Patient Death Experience.

Cricket183, BSN, RN · Aug 15, 2015

This may sound strange to some but it is a privilege to be a part of the death process. Please don't misunderstand me--I'm not crazy and I don't have some morbid fascination with death/dying but there are very few moments as intimate as being present when someone passes.

I worked my entire career in oncology. I experienced a lot of patient deaths. But one of the most memorable was Mrs. H. She was a colon cancer patient who was on our unit frequently. She was very prim & proper. Elegant. Never a hair out of place. She wore silk pajamas. Refused to wear a hospital gown. I don't think I ever saw her without makeup (perfectly applied, of course) which was amazing because at the time I worked nights. I often wondered if it was permanently tattooed on, but never asked.

She was a retired English teacher. I imagine that it appealed to her meticulous nature. She was a sweet lady but boy did she drive me crazy. Everything had to be done just so. Going in to give her nighttime meds would easily turn into a 30 minute ordeal. She insisted on seeing each medication package, took each medication individually followed by multiple sips of "lukewarm water, no ice". Then before I left the room everything had to be in it's proper place and if it wasn't she would be on the call light all night because she honestly could not rest if anything was out of place. And talk--oh my--her husband was mostly absent, they never had children and she rarely had visitors. I imagine she was lonely and whether consciously or subconsciously, she used those times with the staff to deal with those feelings. I often would warn another nurse when I went in her room if I wasn't out in 10 minutes to come get me.

Anyway, she eventually lost her battle with cancer and it was not a good death. She had every kind of bodily fluid imaginable leaking from every orifice possible. It was very early in my career. One of my first deaths to witness and my first "messy" one. I had read about this happening and you like to think you are prepared for it, that you will remain professional and handle it well. Let's just say, I'm thankful she didn't have family with her and that I had an experienced charge nurse there with me because I was pretty freaked out. The whole time I just kept thinking how very much Mrs. H would hate what was happening.

BrittanyNicholle · Aug 15, 2015

I've been a CNA for almost 4 years now, but I remember my first patient death like it was yesterday.

It happened about 6 months after I had been working not only my first medical job, but my first CNA job as well. The patient had come from the ED to my unit (medical/oncology) basically for comfort. He was stage 4 pancreatic cancer, along with some other serious issues. I just remember his entire room being filled with friends and family surrounding him in his last few moments. I remember going in to check his vitals like we do for every admission (per family request), and just knew that it was only a matter of time. He was on our unit for MAYBE 15 minutes before he ended up passing. The in the moments after his passing I have an image that will forever be engraved in my memories of working health care. His older sister came out of the room in hysterics. She just kept saying, "My little brother! What am I going to tell my mom!" That really hit home for me since I have a little brother, and we are very close.

Having gone through that experience I realized that family is above all, and that life really is a gift.

icuRNmaggie, BSN, RN · Aug 15, 2015

I would not even refer to a dying pet as a super goner or describe the dying process as eerily cool.

amoLucia · Aug 15, 2015

I've experienced the passings of so many pts over my career. I'm always caught off-guard by the pt who just calmly takes one last breath and then NOTHING! One last exhale and then NOTHING! Like you never kn6ow when it's coming ...

Then there's the pt whose body hasn't let go! These pts experience the declining 'agonal' cardiac rhythms. And the prolonged Cheyne-Stokes or Kussmaul respirations. Just when you think they've passed, they take another deep sonorous inspiration...

And deaths of pts whose ages are very close to my own are difficult. Sudden, unexpected death in someone generally healthy is one thing. Like from a trauma injury). But the pt death from some protracted serious lingering disease process causes me to reflect on how fleeting life can be and one never knows when!

To OP - your post does have some touch of being too creepily interested in death & dying. I'm giving you the benefit of the doubt in that you just may be seeking info re pt expirations and staff resolution/adaptation to death.

TheGooch · Aug 15, 2015

I would not even refer to a dying pet as a super goner or describe the dying process as eerily cool.

I know, I sat with my Mom as she died and I don't remember it being "eerily cool".

