Not your standard death question....

[hiddencatRN, BSN, RN]

I know questions about dealing with pediatric death come up often but I think mine is different enough to warrant a new thread and if not, I welcome links to threads I have overlooked.

Anyway, newer nurse, I work in a peds ER, and participated in my first code recently. Patient lived to be admitted to the ICU but died a few days later. And....I feel OK. I'm not terribly sad, and when we had the patient I knew the prognosis was poor. I think we did well as a team and I've been assured by my coworkers that I did a good job with my tasks during resuscitation efforts. I trust them and take them at their word on that. I guess my concern is....SHOULD I be feeling more about this than I do? Am I too distanced from it emotionally or do I have an appropriate level of emotional distance? I don't want to be setting myself up for problems down the road by not dealing with it if I need to be, so how does one determine if feelings are being ignored and repressed or if I'm just dealing with it really well?

For a point of reference, I don't believe in an afterlife, but believe that there are worse things than dying. I took care of a patient in nursing school who decided to go in to hospice who I really connected with: I understood his decision and supported him in making it, but still cried for him (not in front of him, but with my clinical instructor later) because he was a vibrant person and full of life. Working as a nurse now I do have patients I have connected with and don't consider myself to be cold or distanced in my care.

Anyway, I think we did our best, that the patient's quality of life would have been very poor at best had she survived, that the circumstances around her death are very sad, but ultimately, I do not feel emotionally hurt or damaged by this experience. So...am I handling it well or am I not handling it at all?

[NotReady4PrimeTime, RN]

I think you're on the right road. Yes, it's sad that a child died, but as you say, there are worse things than death. For this little girl, and so many others like her, death was a blessing. Statistics around out-of-hospital cardiac arrest are dismal, and those for in-hospital, witnessed arrests aren't much better. Time is brain, no matter what the underlying reason for the arrest. It's hard to espouse the notion that life at all cost is a desirable goal. Your nursing school patient, on the other hand, was different. He chose not to prolong his own life, choosing quality over quantity. It was completely appropriate for you to feel emotional about that scenario. I don't think you should beat yourself up for NOT feeling emotional about the death of a child who, by your own assessment, would have had a very difficult and uncomfortable existence had she survived. That too is compassion.

[hiddencatRN, BSN, RN]

Thank you for the reassurance. When the thought popped in to my head that maybe I wasn't dealing with it at all, I tried to google and search and most of what I found was aimed at people who felt guilt or intense loss.