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I'm a nursing student in my 3rd semester and my pt died the other day. I have anxiety, chest pains, and a horrible stomach ache after finding out my patient died. It is my worst nightmare.
I had clinical on Tuesday and I found out on Thursday (kind of) that he died. We usually get the same patient's when we go into clinical. My teacher said "you have two new patients today" and my stomach dropped. My instructor didn't say if my pt passed away or not. So I said "ok."
So I went on with my day looked up my current patient's info and saw my pt. from tuesday still on the pt. list for the floor. About an hour later his name disappeared. The nurse that had the pt. with me on Tuesday came in to work at 7am and went up to the night nurses on the floor and said "What happend?!" I just had this feeling something happened to MY pt. from tuesday.
My pt.'s room from Tuesday was being cleaned by the custodial people. His bed was empty and made. I just knew it was him that something happened. I didn't get to talk to anyone about it and didn't ask what happened b/c I didn't want to be the nosey nursing student. When I had the pt. it was on tuesday and it was a very busy day with med passes. I felt that, on tuesday, I did not provide the best care for him. I know that I'm a student but, I feel like what if it was something that I DID or DID NOT do that contributed to his death early Thursday morning?!
I have a hard time prioritizing my care and I'm still learning....I had clinical on Tuesday the pt. died early Thursday morning. I'm guessing something happened in his sleep? When I had him as a pt on tuesday morning he was doing great, in good spirits, laughing and joking. A very happy man in his late 80's. He was in the hospital for Poss. pneumonia, SOB and had an extensive history for CHF, pulmonary hypertension, diabetes etc. When getting report from the nurse on tues she told me his O2 would desat into the 60's overnight but would be better 80's-90's during the day when awake (and it was)...
I don't know why I feel like what if it was something I did that caused him to die...I feel like I can't accept him dying and I don't know why my instructor didn't tell me what happend...I feel like I want to throw up. Any advice? Comfort words and experiences people can share? Should I talk to my instructor even though she doesn't know that I know about the patient passing? Help...I feel like I should quit nursing school........
it didn't have anything to do c you at all. please don't make yourself crazy over thinking it was. believe me, if you had been doing anything inappropriate, someone would have picked it up right fast.
yes, be assured that your instructor would have come to you much sooner if there was an inkling of a problem.
one of the biggest problems the medical model of care has, in my opinion, is that death is always treated as a horrible outcome or failure on someone's part. it (mostly) isn't, especially in someone like you describe.
death is a part of life.
rest easy tonight. your patient is no longer suffering.
beautifully written post, grntea.
I completely understand!!!!
I too am a nursing student, but I also work at an urgent walk-in clinic. A few months ago I had pt come in who was experiencing dizziness, fatigue, and SOB. I was able to get all of her vitals which were fairly normal but about 15 minutes after she arrived she crashed on us. We ended up sending her to ER via an ambulance and found out later that evening that she had passed away from a pulmonary embolism. I was devastated. I cried most of the evening. I asked everyone if there was anything I personally could have done to save her. She was very young-a few years younger than myself! Still to this day, I have a hard time when I think about it, but the truth is, there wasn't anything I could have done- I did my job and I have to keep my chin up and move on. It's a really hard lesson to learn sweetie but it happens to the best of us in this field. Don't be too hard on yourself and God Bless!!! :hug:
I hate that you had a pt come in to the clinic and ended up dying! Oh, how I wish that young lady would have went stright to the ER....Not because I think you did anything wrong, but the clinic is not the ER!!! PPL if you have SOB, dizziness, chest pain....GO TO THE ER and DEMAND to be seen STAT!!!! And if you have a pt that comes into the ER with SOB, dizziness, chest pain please see them STAT!!! And please, please don't miss understand me, I just hate that the young lady died...God Bless
As hard as it may to accept, we all are going to die one day. And many of us won't make it into our 80's even without all his co-morbidities. It's just the way it is.
