My first NICU death

[usameisje]

Actually, my first patient death ever. I have seen patients die in NICU and elsewhere, but they weren't assigned to me. I have helped in unsuccessful codes of NICU babies, and had one patient with alobar holoprosencephaly (comfort care until mommy out of recovery). I was sad, but I was able to deal with it.

At the beginning of the shift I got to hold a little boy who is now 13 months, but was one of our real miracles...born at 23 weeks. Doing extremely well now, his parents were so excited to see me because they remembered how much effort I put into caring for their little one. Scrubbing back in, I was so excited to get to work.

Through two years of being a NICU RN... and no deaths until just this weekend. Sepsis really is the dirtiest word... the little 27 weeker had spent weeks without any real problems...doing very well. I had spent time with mom and dad teaching them how to care for their little girl, things were looking great at 8 AM. Labs and all. Nothing had gone unnoticed. Doc and NNP agreed with me about how well patient is doing.

Well, you know the story of sepsis. By the end of the shift, my little patient was dying. NNP and Doc said I had caught it extremely early, we all worked so hard. It wasn't enough. We had done everything we had done with hundreds of babies before...but this time it didn't work.

So many nurses stayed after their shift to help us out, and to see how I was after I had given report hours late. Nurses who I thought would never give me the time of day told me they had a lot of respect for my work, and I should know that it wasn't my fault. They had seen me not leave that baby's side, working with the docs and nnp all day long. They said I couldn't have done anything else. I had stayed together to support mom and dad, but I needed to let the stress out. They had already checked my schedule, preparing to cover my shift for me if I had to work the rest of the weekend. It turned out that I had three days off after this shift already. They said I would cry, blame myself, blame God...but I would come back and fight on for the ones that do make it.

Thanks for letting me vent

USAMEISJE

[fergus51]

I'm sorry you had this experience. I wish I could say it got easier. Take the time to look after yourself now. Caring might make this job painful sometimes, but it's also what makes you a good nurse.

[gooch951]

you have a little angel watching over you now...and God is smiling...you are a very good nurse and i admire you for working in such a delicate feild as NICU..heal soon and may the simple things in life warm your aching heart.

[Gompers, BSN, RN]

{{{{{{ usameisje }}}}}}

I'm so sorry. You did everything you could, everybody did. It sounds like you have found a great NICU to work in. The docs, NNPs, and nurses seem to work well together as a team, and you have the support you need with them. Being surrounded by a group like that is one of the things that makes our jobs bearable on the bad days.

And yes, it is okay to cry. To scream, to swear, to blame God, to blame yourself...in your car on the way home, of course. But then make sure you take care of yourself afterwards. Remember that you did everything you could but that you don't control the world. What you can focus on is what you did right, and how that family will always remember you and what you did to try and save their baby. This is the first of many NICU deaths for you. This is probably the ONLY infant death those parents will ever endure. The image of you busting your butt and taking care of that baby and its family is something they will never forget.

One of my coworkers told me that when a neonatal death STOPS bothering you, stops shaking you to the core, stops bringing tears to your eyes...then it's time to get out of the NICU. Like Fergus said, caring is one of the hardest parts of our jobs sometimes, but it's also what makes NICU nurses the special people that they are.

You take care.

[maledi]

Beautifully written Gompers about when to give up the NICU. It's so true. I don't know what it is like to work in a NICu but I am sure it takes a very strong person.

Thank you for sharing your story with us as this is a great place for that. You did all you could and it's okay to be angry, upset, etc. I'm sure you will continue to make such an awesome nurse.

[musicalnursynurse]

I am sorry to hear about your experience, but thankfully have a good team that not only helped through the case, but also your emotions. I remeber my first (and only neonatal death) I went through all the stages of grief. It took me a long time to work through it. It was a case where it wasn't expected either I went for a C/S for fetal distress, however we though the baby just havd a tight CAN. I found myself with a baby with apgar 2-0-0... all I had to work with was a good heart rate (that didn't last too long).

I hope you get a big hug from someone and remember that if you ever have a hard tim coping with something at work most hospitals have a support conselling phone number available on a confidential bases.

Wish you all the best

[EricJRN, MSN, RN]

I'm sorry to hear about the little girl who passed away. I think it was great that you got the visitor at the beginning of the shift and you do have to try and remember moments like that to keep things in perspective. In the NICU, most of our kiddos go home and do well. For the ones that don't, we have to support the family and (with our actions) give them every assurance that we tried our absolute best. In the situation you describe, it sounds like the family will know that the baby had top-notch care and that no stone was left unturned in trying to save the baby.

The unexpected twists and turns of sepsis patients can be really horrible. I know it was hard to keep things together as well as you did. Again, I'm sorry.

[usameisje]

Thanks!

I got a good sleep and things feel much better in my head now. I do feel very supported by everyone at work, it made things much easier. This was a moment when everyone put aside pettiness and grouped together.

I knew this was coming eventually, I don't pretend I can save all of em...

I still can't imagine working anywhere else!

THANKS

Usameisje

[carrotstix]

This thread is from 4 years ago, but I googled "first death as a NICU nurse" and this came up. I am a new grad and I had my first code today. It did not end well. I have cried very much, mostly just as a way to release all the love from my heart. I have also spent a lot of time thinking about the successful babies who overcome all odds. :redbeathe

[ittybabyRN, RN]

Hugs :hug:

I experienced my first death today as well. I've been off orientation about 7 months now and while I have helped others with bearevement cares this was my first patient death. She and her parents broke my heart. She was full term, induction, went in for induction and couldn't find a HR. Stat csection, no HR at birth, 30min apgar was 3. Cooled for three days with a very flat EEG, we did a bedside Cat Scan that also showed severe, profuse damage. She had no reflexes, pupils had no reaction. But her intact brain stem kept her breathing for almost 2 full days after we withdrew all support. I had her during her cooling time on Tuesday, then yesterday where I spent most of the day helping her parents however I could, we did hand prints, footprints, hand/foot molds, took pictures, gave her a bath. By the end of the night her parents were ready (she was having very frequent and severe A/B/D, often dropping her HR to 10 and self recovering), but she hung on until about 3pm today. I have to say, the most horrible sound in the world is the sound of a mothers scream as her beautiful, perfect 8lb infant is pronounced dead.

I don't think I will ever forget that sweet sweet baby and her wonderful family. :redbeathe

[nvsmom]

man..it just breaks my heart reading this..especially the part where you talked about hearing a mother scream when she heard her baby was pronounced dead. I cannot imagine the pain...but this is where I would like to work in the future.

[laughing weasel]

There is no better feeling than saving a life and no worse one than losing one. You will find yourself wondering if there was anything more you could have done. There isn't. You may wonder if you might have changed things if you had noticed something anything just 5 minutes sooner. You would not have changed anything. You did your best and now you have to grieve and that is hard for those of us who are perfectionist and do not believe in fate. One of the hardest things to do is acknowledge responsibility for a mistake. It is sometimes harder to acknowledge that no errors were made and these tragic events occur without reasons that we are able to understand. Keep fighting the good fight. there are angels watching you and your work. Good luck to all you brave souls.