My first death

EricJRN, MSN, RN · Sep 18, 2011

That's a tough thing to experience. It's hard enough the first time, but since you were attached it has to be really rough. There are no simple fixes, but I can tell you about what I do.

I'm kind of a nerd, so my personal strategy is to try and learn something from each of these babies - it could be something clinical that I learn about their care, or maybe some lesson from the baby's family. To me, that adds some sense of meaning to some of the toughest things that we see.

I hope you're able to get some good rest soon. Take care of yourself.

laynaER · Sep 18, 2011

Thanks for your advice, i will definitely take it to heart!

Elvish, BSN, DNP, RN, NP · Sep 19, 2011

Does your unit/hospital have a chaplain? Even if you don't follow a particular faith, chaplains can be a great source of spiritual support. We tend to think of them in terms of what they can do for patients, but they're also (or should be) there for staff - to pray or just listen.

Most of the babies I see in the nursery are normal newborns. But when I work on the floor, the floor nurses deliver fetal demises under 20 weeks. Being with someone for 12 hours (albeit 12 very intense hours) isn't quite the same as being with a family for weeks/months, but catching another person's dead baby isn't easy. Even harder is if their 18-weeker is born alive and we watch him die knowing there's nothing we can do but pray it happens quickly and peacefully. The very first fetal demise I had, I saw that baby every time I closed my eyes for about a week. After that first one it did get easier but I still had to write poems about those babies/families in order to cope. They weren't very good and won't win any prizes but it helped.

You will learn something with each death, as I have with fetal demises, whether you want to or not. Like Eric said, sometimes it's clinical, and sometimes not.

It's hard to wrap your head around a baby dying. All the best, and take care of yourself.

Bortaz, MSN, RN · Sep 19, 2011

My first was rough. I'd been with the baby the first 3 months of my NICU career, and had a great relationship with the parents (who were VERY engaged with the baby and its care). The parents still visit me on the unit from time to time, and we've shed some tears together, and it's helped us all see it for what it was.

We lost a 25 weeker 3 hours after delivery Friday morning. While I was still sad (for the baby, and for the family), it wasn't the same level of sadness as with the first one. We were very busy coding the baby for 2-3 hours, and there just wasn't time for much else. Of course, the postmortem care is always hard, and wrapping the body so the parents can hold him is excruciating. To add to the emotions, it was my 2nd day back after the death of my father, so I was already emotionally compromised.

In between these two, I've had several of both types, as well as a few I prayed would pass on (as I posted in a thread on this forum). It does get easier, but it never gets easy.

God bless you for caring.

prmenrs, RN · Sep 19, 2011

My first death EVER of a pt I was directly involved with was an infant in what was then called the premature nursery. It had, maybe 5 incubators, and was staffed w/ONE LV/PN. I was a student. We only got to spend a week in this little room. Parents were not allowed in, they could look thru a window @ their baby for ~ an hour once a week!

The general pediatrician came in and we "coded" the baby, but it died. The other nurse and I wrapped it up in brown paper and the maintanence man came, tucked it under his arm, and that was that. I feel like it happened on another planet when I look back on it.

Things sure changed over the years, but that empty feeling when the baby dies still happened. I just felt like there was a void in the middle of my body. What was even harder was if I had worked for nearly the whole shift w/that family, and when it was over, the charge nurse gave me another assignment. Once I even got sent on a transport. Good thing there was another nurse on the run cuz I was just about useless.

What I'm saying is that it doesn't get easier w/time, but you do sorta know what to expect when it happens the next time. Which it will. And that will help you cope.

A lot of nurses write about their experiences. Not for publication, just a place to put down how you feel and what you did.

Find a way in the next few days to treat yourself nice--buy some flowers, make a nice dinner (or go out!), spend quiet time w/yourself. Then try to watch a funny movie or do something that will make you really laugh out loud. You'll feel better. And it won't seem so strange the next time.

TeenyTinyBabyRN, BSN, RN · Sep 19, 2011

I am sorry you had to go through that, but the fact that you care so much, despite being painful for you, shows that you have a beautiful heart. It is something we must all experience as NICU nurses. When we show our own grief, it lets the parents know that they were not the only ones who cared for their child. We had an unexpected death in our unit last night, which to me are the worst. I keep hearing his poor mother screaming for us to "help him," after we coded him for an hour. It is haunting and sad, but you just have to realize that we did try oh, so hard to "help him." You just have to realize that you tried the best you could.

My hospital has bereavement kits for the family, and in them are sympathy cards we all sign and send to the family. Maybe if you could do that it would make you feel a little better, to bring comfort to the mother.

Also you must realize that sometimes, regardless of how much we do, when God really wants his angel, there is nothing more we can do. I will pray for comfort for you and your patient's family.

laynaER · Sep 20, 2011

You guys have given phenomenal advice, words cant express how much it means to me. I will carry a bit of each advice with me, especially the one about writing. Thank you all do much! Anyone else with any anecdotal stories or advice, feel free to add! :-)

littleneoRN · Sep 21, 2011

One thing I have learned over time is that with *most* deaths in the NICU, we have given everything and the kitchen sink to help this baby have a chance. By the time the baby passes, their chance of a positive outcome is extraordinarily low. This doesn't diminish the loss for the parents, but it helps me to think about the baby experiencing peace after a likely difficult road that wasnt going to improve. I am generally not so much sad for the baby but moreso sad for the hole this will leave in that family's life forever. My spiritual beliefs probably paint broadstrokes into my views on death too, and we all see those things a little bit differently.

sheridan79 · Nov 15, 2011

I am not a nurse, I am the parent of a 26 weeker who weighed 620g at birth.

This thread has brought a tear to my eye, as I know how much love and care the NICU nurses gave to our (and all the other babies) in the unit. It really takes a special kind of person to be able to do the job that you do, and I have often wondered how on earth NICU nurses cope with the loss of a baby, having bonded with him/her.

It is thanks to people like you that our little girl is now two years old, and is in better health than I ever let myself believe she would one day be whilst on the unit.

I think the work you do is exceptional, and I wish you all strength and love at what must be the hardest time to be a NICU nurse.