2k15NurseExtern4u, BSN, RN · Aug 15, 2015

This may sound strange to some but it is a privilege to be a part of the death process. Please don't misunderstand me--I'm not crazy and I don't have some morbid fascination with death/dying but there are very few moments as intimate as being present when someone passes.
I worked my entire career in oncology. I experienced a lot of patient deaths. But one of the most memorable was Mrs. H. She was a colon cancer patient who was on our unit frequently. She was very prim & proper. Elegant. Never a hair out of place. She wore silk pajamas. Refused to wear a hospital gown. I don't think I ever saw her without makeup (perfectly applied, of course) which was amazing because at the time I worked nights. I often wondered if it was permanently tattooed on, but never asked.
She was a retired English teacher. I imagine that it appealed to her meticulous nature. She was a sweet lady but boy did she drive me crazy. Everything had to be done just so. Going in to give her nighttime meds would easily turn into a 30 minute ordeal. She insisted on seeing each medication package, took each medication individually followed by multiple sips of "lukewarm water, no ice". Then before I left the room everything had to be in it's proper place and if it wasn't she would be on the call light all night because she honestly could not rest if anything was out of place. And talk--oh my--her husband was mostly absent, they never had children and she rarely had visitors. I imagine she was lonely and whether consciously or subconsciously, she used those times with the staff to deal with those feelings. I often would warn another nurse when I went in her room if I wasn't out in 10 minutes to come get me.
Anyway, she eventually lost her battle with cancer and it was not a good death. She had every kind of bodily fluid imaginable leaking from every orifice possible. It was very early in my career. One of my first deaths to witness and my first "messy" one. I had read about this happening and you like to think you are prepared for it, that you will remain professional and handle it well. Let's just say, I'm thankful she didn't have family with her and that I had an experienced charge nurse there with me because I was pretty freaked out. The whole time I just kept thinking how very much Mrs. H would hate what was happening.

I actually saw a "messy" death like this in my ICU clinical rotations. Well, she didnt expire while I was there but she was pretty close. She had Leukemia and was pretty out of it. Very incoherent and confused when she wasnt knocked out. Her intestines had completely shut down and Everytime we turned her, she would gush fluids from her bottom. That was my first time seeing or even hearing about a "Anal cath." I had never seen anything like it. Her family was also very disturbed by what was happening to her as well. So sad.

2k15NurseExtern4u, BSN, RN · Aug 15, 2015

I've been a CNA for almost 4 years now, but I remember my first patient death like it was yesterday.
It happened about 6 months after I had been working not only my first medical job, but my first CNA job as well. The patient had come from the ED to my unit (medical/oncology) basically for comfort. He was stage 4 pancreatic cancer, along with some other serious issues. I just remember his entire room being filled with friends and family surrounding him in his last few moments. I remember going in to check his vitals like we do for every admission (per family request), and just knew that it was only a matter of time. He was on our unit for MAYBE 15 minutes before he ended up passing. The in the moments after his passing I have an image that will forever be engraved in my memories of working health care. His older sister came out of the room in hysterics. She just kept saying, "My little brother! What am I going to tell my mom!" That really hit home for me since I have a little brother, and we are very close.
Having gone through that experience I realized that family is above all, and that life really is a gift.

This is very touching. Thankyou for sharing this. I have 5 other brothers that range in age from 7 months to 28 years (papa was a rolling stone.) Im just happy that he was able to pass in the comfort of family and not die all alone.

2k15NurseExtern4u, BSN, RN · Aug 15, 2015

I would not even refer to a dying pet as a super goner or describe the dying process as eerily cool.

Well for the sake of the fact that we are on an anonomyous online forum, you should be able to relax a little. Thanks for your input. Have a great day.

2k15NurseExtern4u, BSN, RN · Aug 15, 2015

I know, I sat with my Mom as she died and I don't remember it being "eerily cool".

Im sorry for your loss. I meant no offense. I simply meant to convey that my fascination with death is a rather morbid curiosity. Forgive me if I wasn't politically correct in my word choice. Have a great day.

Jensmom7, BSN, RN · Aug 15, 2015

Well for the sake of the fact that we are on an anonomyous online forum, you should be able to relax a little. Thanks for your input. Have a great day.

I'm a Hospice Nurse, so please spare me the "Have a great day" condescension.

You have much to learn regarding death and the dying process. Those of us who witness it on a regular basis would most assuredly never think of it as "eerily cool".

I'm not going to describe any patient deaths to you, because I don't think you have a healthy interest in the process. Quite frankly, your presentation sends a shiver up my spine, and if you were in a room with any of my patients as they were transitioning or actively dying, I would ask you to leave. Immediately.

I hope you outgrow the "let's slow down and look at the train wreck" mentality soon. Dying is a journey, not a fantasy for puerile minds.

OCNRN63, RN · Aug 15, 2015

I would not even refer to a dying pet as a super goner or describe the dying process as eerily cool.

I worked in hospice for several years and witnessed many deaths. For me, they're like something someone tells me in confidence. We would talk about deaths in our staff team meetings, but outside of that, they're kept in my memory.

Well, I lied. There was one patient who I wrote about in an article for a nursing journal.