not permitted to do. Consequently, she spends the whole shift ticked off at me, but too bad...

rpbear · Feb 1, 2008

The first patient I lost was when I was a new grad on orientation to L&D. Nobody in L&D is suposed to die, it is the place for birth. A very young girl went into preterm labor before the baby was viable (23 weeks). The baby delivered, my preceptor and I dried it off and handed it to mom, he was breathing and trying to make noise. He lived for about 45 minutes, durring that time we took pictures, called the chaplin and helped in the blessing of this baby before he died. It was the hardest thing I ever did. I cried off and on for the rest of the shift. My preceptor told me that I did a great job and that the first is allways the hardest. I still cry everytime I have to care for a pt who loses thier baby. I don't dread these cases anymore, I know that these pt's need a differnt kind of care from me. As nurses we are trained to "fix" things, there are some things that you can't fix and you just have to help the family through it.

It doesn't get easier, you just learn to do your job the best way you know how.

This same girl came back 2 years later and had a healthy full term baby. :)

BellaNatalia · Feb 3, 2008

The first patient I lost was when I was a new grad on orientation to L&D. Nobody in L&D is suposed to die, it is the place for birth. A very young girl went into preterm labor before the baby was viable (23 weeks). The baby delivered, my preceptor and I dried it off and handed it to mom, he was breathing and trying to make noise. He lived for about 45 minutes, durring that time we took pictures, called the chaplin and helped in the blessing of this baby before he died. It was the hardest thing I ever did. I cried off and on for the rest of the shift. My preceptor told me that I did a great job and that the first is allways the hardest. I still cry everytime I have to care for a pt who loses thier baby. I don't dread these cases anymore, I know that these pt's need a differnt kind of care from me. As nurses we are trained to "fix" things, there are some things that you can't fix and you just have to help the family through it.
It doesn't get easier, you just learn to do your job the best way you know how.
This same girl came back 2 years later and had a healthy full term baby. :)

Wow, I cant even imagine seeing that. I made up hours tonight at a hospital and had to see a gentleman on his final days and his wife a nervous wreck. It looked like he wouldnt make it through tonight. I left my clinicals a crying mess...I feel like this isnt getting easier.

al7139, ASN, RN · Feb 3, 2008

I will never ever forget losing my first patient. It was really hard, and especially so because the family and the patient were such great people. I am a person who wears my emotions on my sleeve so to speak, so I did cry, and was not afraid to let the family see how upset I was. They really seemed to appreciate that I was able to show that their loss affected me too, and that this wasn't just a paycheck to me, but that I really did care. They knew I was a new nurse, and that I was still on orientation. I was with a preceptor, but was at the point where I went to her only if I needed her. The pt was on comfort care, and death was inevitable, so it wasn't an unexpected loss. My preceptor later told me I did a great job with the family, and in my care of a dying patient.

My opinion is that the day I have a pt die, and I don't feel sad, is the day I resign from nursing.

I hope it never happens.

You will be alright. It is hard. It does get easier, but you will still feel sad when you lose a pt. Just make sure you have good support to talk to about the tough ones. I do, and it really helps to talk it through.

Amy