Lost my 1st patient

Nurses General Nursing

Published

I lost my first patient last night.

I cant help but ask myself if I missed something or did something wrong?

He was over 80 and emaciated is probably not a strong enough word. I still feel guilt. I hope that i charted everything. One of the great things about the ER is I had two doctors at my side. So why do I still feel paranoid that I did something wrong?

Specializes in Hospice, LTC, Rehab, Home Health.

It hurts to lose a patient if you have not prepared yourself for the fact that patients do die even when we have done everything right. Our culture is very death denying. We are trained to do everything for every patient. Sometimes comfort care is the right thing, sometimes curative care is the right thing. It sounds like last night's patient would have benefitted most from comfort care. It's sad that curative care is this culture's only acceptable "first" option. How old do you have to be in this country before it's OK to die?

110, 120 never?

Specializes in NICU.

It is completely normal to question yourself after a situation like this. It is also completely normal to continue to relive the situation afterwards. I'm sure you did everything you could. Don't be so hard on yourself. Everyone tells you not to take work home... but sometimes it is hard not to.

{{{Rookie}}}

Specializes in M/S, MICU, CVICU, SICU, ER, Trauma, NICU.
{{{Rookie}}}

This.

Specializes in ER.

So why do I still feel paranoid that I did something wrong?

Because it's our job to save people. Even when it's obviously an impossible, we want to make it all better and if we can't, we feel like we failed. I really think it bothers us more in the ER sometimes because every pt that comes in starts their journey as someone who can be fixed. We have all the drugs, the Doc on hand, lab, radiology, and RT at our beck and call. We have really cool equipment that can do wonderous things. In theroy, there is no reason we can't go down the ABC line and support and correct whatever problem we encounter. Not breathing, we have a tube for that! No pressure, we have fluids, drugs and blood for that. Heart not cooperating? We have fluids, drugs, and the power of electricity for that. No breathsounds on one side and a deviated trachea.... one little needle will save your life. So easy- but it's not. The drugs, tubes, needles, and shock fail. The body simply won't do anymore. God (or fate, or whatever you want to call it) steps in and tells you 'I have need of this soul', and it's not open to debate. Sometimes, the families can accept this and sometimes not. Personally, I have a problem accepting it. Even in the best circumstance- say a terminal pt comes in, family arrives in time, goodbyes are made and emotional support is given, pain is releived and everyone knows the pt is in a better place- the inner me rebels. God steps in, and I can understand that, but I'd rather make the pt feel better and send them home happy.

So- you didn't do anything wrong. I won't tell you to stop worrying about it because you still will. I doubt you missed anything, and if so it wouldn't have made a difference. Besides, it's not just you fighting the good fight- if you miss something there's a whole team there fighting with you. Usually, what makes me feel a little better is to review everything, find out the final diagnosis, and make sure I learn all I can about it so maybe I can help the next pt that can be helped. If you worry you were not kind enough, make sure next time you are. Then let it go.

When I first started working in the ER, I worried, worried, worried. It doesn't take long to realize that a minor symptom ignored can kill you, people have horrible accidents and die, babies and children die, and life will drive you nuts with the 'what ifs'. Everything was something that could have happened to me or a loved one.

My first suicide pt was a young male who was having a rough time but seemed to be doing well and appeared happy. I called my brother and tried to discreetly contract with him, lol.

After a while though, it shifts. Something clicks, and I can tell you- it will get easier. It's a wonderful thing once it happens. You realize that life happens, and it can end with no warning or reason. So, instead of trying to contract with your brother, you tell him you love him more often. Instead of worrying if your child will have something horrible happen if they go out of town w/ friends, you do your best to make every day count and always tell your child you love them. You stop arguing w/ your husband over stupid stuff, and tell him you love him even after a fight. Yeah, I'm ticked off, but I still love you. I still drive my family nuts though. Now instead of worrying, I am the uber prepared person. I have my mobile emergency first aid kit, a nifty device in the car that can cut a seatbelt and bust out a window (or attackers head) for the improbable possibility that my car will become submerged, and give a standard baby shower present comprised of tylenol, motrin, dosage sheet, and other necessities for a 0400 illness. Useful, but not heart-warming or cute, lol. My hubby gets the GI bug, I have gatoraid and desitin for that- two things no man wants his wife handing to him at o'dark-thirty while sick and miserable. I still tell him I love him though, just in case!

I still won't ride a motorcycle though- it was the TICU, not the ER, that taught me there are things worse then death.

DO NOT keep it bottled in. Post about it, talk about it, blog about it (but remember big brother HIPPA and his evel twin lawyer), or keep a journal- whatever works. Just don't bottle it up and wall it off.

If all else fails, find something you did wong. Even if it's some little silly thing, admit to yourself 'I shoulda....' and resolve to do better next time.

Specializes in Peds Critical Care, Dialysis, General.

It's tough to lose your first patient. Wish I could tell you it get better, but I'd be lying. You'll just learn to cope with the losses.

Sometimes, your best is just not ever going to be enough. When it's someone's time to go, they'll defy any and all best efforts. Just try to learn what you can from each one.

((((Hugs))))

Specializes in LTC.

People die it happens. It's rough. So.

((((Hugs))))) You couldn't a done a nother thing.

Specializes in Progressive Care.

As a 1st semester nursing student, I really appreciate this thread. I'm told that nursing is more about what you learn outside of the classroom, and this proves it. Thanks for the education, my friends.

Rookie. This.

Stop eating the young.

Specializes in Addictions, Acute Psychiatry.
{{{Rookie}}}

Be nice bigfoot! You were a rookie, too!

He came to your facility to die; that's the short of it. You did a great job!

All the world is just a stage and we are merely players.

Stop eating the young.

huh?

who are you quoting, cuz i can't find where jopacu said what you quoted.

and who is eating the young??

Be nice bigfoot! You were a rookie, too!

sue was giving rookie a hug.

"be nice"????

yep, totally lost here.

leslie:confused:

+ Add a Comment