Lost My First Patient Today

[cakegirl]

So I realize as a nurse this is part of the profession, but this was my first patient that died on my shift. I just needed to talk about it. I was taking care of her all week, she Pulmonary Fibrosis, and stage COPD at the young age of 55 & a DNR. I guess what gets me the most is I had just been in the room with her and resp. therapy right before the change of shift. I was pretty freaked out because when I went in she was cyanotic in her hands and face, my first time witnessing this. R.T. said it was ok she was warm and alert and this tends to happen to her when she first wakes up because she gets so anxious. So I gave her anxiety meds & she recieved her TX and I stayed & held her hand because she gets so scared. Once she was settled I told her I'd be back to check on her before I left. I gave my morning meds, the PCT emptied her foley and she had better output than she'd had in days. I walked to her room last thing before going to give report and she was sitting upright sleeping labored respirations which are her norm. When the next shift was going on rounds to do vitals they found she had passed. This was a time frame of 40 mins. I was so sad. She was going home from the hospital in a few days with Hospice her husband was just waiting for all the equipment to be delivered to their home. I felt like I should have stayed with her longer so she wouldn't have been alone. My co- workers say this is how it is and that people that sick pass in a heartbeat & thank goodness she isn't suffering anymore. I understand that but I feel like I missed something I don't know it happened so fast. Now I have to go back in tonight and I just want to keep it together. Thank you all for listening.

[sarahsmile44]

(((hugs)))

[springRN]

you seem like a very compassionate nurse, I am sure you didn't miss anything :hug:

[Sharonlynn]

I remember when I lost my first patient as an RN. Now it has been many years, have seen many deaths, but each one is a spiritual experience. Remember that patients choose the time that they die; sometimes they wait for someone, sometimes they want to be along - it is between them and God. Over the course of time, you are able to set your personal boundaries, and it gets easier to do that. But when we are new, it is so difficult. You sound as if you are a sensitive, compassionate RN, and our practice needs more of you. You didn't miss anything, it was just her time to go. Blessings to you - keep up your good work

Sharonlynn RN

[nursing6207]

Very compassionate!! I love that u sat with her and held hand. I wish I had more time to do this with some of my pts. . Unfortunately when it is their time to go it's their time and you didn't know she was going to die. You did what you could and it sounds to me like u did great.

[Been there,done that, ASN, RN]

There was nothing for you to miss, dear. She was actively dying. There was No way you could know when that moment was going to happen.. The time of death is up to a much higher power, You were SPECTACULAR in your actions for a newbie.

My concern is... some of your patients will die on your watch... please realize that... Know you did what you could... and it is indeed, the darkest side of nursing!

[Forever Sunshine, ASN, RN]

My first dying patient that I took care of, I was 1 month off orientation.

She was "on her way out" for awhile and I learned a lot about care of the dying from taking care of her. She was expected to die so they ordered ativan and roxanol given every couple of hours to keep her comfortable. I made sure I gave those every 3 hours even though they were PRN.

The weekend before she died I was working and the next day it hit me. That I just had my first dying patient. I was gloomy and down. I don't like to talk to people about it, I prefer to wallow and think. Thats just how I deal.. But if it helps you talk to a co-worker or even a friend or family member.

This whole blog series on here has helped me a great deal also.

Body, Mind and Soul

Nursing Blogs - Nursing for Nurses

[tnbutterfly - Mary, BSN]

Losing a patient is never easy, especially the first time. We need to realize that we are human too.....with human emotions. We experience grief....sometimes more than others. Nurses are very susceptible to emotional stress as they deal with patients facing various health challenges, including death.

You might find some helpful comments by others who have posted about their experiences with dying patients and how they have learned to cope with their personal grief in this thread:

Nurses Coping with Personal Grief - Nursing for Nurses

[Neveranurseagain, RN]

I sure hope I don't sound harsh but your reaction may be because in the USA, too often we see death as failure, rather than the blessing it can be for someone who is terminal. We use such words as "losing" and seem to avoid the word death.

Thank you for holding her hand and spending some time with her. I'd let you take care of my family any day.

[910hope]

I'm a new grad working in an Onc unit and i'm starting to feel that I need to find a way to process the grief i feel. over several admissions in and out of our unit i got attached to a patient and her family too. when i met her a few months ago she could walk and she was such a fighter. not even 30 y.o. I could see she was getting worse but i didn't expect her to pass so quickly.

I hope you find comfort in the fact that you comforted your patient. i'm trying to remember the times with my patient and her mom...being a part of that journey.

[Hospice Nurse LPN, BSN, RN]

(((BIG HUGS))).

[Rabid Response]

You sound like a wonderful, compassionate nurse. You did just what you should have, and your patient was lucky to have you at the end of her life. I have seen enough death now to know that, although the ending of a life is always sad, there are "bad" deaths and "good" deaths. You patient died a "good" death. Her pain and anxiety were managed, and she knew that there were people nearby to take care of her needs. It's normal to feel sad, but you don't need to feel regret for anything you did or didn't do. My dad has interstitial lung disease with probably no more than a year or two left to live, and if he ends up dying in a hospital I hope that his nurses are as compassionate as you.