My First Patient Death

[livtaylors]

I am a third year nursing student in my university's BSN program and we typically start clinicals our second semester of sophomore year. However, I had to retake a class so my clinical experience was postponed a year leaving two semesters in between my skills lab practice and my first actual hospital experience, so I was already very nervous to start since I felt so rusty. I am on the telemetry floor and started my first day yesterday morning. I was just shadowing a nurse for the first few hours and we were discharging a patient when the code alarm went off. We all ran to the patient's room and I saw my first ever code blue. We were instructed to watch from the hall because the room was suddenly packed. I'm normally a very emotionally detached person, but I nearly cried just seeing the patients legs flop around during CPR. I had never met the man before and I didn't even know his name, but they don't tell you in training what its really like to see this all happen. They asked me to come in after about 15 minutes to do a round of compressions. I had never even touched a patient before let alone performed CPR on an actual person. I knew that CPR had to be rough and that you might break a rib, but I wasn't prepared for the wheezing sound that apparently happens with each compression or the movement that comes from it. I watched them shock him and then restarted CPR. After about 30 minutes the doctor called it. I was fine for a while and considered it an interesting learning experience, but after a few hours I started to feel uneasy. It hit me pretty suddenly and I couldn't stop crying all day. For the first time ever, I saw a person die from a foot away and I don't even know his name. How do you go back to feeling normal after that? I feel different and I can't explain it. I know that I learned a lot from the experience and I'll be a better nurse for it, but someone had to die for me to learn. None of my professors or anyone at all had ever talked to me about this, even though I knew it was a possibility and afterwards everyone just kind of treated it like an exciting experience that I got to be a part of. Of course they reminded us to keep in mind it was someone's family member and they didn't necessarily trivialize it, but they were definitely desensitized. I feel like I'm being dramatic for being so upset because he wasn't my patient and no one told me how to feel about this or if it's normal to cry or feel so terrible even the next day. It was awful and terrible to watch. Is it normal to feel like this? When does it stop? How do you cope?

[BAY AREA RN, BSN]

i think your feelings are normal. The next time you might not be so thrown back since you know what to expect. don't question your reactions because u don't think anyone else responded the same as you, everyone have a diff. coping mechanism and might express their

feelings in private.

[AnLe, ASN, RN]

During my rotation through the ER, we had a patient who was in pulseless electrical activity (PEA) and they had been performing CPR for the last 15 minutes. He had come in from dialysis and had no family with him. Everyone chatted while trying to treat him. My classmate and I were a bit thrown off, but still assisted during the CPR compressions. The physician called it after going through the 4 H's and T's. I don't think everyone in the room, trying to restore the patient were desensitized. I do think it's a coping mechanism to stay focused on what needs to be done to bring back this individual.

As forevergreatful said, everyone has different coping mechanisms and may express themselves in private.

My classmate and I were a bit shaken at first but had to keep on going. This may sound bad but there doesn't seem to be a lot of time to grieve and collect yourself when you have 7 more hours to go and patients to see. This is what clinicals is for, to expose us to what goes on in the hospital and help us be prepared for it.

[Nature_walker, ASN, BSN, RN]

I had a pt code in my third term at school as well. He ended up passing as well. I went to my instructor at the end of the day to discuss privately with her what I was feeling at the moment. I was very much in shock and like you, I didn't feel school had prepared me for that experience. My instructor sat with me and talked about it for a while. After I went home, I had a good cry and just did things that were relaxing to me, like drinking a big cup of tea on the couch with a favorite movie on. Like you, I felt different. I felt that other saw this as this experience that I got to have, however they didn't see up close and personal what happened. This was on a Friday.

On Monday, in class, then head instructor came to see me. She wanted to talk about how I was feeling and what supports did I need to go forward. It was really nice to know that school was ralling to help me with this experience. I felt that after I had a few days to process it, I was able to face what I saw. Going back to clinical on Friday was hard, but I had a lot of support and was able to take a lot away from the experience.

Codes are hard, and being part of one the first time is scary. Death is hard and that first loss will be something you carry with you. Honor it and take is as something that will shape you as a great nurse as you go forward.

I wish you all the best as you finish your studies! Hugs to you!

[Triddin]

First patient deaths are hard, and codes are harder because of all the adrenaline. I find that at the end of a long code, coworkers will become more chatty. It's honestly just an outlet for that energy. The first bit of the code is trying to figure out what caused it. As the code progresses, the chances of bringing the patient back become more slim, you've done the majority of the interventions and are just passing time until the next pulse check.

You will be more confident as you experience more codes and will find your ritual to help calm down afterwards. After the code has ended, If the patient passes, I say good bye to th patient, acknowledging we did everything we could. It works for me. However, I remember after my first time doing CPR, I went home and cried and felt deattached from life for a day or two before coming to terms with that happened

[emmjayy, BSN, RN]

I've gotten to witness/participate in a few codes and have witnessed them be successful and fail. I've never been particularly shaken by it, I think it's because the adrenaline gets to me and prevents me from feeling much of anything, and then I also have the reassurance that I did my part and the team as a whole did literally everything they could for the person who passed.

What got me was when I was floating on an oncology floor and a comfort care patient who I was assigned to died on my shift. Horrible. All we could do for him was give medication to help him relax. I nearly cried when I looked in on my rounds and saw that he had passed, and I also struggled with doing his postmortem care. I'd never done it before and it was weird. It still gets me a little when I think about it, but I dealt with it by helping give the best postmortem care I could and being available to the family. I was able to tell myself we did the best we could, even if it wasn't very much. Then, I simply had to detach, push down the "wanting to cry" feeling, and go answer the call bell for the very-much-alive patient down the hall.

I did cry when I got home. I've cried over patients many times once I've left the hospital and taken off my work "hat" so to speak/let myself feel all the stuff I shoved aside to make it through the shift. I think that's super normal. I don't think it's healthy to dwell for a very long time on it, though. If you find yourself continuing to be bothered by it, having intrusive thoughts about it, or feeling very upset/emotional about it for a long period of time I think you should talk to someone - another student, an instructor, or possibly a therapist.

It is what it is, but seeing patients die is certainly not fun, and not an easy thing to witness regardless of the situation.

[livtaylors]

Thank you to everyone who shared their stories! I wrote this the day after everything happened so it was still pretty fresh, but you all were right and I felt normal again after a day or two. I guess I just wanted to hear that I wasn't the only one who felt odd after something like that. I was fine in the moment and for the hours following, but I got a little overwhelmed with emotions later at night. I learned from it and everyones comments taught me something about how to deal with these things in the future, so I really appreciate it!

[vintagemother, BSN, CNA, LVN, RN]

Thank you to everyone who shared their stories! I wrote this the day after everything happened so it was still pretty fresh, but you all were right and I felt normal again after a day or two. I guess I just wanted to hear that I wasn't the only one who felt odd after something like that. I was fine in the moment and for the hours following, but I got a little overwhelmed with emotions later at night. I learned from it and everyones comments taught me something about how to deal with these things in the future, so I really appreciate it!

I'm glad that you feel better, now. I think that debriefing is very important after codes. Debriefing allows you to vent your feelings and to also go over the cause of the death.

[livtaylors]

I agree. I wish we had discussed the situation after it happened, especially since we were all extremely new. The only acknowledgement of it was that it was a cool experience for our first day. I feel like I should discuss that in my review of the course and just mention that I wish we had more emotional preparation or even discussion after the incident. I'm not sure if that just didn't happen because he wasn't technically my patient or because they simply glossed over it.