my patient died...may i debrief here?

[RNin2007]

For the last 10 weeks I have been in an acute care psychiatric facility (as a bsn student). My patient was a female (late 40s), severe pulmonary HTN and right sided heart failure, on top of being bipolar. She had a hubby and a few kids that never came to see her. I did a 25 pg. (psych-soc) paper on this patient, another 15 pg. process recording paper, and spent quite a bit of time talking to her...enough time that I will never forget her. She was given two years to live, and tuesday afternoon I got a strange feeling and checked the online obitiuaries, ...nothing there. So when I went in this morning, they told me she died on Monday. How strange is that?

I just wonder, what would her life have been like if she did not have a mental illness to compound her medical issues. Would she have been compliant with her medication? She was taking Seroquel and doing very well with it, but had to stop taking it due to problems...Trilifon just wasn't cutting it for her. I guess I am just feeling the sad for what happened, and didn't talk to anyone about it. My last encounter with her was last Thursday...she had been sobbing on the unit (she was readmitted after going home for 2 wks) and was refusing all meds, including lasix. Her abdomen was bloated up like she'd swallowed 3 watermelons. She screamed at me when I came it to tell her I had her morning insulin. I thought she might slug me, and I got the dirtiest look you can imagine...it just wasn't "her" anymore. I'll never forget her because she was the first patient i've EVER had scream at me, or even be rude to me. Guess there is a first for everything, hah.

On a lighter note, I was offered a job on the unit as an MHA, so that is good news (first job i've had in 9 yrs...have been a SAHM). The unit is really good, and I love the staff.

Thanks for listening.

~J

[NRSKarenRN, BSN, RN]

Vent here anytime! That's what were about.

Sounds like your assessment skills were honed caring for this patient that you were able to perceive "not" the same person.; often that skill not developed til graduation. Your first patient death and how it is handled often leaves a lasting impression. Glad you were able to be there for her.

Hugs.

[lisabeth]

I am sorry about your patient. I know that must be something very difficult to deal with, and I know we will all see it at some point as a nurse. I am not there yet, so it will be a while for me.

Congrats on the new job. I hope it goes well for you.

[Spazzy Nurse, RN]

I'm sorry. It's tough losing a patient, especially one who struggles so much with a mental health issue that no one else can see on a scan or a test---only by their behaviors. I've lost a few and I always tell myself over and over that they are finally at peace with this horrible internal mystery that has been tormenting them for so long..... this illness that lead some of them to have the crummy home-lives that they had.

Good for you for giving her all the time that you gave her. You will be (already are) a great nurse. :)

[RNin2007]

Thank you to all who replied. It is just nice to be supported and listened to sometimes...and encourgaged. I didn't realize how much I would think about this after it happened so I appreciate you reading and responding to my thoughts. =)

~J