It might help if you remember that even when we 'save' a patient, it's not us that saved him. Not the doctor, not the nurse. We merely treated his illness or injury to best of our ability - and he either lived or died according to his alloted time on earth. Whoever or whatever or nothing at all controls this (depending on what you believe) - not you. Hang in there.
dear, his time had come. sats in the 60s aren't compatible with life for long. he was in the care of others a whole lot more experienced than you for a whole lot more time, too. it didn't have anything to do c you at all. please don't make yourself crazy over thinking it was. believe me, if you had been doing anything inappropriate, someone would have picked it up right fast.
one of the biggest problems the medical model of care has, in my opinion, is that death is always treated as a horrible outcome or failure on someone's part. it (mostly) isn't, especially in someone like you describe.
death is a part of life. the dying process is not fast, except for trauma or exceptional cases-- most people die for about 6 months. this man had been dying for long before you saw him. i know it's hard for you to think about that. that's because, in my opinion, our culture also hides death so well, or distorts it so well in the movies and tv, that young people don't know what it's all about. in the movies, it's over in seconds, cue the violins. if you haven't already had it assigned, go on to amazon or someplace and find yourself a copy of kubler-ross's on death and dying. i had it assigned to me as a sophomore student and it transformed my life.
hundreds of years ago, and sometimes maybe not even that long, when grandma had her stroke, or uncle got kicked in the head by a mule, or developed symptoms of advanced malignancy, they were put in the warm room behind the fireplace and tended until they died; everyone, including the children, came to see them; everyone attended the wake in the front room and funeral and went to the churchyard for the burial. and mourned, and then life went on. older students who have lost parents and grandparents have a better understanding of this than most younger ones, many of whom may not have even lost a grandparent yet.
rest easy tonight. your patient is no longer suffering.
beautifully said grntea........honey, people die. sometimes they die even when we are doing everything in our power to save them. sometimes they will die before they have had a chance to live. we don't have any control over who lives or dies. whether you believe there is a greater power, greater person or deity or cosmic plan......we are given a great gift and responsibility to try to heal those who are meant to be , save those who are going to be saved, and let those pass on who pass on.
if i controlled these things......no infant, baby, child would ever die. i know, i believe there is a better place and a bigger plan. forgive yourself for being human. allow yourself to grieve. but be the nurse you are meant to be.:hug:
Thank you all for the comments! I'm feeling better and better as you all comment and give me your advice, input, and shared experiences. I'm going to talk to my instructor and let her know how I feel. I hope this heaviness in my chest goes away... I ordered the book "Death and Dying" by Elizabeth Kubler-Ross in hopes that it provides me with some insight and learning to this experience. It's very sweet of you all to take the time to share your perspective to a total stranger to make me feel better. I very much appreciate it!
I hate that you had a pt come in to the clinic and ended up dying! Oh, how I wish that young lady would have went stright to the ER....Not because I think you did anything wrong, but the clinic is not the ER!!! PPL if you have SOB, dizziness, chest pain....GO TO THE ER and DEMAND to be seen STAT!!!! And if you have a pt that comes into the ER with SOB, dizziness, chest pain please see them STAT!!! And please, please don't miss understand me, I just hate that the young lady died...God Bless
I agree!!!!
I went through many stages dealing with my grief and guilt over this pt! At one point I even remember thinking, 'why did she wait SO long to come see us!?' and 'why didn't she go to the ER?!' It's just so sad when this happens...I'm sure many of the people in her life have thought/felt the same. The only positive I can take from the situation was that I definitely learned a lot. As you said, now ANYTIME someone comes in with those symptoms I will be more prepared!
No, there's nothing you could have done different. If anyone bore any blame on this man's death, it wasn't you, if he did, in fact die.
I'm just struck by something in your description of his case. Sats in the 60s at night? I imagine he had a DNI order, and a no Bi-PAP order. That was a man in need of serious breath support. The problem is, that offering that breath support would only be a bridge to treat his symptoms while you treat the underlying disease, CHF. Depending on the stage of CHF he was in, even breath support could have beeen futile.
MattNurse, MSN, RN
154 Posts
I don't see how a nursing student could possibly cause the death of a patient as long as you have a licensed nurse supervising anything you do that could cause the death of a patient.