New Nurse..Lost a pt. I didn't know ID hurt so deeply

ruby_jane, BSN, RN · May 8, 2019

50 minutes ago, SaltineQueen said:
If his body was already worn down due to addiction this may have been the straw that broke the camel's back. But sometimes, even despite our best efforts, patients die. I lost my first patient in my very first nursing clinical and was pretty upset. My instructor told me, "There are some things worse than death," and that has helped me get through the others that came after. Check with your HR to see if they offer an EAP to help you through this.

yes, and yes.

You can't care more about your patient than s/he does about him/herself. Is it because he was young? Is there someone in your past he reminds you of? You can't personalize death and dying. Death comes for all of us eventually. Hugs to you.

NutmeggeRN, BSN · May 8, 2019

Death is a part of life...and we all experience it. In time, you will develop the ability to see it in a more clinical frame (I hope). Process it, and put it away. Take care of yourself.

Snatchedwig, BSN, CNA, LPN, RN · May 8, 2019

Is this your first patient death?

Here.I.Stand, BSN, RN · May 8, 2019

(((((Hugs))))). I have many times worked my shift and started to cry as soon as I was in the privacy of my car. Sometimes I have to blink back tears in the room, because it is HARD to see the suffering of others.

I highly doubt there was anything else you could have done. He decided he wanted to end his life and was likely past the point of help — just like if he had initially survived a GSW but died in the hospital.

Human mortality rate is 100%. He just happened to meet his end while you happened to be there.

emmjayy, BSN, RN · May 9, 2019

I recently lost a patient who was young but going to die due to metastatic cancer and many complications. Her blood pressure was very low (on multiple pressors) but her heart rate was SUPER high (think, almost 200 bpm). It was a complex situation and we tried a lot of things to fix her heart rate without crashing her blood pressure. Finally, we had to push a beta blocker because her heart rate continued to go up. I was her nurse, so I pushed the med (with the affiliate in the room supervising the entire thing). I pushed slow. Really slow. I wasn't going to take chances on this unstable patient. But as soon as the drug started hitting her, her blood pressure started to nosedive and despite titrating the pressors up and me stopping the push, she went into cardiac arrest. We coded her for 45 minutes and she died. I felt horribly responsible. But, I realized that there was no way she was going to make it through no matter what we had done. And it was our duty to try to fix her problem. Her family wanted her to be a full code and for us to full steam ahead with treating her, and we couldn't just choose not to treat such a high heart rate. All you can do is learn from it and move on. As long as you didn't act recklessly, negligently, or intentionally do something to harm your patient, you shouldn't beat yourself up... just try to learn from it.

Forest2 · May 9, 2019

There are good deaths and there are bad deaths, but how ever you look at it there are going to be a lot of them. I hope you learn to process these occurrences because as I said, there are going to be a lot of them. Of course the first few are more difficult if you aren't used to dealing with death. After awhile a you will become seasoned and stuff like this won't bother you so much. So, at least there is hope that the intensity of your feelings probably won't continue to be so strong with subsequent deaths.

ptier_MNMurse, BSN, RN · May 9, 2019

I agree with missmollie. This event did not happen because of you. Anyone who has been through this experience will know that feeling that they feel they did something wrong, or missed something and maybe lost some sleep over what could have gone differently or better and whatnot. However, the bottom line is, you did everything you could, and by the way you are responding shows that you obviously care for your patients. This feeling down in your gut is what makes you a good nurse! Remember that!

SaltineQueen is also right in that death IS a part of life! We are all heading there and will all make it there.

It’s hard to say what happened with this guy, and I don’t think anyone on here would really want to speculate much, without really knowing the case. What you should do is talk to your nurse manager and see about setting up a debriefing session. That way you can talk with other people who cared for this guy and get some collaboration because likely others may feel the same way you are. People can feel very isolated when these situations occur, but just know it’s not above anyone to feel this way about this situation. Talking about how things went, being open about your thoughts and feelings, and getting some clarification on what happened to this guy from the providers can be helpful.

OD sucks, especially because it often affects younger patients and cuts life too short. What we do in the hospital simply supports patients through a period of illness. Their body does all the work to heal. Sometimes, no matter how profound the measures we implement, no matter how hard we work, no matter the devices we employ, people’s medical conditions can overcome those measures and they can still die.

Remember, you ARE a good nurse, you did everything you knew to do, it is not entirely up to you, and you are NOT alone.

Remember to take care of yourself and do it in a healthy way!

Keep your head up!

Ruby Vee, BSN · May 9, 2019

I lost my first patient in my first clinical. He was in his 90s, a nice old man who was looking forward to dying and joining the rest of his family, some of whom died in the Holocaust. It was then that I realized that death is a part of life; we all die. It is much more difficult when the patient is younger and healthier.

Did you get a chance to talk to any other members of the team after your patient died? Sometimes they can help you to put it into perspective. It's not too late to talk to the charge nurse or perhaps the providers to get their take on what happened. It is better and more helpful to ask them right away, while it is still fresh in everyone's mind, but whatever you can do.

I've also found that journaling helps. I do mine on my computer now, but I used to use a really nice notebook. Set a timer for 20 minutes, or whatever you think you can manage, and then write until the timer goes off. If you don't know what to say, write that. "I don't know what to say. I don't know what to say." Before you know it, you will find yourself writing about things that are bothering you. It's a great way to process your feelings.

inthecosmos, BSN, MSN, RN, APRN · May 10, 2019

I believe we all remember our first death vividly. As a former hospice nurse, I have seen many deaths, but my first one still stands out. There is nothing you did incorrectly, unfortunately, it was his time to go.

Reach out to employee assistance or perhaps your manager.

TriciaJ, RN · May 11, 2019

Sometimes they die anyway. They.Just.Do.

One time while working relief charge, we had a completely unexpected demise. The regular charge nurse called me at home the next day to debrief. I appreciated that very much. OP, I hope you can find someone to debrief with, face-to-face. It does help.

Long Term Care Columnist / Guide · May 12, 2019

The first death is always the hardest. It's unfortunate that your first was a young man with seemingly everything to live for, but every death affects us differently no matter who it is. I worked with mainly the elderly during my career, and some of them hit me harder than others. Sometimes I was shocked by how sad I felt after a particular patient had died. But it made me human, and as a nurse I always had to find the strength to go on and take care of the next patient. We do get used to it in a way, but the way I see it, if you can't feel something when someone passes away, it's time to get out of the profession. I hope you never get to that point. Thinking of you and wishing you smoother sailing.