Published Mar 11, 2010
Kei35
30 Posts
Last week, I lost a patient for the very first time. I have been a home care nurse for one year.
I work in home care in the Bronx, New York. I had been seeing this patient for about 7 months, 2-3x/week. He had a medical history of HTN, CHF, and venous stasis ulcers. He had a personal history of a hard life, drug addiction, imprisonment, alcoholism. He had no family nearby, just some neighbors on his block and in his building who would come by and help him by doing groceries and laundry when he couldn't get out. I was seeing him to care for a progressing venous stasis ulcer.
He was pretty non-compliant with his meds at first, never went to the doctors appointments he had, and I pretty much had to beg him to follow up with the community clinic. For the first few months, he was flat-out nasty with me: mumbling things under his breath while I did my visits about me not caring about what happens to him and one time he even greeted me from his stoop, beer bottle in hand, with beligerent yelling and cursing. I always kept my cool with him, did everything I had to do, and would always reply back with: I do care for you, even if you don't think so! Truthfully, some days I dreaded to visit him because I was not sure whether he would be in a good mood or not. Four months into our working relationship, I stopped hearing negative comments and he was proudly telling me he was taking his meds, which he was.
He tried his best following up with community doctors from then on. He remained stable. But to make a long story short, I think he got lost in the system. He never had the same doctor at the community clinic so his needs were not met, despite his attempts and mine. Orders remained the same for meds and wound care. I then found a wound clinic that accepted his insurance and would provide transportation. We set him up to go. I visited him on Monday, March 1st and told him I'd be back Wednesday to follow up and jokingly said, "If you're not here, I'll know you're at the wound clinic!" He replied, "Yes, dear!" as he always did.
Wednesday came and I had to call out sick. Later that day, I reviewed my patients' cases online, and read a short note on the nurse's visit to my patient. "Pt expired". What?
Could not be true. I called the nurse who attempted to visit him and asked if he was sure. He replied, "I believe it is true. His apartment door was sealed by NYPD tape. And there were candles in front of the building. His neighbors all informed me he died on Monday. I am sorry. Get some rest and get well yourself."
For a few days, I could not stop thinking about my patient: where was he now? What did they do with his body? I kept thinking back to our visits and how we were making progress. Weren't we trying our best? Did I? Did he? When I went back to work, I drove by his building, and the candles were still lit, and the side of a cardboard box was taped above the candles with messages scribbled onto it. I could not yet get myself to stop and walk up to read the messages.
A lot of things ran through my mind the following days. It stressed me out. But by thinking it through a couple of times, I remembered I would never know everything. All the questions I had would not be answered. I realized all I am ever left with was myself. I realized that my patient had left a profound mark on me although I only knew him on the surface. I then became somewhat comforted that I knew he (eventually) valued me. I knew that this experience re-affirmed my duties as a nurse, as a person; that each patient, PERSON, deserves 100%, and that we need to at least try to give them that while they or we are around. RIP RB.
nursejoy1, ASN, RN
213 Posts
Bless you! This person will forever be a part of you and will color how you treat future patients. (((((((hugs)))))))
cherrybreeze, ADN, RN
1,405 Posts
I'm sorry you're hurting. It can be hard to lose a patient at any time, especially unexpectedly.
Kudos for persuading this man to follow his POC. You did a lot for him that way. Unfortunately, it sounds like the cards were already stacked against him, healthwise.
Be sure you have someone to talk to, to help you deal with what you're feeling. Use this experience as you go forward in your career, and don't stop caring. You sound like a wonderful nurse.
((hugs))
calif-me
43 Posts
Whether you realize it or not, you made a difference in this patient's life. Where one nurse would have given up because of the negativism in this patient, you didn't. I lost a patient this past week. I didn't have a long relationship with this patient, but his unexpected passing is still bothering me alot. Take comfort in knowing that you were able to get this patient to become compliant with his meds, you did what you could within your ability to make a difference during his remaining time.
Ruthiegal
280 Posts
You gave him a reason to try by your persistence and unwillingness to give up on him...That is probably more than he ever had during his "hard" life. Good for you!
classicdame, MSN, EdD
7,255 Posts
please check to see if your employer, or your health insurer, offers counseling. Just because you are a nurse does not mean you do not need to be nursed once in a while. I recommend it for your own peace of mind.
leslie :-D
11,191 Posts
you lost a pt, he gained a dear friend.
he died knowing he was truly cared for.
i can honestly tell you, not all folks die feeling this.
wonderful job.:hug:
leslie
iluvivt, BSN, RN
2,774 Posts
YOU GAVE HIM A BEAUTIFUL GIFT...:redbeathe:redbeathe you did not give up on him and it took him 4 months to realize that ...I would suspect that his nastiness was just defensive posturing....YOU got past all that and just related to him as a human being..in need of some caring
nursel56
7,098 Posts
Your actions with this man are an example of the very highest ideals of nursing. Educating, advocating, communicating, and recognizing and processing your own feelings of grief about his passing.
My mind easily recalls a handful of patients that are "the ones you never forget" I still cry about them after all these years. I've only shared them with 1 other person (who isn't a nurse) Sometimes I think about starting a thread where people could talk about these things.
I know that what you did for him, was a spiritual gift. Thanks for sharing your story.
Thanks everyone for the inspiring comments! Our job can definitely get frustrating but it's the moments when you realize you have helped truly helped someone, or have been helped yourself, that make it all worth it. Kudos to all of us.