Lost my first patient

[spartan_nurse]

I am senior nursing student in my final rotation through an ICU. During the day my preceptor had the code pager. We responded to a cardiac arrest code. We did compressions for 45 minutes while pushing emergent medications (Epi, atropine, dopamine) and shocked twice, and paced for 15 minutes. But despite our best efforts we lost the patient. I was mid-compression cycle when a family member put his hand on my shoulder and said "let him go". It hit me like a ton of brick. All the adrenalin running through my body vanished, everything went quiet, I stopped compressions and looked up, totally bewildered. I felt so empty in that moment as I silently stepped back, gave my name to the code recorder and walked away. My preceptor and I walked in silence back to the unit. All the while thinking "how do I go back to the happy and positive nurse my other patients need?" So, nursing students, experienced nurses, and everyone in between, do you still remember the first time you lost a patient, how did you finish your day? I was able to decompress a bit, but I'm still thinking about it a week later.

[NurseGirl525, ASN, RN]

Awe, that is so sad. I'm glad a family member was there and told you to let him go. In my first semester, we were at a LTC facility. There were a couple of residents that I got close with. One was a cute little lady who loved it when I would go and talk to her. She always was offering me the little snack bags of chips. She had a recliner in her room and always wanted me to sit in it when we would talk. She always wanted me to be comfortable. She was so super sweet.

One night I was in the dining hall and one of the residents called me to her table. My little sweet lady looked at me and said she didn't feel well. She did not look good at all. I knew something was seriously wrong. She couldn't even eat her soup. I got her back into her room and comfortable. I told her I was going to get her nurse. It was past my time to leave but I wanted to make sure she got taken care of. I got her nurse and he was taking care of her and I left. She grabbed my hand as I was leaving the room and told me thank you. For the next week I thought of her constantly. It was just in my gut something was wrong.

As soon as I got there the next week I pulled one of the CNAs aside and asked about her. She got teary eyed and said the woman was actively dying. Her family was there. I went down and it broke my heart. She did not even look like the same woman. I talked with her family. We shared stories. I told them I loved looking at all of the pics she had shown me over the last several weeks. We talked about her chips. I told them we always had a bag when I was there. They never understood why she needed all of these chips until I explained it to them. I got to hold my lady's hand, I had the opportunity to say good-bye. I was quiet the rest of the day. She died later that night after I left. It took me a few days, but I was finally ok with it. She had lived a good life and it was just her time to go. I had to compartmentalize it.

Yours was not like mine but I know that initial feeling of sadness and how to deal with the losses. It was at that point I decided I could not work in LTC because I got to attached to the residents. Death is something we will face in this profession. I think you need to let yourself grieve and then move on. Your feelings are normal and I think as we go on, we will learn better ways to cope and it will get easier. Watching a person die will never get easier, but I think that going through the grieving process will.

[Leonardsmom,LPN]

The first patient death that you experience is never easy, especially when it is unexpected. Over the past almost 8 years now working as a CNA I have experienced the passing of many patients, some that have passed while I was in the room and others that I was the one to find that they had passed. The ones that pass unexpectedly can be some of the hardest. One of the hardest ones that I have experienced happened years after I had been working. She had been complaining of chest pain and trouble breathing ( if I remember correctly) after dinner. I had let the nurse know and we reassessed her vital signs, everything was within normal parameters. The nurse consulted with the unit manager who was still on duty and they gave her some medication. At first the patient didn't want to be sent out to the hospital, shortly after receiving the medication she had changed her mind and wanted to be sent out. The unit manager talked her into waiting to give the medication time to start working. I had stayed in her room for about 10 to 15 minutes until I knew that her oxygen levels continued to stay good. I made sure that she felt okay being left and let her know to put on the call light if she needed anything.

I was training a new aid that night and we had gone to another patient's room to get them ready for bed. While we were in there the call light for her room came on. As soon as we could we went to check on her. The nurse was in the room and went to help her into the bed when she lost consciousness. We got her into the bed and started code procedures. First responders eventually arrived and took over the code. They were never able to get her back. It was a difficult situation for me since I felt that they should have honored her request to be sent out to the hospital. The thing though is that it may still not have changed the outcome of what happened. What helped me through the situation was knowing that I myself did everything that I could for her. I had informed my nurses of what was going on, and also had let them know when she had changed her mind about wanting to be sent out and before I left the room made sure at the time she was okay with me leaving. Each situation is going to be different, some will leave you wondering if there was more that you could have done. While there will also be times when you will experience the passing of a patient as being peaceful.

If there is someone who is appropriate to talk to, talking with them about what you experienced and how it made you feel might be a good thing. At one of the facilities that I worked at they actually brought in someone from hospice for us to be able to talk with during a time when we had experienced a lot of deaths on the unit.